Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 undergone many tests to determine the cause of my shortness of breath that occurs immediately upon slight exertion & chronic fatigue. Not to go into the long list of symptoms, it just occurred to me that my degenerative disc disease in my c-spine could cause my s.o.b. I have moderate ddd in C3-C4 & advanced ddd in C5-6 & C6-C7. My s.o.b occurs when I begin the slightest movement with my arms such as washing hair, reaching for high objects, etc. Cardiac & lung tests are normal. ### REPLY: Hi, From history as cardiac and lung tests are normal this problem might be due to pinched nerve pressure due to cervical spondylitis. There is a possibility of having frozen shoulder called peri-artheritis precipitating your problem. After consulting orthopedic surgeon go for active physiotherapy, short way diathermy and if you require for cervical traction. Avoid putting pillow under the neck while sleeping. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, My age is 40 year, My wife age is 32 year. 9 years passed for our marriage. We are taking treatment for pregnancy from last 8 years, but yet no result. Our questions as below1>Earlier My wife monthly period cycle  used come naturally, but since last 5 years, cycle is not coming naturally . By Doctor suggestion, she is used to take TABLETS  for cycle like Divery/ Or Regestron..Then period cycle is coming.2>Laproscopy done. 1 time IUI Done, HMG 75/150/300 injection continuously taking  since last 5 year. But problem is with Folicular groth. & improper ovulation.3>Doctor suggested try for another 2month treatment. Now in this month,they have given 300 HMG & OOsure Tablets  for 1month I.e 60 Nos( 2 nos/day). Next month, they will try for 4 to 5 injections.4>Doctor advise, after try of above two months, you can go for IVF.5> What we should be done for to start my wife period cycle naturally?6>Because of irregular Period cycle & delay in pregnancy, my wife used to take tension & irritation. this is affecting our sexual life also.Pl advise for above querries & support us. ### REPLY: Hi, Thanks for the query. You have to find out the cause for irregular periods once. Periods can get affected by many factors. Refer:http://srsree.blogspot.in/2013/07/infertility-2-female-factor.htmlSo, better to get evaluated once to find out the cause for irregular periods. Then better to take treatment for the cause for few months. As stress and strain can cause irregular periods and prolonged infertility treatment can impose pressure on your wife, better to take some months gap with your doctors' advice. This gap can help for rebound ovulation naturally. But you have to take steps with your doctors consultation only as clinical examination is superior. For more details you can ask me through: http://www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fractured my L1 from anterior to posterior and crushed it 40% I am still experiencing back ache 6 months later and many routine activities exacerbate the pain level..back stiffening, sometimes throbbing pain etc. Is this normal..how long may that continue. ### REPLY: Hello, I have studied your case. I will advise you MRI spine and if there is any cord compression with lower limb weakness then you may need decompression. If anterior wedge of L1 is unstable then you may need fixation. You need decompression if fracture is compressing spinal cord. Decompression is necessary if neurological deficit or bladder involvement is there. If there is no neurological involvement then conservative brace or rest is sufficient minimal wedge compression just bed rest is sufficient. Later on follow rehabilitation and physiotherapy. It may take longer time to heal. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is Netra and I am 16 years old. I think I may have depression but im not sure if its actual depression or its just a mindset. I feel sad lots of times and do get bursts of low esteem and start crying but I have no one I can ask this sort of this about. So what should I do? ### REPLY: Greetings ! Well the symptoms that you have enumerated above are suggestive of depression which you have slipped into so I reckon that you get yourself evaluated for the same by a clinical psychologist who after confirming your diagnosis shall start you on therapy/ counseling. CBT (Cognitive Behavior Therapy) is a specialized therapy which is effectively used to manage this condition of depression, and it shall help you to learn coping skills to fight against depressive emotions and feelings in the future. I hope this helps. Wish you all the best. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mom is 103 years old and has dcef. This is the third bout she has had and has been put on flagyl 500 mg. this seems to be to strong of a medicine for her age. She has just gotten off a strong medicine 9days ago for this which was strong also. Seems to keep reoccuring ### REPLY: Hello, I understand your concern. I am , infectious disease specialist, answering your concern. If I am not wrong you are talking about c def and not d CEF. C. difficile is the bacteria causing infection in the gut of the patient who is taking a antibiotic for long period. C. def causes diarrhea in delimited patient like your mom. Many a times bacteria present as communal flora and not cause any symptoms but if the symptoms occurs than treatment is necessary. In the first step it is necessary to stop injudicious use of broad spectrum antibiotics. You can take lactic acid bacilli spore under your doctors' guidance. It helps the growth of the communal bacteria which further stops the growth of C.difficile infection. In severe cases you can take the Combination of Vancomycin and Metronidazole under your doctors' guidance. I will be happy to answer your further concern you can contact me here, or you can contact me on bit.ly/ .  Thank you, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have chest tightness, when I breathe heavily it sounds wheezy and I cough.When I lie down and cough it makes a popping/cracking sound after for a while.Nose is not blocked so I wouldnt call it a cold but I am feeling tired with a dull head and lack of appetite. Any advice? Thanks. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion you are having bronchitis. You're all symptoms like chest tightness and wheezing are seen in bronchitis. So we need to first rule of bronchitis. So consult pulmonologist and get done1. Clinical examination of respiratory system. 2. Chest x-ray. 3. PUT (pulmonary function test). Chest x-ray is needed to rule out lung infection. PFT is needed to rule out bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and antihistamine .  So consult pulmonologist and first diagnose yourself and then start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I bought a roasted chicken from Whole Foods and at home I made the dumb mistake to put it in the oven in the same black plastic container without the lid. I thought it was fine because it said it was microwavable safe. After a while I realized that the container melted in the outside. I pulled it out and saw that the chicken was fine and served it for dinner to my daughter and myself. I am now concern from what I have read in other websites that it can cause some health issues such as cancer. Could that be the case from just one time? ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. I suggest you not to worry much. Our body knows how to throw out the things which it does not need. Digestive system is very powerful. Thing goes into the stomach when we eat. Immediately on finding something strange in the food, stomach reacts and throws it through vomiting. Second option is diarrhea. Colic etc. Third, our liver disintegrates any toxins and removes them through sweat and urine. Means we have our own defense. Melted plastic, should come out through your digestive waste. Cancer means malignant tissues. That happens when there is some sort of malignant tissues inside like gangrene or so. Continuous intake of plastic could cause cancer. That is all. Once or twice is not a problem. Take a deep breath. 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 doc, I just fell from a windowsill where I was hanging some blinds and hit my shin against a radiator. It is quite painful, and I am having pain while flexing my foot. I was wondering if I should go To a doctor about this, or just have home treatment. Thanks ### REPLY: Hi I am . . In my opinion if your injured leg could withstand your body weight without the help of your other leg (weight-bearing) some analgesics when needed only, icing it for the first 48 hours, massaging it with topical gels, elevating your leg will be fine. If pain persists with swelling I recommend an X-ray to exclude minor fissures or fractures. Please click THANK YOU and consider a 5-star rating with some positive feedback if the information was helpful. Hope the above information helps you, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i m Zarin. My father Mr. Zahurul Haque is suffering from hepatities B+ and lever serosis . he is now geting his treatment from apollo hospital Chennai. but the main problem is  language. He doesnot communicate properly with the doctors.he is now under Dr. Ubal Dhus, hepatoenterology . i want to communicate with the doctor to now his proper scenario. how i communicate with him??? i need his email id or phone no...or anything else so that i can communicate ### REPLY: Hi.thanks for posting query at .Bag can not be completely eradicated in a patient suffering from Herb.however, complications maybe prevented if proper medication is taken and proper diet plan is followed. Treatment is advised IF high values of liver enzymes AND high viral Load on a PCR. If HBV DNA count in PCR are not high, Liver enzymes should be monitored regularly while Herb markers maybe checked every 6 to 12 months. Hope to answer your concern. Wish you good n sound health. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with mild scoliosis around the age of 10, lately I been having swelling on my left side below my ribs and it s minor pain. When I went to the doctor they told me that my ribs were going in my muscle. Is this because my scoliosis is getting worse? What should I do to prevent this? ### REPLY: Hello, Yes, scoliosis can cause pain in the ribs. Depending upon the curvature of the spine laterally there is change in the muscular system leading to tightness on one side and lengthening of muscles on the other side.  Doing regular exercise for the correction of scoliosis and postural correction is of utmost importance to avoid the scoliosis curvature to increase. Exercise will include the breathing exercises, scoliosis correction, posture correction, core stability, and general aerobics. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 37, i was born with a large pelvic kidney only, my creatine levels have always been a 1, now its a 1.4.... will water fasting lower my creatine levels. I also have a mass in my utereus that is pressing on my kidney. i am checking on it to have it reomoved.  Will water fasting lower my creating levels ### REPLY: To be honest, never try to reduce creatinine artificially by .  Creatinine is just a lab test and per se it won't damage our health.  Actual culprits are other molecules called as uremic toxins. We measure creatinine because of convenience. Instead of concentrating on reducing creatinine, try to maintain healthy lifestyle like avoiding painkillers, BP control, vegetarian food, daily 30 min walking etc. Best of luck. If you have any questions feel free to contact me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 an adult foster care home and a new client of mine has recently been put on clozapine which I know from experience is a pretty strong medication and needs a lot of monitoring.  Since he moved in with us he has not been stable enough to stay at home for more than three days and he starts getting really delusional.  He is on 700 mg.  The other psychotic medications are zyprexa and affexor.  Can there be a contraindication happening here? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. There is no significant interaction between the .  But looking at the medications, and their dosages it appears that the patient is probably having resistant schizophrenia and it's a difficult to treat illness. If he is still having delusions, then it would be wise to get him admitted. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is taking methadone and his teeth are giving him problems.  They ache and he has had to have some pulled then another tooth will begin to ache.  The dentist has prescribed antibiotics where he lives but he wont be home until next week.  Can this be dangerous to wait that long?  Is this a common problem?  Can you suggest a website that people actually write their experiences with methadone on??? ### REPLY: Hi. Thanks for the query. Yes, Methadone can be a cause for decaying of teeth but as an indirect effect. This is because Methadone can cause . As saliva plays an important role in continuous cleaning of teeth therefore in absence of optimum amounts of saliva there can be increased decaying of teeth due to reduced flushing debris from the teeth. Waiting for a week under antibiotic cover is fine, and you need not worry about it, but you should get the cause ruled out and work on it. If it is due to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: More of a dental question.  Had a great deal of dental work which left me with a part of my gums that is very sore inflamed feeling but the dentist stets there is nothing wrong.  This has been an issue since last March.  I have had numerous exams and even a CT scan.  Any ideas ### REPLY: Hello:)Welcome to . Great amount of dental treatment does not make your gums weak, rather it will improve the gum health. You already checked with your dentist and cleared there is nothing wrong. I recommend you to check with your general physician regarding this. You did not mention if you are under any medication for general health. Maintain a non-alcohol, tobacco free lifestyle. Have a proper oral hygiene. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is 66 years old.He was diagnoised with prostate cancer in 1998 and has undegone surgery for the removal of testicles.For the past 12 years he is on medication i.e calutide-50 tablet once a day.Is there any need for change in medication.should he consult an urologist on an oncologist?? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has prostate cancer. Treatment depends on Gleason score and spread of cancer. He has surgery in the past. Now you should check his PSA level. If it remains in normal range then no need to worry. If his PSA level is high then you should consult your oncologist. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had an abscessed tooth, after popping the bubble on my gum, white pussy stuff came out, I popped it and spit it out, careful not to swallow any but the next morning my lymph nodes were swollen, my tonsils are swollen, including my tongue and lower palette on the left side. I went to the ER and they diagnosed me with acute tonsillitis and tooth disease. They prescribed me antibiotics and told me to take Tylenol ad use throat spray. I have also been using orajel. I went to sleep 4 hours ago and when I woke up I noticed a tiny amount of blood in my saliva. When I looked under my tongue my palette is extremely swollen, all the way to the top of my teeth on the left side. Around my teeth is all white and past that it looks like bruised and bloody sot of. WHAT DO I DO!? ### REPLY: With you query, I really don't understand what do you mean by ER and coming to your problem you might have had a Posterior tooth infection with deep dental caries which resulted in periapical abscess or dento-alveolar abscess through which the infection would have spread over to the posterior tooth areas resulting inflammation and infection of the mentioned areas like tonsils and palate. Generally, when there is a tooth infection one will have swollen lymph nodes or palpable lymph nodes which are first defense system for locally infected areas. Hence, I request you to visit an endodontist or oral surgeon along with ENT Specialist opinion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 27yr old....got married on 11may2011....jus nw im 3 months pregnant.....i used to have  pain in my back n buttock region fm past 5n half yrs....i did all blood test...it cums HLAB27 positive....bt crp was coming neg....nw also i used to have pain...sumtimes in groin region n nw in buttock n stiffness in back.....plz jus tel me wat all drugs i can take nw n after delivery?..can i tk ecosprin75mg til 7th month?my height is 5ft1inch...wt nw is 78kg... ### REPLY: Hello and welcome to , pain in back and buttock region with positive HLA B-27 is suggestive of ankylosing spondylitis. Ankylosing spondylitis is an autoimmune and degenerative disorder characterized by autoantibodies directed against the joints of the backbone. The management of ankylosing spondylitis is primarily with steroids. Painkillers can be taken for the backache. During pregnancy there is restriction in type of medications which can be taken, However, after delivery of the child there is no such restriction. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my gallbladder removed six yrs ago...I have been seeing a chiropractor three times this week and felt good today;however, I just ate a salad and I have pain under my right rib cage again.  It doesnt hurt when I breath...but this is very uncomfortable ### REPLY: Thanks for your question on . I can understand your concern. Since your pain is associated with eating, possibility of acute gastritis and hyperacidity is more. So better to avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Avoid stress and tension. Take pantoprazole tablet on empty stomach. You will mostly improve with all these in 5 days. If not improving then get done ultrasound examination of abdomen to rule out internal cause for your pain. 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: I have pedal adema and am a stonemaker. My stones are composed of calcium oxalate . How serious is this? Could I possibly ever need dialysis? This is my worst fear. Ive had open surgery for a staghorn calculus ten years ago, several lithotripsy procedures . I had lithotripsy done one week ago but the treatment was unsuccessful. Currently I have stones on both sides. The pedal edema has been going on for two weeks. What is your opinlon of what to do ? ### REPLY: Hi, many thanks for the query! As you are recurrent stone former, do - Metabolic workup of 24 hrs urine sample, Sr. PTH, Sr. Calcium, Sr. Uric acid. B/L obstruction to urine outflow due to stones may compromise renal function, do- FT, USG PUB. Dialysis is needed when renal function is severely compromised, in your case, your Sr. creatinine (more than say 7.5 to 8) will decide need for dialysis. You haven't mentioned exact size & site of your stones. Lithotripsy failure is expected as Ca-oxalate stones are very hard to break by ESL, need to be removed by copy/open procedure. Wish you a good health. Take care. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a pic line improperly inserted into my artery for 10 days .I was given 40k and 2 bolis of k packs to boost my levels until during and line flushing was given a lt sided stroke .My question is what damage was caused by the long term and direct infusion of the high concentrations of potassium and other drugs ie dilaudid fortran gravol ect. to my brain ### REPLY: The fact that you were able to type this question into this forum, find this website by navigating through the internet, and comprehend sufficiently to pose the question suggests that the "thinking" part of your brain is intact.  If you feel there are physical changes that have reduced or inhibited neurological function to your body, limbs, etc. then, you would require a neurological examination to assess for that side of the equation.  Bottom line is you would need to be examined and have tests done in order to confirm the presence of any "damage." ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HiI had a fall on my hipHard on ground playing with my dog It as 10 days stop, its now Just a hard lump size of a.plum on my hip bone on side Its not  bruised colour, just lumpShould I go to see, Im stiff 2nd lump ing when I try and do my light jog w my dog on sand, its painful stiffSho ups I go to See Dr get. Cortisone shot, Im using Arnica, cannabis oil topical , and cellebrex. ### REPLY: Hi. Thanks for your query. Noted the history and understood your concerns. History of fall on the side on a hard surface and then limping, hard lump indicate an internal injury due to fall. This should not be taken lightly as impacted fractures do not show more symptoms and signs.Hence, the following is needed in your case:Get an opinion of your Doctor and get clinical evaluation, examination preferably by an Orthopedic or General Surgeon. The investigations needed will depend upon the clinical findings which may be X-ray or CT scan of the affected area as this is superior investigations and help to get any internal trauma clearly to plan the further management. Till then continue the anti-inflammatory medications. You may please take Ibuprofen if it suits you. Take full rest ill a proper diagnosis has been made. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Every evening about 6 PM, my entire body has such deep spreading pain. As soon as I sit down to relax, the pain radiates through my wrists, arms, elbows, shoulders, legs, and back. I nearly groan out loud with the pain and become terribly exhausted. Lying down makes it worse. Sometimes, between spasms, I fall asleep for a minute of less while watching TV in a recliner, and that helps relax my body for about 15 minutes. I am on 1 mg ropinirole HCL at dinner time which helps. When I go without, the pain keeps me awake until 3 AM or later. Pain meds do not help. Walking around does not help. One of my doctors said the pain is from a variation of restless leg syndrome. Since it responds to ropinirole, that makes sense. Your opinion will be appreciated. Thank you. ### REPLY: Hi, The location and movement of a pain give clues as to what is going on. And if it is all over, then it is not due to a particular joint, muscle, disk, or nerve problem. Overall problems such as electrolytes, hormones, inflammation might do it. Psychological causes are easily 10-fold more commonly associated with it. Indeed, an otherwise second-rate anti-depressant Cymbal ta became quite popular due to its side effects that also work on pain. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I hav a 1.5 yr old baby boy. when he was a 5 days old he had a loose motion problem. that was the day and today he have always on and off loose motion every week. We cunsult many doctors but the problem remains the same. Pl help and advice. regards ### REPLY: Treatment of Loose Motions with Mint, Lemon and Honey: mint is very valuable in treating diarrhea. It may be given in any form. If one teaspoon of mint juice is given with a teaspoon of lime juice and one teaspoon of honey, it shows excellent result. This mixture may be given two or three times a day. Loose Motions Remedy with Wood apple(BAEL fruit): Take 25gm of .  Taking this mixture 3 to 4 times a day gives relief. Home Remedy for Diarrhea with Buttermilk: Buttermilk works like magic in diarrhea. The acid in buttermilk fights germs and bacteria. A glass of buttermilk mixed with a pinch of salt, taken 3 to 4 times a day provides relief. Cure Loose Motions with Bottle gourd: The fresh juice of bottle gourd(hiya) should be given to patient every day to restore the loss of water in the body. Natural Remedy for Loose Motions with Banana and curd: Banana taken with curd is a useful home remedies for diarrhea. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What mental disorder do I have? I m really depressed so it s hard for me to type. I ve just had to re write this so I m very angry, but i ll just put symptoms. Symptoms Used to hear voices (first of my guardian angel and then from god- lasted from January- till Christmas day 2012- only very rarely talk to him agin) - Have many beliefs (voices explained to me about the universe and how he created it from experiments on planets in the solar systems he had made then he let it all die out so that he could use all that power to create a world big enough to plant and create a cycle of many creations and many other stories) - laugh at innopropiate things- laugh at sad things or serious things (that inside i know is not funny, but I can t help it) such as people crying, people shouting or being shouted at, people saying there loved one had died or something sad had happened to them. Don t laugh at funny things, like people laughing so badly at a joke, that I don t think is funny, and I m the only one who doesn t get the joke and I look miserable. - sleeping patterns- cant get to sleep until at least 3am and don t get up until at least 11am. - scared of people- walking past people or seeing people that aren t my sister, my mother, sometimes my father or me makes me disturbed, petrified, paranoid and a panic attack feeling. - staying in bed all the time- always in my bed away from everyone either sleeping, hiding under bed sheets or planning a new life (obsessed with it even though it s not something I like). - obsession with certain numbers- obsession with numbers 2 and 5, always using them for things like, I will have 2 sips and 5 gulps, I will get out the cold shower in 2 minutes and 5 seconds then 5 minutes and 2 seconds. -Talking- I hadly answer people when they speak to me and I never seem like I m listening. - referred to as rude- although I see my self as being polite - don t have any ambitions in life, and just think about death -too scared to go out in public - dont care about anything (I mean anything except for my dad, sister and mother and pets) - crying- always cry when pet usually does but when my last pet died on my birthday I seemed ok about it. -uncomfortable with speaking to people - swearing- I ve never swore, but recently Ive been swearing with words that I would never dare say. - sex- got obsessed with sexual activity, such as wanting to have sex, imagine having sex, and planning my dream life as being raped (even though I would never dare to be raped) -hallucinations or dream- woke up at night seeing blue dots on the ceiling and hearing a Disney film being played although cannot see, then I m being strangled and cannot scream that I can feel- did not wake up from this- same side I was on- same darkness from outside and all just disapeared over time with a pain still in my neck- I believe it was a hallucination. Hugs- uncomfortable with being hugged Delusions- believe that talking or seeing someone that they will call me a lier, criticise me and spy on me all the time- feel as if someone is watching me and more. Thoughts- suicidal and depressive, unhappy, sick feeling thoughts. I just want to know if I have a disorder or not, because something is not right, I already treated for being depressed and there are a lot more symptoms but that s enough I think. ### REPLY: Hello Lalalalala2222255Welcome to  You have mentioned all of your symptomatology in detail and in elaborative manner. The symptoms you are having like-- Hallucinations (hearing voices of angels, talking to you about supernatural ideas)- Social With .  Also, you are having obsessions for number 5,2, sexual obsessions these may be secondary to the schizophrenia as in about 35% of patients of schizophrenia, Obsessions and compulsions are also seen. Kindly visit a good psychiatrist and take opinion ASAPThanks 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 using Ramipril 10mg for over 5 years, now they change the medication to Amlodipine 10mg, due to fact that I have been using Ramipril for such a long time, hence am now having eractal issues, why is that the case. I had no issues when I was using Ramipril ### REPLY: Hi, Brief answer: Amlodipine is very rarely associated is erectile dysfunction. Detailed answer: Blood pressure lowering medications can cause low libido and erectile dysfunction. Diuretics (or water pills) and beta blockers are two classes of blood pressure lowering medication that are known to cause problems with sexual performance. Amlodipine is a calcium channel blocker and this group of medications rarely causes erection problems. Rather than a medication side effect of amlodipine, erectile dysfunction might actually be a sign of inadequate control of blood pressure. High blood pressure damages blood vessels, reducing the blood flow to the penis and thus making it more difficult to achieve and sustain an erection. I suggest that you talk with your doctor about your symptoms and to check your blood pressure. Hope this helps answer 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: 44 year old male 5 ft 7 210 lbs, just noticed a few weeks ago a numbness in right foot below ankle. Has been intermitant this is the first time I ve noticed lasting for 24 hours+, no health issues, good blood pressure, non diabetic, I sit at a computer all day. Could I be compressing some nerve or blood vessel? ### REPLY: Hi, Numbness localized to foot area is either a result of nerve root compression which is usually unilateral or peripheral neuropathy which is usually bilateral. As you have a prolonged sitting job chances are more towards the root compression. All you need to do is to improve your posture, along with some physiotherapy, if it improves in a week or two that's good, if not then you need to have a thorough clinical evaluation before proceeding further. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had ureteroscope  and  lithotripsy  last week for a 8 mm calculus in the right ureter,however the pre and post iv contrast enhanced CT of my abdomen and pelvis report says that Ive  5mm calculus in the upper pole and 2 mm calculus in the lower pole of left kidney. What are the most probable treatments so that I can get rid of all my stones? ### REPLY: Hello, After the ureteroscope and lithography, the right ureter is treated already and as for the left upper pole and lower pole calculus are small. If its asymptomatic you can be on observational follow up and 3 myths ultrasonography can be done for any inscreasement of size of calculus. Need to .  If it falls on ureter part you can have tamsulosin which increases the mortality of the ureter. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tightness in my chest and my musles hurt in my chest sinus infection and upper respitory infection back to back for about 3 months dizzyness and pressure in my head ,shakes,upset stomach,sore all over,had ct scan chest x ray x ray on my sinuses and blood work everything comes back normal but symptoms still there they come and go all day ### REPLY: Hi. I can understand your concern.  Chronic cough is commonly seen in bronchitis and lung infection. Since your chest x-ray is normal, no need to worry about lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. 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: kindly i got my right leg swollen and it is paining. i was scratched 2 months ago by a small cat which i bstepped on accidentally and it scratched me on top of the trouser,i ignored but 2 months later the leg  has swollen.i went to hospital yesterday and was given an injection on the vain and supraben 500g which iam now using.The dog said it sclerolis or something like that what is your advice. ### REPLY: Hello. Thanks for writing to . It is unlikely that the current swelling and pain is due to the cat scratch as quite a lot of time has elapsed since then. If it was as a result of the cat scratch, it would have appeared within 1-2 weeks. The current medication you are on, Supreme 500g, if the contents of it were available, it would be more helpful. Right now I can think of the following possibilities:1. A sprain in the right leg - either in near the knee or ankle, which was caused by an injury subtle enough for you to have not noticed it.2. An abnormality of the bone - infection or any malignancy (unlikely if you are more than 30yrs of age) 3. An infection of the skin or cellulitis - likely if you have had any injury or even without an injury especially if you have diabetes, with uncontrolled sugars.4. Varicose veins - if your job involves prolonged standing or are very overweight or have any other condition affecting the valves of the veins of the legs. You need thorough examination of the leg and blood tests like a complete blood count, an HbA1c, random blood sugars - mainly in addition to other usual tests that your doctor may ask for. In addition to this, a venous Doppler or ultrasound of the leg and X-ray if necessary may be required. Hope this helps. Wishing you a speedy 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: is mazetol and tegretol same for a boy of 11yrs and taking medicine for 8 yrs.earlier it was 200 mg twice daily and now tegretol 200mg morning and 300 mg in the evening.He is anemic now and affecting his studies.Whom should we show and what should we do?Please help. ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. Due to his growth, the dosage is increased in evening. However, both are same . 2. Anemia is important and needs to be treated. Meet a pediatrician and get a complete hologram done to identify morphological type of anemia and treatment can be started based on it. Specific tests may be necessary, if reticulocyte count does not increase after 15 days of treatment.3. Diet can also be improved with eggs, fish, green leafy vegetables, red meat etc. It will help in improving anemia. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 always had a cold feeling in my eyelids when I eat cheese. Now it seems to be happening when I drink milk or eat yoghurt. Am I becoming dairy intolerant? I do have allergic rhinitis and suffer from frequent stuffy nose, headaches and sore throAts. ### REPLY: Cellophane You for contacting . Your description is telling that you have chronic allergy problem from dairy products(in your case it could be cheese). You did not mention your age. If I were your treating doctor then I would suggest you following things:> First and most important thing is that you need to find the cause of allergy. As you are having from cheese, so you need to avoid it.> In the meanwhile take Montelukast once daily for 1 month. Research has shown that it decreases sensitivity to allergy.> Cetirizine one at night for allergic response.> Try to avoid dust as it is an important factor in initiating allergy. I would also suggest you to undergo allergy testing at allergy clinic as you have chronic allergy problem. It will tell that you are allergic to what specific thing. The results will help an allergist to prescribe you immunotherapy to that specific allergen, and it will improve the problem. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Afternoon!! Well my problem is this one . i being having my liver enzymes slighted high for long time they perfomed two biobsy and thank GOD I don t have cirrhosis of the liver , I don t drink. now the DR order an MRCP, why ??? I m claustrofhobic he prescribed Ativan 2mg , my question do you think that help me to take the test on the mri .Thank you ...Mrs. Gonzalez ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through.MRCP is routinely prescribed as a liver investigation, and you need not worry about that. It's a non-invasive procedure. Asian will help you in reducing the anxiety of claustrophobia. You may take it at least an hour before the test. Also, you may have a mock sitting a couple of days before the procedure after taking the medicine to get a feel of the experience. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr s ;I notice today that my son his 2 don t want me to touch his penis when im washing him or changing him his say ouch like it hurts , I see everything normal ,nothig red , the urin have it s normal color ;theres no trace of blood . the only thing that a observe was that when he whas urinating his face got red like he felt a disconfort.what can it be? thanks. ### REPLY: Hi... I have just red through your question - I think these are the possibilities -1. Stranger - due to concentrated urine. Give him a glass of sugar water followed by 2 glasses of normal water and this will settle the issue if he passes large amount of urine.2. Balanoposthitis - please consult a pediatrician as this might require antibiotic therapy.3. Urinary tract infection - Unlikely as there is no high grade fever or vomiting. But better to get a urine routine analysis done if the symptoms are not better by suggestion number one.4. Posterior urethral valves - get an ultrasound abdomen and pelvis done. 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 metastasized liver cancer now which was diagnosed last sept. my primary cancer is breast which was diagnosed last 2004. my treatment is complete but still it was metastasized.at present my treatment is zeloda 6caps/day for 14 days & rest for 7 days. then repeat. my question is, how long will i live because my doctor will say nothing everytime time i asked him. i want to know so that i can be ready anytime. anyway i already accept all what will happen. ### REPLY: Hi, Thanks for writing in. Sorry to hear about your cancer of the breast which has spread to the liver. It is possible that if there is a small liver metastasis then there are good chances of extended survival for you. Since it is stage 4 cancer and your general condition is good therefore a survival of 2 to 5 years is expected with good treatment and care. I understand it is difficult for your doctor to discuss your survival, and they are doing their best to fight the battle against cancer. Please maintain a healthy nutrition and discuss any pain relief measures that might make you comfortable. There are patients who might out live expectations and I hope you have a long survival with regular treatment and follow up. Your doctor is providing the right treatment. 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: G My name is Nicole and I have a few questions, about early detection signs of pregnancy. In my case, it s very hard to tell if I am or not. Reasoning b/c I usually have a menstrual every 3mths. However, the last menstrual was in Aug. My primary OBGYN has informed me that if I don t have a period with in 3mths that she would prescribe me medicine to make me have one. So November comes and I started to notice ONLY a brownish spotting which is very faint but still showing; which is known as Implanation Bleeding. Knowing that you can still ovulate w/o have a menstrual still is a chance of pregnancy. Other symptoms that I ve notice is, the Hot Flashes, Nausea but can t throw up, Abdominal Bloating, Mild Headaches, change in appetite, and frequent going to the bathroom. I took a pregnancy test which was negative but I believe that it was too early to detect the HGC hormonal levels. My question is, I ll be taking a blood test this Friday to get a more accurate result, but if that still comes up negative, what could case this? But the last time that I had my menstrual I didn t feel like this, and a Woman knows her body due to unusally changes if this has never occurred. Thank you So Much ### REPLY: Hi Nicole, Reading about you, it is unlikely you are pregnant, more so as you have a negative pregnancy test. Yes, women with irregular bleeding can be ovulating, but less likely than women with regular cycles, also the symptoms of bloating, hot flushes, nausea, point more towards menopausal vasomotor symptoms. Depending on your age, I would say you are probably premenopausal. It is termed premature menopause if your age is less than 40. I would advise you to do FSH levels in blood, to know if you are menopausal or not. As if you are then, hormone replacement therapy would be treatment advisable to you. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went swimming in the sea on Monday in a wetsuit in Cornwall for about 15 minutes only, and I have developed a very sudden chesty cough. Sounds like mucus, but not coming up, very noisy, very painful. Advice please? I have suffered with bronchitis and pneumonia in the past. I am 51 and female. ### REPLY: Thanks for your question on . I can understand your concern. Sudden onset cough, mucus in chest, chest pain etc. are commonly seen with pneumonia. And swimming in seawater can be a risk factor for pneumonia. So better to consult pulmonologist and get done clinical examination of respiratory system and chest x-ray. You may need antibiotics, antihistamine and anti-inflammatory .  Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: feeling flaky mentally better part of the day.  This evening it continued, feeling cold, nauseous at dinner, tried to go to sleep and it felt like a serious of explosions thoughout various parts of body (have history of heart problems, elevated cholestrol and bp in case this could be cause)  what could this be? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have nausea, fatigue and cold. You may some viral or bacterial infection most likely.  Your heart problems and high cholesterol has no relation with that.  You should go for complete blood count. It will give you some idea about cause.  Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The right side of my face is swollen, Went to the doctor office yesterday and he said something about salivary glands The antibiotics are not working, and the pain is unbearable. What can I do, and where do I go to see about this problem? What can I take for this pain. ### REPLY: Hello thanks for consulting at .it could be sialadenitis, if salivary gland is involved,it could be also be due to infected teeth, kindly check for those with a dentist,u have to get a sensitivity test, if not go higher antibiotics and analgesics with the prescription of your treating physician.get an Iowa radiograph done for the involved area with a dentist, do salt water gargle thrice daily,hope it helps,TC ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffring from pyrea disease from last many years and few days back i have consulted the dentist she has started the treatement but she was saying your condition is really bad even i have have lost some of my teeth.My question is will i be fine after getting proper treatement and the dentist i am consulting is dental surgeon. ### REPLY: Hello, Thanks for consulting , Read your query, as you have bad breath this bad breath can be due to poor oral hygiene, sinusitis, eating certain foods, gingival or periodontal problem, constipation or due to decreased salivary secretion. As you are asking for its treatment yes you will be fine after completing your treatment, consult dentist and go for oral examination, removal of cause, and oral prophylaxis, Maintain proper oral hygiene, Brush your teeth twice daily, Do warm saline gargle two - three times a day. Use mouthwash, Do floss. Hope it will help you. Wishing you good health.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband had a stroke on Nov. 29, 2014. It was caused by A-fib. He is on Eliquis 5mg 2 times a day. He was given the blood bursting drug and by evening his MRI showed no sign that he had the stroke. His speech was slurred, mouth drawn & right arm was tingling. He now has a soft knot on the back of his left hand that is the size of a marble. Could this be a blood clot? If so how dangerous is it? He also has episodes of his speech being slow. It takes time for him to get words out. ### REPLY: I read your question carefully, and I understand your concern.First since he still has some symptoms I doubt that the MRI had shown he had had no stroke. Perhaps the doctors meant that the MRI showed the blood vessel to have been recanalized, meaning blood flow was restored after thrombosis (blood bursting . As for the soft knot on the back of the hand, certainly is not the same clot as in the stroke, but I don't think it's a new clot either, clots are formed and spread inside the arterial blood vessels, wouldn't be visible. It's hard to say what it is without being able to see it but I don't think it's a clot. I hope to have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, for the past 4 days i have had a LOT of pain in my stomach, i get a burning sensation in the lower part of my belly and cramps just below my ribs. i have been taking ibuprofen every 6 hours but it only eases the pain slightly, and today it has started becoming painful a few mins after i eat. My stomach is gurgleing constantly. I have been passing wind, and have has regular bowel movements please can you help me?? ### REPLY: You could be having acid reflux and possible peptic ulcer disease. First stop eating oily, spicy food. . Avoid smoking/alcohol. You should never be on an empty stomach for long periods. Start antacids before meals like omeprazole.Don't take ibuprofen before you take the antacids. Always after food. If the pain increases, you need an ultrasound and prescription antacids, so please see a 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 baby 1.2 years. suffering from fever.it was started on 30th march 7.00pm.there was no doctor at my locality at night.temp goes up to 103 f.i gave him dose of crosin drop 3 times.but temp not reduced.at 3.30am he started fiver convension and stop within 5min with flash /sponge cold water.we thought he almost dead.immediatly start searching doctor and at last at 4.15 am we got pedritic md doctor and admit to hospital.he was given saline 2 bottle,antibotic injection along with vomiran,rantac.and frisum tab.situation become normal. he was given 2 antibiotic inj at 12 hour intervel.1st Aprl dr. release my baby. but from 2nd Aprl morning tem. start rising 100.4 f.we rush to the doctor and started nimsulide and paracetamol susp.,cefixime oral susp ip,and now last dose given augpod ds(cefpodoxime proxetil and clavulanate potassium for oral suspension) replacing cefixime.from starting dr tell me it was viral fever now telling throat infection.but till now have fever please help. i am in very stressed condition with my baby.Datta,Gujrat,India ### REPLY: Hellenist common cause of fever in this age is some viral infection. In viral infection high grade fever may persist for initial 3-4 days and then fever starts declining. Along with fever there may be loose stool, cough/cold, rashes or redness of eyes. Most of the time it responds to conservative management and even antibiotic is not needed. In this age the most common cause of fever with convulsion is febrile convulsion particularly if it is of brief period and child gains full consciousness without any neurological deficit. Other less likely possibility is infection in brain. Here in your case it appears to be febrile convulsion and your doctor has managed on the same line of treatment. I won't get worried as it is still 4th day. If fever persists longer I would like to get investigations done to rule out any bacterial infection. Give medicines to control fever and also do sponge as this may again precipitate the seizure. Consult your pediatrician if condition worsens or fever persists longer. 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, maymy mothers blood pressure is extremely high right now (169-101) she took her pill but it still hasnt gone down and she will not go to the ER how do we lower it with out taking her to the ER?? I answer your health queries right now ?  Please type your query here... ### REPLY: Hello, I would recommend giving her one tablet Captopril sublingual. It will help reduce her blood pressure values very fast. If these blood pressure values persist in the next days, I would recommend consulting with her attending physician and discussing the possibility of making some changes to her actual antihypertensive therapy (increase the doses or adding new .  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi thanks.my dad has had bypass surgery (double) about 2and a half months.it has lefet him with some numbness ans swelling in his hands.also after he walking up some steps today about (ten times )  he had an increase pulse rate that made him uncomfortable (132) that took some time to settle.could you kindle explain this ### REPLY: After surgery, there are a few problems that are common. Quite commonly, an abnormally fast heart rhythm known as atrial fibrillation may occur. Your doctor may already be aware of this and have him on appropriate medication but let the doctor know of the 132 heart rate just to be sure. Hand numbness may occur after surgery due to changes in nerve function with medication and fluid shifts. If this does not disappear after 2-3 weeks testing should be done to be sure of the source of symptoms. Often, all that is needed is a protective hand brace worn for a few weeks to achieve 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 have what my pcp believes to be petachia on my feet and ankles. He did bloodwork checking for platelet counts and inflammation markers. Bloodwork was good. He didnt schedule a follow up appointment or anything. It has been a month and the petachia have not gone away. I feel like I need additional testing and am not sure whether to follow up with PCP or right to a dermatologist. What would you recommend? ### REPLY: Hello, As your all the blood work is normal, I suspect it to be either infectious or vasculitis. But it is better to check the clotting factors level. Because its deficiency may also cause Leticia. Some Autoimmune diseases and . Please check for antinuclear antibodies. Treatment depends on the cause. Please consult the Dermatologist as well as infectious disease specialist. Hope this helps. Please write back for further queries. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i brought my friend in the emmergency 2weeks ago because she vomit blood.they made some test on her but they got a negative result for ptb,they release her from the hospital but she ask them to comeback on the following week. one day i came to work with her before her doctor s appointment. last tuesday a day of her doctor s appointment they told her that she was positive in tubercolosis.I m afraid i might got her tb virus or bacteria? ### REPLY: Hi, Sorry about your friend hope she recovers soon. TB especially PTB (Pulmonary TB that affects lungs), is contagious, and it is airborne that is, it spreads through air when an infected person coughs. Although one can get infected with these bacteria, it does not lead to disease in all cases. It depends on the individuals' immunity. Going by the history you give, the chances of you developing TB disease is very less (less than 5%) provided your immunity is good. And if her TB is other than PTB, it does not spread. If you develop fever, cough with flag, seek medical attention. Take Marrakesh ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been having some tingleing on my left side radiating to behind my ear and down my left arm. I have a sensation as if i had oxygen mask on. discomfort over my heart I am 43 years old 119lbs non smoker/drinker. Should I be worried? Have been having this discomfort for about 5 days now. ### REPLY: Hi thanks for asking question. You can have following differential diagnosis. First one it might be simple musculoskeletal pain as no other specific symptoms are present. Take enough rest with proper sleep posture. If pain more simple analgesic can be taken. Secondly though chances are less heart problem has to be ruled out by doing simple Electrocardiogram(ECG). Third rare possibility is off respiratory problem if associated cough and fever is present. If suspicion of that x-ray can be taken. You have no serious problem, on preliminary approach investigate with ECG and CRP estimation with simple analgesic. I hope my suggestion will help you. If still have problem then further work up is to be done according to physical examination and further history ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For past couple months, I ve had extreme weight gain, swelling in face, hands, stomach and ankles. Severe backpain and pain in legs. Now i have hemroids that are bleeding. I feel as if i were pregnant but I ve had my tubes tied, so I know that couldnt be the cause. Please help.., ### REPLY: Thank you for question. After reading your question it seems to be one of two things:1) A thyroid condition: A condition called Hypothyroidism may result in the above-mentioned symptoms. The tests you should get done are T3,T4,TSH along with a Complete Blood Panel. Discuss this with your doctor as a thyroid scan may be required2) Kidney disease: A less likely condition which does lead to swelling of ankles and face and hands. It does not lead to weight gain, but that could be mistaken with Anastasia, a condition in patients of kidney disease where there edema in the whole body. I suggest a urine profile to rule that out ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son had an MRI that found a small lesion on his left side of the basal ganglia, no idea how long its been there how it got there ect.. but he has been diagnosed with ADHD OCD Mood disorder insomnia with the tonsil and adniods removed in hopes to help him sleep better, but no luck. He has always complained of achy joints knees, ankles neck and lately his lower back, he is only 12 and now to think back on it he had alot of problems a a baby with upper and lower GI problems asthma colicky(stiffing out) and he cried constantly, could this be due to this small lesion should I be more concerned? I am starting to think that the low back pain knee aches ect.. are being brought on from this lession? ### REPLY: Hello, I understand your concern, but I do not think the multiple joint problems are related to the basal ganglia lesion. I feel that this could be growing pains or growth pains are a sign of vitamin D deficiency. May I suggest that you consult his primary care physician or pediatrician with these possibilities and discuss, please. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have noticed,just for the last few times,a small amount of pink color in my semen. 10-12-years ago blood appeared to a greater degree,but after THOSE 3 or 4 incidents,and have a camera of some sort inserted into my penis,no problem was found. No pain or other symptoms.ectshirt ### REPLY: Degree understand your concerns went through your details. You need to understand that semen is off-white or white.  If you notice a change in its color, there may be something serious going on here. You know about this from your previous experience. You should consult your doctor immediately to have expert opinion. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had already experienced what I would describe as lethargy, which I attributed to the Atorvastatin (generic), and then as a gardener with already-weakened shoulder muscles stressed from a thyroid condition (treated) , experienced extreme/throbing pain and weakness for several days after a gardening episode where I had used my shoulder muscles!! I thought, Have I hit a wall where gardening is becoming out of the question? I took magnesium, CoQ10 and B complex supplements, which I think brought me relief! Phew!! ### REPLY: Hello, You can do gardening with shoulder pain. But I will advise you to do in multiple breaks. As you may not be habitual with this work so the pain comes. Usually, when people don't have the habit of doing certain work and when they tend to do it leads to DOES (delayed onset muscle soreness). So you should do less work and make it a habit.  Regarding the shoulder pain, I will advise you to do shoulder exercises by which you develop some endurance which can help you to the job with ease. In my clinical practice of over 12 years, most patients who are doing a job once in a while I advise them to do in multiple breaks and also take sufficient rest. Meantime I even advised them to improve the endurance of the muscles so the pain doesn't bother much. 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: My husband had 2 blood clots  in rt iliac vein. Stents were placed each time. He was also diagnosed with metasatic colon cancer and is taking chemo . The issue is the reoccurring pain in his hip and groin that radiates down to his knee. This pain is very intense. He has mentioned it to the Dr. but he doesnt seem to address it , like maybe it will go away . It has been 7 months.  He needs to get some answers . It affects his ability to sleep ,think clearly, being in this pain. We think maybe some kind of nerve damage?  Any ideas on what might be happening ? If he did not take hydrocodone I dont think he could stand the pain. He is to a complainer . So I know it  is bad. ### REPLY: Hi and welcome to . Thank you for your query. Well, you should first find the exact cause of hip pain. It can be metastasis, degenerative disease or something third. If this is such intensive pain he should take some stronger morphine based painkillers.  It can also be caused by chemo. Unfortunately this is sometimes inevitable, but he should do MRI of hip to see is there some pathology which can be treated. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have inverse psoriasis and 2 small scaly psoriasis bumps that flare ar the same time. I also have a lump that gets very red, swollen and irritated on my majora. It breaks out at the same time as the psor. It comes back in ezactly the same spot. Visually derm dr. Says herpes. Used valtrex for7days, seems to be better. It has a light scale on it but has never itched. I have not used any topical on it this time. It has been there for over a month. Other areas are healing. For 3yrears l have had this raw sore off and on and thought it was another psoriasis issue. I have been celebate for 12 years. It is located in an area that l sit on and clothing rubs. What is the best test for herpes,,? Blood or culture? ### REPLY: Hi, Dear,Welcome with your query to . Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You seem to suffer from-flexor psoriasis, due to tight clothes increasing friction at the flexor areas. Treatment-Tab Dapsone-would reduce the recurrence. As treat with anti-herpes . Reduce on flexor friction by Vaseline and oil smearing, which would reduce the growth of any organisms which increase the redness patches and bruises in the flexor areas.-Would suggest Second dermatologist on the line suggested reassessing the diagnosis. Check for DM-diabetes by blood sugar test with your doctors advise, to understand the cause of the inverse psoriasis. This reply would help you to plan further treatment soon with your treating doctors. Best of Luck and early recovery. Welcome any further query in this regard, which would be replied in next session. Good Day!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am trying to conceive got a HSG exam done on Oct 22. I have an air travel coming up on Nov. 6 to SFO. It is a direct flight and I will be back on Nov. 12. I am going to see family so it is not a stressful trip. Can I travel? I have been trying to conceive for the last 2 years. I am not sure whether to cancel the trip or to go because I am not sure whether I will conceive or not. Please advice. ### REPLY: Hi, Yes you can travel after HSG. There is no contraindication for travel after HSG. Since you had HSG on OCT 22 probably you had your last period around 14-15 Oct. Do the pregnancy test after returning from trip if you miss your period. Is your journey more than 4 hours? To keep you healthy during your journey I am giving you general advise. Move your limbs every 1-2 hours, take a walk along the aisle for about 5 minutes every two hours. There is low humidity in the plane.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dad has a very bad heart and his feet started to swell today. He is almost 74 years of age, weighs about 135 lbs and is about 54. He has had by pass surgery 13 years ago, had a stroke 5 years ago, heartache 2 years ago and a heartache 6 weeks ago. Is this a concern ### REPLY: Hi, Yes, certainly it's a matter of worry and indicates that heart is pumping adequate blood so leads to swelling of legs and other sites. However, it's a treatable condition. His echo should be done and hell need some medicine called as diuretics like Dy tor etc. At home, he should have strict salt and water restrictions preferably less than one liter.  Also, he should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, or just walking according your capacity at least 30 min a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. 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: good morning! I already have consulted to medical practitioner and tests results showed that all my internal organs are functioning well but still I have mucus on my nose, congestion and hard to breathe. Been drinking medicines for asthma, antihistamine and colds & cough remedy and nothing is happening. What is wrong with me? ### REPLY: Hi, thanks for the query to . C. Asthmatics allergic bronchitis is a most common disease, but this is a precursor of asthma. Running nose, watery discharge from nose, redness in the eyes, stuffy nose, difficulty in breathing are commonly troubles which patients encounter due to this disease. Some tests are done as for allergy test, but exact treatment of this disease (asthma) is not yet known. Symptomatic treatment is given and that causes relief in most of the cases. If you think that you are not getting relief from present TT, change the treatment, after the advice of doctor. Still no relief change the doctor and consult a pulmonologist. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having slight cramps and I am not due for my period for 7 more days. This is my third month of being on tri-previfem birth control. My boyfriend and I have had sex without a condom (he didnt ejaculate in me) but I always take my pills on time and never forget them. Is there a possibility I could be pregnant? ### REPLY: Hello misunderstand your concerned Tri-previfem birth control pill is very effective in preventing the pregnancy as you took pill on time and do not forget to take. Its failure rate is only 0.5-1 percent. No matter you used condom or ejaculated inside or outside the vagina as you are on contraceptive pill and its prevent the ovulation. So do not worry and there is no chance of pregnancy. You can clear your doubt by urine pregnancy test if your period will delay by 8-10 days. But It thinks you will not need of that as your period will come as there is no chance of pregnancy. Hope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister age 33, has suddenly noticed a honeycomb or spiderweb looking rash on her right thigh, also her left leg is slightly swollen mostly in the calf to ankle area. No swelling in the leg with the rash. The rash is not raised like hives, does not itch or burn. No pain other than periodic muscle cramp in left leg. ### REPLY: Hello, Welcome to . From your description, the rash may be a pattern called as lived reticular. It is a pattern which could be associated with autoimmune disorders and antiphospholipid syn .  This could also explain the painless swelling of the other leg. She requires a detailed evaluation for the same. However, a honeycomb rash on the thigh can also occur in a condition called erythema an Inge. This occurs after keeping a hot surface in contact with the skin for a long time (laptop, hot water bag, etc.). But this is not associated with limb swelling. Hope this helps you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: GOOD EVENING, I AM SCHEDULED FOR AN EXTRACTION OF SEVERAL TEETH I AM TOLD THE DENTIST WILL BE USING EITHER LIDOCAINE OR ARTICAINE I WAS ALSO SHOWN TO RECOMMEND LIDOCAINE OVER THE OTHER ANYWAYS I AM BREASTFEEDING AND I HAVE BEEN USING HERBS FOR OVER 20 YEARS I HAVENT HAD ANT CONVENTIONAL MEDICINE IN MY SYSTEM FOR ABOUT 25 YEARS NOW...I AM SERIOUSLY CONCERNED FOR MY NEWBORN YYYY@YYYY ### REPLY: Hello, Welcome to  forum. I have read your concern. There is nothing to worry to extract teeth while breastfeeding. The only concern is-you need to take rest after extraction of teeth. Certain antibiotics can cause diarrhea to the child while breastfeeding. Please do inform your dentist regarding this. You can proceed with the required treatment to be done. Meanwhile, maintain oral hygiene well. Take a balanced diet. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...  When i leave a certain window in my house open i have Deep nightmares when its closed i dont, sumtimes on the fence outside the window i see a shadow moving then its gone ### REPLY: Hi . It is related to sleep. What you experienced it is like illusion or hypnagogic hallucinations which are occurred while going to sleep. It is normal. Nightmares occur rapid eye movement sleep and it is normal. Do not think about it. Benzodiazepine like lorazepam can be beneficial to reduce it. I hope I have answered your question. Still if you have a query then feel free to ask. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Dr.. i am 29 years old. i feel pain on my left central portion of back side ..i mean almost netral of back bone but in left side... befor my weight 65kg.. now 52 only. also i fell tiredness & my urine yellowish colour..i made some lab test .. isee total bilurubin level is exeed.. ie 33.9 umol/ litter.. please advice me what the problems for me & what the further treatment... iam attaching my reports. ### REPLY: Hello and welcome to , Raised levels of bilirubin and yellow colored urine suggest jaundice. The next step is to determine the level of direct and indirect bilirubin levels. Direct and indirect bilirubin are raised in different states. Direct bilirubin is raised in obstruction of the biliary tract and indirect bilirubin is raised in hemolytic anemia to name a few conditions. The other liver function tests should also be done -S GOT, SEPT, alkaline phosphatase, and 5- nucleotide. These investigations will throw more light on the causation of jaundice and hence its management. Consult your physician ordering the investigations. Thanks and take care .  ### END