Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sirI am pratima having 11 weeks of pregnancy. My back is aching like anything. I am unable to my regular activities ; i have consulted a doctor and she has prescribed suprox r tablets for 1 month. Couple of my frnds are telling that it may increase the pulse rate of baby and the mom.Please suggest me ### REPLY: Hi, thanks for posting your concern in the . The medicine you mentioned is a uterine relaxant used to prevent uterine contraction and premature labor. It is safe in pregnancy. However, it can cause increased maternal heart rate. Back pain is quite common in pregnancy. You should avoid constipation and maintaining fixed posture or prolonged sitting to avoid worsening of back pain. Spatula husk 2 SF in cup of water at bedtime and high fiber diet would help you avoid constipation. After the first trimester, you may also start pregnancy exercises after proper training from your Obstetrician, which would also help you. Thirdly, preferably you should lie down in left lateral position. This will help in blood circulation and also avoid stress to para spinal muscles. Please avoid any analgesic. You should also have a routine urine examination, because UTI is very common in pregnancy and may cause back pain too. For any further questions, please write back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lower back pain for past 2 weeks following a period whicChatDoctore out of the blue after 2 yrs of no periods. I have had menopausal symptoms for past 2 yrs. Im 46yrs old. 36hrs ago I had a diagnostic hysteroscopy and a biopsy was taken. The hysteroscopy was done in an outpatients and nothing untoward was found.Since yesterday my lower constant back pain is worse - unrelieved by NSAIDs and simple analgesia. No frequency or painful urination symptoms, no fever, just the pain in the back. Any ideas? ### REPLY: Just get a BMD done. A post menopausal women is more prone to osteoporosis. Also get your Serum calcium and it D level checked. I am sure you will have hypocalcemia. Just start calcium and vitamin D tablet like Tab Climax Forte once a day. Along with that take sachet Cairo once a week for e period of 8 weeks if calcium and vitamin D level is very low. Start some back stretching exercises and also have at least one glass of milk every day. I am sure the symptom will get relieved in 1-2 months time. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 7 year breast cancer survivor and recent blood work shows elvated RCD width- SD= 52.3, CV= 14.7 Mean platelet count = 13.1. Immature granulocytes are 0.04 with metamyelocytes,myeovytes and promyelocytes. WBC is in the high normal range at 10.2.My doctor is out of town and can t speak with me for over week.Thank you,Jude ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your red cell distribution width indicates variation in size of RBC. It is normal. No need to worry about that. Your WBC count is at high normal range with few premature cells.  You may have some infection.  You should take a course of antibiotics a d repeat your total WBC count after a week. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell and hit my head on a stone flower pot when I slipped on the icy sidewalk outside my house this morning. I didnt passout but i hit it pretty hard. Do I need to go to the dr.?Im 29 and it happened so quickly that I didnt catch myself as I fell backwards so the only thing that broke my fall was my head hitting the cement. I feel tired but its just a little sore on that spot. No headache or double vision or abnormal feelings/behavior. ### REPLY: Hello there, To answer your question, if you hit your head very hard on the pot and if you have any bleeding from nose or ears, blackening around eyes, nausea or vomiting, double vision or episode of unconsciousness you need to visit your doctor immediately. If everything seems alright and only there is a painful spot then don't worry. That soreness will remain for a day or two. 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: My husband has a loose congested cough and has had it for a while it seems to worsen after taking his meds. And now has a min amunt of blood in mucus.  Wondering if xarelto 20mg ,Crestor or any other meds for heart patients could be causing the congestion ### REPLY: Thanks for your question on . I can understand your husbands situation and problem. Blood in mucus after coughing is known as hemoptysis. And yes, Erato can cause this, because it is a anti coagulant in nature. So you need to stop Erato till blood stops. And we need to treat the cause simultaneously. Following are the possible causes for hemoptysis in his case. 1. Lung infection like tuberculosis or pneumonia. 2. Bronchitis. 3. Congestive heart failure because he is on cardiac .  So get done 1. Chest x-ray to rule out lung infection. 2. PUT (Pulmonary Function Test) to rule out bronchitis. 3. ECG and 2d echo to rule out cardiac failure. So, first diagnose the cause of hemoptysis and then start appropriate treatment. Till that time stop Erato. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 woke up this morning to extreme stabbing pain in my right rib cage. It hurts to walk and breathe and I have very short breaths. Couldnt sleep last night at all and it just arrived early today. Is this just inflammation in the ribs/lungs? Or is this something to be concerned about? ### REPLY: Hi I understand your complaints. In my routine work I see several patients with this concern. This kind of pain that you prescribe have several lung factors. The inflammation of pleural space may cause this. The Costco . Pneumothorax (air in the pleural space) is another factor. So my opinion is that you should some tests to explore the lungs as listed:Chest X-Ray p-a and right lateral lifeblood count, CRP, Abdominal ultrasound then to see which is the factor that cause the painting 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: Just in the past two years I ve been having a few strange problems, including shortness of breath, excessive dizziness and strange discolouration and pain in my legs. I saw many doctors who checked my blood, heart and lungs but nothing has come up, I even saw an internist. Just last night I was laying on my side and I was just started to get tired when suddenly my heart jumped and seemed to this against my ribs. It felt like it was twisting and grinding against the left side of my ribcage. It continued for a few beats and then it seemed like it stopped beating altogether. I got scared and felt for my pulse and couldn t feel it for at least a second or two. But then it started to beat steady again. After it returned to normal, I felt a wave of heat come over me and I started feeling flushed and kinda sweaty. I kind of want to tell my parents but they think I m being a wimp because the doctors haven t found anything.. Any ideas on what is wrong with me? Thanks ### REPLY: Hi, After going through your question, I would suggest you must consult cardiologist because this it could be due to paroxysmal supra ventricular tachycardia (PSVT) or premature atrial or ventricular contraction or ectopic beat or LBBB/ BBB. Above terms are medical terms,maybe you won't be able to understand but if you are facing this symptoms then you must rule out above causes first.Non-cardiac causes like anxiety, hypoxia, asthma, . . As I said first thing is to rule out cardiac causes then consult accordingly since you have consulted many doctors already. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 7 year old daughter has asthma as diagnosed by the doctors for the last 4 years and she has been given steroids in the past for her treatment such as Betnesol N. is that good for her or has any side effects? She often has breathing problems while asleep and we nebulize her with Optra or solubemetrol or sometimes clenil compositum. we have been giving her one tablet of sodium montelukast daily in the night for the past two months and brittanyl syrup. she was also given acefyl syrup a few days ago but she is still having asthma attack at least once a day. is her asthma curable. what medicine should we give her now. ### REPLY: Your daughter is suffering from asthma and steroids is the mainstay of treatment for asthma. For better control of symptoms, give her long acting steroids and long acting beta agonists combinations in inhaler form like Aeroflot in 50 or 100mcg strength instead of Benson N. This will minimize the side effects. These can be taken either directly through the inhaler or through a device called spacer. You may continue giving her montelukast and an antiallergic. Most of the child .  Even if she continues to have asthma in later life, it can be controlled very well with modern days inhalers and other medicines. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi sir, My frenulum was little bit teared when I was masturbating in bed. Blood was coming out from it.now 2 days had passed still I had some pain , while touching wound and I m worried that it won t heal .is there any problem..will it heal naturally? ### REPLY: HelloGenerally small tear will be healed by itself. And this kind of tears occurs when person follows faulty technique of masturbation. And usually it occurs by rubbing against hard surfaces. There is no need to worry. But I advise consulting you doctor to check how large is the tear. Because if it is large and if it fused wrongly then there are chance of development of fibrosis.  So better consult your doctor and just don't worry. Hopes this helps you. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a married 38 year old female....no past health issues except some fertility problems due to PCOS. for the past 8 months i ve noticed some abdominal pain & extreme lethargy. most of the pain in my right flank. for the last 3 months, i ve experienced postcoital bleeding after intercourse each time. went to OBGYN ....mild case of bacterial vaginosis . she gave me antibiotics to clear up & sent me to urologist because i have blood in my urine. urologist did a ultrasound & found a 1cm lumpy mass in my kidney. flank pain on right side continues....should i get a CT scan & from your experience what do you think i m in for? many thanks. ### REPLY: Hi, Thanks for writing in to us. As you are already being treated for bacterial vaginosis, your lump in kidney becomes more important right now. Especially in the light of blood in urine. By ultrasound scan, very little is known about the content of the lump in kidney. There are classifications to say if a lump or cyst is worrisome. As you are passing blood in urine, a CT scan with contrast becomes a necessary investigation to know what exactly is present in the lump. In CT scan, we can say if a lump is having fat, fluid or muscle. Even the blood supply of the lump is best known though CT scan. Your doctor will discuss the CT scan report with you and tell if It's something to really worry about. A repeat ultrasound scan may be advised after 3 or 6 months if it is felt as not worrisome. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump On My labia majora for 3 weeks now. After 3 days it kind of bursted and a little pus and blood came out. But it never compleat disappeared. I have been bicycling and now it got worse and big again. I did try hot baths/ hot water on. What to do? ### REPLY: HIIT could be infected sebaceous cyst. Though the pus has come out, the cyst wall would have been present. Please consult your Surgeon and get examined clinically and proceed witChatDoctorplete excision of the swelling. I prescribe Antibiotic like Cefuroxime tablet and anti-inflammatory tablets to my patients with similar complaints after removal of the swelling. Nothing to worry. 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: hello:5 days ago i had 13 teeth removed everything went great no pain except when the stiches move a little. my probem is im getting a strong salty taste in my mouth and on my lips it started today.i have been using scope to rince &  clean out my mouth out everytime after i eat since the extraction.just noticed One Question is ($18.00) ?ill go somewhere else to find out my answer im not paying to get my ? answered.thats crazy you have to pay there are so many free dental sites that will answer my ? for freethx anyways ### REPLY: Hi, Thanks for posting your query, Strong salty taste in your mouth can be because of abscess formation. Sometimes due to food lodgment in the healing socket there can be formation of abscess, after extraction healing process starts and there is increased salivation due to which you may feel salty or nauseating feeling.  Follow the post-operative instructions properly, regular rinsing with lukewarm water use antiseptic mouthwash solution, take semisolid diet , this will help in preventing infection and fasten the healing process. Take complete course of antibiotic and analgesic. If the symptoms still persists you can visit to your Dentist and get complete clinical evaluation done.  Hope this helps out. Regards........ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a  spermatocele which has grown to about double the size of a norman testical.  It is not painful, but does make me aware through exercise, pants, etc, that " something " is down there.  I have been informed that surgury is not reccommended at this time.  Are there any homeopathic or herbal remedies that you can suggest? ### REPLY: Hi, Dear,Thanks for your query to . Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Spermatocele- which is a Cystic Swelling of the Va's difference . Remedy-You should take Consults from Urologist and should take second Opinion from Surgeon, before thinking of any other path medicines. This is because, Surgical Treatment at the experts hands is the only permanent treatment for Spermatocyte. Treatment with Antibiotic cover+NSAIDs +Choral Forte-x 10- days would be needed before panning surgical Excision of the Spermatocyte. Herbal and HomeopatChatDoctoredicines may give you temporary relief in pain, but permanent regression is achieved by a Planned Surgery Only. So rethink about your confused decision and act fast for needful treatment from expert doctors. Hope this would help you to solve your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 grand ma was complaining of being hot an dizzy well she fanted she was trying to say a word but keep repeating only part of the word we believe she had a heart attack but for a sold min or so she didnt say anything an her eyes were rolled in the back of her head wide open did she die an come back? ### REPLY: Hello! Thank you for asking on ! The episode you describe seems to be related to a transient ischemic attack or to an epileptic seizure. What were her blood pressure values? I recommend bringing her to the ER for a careful physical examination, and some tests : - a resting ECG, to exclude possible cardiac arrhythmia - blood lab tests (complete blood count, PCR, sedimentation rate, kidney and liver function tests, fasting glucose, blood electrolytes). - an EEG and a brain CT scan or MRI if possible to exclude the above possibilities. You should discuss with her doctor on the above issues. Hope to have been helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a acorn sized lump beside my left testical. A few days ago I squeezed it and got white stuff out of it. It has gotten so painful that I cant sit down. I tried squeezing it again but nothing comes out. Its really too painful to squeeze anymore. It is red and hot to the touch. ### REPLY: Hi! Good evening. I am  answering your query. Even though a personal physical examination would confirm it, from your history this seems to be an inflamed sebaceous cyst not uncommon in the skin of the scrotum. If I were your doctor, I would advise you not to fiddle with it which caused the cyst to get infected and painful, prescribe you with a broad spectrum antibiotic, and an anti-inflammatory with a proton pump inhibitor which should be able to control the infection and the pain symptomatically. Once the infection gets controlled, I would advise you to consult a general surgeon for a surgical removal (a minor operation under local anesthetic) of the cyst for a complete cure and prevent recurrent infections. This should permanently solve the problem. However, if the infection does not get controlled at this stage, and an abscess forms, I would advise you for a simple incision and . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 19 years old I do no exercise. I work at a fast food restaurant 5 days a week. I am female. I weigh 108 pounds. I think Im getting a cold so I took the equate brand daytime cold and flu medicine. I am not allowed to take pseudoephedrine or Sudafed. I checked my pulse because the Sudafed races my heart. My pulse per minute is 98 and Im laying down. Is that bad or good? ### REPLY: If you feel you have caught a cold, your body might react in terms of you getting a fever. A high heart rate between 80 -120 beating regularly is quite normal when a person has fever. These are the bodies compensatory mechanisms to fight the infection, e.g. Flu (viral). A heart rate between 60-100 is usually normal and not of concern. If you have taken Sedated, which is not clear in your question whether you have taken it or not, it will also cause a slight rise in heart rate which will settle on its own once the effect of the medicine subsides. In your case a heart of 98 should not be an issue. Although, knowing your normal heart rate would help understand better in comparison to your present one. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 using gap bands to close the gap between my two front teeth. It is almost closed but now its almost like a bubble behind my two front teeth and its very tender in the middle of my two front teeth. Am I stopping blood flow from a vein and its builing up in a bubble behind them? The skin attached to my upper lip and him are also very tender ### REPLY: Hello. I read through your query, and accordingly I must say that nothing much to be worried here. The bubble is due to inflammation of the gums in between the teeth(interdental gingival)which usually occurs during any movement of the tooth. It will be reduced once the tooth are properly aligned and spaces are closed between the teeth. In the meantime you must follow proper oral hygiene habits and be more careful by cleaning the areas in between the tooth by using interdental brushes. Hope you are benefitted something from this reply. Have a healthy 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 woke up three days ago really hot, so I took my blanket off and I got really cold, I couldnt control my body temperature. I had a head ache when ever I stood up and I couldnt eat anything. Then two days ago I still felt like I couldnt eat but I tried anyways. But every time I ate, my stomach pain would get really severe. That night my stomach pain was unbearable. And then today I woke up with stomach pains again. I went to the bathroom and had really liquidy whitish diarrhea. What am I sick with? ### REPLY: Hi! You have not mentioned if you ate anything from outside shop a day or two before. Most likely you have got a food poisoning due to ingestion of stale/infected food. Any kind of infection in the body will give rise to fever, and so you had a headache and body ache with variation in your body temperature. If fever troubles you, then you should take a tablet of paracetamol/acetaminophen. The hot and cold flushes you get could be due to excessive sympathetic activity. Your treating family physician may advise you for getting a routine test of your stool or blood sample apart from prescribing you an appropriate antibiotic and some anti-spasmodic if the abdominal pain is severe enough to warrant it. If you get nausea/vomiting which you might, then go for an anti-emetic. At the same time maintain your HY .  If the pain increases, and you do not get relief even after these efforts, then you should consult a general surgeon, who may advise you for an ultrasound and other necessary test which can be decided only when he examines you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,i ve been having chest,right and left kidney pain,chest pain,throwing up,and now I have two new symptoms a tingley feeling below my right rib cage and a weird hard pulse thumping feeling in my right chest area.. I ve been to the er 7 times last month and all they say is it s from a uti... I don t believe that.. This is to much pain and symptoms for it to be a uti.. Please help me,i don t wanna due,in scared. Thanks. ### REPLY: Hi, there are many causes for pain in the chest and ribs, and most of these causes is not related to heart disease. The most common cause of chest pain is the pain arising from the chest wall (muscle, bone, tendon, skin) and they do not usually cause death. However, we should always research the most common causes, but that can bring risk of death, such as a heart attack, pulmonary embolism, dissecting aortic aneurysm ... The heart attack has sudden onset, intense chest pain like a running pain, accompanied by nausea, vomiting, profuse sweating... These makes everyone go the emergency room immediately. The chest pain pulmonary embolism also has sudden onset, is accompanied by severe breathlessness, faintness and impending death, so the discomfort makes patients immediately seek the emergency room. The dissecting aortic aneurysm is a very serious disease and the chest pain is described as the worst pain a human can feel, looking like a spear into the chest, causing the patients also seek the emergency room. For all that, the description of pain you reported does not appear to have the characteristics of these serious diseases. However, as the pain is being repetitive, it is important to look for a good doctor to rule out these serious diseases and arrange treatment. Hope I have answered your question. If you have any further questions I will be happy to help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 19 years old, and I was cutting grass and I didnt have a bump on the roof of my mouth at that time, and I ate some chicken and the next morning my tooth, when I bit down It didnt hurt, but I could feel pressure like it was loose, but its not loose or anything, well two days later its inflamed and a little painful, but very very discomforting, I got my mom to look at it to see if its an abscess, and she said no because their wasnt a spot on it like an abscess would look like, and she said its just swollen, and inflamed.. Its been two days since its been there, and I wanna know what it is, I have no fever, no headaches, my teeth dont ache, its just pressure when I bite down, and dont hurt, I brush my teeth daily, good hygiene, its just that bump thats sore and painful, I know what an abscess is, Ive had two before and had em extracted, and it looks nothing like an abscess period. Its no where near my teeth, or the cracks of my teeth, its more to the top way above my teeth near the middle of the roof of my mouth, can anyone please help me, on how to get rid of it or something? Cant see a dentist, no insurance and no money to see one, so please someone help me? ### REPLY: Hello and thanks for consulting .I have gone through your query. According to your case it doesn't look like an abscess.It's rather an inflamed (sore) palate(roof of mouth). Its generally caused by local irritation like:~eating hot and spicy food~irritation from any sharp-edged tooth~improper fitting denture~alcohol use in your case hot and spicy food can be the cause. You don't have to worry about much. If I were your treating doctor I would advise you to use an anesthetic gel like travel, rinse with a good mouthwash thrice daily. Avoid hot and n spicy food for that period at least. Following this will resolve your condition. Hope this answer helps. Take disregards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 noticed a hissing in my head . I used to suffer from severe dizziness which became worse when i lay down or turned over in bed. It was accompanied with a buzzing noise too. Everything has gone now except the hissing - its not in my ears its more in my brain. I have a very poor memory since then as well. Thanks ### REPLY: Hi. Thanks for contacting us. You have dizziness which gets worsened out on positional variation. You are also experiencing hissing sound. First in the diagnosis is benign positional paroxysmal vertigo which is a benign condition causing giddiness. The second in the list is meunière"s disease which is due to excess amount of fluid in the inner ear. You need to meet an ENT surgeon, and he might give you vestibular sedatives, adv on vestibular rehabilitation and surgery also if warranted. Till then be little slow in changing posture, avoid alcohol and avoid claiming up hills. 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 High Blood Pressure average 209/109  is a average My weight is about 185 now and have  had bad gallbladder attacks of late. I am also Diabetic but have been able to control it with correct eating. How can I avoid the gall bladder attacks. I have now taken away fatty foods starches for the most part, started eating  with more beans no wheat grains . I am 52 and this is really getting depressing and I walk and do yoga so it does not really get to the point of depression. ### REPLY: Hi welcome to the  The mentioned blood pressure above 200 is not normal... Even though you might be asymptomatic high blood pressure should be treated with medication You might need initially combination of two antihypertensive .  Adílio tablet can be consumed that contain ursodeoxycholic acid. If repeated gall bladder attacks comes then surgical removal has to be done Hope your concern solved Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I Have been feeling a throbbing pulsating pain on LLQ. My abdomen seems bloated. I had recently started to juice and have been consuming collard greens, spinach , papaya, and apple in my mixture. Could this be causing the pain? I also have my left tube tied ( ectopic pregnancy /right Fallopian removed) and in transition into menopause . Would this also cause symptom? Thanks in advance for replying. ### REPLY: Dear madam, my opinion is that these symptoms are more likely associated with your previous surgical procedure than with your diet. You should definitely check your pelvic organs. This means you should do pelvic ultrasound or CT scan to see if there is some collection or abscesses formation or adhesions in area of removed fallopian tube. Adhesions could cause intestinal obstruction and symptoms you're describing. Pulsating pain could mean that vessels are involved, but Ultrasound should detect this too. Many other disorders can be considered such as diverticulitis, Crohn disease or ovary cyst so i advice first to do tests i ve mentioned. Wish you good health, Ivan Comic ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 the flu recently which lasted longer than normal for me (3 weeks) but 2 weeks ago I noticed my lower ribs hurting. I assumed I strained them coughing but we are now 2 weeks later and the pain is getting worse. Is there anything I can do or do I need to see my gp? ### REPLY: Hello, More information is needed for a complete answer. I'll try to guess what's missing and give you the best answer that I can. You mentioned having flu, but you did not say anything about laboratory investigation. Was there a positive flu test? Did you have an X-ray? Is the pain one-sided? Is it worse when coughing or taking deep breaths? Do you have shortness of breath? What about fever? I would be more worried if you had ongoing fever (even low-grade), one-sided pain, getting worse when breathing particularly if you also felt you can't get enough oxygen. Sometimes inflammation may spread to the outer layer of the lung and cause pleuritic. The same can happen to the hearts lining layer (pericarditis). Besides the above, other serious complications may cause worsening rib pain. You definitely need a GP visit. If the aforementioned symptoms describe your case then you should see your GP right away. I hope you get well! Kind Regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How do I recover from a osteochondral lesion of the lateral talar dome with unstable subchondral bone plate fragment, moderate ankle effusion, and a chronic full thickness tear of the anterior talofibular ligament and scarring of the calcaneofibular ligament-I just got my MRI results back? ### REPLY: Hello, As the treatment line is both sides as conservative as well operative. But conservative is the one tried in the initial line of action and if its successful than operative might not be considered. Making the joint immobilized in case, ankle brace, crêpe whatever is possible and handy will be done. Post 4-6 weeks of time if the cast is applied then physiotherapy has to begin for stabilizing the muscle and joints. Also, balance board training if improvement is found. Most cases recover with conservative management.  In case if it fails then the surgical route is opted for. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Early this morning my abdomen started out as a cramping feeling thn gradually became stabbing pains in my right side. I was very dizzy & nausea never threw up tho & tried using rr & im constipated. Lasted for about 40 mins felt better in fetal position it calmed the pain. Now its no sharp pain but tender to mash on right side. ### REPLY: Hi welcome to  forum.  Thanks for choosing . Forum.  You had pain on the right side, dizzy, and cautious, after 40 minutes, sharp pain subsided, and there is tenderness.  It appears that the pain is due to gastric irritation or gall bladder pain, may be due to urinary tract infection as well.  I advise you to consult a surgeon, for diagnosis and treatment, to prevent relapse. You may need to have gastrostomy, M.R.I. besides other routine tests, for confirmation.  I also advise you to follow some diet recommendations as avoid taking spices, junk foods, and oily foods to prevent gastric irritation.  Wishing for a quick and complete recovery.  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: hi sir, i had my xray yesterday and the doctor told me that i had a pneumotities and haziness in my right lungs... i just wondering sir i dont have a cough, but i have a backpain and my breathing is not normal, and sometimes i have a fever..and the doctor gave me this medicine AZithromycin(Azithro-Natrapharm) to be intake 1 tab once a day x3 days. is this a serious problem to my health sir? because im working in a restaurant as a waitress.what will i do to this? thank you ### REPLY: Hello Haziness in right lung may be due to pneumonia. Pneumonia may present only with fever. It is not necessarily associated with cough etc. Empirically, you have been prescribed right medicines. I also suggest follow-up chest X-rays to my patients to seen regression of pneumonia. In non resolving pneumonia, other causes like tuberculosis etc. should be ruled out. Generally it responds well to medicines, so don't worry at all. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am Shuhana Sultana (Nila). I am 27 years old, height- 5 .1 , weight- 53kg. Recently Doctor find out my Kidney disease. My creatine level= 9.5, Hemoglobin=6.4, non diabetic, non jaundice . But cardio Vasculous, Vomitine Tendencies and sometimes water affacted by body. Urine not so accountable and dialysis stage is over come first time . now i am the patient of National Kidney Hospital of Bangladesh at Dhaka. What is the better sugession in India and where and how many cost be needed for my preparation. Please send your comments as early as possible . ### REPLY: Hi Nile;welcome to  You are suffering from renal failure and the treatment is either dialysis or transplant. In India also treatment will remain the same but according to our country law transplant can be done only if the donor is a blood relative of the patient;and as for dialysis it is done in most major hospitals in all major cities. Regarding the cost of treatment it can be known by contacting the hospital authorities where you want to or decide to get treated. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been sick for about 5 months.  First diagnosed with UTI.  Took antibiotics felt a little better, sick again.  Kidney stones diagnosed and removed.  Got an infection with symptoms of fever, chills, fatigue.  Went in hospital on iv antibiotics.  Come home stay on oral antibiotics.  When I am done with that  round -- infection is back.  Back to hosp. for 5 days.  Oral antibiotics at home -- take at home and when they are gone sick again within 2 days.  Back to hospital for iv antibiotics.  Oral antibiotics again -- use and when finished sick again.  Check gall bladder have it removed.  Run out of oral antibiotics get sick again.  Refilled and can do a few things, still fatigued, heaviness in chest and back, short of breath with any exertion.  Family dr referring me to infectious disease dr.  Went to ER for heaviness in chest and back pain.  EKG and blood work fine.  All white cell counts are ok.  Have had x-rays and ct scans.  Not sure what comes next. ### REPLY: Hello,First no need to worry about heart diseases because your cardiac workup is normal. Heaviness in the chest with breathlessness on exertion is also seen with bronchitis (inflammation of airways). So better to consult pulmonologist and get done a clinical examination of the respiratory system and PFT (Pulmonary Function Test). Pulmonary function test will not only diagnose bronchitis, but it will also tell you about the severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Don't worry, you will be alright with all these.  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: painful lump about a centimeter in diameterin my underarm for the past 3 days. it began as a little dot that hurt a bit to touch and has grown into its current form. feels a bit hard to touch. is it an abscess? WHat is usually the treatment for this. ### REPLY: Hello! Welcome to . You haven't mentioned your sex, presence or absence of fever. This can be an enlarged lymph node or abscess or sebaceous cyst... Local examination tells us the exact diagnosis, as per its consistency, presence or absence of puncture, mobility etc. If required, FNAC - fine needle aspiration cytology is advised. Treatment is done accordingly, usually excision biopsy if there is no suspicion of malignancy otherwise search for primary. Hope this information is useful to you. Wish you a good health. Thanks. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have got a lump in right breast , FNAC report is not particularly telling about Cancer , Doctor has suggested to get the lump removed and then do testing , pls suggest whether I can get the surgery done by any general surgeon or only by oncoligy surgeon ### REPLY: HI. Very good question. This depends upon how big is the lump, the exact site, whether you are unmarried or married (child .  Any surgeon with a good practice knows well all these criteria, so please do not worry. General Surgeon can do this nicely. Please discuss with Him all the points I have noted. Well the lump being of cancer or not is the most important criteria and an excision biopsy is the best way, so go ahead. The Surgeon surly will be bothered about the aesthetic. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lump on the back of the right side of my neck. its not painful, but the right side of my neck is stiff. it feels as if the bump is on a tendon and it moves when I turn or stretch my neck different ways. I noticed the bump after I had been carrying a lot of weight in a bag on my right shoulder several days in a row. do you know what it could possibly be? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma or dermatofibroma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly.  Surgical excision is the treatment of choice for most of the benign lump. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had a heart attack, about 3 weeks ago and have since given up smoking with the help of a nicotine patch. I am experiencing muscle pain in my shoulders, I have since been back to the cardiologist and this pain is not associated with my heart. Could it be associated with the patch? ### REPLY: Thanks for your query, I have gone through your query. The pain in the shoulder can be secondary to musculoskeletal origin. It is not because of the nicotine patch. You can take an analgesic with muscle relaxant like diclofenac and serratiopeptidase respectively. Give hot fomentation over the shoulder. Pain will subside in 3 days. If it is not subsiding then consult a general physician and get it evaluated. I hope I have answered your query, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 42 year old female in good health. But over the past two weeks I am having pain in the center of my chest. The pain wakes me at night. I have also noticed shortness of breathe when doing simple things - walking up hill, climbing stairs ( this is out of character for me). ### REPLY: HelloSevere chest pain and shortness of breath may be due to many reasons like cardiopulmonary causes, acidity etc. You may need clinical correlation and few investigations. You may need routine hologram, random blood sugar, liver and renal function test, lipid profile, chest X-ray (PA view), upper GI endoscopy, ECHO,TMT, ultrasound of abdomen. Further investigations may be advised after evaluation. Proper treatment depend upon findings. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am experiencing some some chest pain in the middle of my chest below my breasts, it is radiating around to my back. I can take in deep breaths with no problem. I feel alittle hot and clammy, I can t seem to get comfortable in any position. Hoping it is just gas or something, but not sure. ### REPLY: Thanks for your question on . In my opinion, it seems HERD (Castro Esophageal Reflux Disease) mostly. But we need to rule out cardiac cause first. So better to get done ECG to rule out heart problems. If ECG is normal than HERD might be the cause.  It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 working as software engineer i have back pain . i am sotting 10 hours daily ### REPLY: Hi, Welcome to . Since you are spending a lot of time siting down working on a computer, the back muscles are getting strained, causing pain. This is one of the professional hazards that you are having. Try to frequently change your posture and don't work continuously at a stretch. Take frequent breaks to stretch your legs and relax your back muscles. Avoid taking any painkillers, as they are harmful to the body. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a nineteen year old female and my resting heart rate is always in the high 90s to 100s. On one incident my mother checked my pulse while I was asleep and my BPM was 119. Sometimes when I exercise or when I bend over my chest feels very tight. Is this normal? Should I be checked my the doctor? ### REPLY: Hello! Welcome on ! Regarding your concern, I would explain that your symptoms (chest pain and tightness when exercising or bending) are not typical of any cardiac disorder. They can be explained by gastroesophageal reflux. Regarding your heart rate values, they seem to be within the normal ranges. Anyway, I would recommend performing some blood lab tests to exclude other secondary causes that may lead to a higher heart rate: - complete blood count for anemia-thyroid hormone levels for thyroid dysfunction- blood electrolytes for possible imbalance- a chest X-ray study. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a 20 year old female i was diagnosed with loss of normal cervical lordosis and a minimal disc bulge at c4-5 and c5-6 levels last year. one year later the pain is worst and lately i have been having a shortness of breath problem where i have to take a deep breath and sometimes i have a vertigo feeling. please explain my problem to me i dont understand it ### REPLY: Hello dear, welcome to .come have evaluated your query thoroughly.* Causes of disc bulge may be - trauma - undue angulation or blunt injury - ligament issues of cervical region - others.* Causes of symptoms are - neuropathy and radiculopathy from the compression of nerve roots exiting from the foramina.* Needs detailed evaluation with the MRI for further precise management. Hope this clears your query. Welcome for any further guidance. 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: Hi, I m 25 years old male....I has black spot on my nose....as it seems hyper pigmentation....one of my friend suggested cosmelite so from last 4 weeks I m using the same and it works.....but then my anther friends suggested to stop using as it harmful to skin....can u pls suggest what would I do?? Shall I continue or stop using?? ### REPLY: Hi. Thanks for posting your concern at ChatDoctorCosmelite cream contains Mometasone, retinoid and HY .  It is usually prescribed by dermatologists for Plasma and Pigmentation over face. Usage is limited to 2-3 months because prolonged use can lead to steroid related side effects like acne, photosensitivity, skin thinning and telangiectasis, facial hair growth specially in females. It should always be used under the supervision of a dermatologist and that too for not more than 2-3 months would advise that you visit a dermatologist who might ask you to use a triple combination cream like Carmelite initially for 2-3 months but after that usage of a cream containing ingredients like comic acid, glycolic acid, albumin, betray ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister has a nodule in the left center of her right lung near the aorta. The PET scan came back at 17.5. The doctor is going to try and remove it tomorrow after removing tissue for analysis while she is in the surgical theater. What are the possible side effects and outcome of trying to remove the cancer at this time? ### REPLY: Hi, Thanks for writing in. This is going to be a delicate procedure and the doctors will take all possible precautions to make it safe. Since it is close to the heart, the area of surgery will be precise and the doctors will take the safest approach to minimize bleeding and any trauma to the heart. The safety of the lungs is also important. Collapse of lung is a potential risk and this can be avoided by taking the shortest route through the lung. Precautions will be taken for this. 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: Due to over bite and TMJ, I had a lower jaw surgery 9 week ago to move my jaw forward.  I was wired shut for 4 weeks.  After that I wear rubber bands until now.  My problem is my jaws are now locked.  I cant open my mouth more than a width of my thumb, and my lower jaw only move up and down.  I can move my lower jaw side to side nor in and out.  Why my jaws are locked?What can I do to be able to open my mouth normal again? ### REPLY: Hello and welcome. Please do not get worried. This type of lock jaw is seen in many cases after a surgical procedure. You can keep exercising your jaw regularly. Keep chewing gums in your mouth and keep chewing them. This helps in two ways one is promoting excessive salivation and keeps your mouth infection free. Secondly exercising your muscles. You may also revisit your dentist and get a course of antibiotics prescribed for yourself. This would also be beneficial. Hope it helps. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 78 yr old Female c hx of hypotension , ulcerative colitis , TIA, DVT , kidney cancer resulting in removal of 1 kidney, subsequent CKD stage for with 20% function remaining. 6 days ago arrived in ICU due to abscess size of twinkie in rectum. Primrose in place to facilitate drainage. Sepsis with postivite resistant staph hominis. Tx with doxycycline and clindamycin. Intubated x3 days to prevent ALI, now on SIMV. No hypoxic events. Sedated with ativan and morphine. Off sedation for 25 hours with still no movement. Kidney function still adequate, WBC now 9,000. Lungs clear, liver function good. TPN to rest gut. Why has she not awakened? ### REPLY: You yourself admitted that she is under sedation and again asking why she has not awakened which are contradictory. You need to understand that she is in a very critical condition. The fact that all the organ functions are normal is a good sign. If her sepsis IC controlled, and she is weaned off the ventilator gradually, there is all likelihood that she would recover completely, but all this will take time perhaps few days to weeks. We need to have patience ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 41 year old female, have been having chest pains since Friday, today is Tuesday.  Went to the hospital yesterday and they did a blood test and x-ray found nothing and sent me home today.  They kept me in overnight because of my history of clots (3 P.Es 2 mini strokes due to LVF) but my pains started again.  The first one was a clenching pain that passed to my back then shoulder then left arm, the pains since have all been short clenches.  Im not stressed out (except about this pain) or anxious about anything so dont understand ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should definitely rule out heart diseases in your case because you are having history of heart failure and clots in lungs (pulmonary embolism). Your symptoms like chest pain and radiation to left arm are classically seen in heart diseases. So better to consult cardiologist and get done 1. Blood pressure monitoring 2. ECG 3. 2d echo 4. Stress test (trade mill test) 5. Coronary angiography if required. You may need cardiac supportive .  Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. Im just wondering because i forgot yo take my birthcontrollpill 2 times in 8 days, iv been jumping over my period like 4 times, so i get a little bleading(is this dangerous?), and i had sex yesterday, do you think the risk for pregnacy is there?? if it is, is it to late to take the morning after pill?? im super scared, i do not want to be pregnant!!!! and if i am, how soon can i take an abortion? is there any boots pharmacy near ocsford circus, london that is open 24/7 I can go and buy the morning after pill too? if there is not, is it to late to take the pill 3 days after? what should i do, stop the pill and have my period or just keep going? ? ? thanks for your answer :)) ### REPLY: Hi dear, and thanks for your query. If you have forgotten to take birth control pill two times within 8 days, you had been unprotected during the time you have had intercourse. You can use unwanted pill within 72 hours of unprotected intercourse.Hence, you can wait until morning to buy the pill. Another time please be regular while you are using birth control pill because :1.you may have hormonal imbalances causing irregular vaginal bleeding 2.you have the risk of unwanted pregnancy. All the best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with anterolisthesis grade 1 at l4 - l5 is this mean that I need to correct this problem with surgery and what tipe of surgery do I need or what consequences there are if I don t get surgery I mean can you live with this condition without getting any worst . Thank you ### REPLY: Hello, It depends on the severity of the symptoms and in the fact that if the listless is stable or unstable in the upright dynamic x-rays. Mild symptoms and little to no displacement may be treated conservatively and followed up. In case that surgery is indicated, posterior decompression and stabilization is a common procedure. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I carried a heavy on my left arm and often lean on the left side in bed.  I began to notice my left arm would hurt and then I stopped carrying my heavy purse on that side and it got better.  No more pain.  I started again with the heavy purse and now the pain is in my neck and shoulder.  But since I stopped carrying my purse on that side, the pain is not there but my left arm gets num and when I massage my neck and shoulder it goes away. ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to:1. Para-spinal spasm and entrapment of nerve fibers at the Cervico-dorsal region.2. Inadequate HY .  Dietary deficiencies of certain nutrients like Iron, Calcium, vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.4. Peripheral neuropathy caused due to any fluctuation in blood pressure or blood sugar level. Symptomatic relief can be obtained by intake of cervicogenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & vitamin D needs to be added in your diet. Physiotherapy & postural exercise will also be helpful. If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done. Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.X-ray & MRI of Cervico-dorsal spine can also be carried out to detect any nerve entrapment. Wishing you a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My eight year old daughters teeth have suddenly started to bleed during flossing and brushing.  My husband or I have always flossed her teeth (nightly) since she has had them.  At her dentists suggestion we started letting her brush them in the am about 8 months ago.  But we still floss and brush them for her in pm.  Her teeth are very crowded together and has lost her first 6 teeth in the last year (one adult tooth never emerged)  Her gums seem red and it looks like teeth are erupting all over- but it is so sudden. Our dentist said to let them come in at there own pace and keep her regular appt.- Would you suggest we seek a second opinion?  She has not seen her dentist in 5 months and has an appt scheduled in 4 weeks. ### REPLY: Welcome to  I would like to tell you that your child is in mixed dentition stage & crowding can be due to that reason. Regarding this you should wait for some time & if it does not resolve then consult orthodontist. Your daughter is having gingivitis & its symptoms are bleeding gums & foul smell from mouth. Ask her to use soft bristles tooth brush. Along with that give her chlorhexidine mouthwash for maintaining good oral hygiene. Once she needs to go for oral prophylaxis. Maintain proper oral hygiene & consult your dentist. Take Disregards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, I am 48 yrs old, and expiriencing bleeding in between menses,for more than a year now, had Undergone D & C, last nov,2008. & still have abnormal bleeding. I am expiriencing severe pain, before, during ( at least for 2-3 days, im having it the least is 8 days ) on the lower part of my abdomen, radiating on my upper part of abdomen. ### REPLY: Hi If u need doctors opinion u need to click on the live chat with a doctor link on top. Here u can get info from forum members who r mostly ppl like u n me, not doctors. Anyway, I'm 52 F. I started bleeding by periods at the age of 46. No cause was found after many tests. Ultimately I decided to go ahead with hysterectomy (uterus removal surgery) at 48 yrs. Now I am perfectly alright. No problems since then. I think u really do need to see a doc. This isn't a problem THT u should be ignoring. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 problems focusing on one thing, I am at all times thinking of atleast 10 different things. If i read a paragraph i can comprehend the whole thing ,but also be thinking about something else in vivid detail, then when I finish I could not even begin to tell you want I just read. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the given description, I just can conclude you that you have concentration problem. You should have mentioned your age and other medical conditions. I assume that you are a teenager or a young adult. Concentration cannot be lost on single subjects. If you are able to see a blockbuster movie continuously, then you have good concentration level. If you are able to play a video game, then you have good concentration. Then what could be reason for your low concentration in reading your education related books. Lack of interest, of course. The books are boring. You do not have the passion with your subject. You are not alone. Millions of youth around the world are on the same path. Once you are able to cultivate interest, in the study subjects, the wandering stops. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. 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, age-26, height-5.7 weight 60kg male I have in various body parts. one is in neck. I could not work for long with my neck down. the pain continue to go to head region. then there is a pain in spine region between shoulder girdle. pain in low back and pain at the base of the heel. get accentuated when standing is prolonged. pain in the region below patella which get accentuated while running for a minute or two, please help ### REPLY: Hello, Your symptoms could be related to chronic degeneration of the vertebral column or a connective tissue disorder (like arthritis). Vitamin D deficiency can not be excluded either.  For this reason, I would recommend performing some tests: -complete blood count, PCR, ESR for inflammation -vitamin D plasma levels for possible deficiency-calcium plasma levels- a cardiothoracic spine X-ray study.  You should discuss it with your doctor on the above tests.  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: Ive been having these sharp pains in my chest for about a week. They come and go and started in just a spot on my chest but have streched over the spand of my chest in a little over a week. I have been sick for about 3 weeks and have been coughing a lot, but i dont know if that has anything to do with it. ### REPLY: Thanks for your question on . I can understand your concern. You are having chronic cough (cough for more than 2 weeks) and fever and now developed chest pain. So we should definitely rule out pneumonia in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and chest x-ray. Chest x-ray is must for the diagnosis of pneumonia. You will need antibiotics, antihistamine, anti-inflammatory and other supportive .   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. Happy New Year.Ive recently had a really high fever virus, reaching 39.5 and it was totally flooring, it lasted about a week and then cured, but Ive felt fuzzy-headed ever since, very sleepy and I have small pupils in my eyes.. I dont feel Im awake at all but I know I am... ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Such feeling is common after the viral infection with high fever. Because of high fever all the energy component is utilized the weakness is because of this. I advise you not to worry about it, it will soon go away. You can take the glucose powder orally under your doctors' guidance. Please mind that you should not be diabetic for it. Please start exercise early in the morning since this can adapt you for the situation you are in. High protein diet can help you recover also. Eggs, meat soda bean all are suggested to you to eat. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my husband 45 years old has at L5/S1 level, there is evidence of a broad based disc buldge posteriorly with a focus of calcification in midline. Disc material is seen encroaching into the right L5 nerve root canal. Disc material is seen abutting the exiting right L5 nerve root postero-laterally.   What does this mean and what treatment will he require? ### REPLY: Hi, Welcome to . After going through your query I came to know that your husband is suffering from lumbar disc prolapse at L5/S1 level. Above description say that intervertebral disc between L5 and S1 vertebra has come out of place, and it is going towards the hole through witch L5 nerve root goes and pressing it. There are two treatment options. First option is Rest in position of relief(generally lateral position with both knee bend), NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as attract three times a day after meals) is required. OMEPRAZOLE before meals prevent acidity caused by analgesics. This method needs patience as it take longer treatment times sometimes up to 6 months. Second option is go for surgical operation(Discectomy). You can discuss with your treating surgeon. I think your query answered. Welcome to any follow-up 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 5 yr old was in pool when i bought him a new float to play on when he got out he had little blistters between his legs where he was rideing on float and one arm where he held on dont no what they r been putting anobitic cream on them but they r drying up but he scratches them and they open up dont no what it is ### REPLY: Hello and Welcome to Ask A Doctor service.  I have reviewed your query and here is my advice.  A rash with blisters that itches that appeared while riding a new float.  I am going to make a suggestion. Your son might be allergic to the plastic that the float is made of.  It doesn't sound as if the rash is infected.  You can stop the antibiotic cream. For scratching, you may use Ben . The most common side effect of Ben ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 given my son his first 5ml dose of Zithromax for an ear infection before bed. His ear has been sore & Ive been regularly giving him some calpol too (well within recommended dosage). Now Im reading the small print & noticing I should have consulted the doctor if my child is taking or has taken any other medication recently along with the Zithromax. Im just checking that the  calpol & Zithromax combination are ok? ### REPLY: Hello! I have been through your question. Related your concern you shouldn't worry because that it is known that azithromycin and paracetamol don't exist any data to have interaction between them. So, what I suggest is only to give your child Cal pol not less than 4-6 hour between, if need it and continue to give the dose of Zithromax based on your son weight. I hope my answer help you. I wish your son a quick 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 am desperate to find out cause of these symptoms, if you could help me please! Symptoms are lower abdominal pain, back pain is about a 9 on a pain chart, my sciatic nerve kills me everyday, starts lower in stomach, some sparatic sharper pain throughout everyday, nausea, bloating/fullness, difficulty eating due to upset stomach but no weight loss, dizziness/faint, white outs and hot flashes, always not feeling well, always tired and run down, severe pain most of the time so bad that uncapable of moving or standing more so falling over because of the pain. I cannot see a doctor b/c I have no insurance and cannot afford it. I have to work to support my 2 kids and I can t take the pain anymore. Please help me?!?! ### REPLY: Hi I am , General Surgeon welcome you to  and I will be looking into your query. . .  I have gone through Question and understood your concerns. It appears to sciatica; pain that is caused by irritation or compression of the sciatic nerve where it exits the spinal cord, usually by a prolapse/herniated intervertebral disc. First we need to diagnose the case with investigation starting from X-Ray Lumbosacral spine and up to MRI Lumbosacral spine. The investigation will helps us to know the cause of this sciatic pain. Meanwhile your pain can be controlled by over the counter painkiller medications ibuprofen [Advil, Motrin], fetoprotein, or naproxen [Alive]), Prescription muscle relaxants like tizanidine to ease muscle spasms along with local painkiller ointment like meloxicam gel. However, owing to the severe nature of pain and the disability it's causing to you. You need to see a spinal surgeon with above-mentioned investigations. Wishing you rapid and complete recovery. I hope that my answer will help you. Do rate it, if you like regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump in my throat and it has been there for three years...I have Globus as well and it seems to come and go. I have been to an ent and they have looked in my throat and they see nothing ... I am worried because it feels like something is deffinately there but they don t seem to see it. I find a lot of mucas comes from that area...worried sick ### REPLY: Hi, Dear,Thanks for your query to  virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns. Cause of the health problems you queried-The lump on the throat with Mucous discharge seems to be with Acid reflux you have. Your query indicates this by the reflux mucous out pouring from the acid reflux, which needs to be treated.GOR-gastro-esophageal reflux, with reflex Hypertonicity of the UOS(Upper Esophageal Sphincter) is proved cause of the globes feeling in the throat, which hampers swallowing of the reflex mucous outpouring leading to excessive mucous discharge with it. There are many other causes as-retroverted epiglottis, or /hypo-pharyngeal cancer/or Remedy- -PPI (Proton-D)-for the HERD associated is commonly tried to rule out the HERD. Rigid Esophagoscopic examination would relieve by dilating the sphincters spasm. Reassurance- if associated with anxiety would relieve globes. Fiberoptic laryngoscopy orTNO-Trans-nasal esophagoscopy would rule out any growth besides other causes and would help in planning treatment of Globes clearly. Other factors related to stress/anxiety / and anatomical abnormalities and pharyngeal disutilities need to be ruled out. I would advise you to consult ER ENT Surgeon, who would differentiate from other possible causes for the lump in that area. As I don't have any direct photo of the lump / or not many details from you, I would advise you to consult surgeon. Hope this would resolve your query with full satisfaction. Welcome for any further query in this regard to ME by direct question at . Write excellent review and hit thanks, to narrate your experience, which would improve my rating for many other visitors to . Wishing you fast recovery. Have a good day. . N. Senior Surgical Consultant. M.S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a 26 years old male actively involve myself moderate to high intensity training daily. I usually do a 6 days a week training of 1-1.5 hrs in weights room/ basketball. So I havent stopped training for 9 days, this morning I woke up tired and sleepy and sore from yesterday afternoon training, then I went to the gym and hit the weights for about an hour, was feeling tired all day and then I played basketball for half an hour just in the evening. Since then I felt different with my breathing pace, almost feels like as if I am short of breath and my heart rate was kind of rapid. I eat a pretty clean diet. I am just kind of worried. Any advices for me for this time being? thanks. William ### REPLY: Hi William After going through the details provided by you its clear that you are just pushing your body to extremes. What's the hurry buddy just take it easy. Whenever we exert or hit weights our muscles undergo catabolism which then need some time to recover from that injury which you are not giving to your body and doing total injustice. I want to suggest you that make a proper schedule of 5 days work out in a week that too bot more than an hour. And before and after every workout take a warm up and cool down of 15 mins each respectively. Your heavy activity schedule is the reason of your tiredness activity ND fatigue. Follow the advice given and feel the difference. Good Luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother has COPD and her quality of life is terrible. She could not walk across a flat golf course to watch her grandson run in a cross country meet. She loves the beach and can t walk down the beach anymore. I do not have a lot of info on her current treatment, except that she has a nebulizer that seems to help very short term. Is there any way of improving her lifestyle? She is 73. ### REPLY: Thanks for your question on . I can understand your concern. COPD is chronic and progressive lung disease. Treatment of COPD is multidimensional. Only Nebulization will not help. She needs following things for better symptomatic relief. 1. Pulmonary rehabilitation. This includes chest physiotherapy and deep breathing exercises. 2. Adult pulmonary vaccines like pneumococcal and influenza vaccines. 3. Smoking cessation if she is a active smoker. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been prescribed ovanac plus by my gynac (before we attempt IUI) but i feel dizzy since i ve started taking it. i stopped taking it for a few days while travelling and i was alright. now i ve re-started taking the medicine and again feel discomfort esp while traveling in metro etc. is this normal? are there any side effects of ovanac plus? ### REPLY: Welcome to  Ivana plus is known to increase the chances of clot formation. This means travelling long journeys can increase clot formation in the legs which can send clot to the heart and can be very dangerous. I suggest you visit the Doctor immediately and tell him this problem as if not detected early it can be fatal. Stop taking the medicine and request alternative medication from 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: my mensuration cycle is of 40- 41 days i had my LMP on 25 august and i supposed to get my periods on 6 oct but till now my periods not yet started and there s no sign of coming as well. I also took 2 pregnancy test one on the day when my periods supposed come and other one after a week but it comes negetive. can you please tell me whats wrong with me? ### REPLY: Hi there, There could be a lot of reasons for absence of periods. Age, Ovarian reserve, hormones, like thyroid, prolactin, FSH, or uterine lining, this needs to be evaluated. It could also be due to stress, anxiety, change of lifestyle, or any medical conditions. Do you have any other symptoms like hot flushes, sweating, weight gain, weight loss, galactorrhoea? Proper evaluation is needed. I would advise you to visit a Gynecologist to rule out all the above factors. Hope this helps. Regards. ### END