Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 fell from a 3 foot drop right on the back of his head on ceramic tile, 3 days later i noticed a soft spot, hes been acting normal and that spot is still there. If i touch the spot he moves and whines. im just worried, we took him to the hospital and the doctor said it was a cyst. but i dont think so, and the pediatrician said it was no cysts and that it was from the fall i am very worried. ### REPLY: Hi...it is just a boggy swelling what you are describing. It occurs because of the trivial injury he had during the fall. Nothing to worry. It will get absorbed by itself in matter to 7-10 days. It is definitely not a cyst. At this point I will suggest you the danger signs when you need to worry after a head injury. Be rest assured. Danger signs of head injury include -1. Vomiting continuously2. Seizures3. Watery of bloody discharge from ears and nose4. Unconsciousness5. Altered sensorial or behavior. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was punched in the face 5 weeks ago and the area around my eye is still black. it isnt bruised any longer but the area under my eye is black. There is a lump where i took the impact and when i pull my skin tight there is a slight dimple where the lump is. do u know what this could be? ### REPLY: Hello! Thank you for the query. Most likely there is some blood collection under the skin. Due to the injury blood vessels were ruptured what caused the hematoma. If it is a small lump, your body should absorb it by its own. However, in some cases such hematoma needs to be . I suggest you to consult a general surgeon with it. In case of doubts, an ultrasound can be done. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 21 year old male just got out of the army, Ive had abdominal pain for over 16 months now, frequent bright red blood in my stools. Ive been diagnosed with crohns and IBS. I just started a new workout regiment for the first time and I had alot of blood in the stool again for the first time for over a year now. Ive takin pregnosone and been on humira for several months. Wondering if this is cause for concern. ### REPLY: HI. Thanks for your query. As per the history you have provided you are already suffering from IBS and Crowns- It may be either of it. You are bleeding in intestines in spite of the medicines means you need to get a review. I would advise you the following:Get an appointment with the Gastroenterologist Get a colonoscopy and biopsy to prove what exactly is the problem. Histopathological diagnosis is very important as the treatment of both the diseases is different. I would advise the following investigations and treatment in a such a case:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen, *Colonoscopy All these investigations should be within normal limits for one to say you have IBS. Treatment:STRESS = stress is the most important cause of IBS. Please remember, and you must have observed that when you do not have stress your problem with IBS is reducedChange of lifestyle. I think maybe you are not coping with something. Vacation outside your area, mobiles phones to be off. You must have noticed already that these changes help a lot. Try to avoid anything which you are / have to do against your will and wish. Get into the hobbies which make you forget the world around you. Life comes only once, boss. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About one week back, suddenly i got small rashes in my face and body. The day before my wife got the same. I thought, it was an allergic problem, and so i took some medicine on allergy. However, after two days, i started getting pain in my hand joints, finger joints. On the very next morning, I found that my joints were swelled up and started pain in all the joints in my body. Few months back, i consulted with a orthopedist because of hip joint pain, which I have been suffering for more than 2 years, and he gave me some medical tests. However, I couldn t manage time to make those tests. Now I made those tests and found that my ESR is 14. Now my question is why suddenly these happened? Is there any relation between rashes and joint pain? Why ESR level rises? Thanks a lot. ### REPLY: Hello, Welcome, and thanks for sharing your concern I went through your query, and I feel, your symptoms are of reactive arthritis, following any viral infection, this can occur even months after the initial viral fever, so see 1 if you have a history of any such febrile episode in the past, 2 Do you have arthralgia, which simply means tender painful joints3 Any history of inflammatory arthritis in the family members, like RA.check for these and revert, we could help you reach the diagnosis, if we can have answers to these questions. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter who is 15 weighing about 120 lbs just started adderall today about 2 hrs ago was her first dose. she says she feels really dizzy her head hurts and she feels shaky. i am thinking her blood pressure is elevated and wanted to know what i could do at home to help her or should i thake her to the er ### REPLY: Thanks for contacting . You have not mentioned why your daughter has started Adderall. If she is taking it to reduce weight then it should be discontinued immediately as it has no proven effect in reducing weight but has potential for really serious side effects and even addiction. Adderall has known side effects of causing dizziness and high blood pressure. Take her to Er get her Blood pressure checked and get her treated for dizziness and do not give her any products and medication including Adderall without consulting a doctor. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, I am 33 year old. married in 2010. we don t have children. I recently done a semen analysis . and the result showing very disappointing. B cause my sperm count is only 3.7m/ml and motility is 5% active and 10% sluggish, mopholology is 20%. I had an surgery for varicose vein 3 years before. so what i have to do now. whats the reason effecting my count. How can I increase my count and motility. Please answer me ### REPLY: Hello, Welcome to , I am .  Firstly, your sperm count is lower than normal (normal is 15million /ml as per WHO 2009).  The motility is lower than normal (normal is >40% as per WHO 2009).  The morphology of the sperm is within normal limit (>04% as per WHO 2009).  So, your count and motility is substandard. For this, you have to be investigated thoroughly. Consult with an infertility specialist for ordering required investigation, for prescribing medication like coenzyme Q, vitamin E etc., and for further management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father has been told he has an extra valve in his heart (and is needing to go in for surgery) and when i jump on cardio equipment my heart rate is abnormally high and can be held above my indicated maximum heart rate for periods of time, is it possible these are related issues, if so what should I do ### REPLY: Hello their understand your concern and will try to answer to my abilityFirst of all I think your father doesn't have an extra valve but an extra cusp probably in his aortic valve, perhaps. For you to have the same issue is rare but not completely impossible. You can get an Echocardiogram done to check. But if you are able to do your cardio well you needn't worry. Lot of people have high basal rate I hope all turns out well for you. Let me know of future developments if any. Stay healthy. All the best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hard worker, delivery of heavy objects for past 30 years, 60 years old, smoker, high cholesterol, not taking prescribed medication. Today out of nowhere-middle of chest tightness, no pain, dizziness, light headed, couldnt get air, lasted about an hour. Slowly went away. If I kept moving and working it stayed. when I slowed down or stopped it slowed down. I had to lean against the wall to catch breath and deal with light headedness. ### REPLY: Hi There After reading your medical details I would like to tell you that your symptoms and medical history is clearly indicating towards Coronary artery disease which is causing ischemia to the heart leading to chest tightness which get relieved after slowing down. Its advisable that you should personally consult a cardiologist and get your self evaluated on time to prevent a cardiac event. Till that time you should keep sublingual arbitrate with you all time. I 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: Hi, I started off with neck pain on my left side, then I got this swooshing sound in my left ear it is always there. I have been to an ear doctor he had my ears cleaned an told me to come back in a few months. I left with the noise still there. I have bee to a chiropractor, went for a month worth of treatment no help. now I have joints that are hurting but not swelling. this has been going on several years. I am 46 and I have an avm in my right leg and left foot. other wise healthy ### REPLY: Hi, Thank you for providing the brief history of you. As mentioned by you, that you have pain in the neck and tingling sensation. Apparently as per your history mentioned neither the ENT nor the chiropractor was helpful. Well, first I will advise you to take the MRI of the cervical spine and also perform some orthopedic special tests prior to MRI to assess the cervical spine. With the help of MRI the understanding of the soft tissue is better than we can visualize the inner body structures. Also, due to any nerve impingement there will be a persistent neck pain and also some swooshing sound in the ears. For neck pain and the swooshing sound in your left ear I will recommend further to undergo physical therapy. The use of therapeutic ultrasound therapy and TENS therapy will first help reduce the pain in the neck. Also, the latter part will focus on the exercises. Exercises will be focused on the Strengthening of the muscles of the neck and also Vestibular rehabilitation exercises which will help reduce the sound in your ears. Now vestibular rehabilitation helps the movement of the fluid in the vestibular system, as dude to the inability of the vestibular system to function properly the swooshing sound is heard. Physical therapist have been helpful to many patients in these conditions of neck pain and swooshing sound. It is a non-invasive therapy and not only it reduces the pain but also will help you avoid future complains. I personally have 99% success rate of my patients with physical therapy. RegardsJay 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 6 year old nephew had cranial surgery for lamdoid synystosis in December and this morning he had a nosebleed and this afternoon a large lump developed on his forehead with no trauma occuring.  Is it possible there is a connection between the surgery and the lump developing? ### REPLY: Welcome to  .1. Possibilits of the previous surgery can not be ruled out.2. In case of any infection / inflammation to the post-operative site with edema may appear as lump.3. I would recommend you to see the treating doctor / pediatrician as soon as possible both for the lump and nasal bleed.4. In post-operative case delay is not accepted - as it may complicate. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Today I noticed a swelling on the front of my left leg, about two inches below the knee-cap and slightly to the left. It it only slightly raised, round, and about 3 inches in diameter. It does not hurt and I do not remember injuring myself there. Should I wait and see if it resolves or go to see a doctor? ### REPLY: Hello, As with history, it appears to be nothing to worry. Using icing, if you aren't diabetic, and if diabetic the use hot water bag. Keep the leg elevated on a pillow and use a knee brace.  Do some simple static qua .  In case not better in a week of time than we will see if you really need an X-ray.  In my clinical practice of 12 years, most cases are better with preventive measures and simple exercises. 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: Hi, I have been prescribed steroid tablets and clarithromicin for a bad chest infection. Since I started with the chest infection my legs and hip have been aching which is more noticeable at night. I was wondering if I can take paracetamol with the above? I was worried of the amount id be taking as I need 6 steroid tablets everyday for 5 days. Thanks Leanne ### REPLY: Hello dear, thanks for your question on . I think you should consult pulmonologist and discuss your problem again. As high dose steroids are not given in lung infection. Steroids actually flare up the infection and worsen it. Your hip and leg pain can be due to 1. Infection2.  Steroid induced myositis. So better to consult pulmonologist and discuss all these. You may not require steroids. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood pressure has always been in the normal range. Im a 49 year old female, within my weight range and I have noticed over the last few months that my blood pressure is higher every time I test it. Last reading was 139/94. Is this normal with age. ### REPLY: Hello the blood pressure range for you is to maintain it below 140 / 90. Considering it is just hovering at that range I would assure you that nothing to worry and just some lifestyle changes will present development of Frank hypertension in the future. Some general things you should follow to control your blood pressure are. 1) try maintaining blood pressure upper under 140 and lower under 90 mm Hg with lifestyle and medication if necessary 2) if overweight, losing weight should be a priority, try achieving BMI less than 25.3) 40-45 mins of aerobic exercise daily4) be regular with your life, food at regular intervals and adequate 8 hours of sleep 5) in diet -low salt. Max 3 GMS a day. - avoid preserved food as all preservatives have salt. - no pickles, chips, aerated .  - at least 2 serving of fresh fruits in a day. - 1 serving 35-40 GMS of nuts like walnuts, almond to be included - if you take fish 2 serving of fatty fish per will like salmon. -avoid red meat, egg yellow, fried and spicy oily food - may shift to better oils like olive in cooking 6) may consider supplements, like cod fish oil capsules, flax seeds, chia seeds, krill oil as they have good content of omega 3 fatty. Hoping the above measures will help you stay healthy.  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 scraped my leg up falling down some steps. Now I have a sore squishy lump and my ankle still swells. i did not twist anything. Also knee hurts when even material touches it. I tripped about a month ago. I start out my day with just a little swelling. it does not swell a lot. But it does swell above ankle. ### REPLY: Hello, As this looks like a ligament sprain within the knee joint leading to swelling and pain. I will advise for a knee MRI. Also, using knee and ankle brace will be helpful to stabilize the joints. Post which doing hot water fermentation will help vascular supply to be good. Also, keep the leg elevated over a pillow while lying down this will help boost the swelling to come down more. Post the pain comes down a little. Start exercises like - ankle toe movements, straight leg raise, static qua .  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: I had a period on da 18th of this month which only lasted one day which was hevery but normally it last about a week Is dat my period or could I be pregnant also I had unprotected sex a week before my implant was due to come out now Im feeling bloated getting tummy pains n  headache but not not the sytoms of needing the toilet or feeling sick could I be pregnant even tho 3 pregnancy test come bk netgive. ### REPLY: Hello, Here, you can undergo one blood test for beta-ChatDoctor to rule out pregnancy confusion. Other reasons are hormonal imbalance (most common) due to effect of implant, stress, irregular food habit, over weight or loss, thyroid disturbance, increased prolactin level, ovarian cyst etc. In exclusion of pregnancy, you should consult with your gynecologist for clinical examination & relevant investigation (like pelvic USG, hormone assay etc.). Take suggestive measures accordingly. Take healthy diet with vitamin & iron supplements, avoid stress by meditation/ yoga, control body weight, maintain genital hygiene & take sound sleep. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The dentist prescribed me to use Paroex for my sensitive teeth...but Im finding its changed color on my fillings that I have...from silver to black...and Im still having sentivity teeth...what can I do ?"b"Sorry cant afford this ? Thought I would get free advice. ### REPLY: Hello, thank you for sharing your problem with . This Parker toothpaste contains chlorhexidine which is an effective antiseptic for gums.  It is not used for sensitive teeth. In case of sensitive teeth you can use Colgate sensitive toothpaste as it is very effective for sensitive teeth. But you have to remember the procedure that you have to apply it for 10-15 minutes on the teeth and then rinse it off. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good evening Doctor, My son is 5 years old and weigh 19 kgs. He gets frequent problem of short breath after 1-2 days of cold. some doctors say he is having bronchitis, some say it is asthmatic attack. for last 3 years he is suffering this problem. He is fine for few months and during weather change he again gets this problem. This time he got ill on 30.11.13 then he was admitted for a day. after giving a weeks medication he got fine then again after a week he got ill (fever + short breath) given levolin 0.63 three times a day, budecort for three days (twice daily) we continued with montair kid plus since 30.11.13 and still we are giving. A week back he got OK, but on 05.01.14 again he got cold. Though short breathe is not this time, but having problem of running nose and cough sound. My first question is how long we can give Levolin (Twice daily) without any side effect. In last three years he might have taken levolin very often. Next question - Does levolin helps in running / blocked nose and in congestion. My next question is at what age will he able to fight cold without medication / he will be free of short breathe. Third when he gets short breathe I get tensed, how much risk is there in such cases. Waiting eagerly for your reply, please. Regards ### REPLY: Leveling helps to relieve the bronchospasm and shortness of breath. It can be given whenever the child has breathing difficulty (bronchospasm), generally for not longer than 2 weeks ATA stretch. No it does not relieve run or blocked nose. These problems generally improve as the child grows older, but no definite age can be predicted. This is treatable condition and with proper treatment the problem can be well controlled. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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!From past few days i am feeling restless, uneasy, breathless and not able to sleep properly.  Due to some mishappening at home i am tensed and now BP shoots up at night.  May be i have cough and sometimes feeling of acidity problem may be the reason.  On last saturday my BP was 102/142/98 and got ECG done it was ok.  The doctor prescribed Alprax 0.25mg. What do you suggest shall i continue taking this medicine everyday as yesterday i was not able to sleep ### REPLY: Hello, welcome to . From your history, it appears that you have anxiety symptoms. These symptoms can occur in anxiety disorders and in adjustment disorder due to severe stress in life. It is better to take help from friends and family members to resolve tension in family environment. Same time problem-solving and supportive counseling from psychologist will be helpful. To de-stress yourself do relaxation exercise like daily morning brisk walk, yoga and meditation. As you have sleep disturbance you can use alpha (for few days only) as advised by your physician. Also monitor BP daily to rule out hypertension in your case. Wish you all the best.  . 99doctor.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 3 month old baby is having green mucusy stoll. Stoll test found white blood cells (30-50). She is gaining weight (5.7kg) , chubby, and happy. Her stool has been taken to caltivated. Meanwhile, the doctor has prescribe antibiotics for her. I am reluctant to give it to her if unnecessary as I have a feeling that she has an allergy to food through my having my breast milk. Will she still need to take the antibiotics if that is the case or could she take bioflor ? Thank you ### REPLY: Thank you for posting your question. Greenish mucoid stools are an absolutely normal occurrence in an exclusively breastfed infant and so is increased stool frequency(up to 20 times a day may be considered normal). This is because of a phenomenon known as gastronomic reflex which causes reflex defecation in response to feed. Here the contents of the intestine do not get time to change color and are excreted in the same color as they are found in the small intestine. Thus, if your child is being exclusively breasted, these symptoms are to be taken as normal especially in the face if a happy and normally growing child. Thus, antibiotics are not indicated. Also, since it is a normal occurrence, probiotics like bicolor are also not indicated. If it is the stool report that is causing the confusion then repeating the report before starting antibiotics would be my suggestion. Having said, so I would suggest you also keep a watch on your children symptoms. Any change, decreased feeding, decreased urine output or activity, faltering in weight gain should be reported and dealt with immediately. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Good morning Dr. I have a 5 month old babba who I ahve to leave teh entire day as I am a working women. I wanted to start him with the Amul Tetrapack milk by dilluting it with water till he gets use to it inorder to avoid loose motions. Will it be safe for me to start that milk for my babba. Since I am at work teh whole day consuming teh lactogen milk becomes very expense by the weekly as weekly i have to buy a new packet . but if advised to continue then I will keep him on lactogen . ### REPLY: Hi, exclusive breastfeeding till the age of 6 months is a standard guideline. Since you are working woman and not possible for you to do so, you can start the child on Amur tetra pack milk. But It's absolutely not advised to dilute the milk before giving. That will affect the children nutrition and health. Also take care that you give him in clean and washed equipments as the chances of bacterial diarrhea is very high with use of packaged milk. Besides boil the milk, let it cool down and then give your child 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: I am a relatively healthy 52 year old woman. I was shovelling snow and realized I was getting short of breath. I continued shovelling but all of a sudden my heart started to pound. It felt like my heart was going to come out of my chest. I could not catch my breathe and felt like I was going to be sick. It took about 15 mins to settle everything down. My chest hurt for quite some time. Are these symptoms of COPD or Angina ### REPLY: Thanks for your question on . I can understand your concern. Sudden onset breathlessness and chest pounding are more suggestive of heart related diseases than COPD. So better to consult cardiologist and get done blood pressure monitoring, ECG, 2d echo and stress test (trade mill test). You may need cardiac supportive .  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: My 10 year old son just developed a rash over night just in the armpit area and the tops of the thighs. we haven t changed anything and he didn t eat anything new. its flat and hot to the touch. not really spots but big blotches. any ideas? I m just not sure if i should take him in, he says it only itches alittle ### REPLY: Hi... Thank you for consulting in . By what you quote it should be an urticaria or a simple skin allergy. You can use HY .  Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine, but I suggest you get the kid evaluated with your pediatrician. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid 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: Hi, my creatinine, serum level is 1.33, what does this mean? I have coke colored urine, low grade fever, and terrible headache that wont go away. Also my eyesight of 20/15 (checked last year) has gone down considerably. When I went in to get my license renewed, I was told I am considered legally blind in one eye. Please help me figure out what is wrong. I know I have to go to a specialist but no one has an appointment for weeks and I dont wont to stay in the dark that long. Thanks ### REPLY: Hi dear, welcome to . Kindly see your physician straight away (urgently). You need to check your BP, have certain blood tests (CBC, KT, LFT, Clotting, etc.), scan of the kidney (ultrasound) at the very least. The doctor will have a look at the back of your eyes (retina) as well. Creatinine of 1.33 is mildly abnormal only but once again it depends on your age, sex, race and BMI too. CONSULT A Doctor PRONTO!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Dr.Rangadhar Greetings My mother has a genetic disease, which has risen polycystic kidney toxins in the body do you have a cure for this disease, please tell us because the toxins in the body increases and lost a lot of kidney function Creatine 7. R Urea 120 Thank you saleh ### REPLY: Dear sir/madam, she is in renal failure. There is no cure for polycystic kidney disease. Only options for the renal failure will be dialysis and kidney transplant(depending on her health profile). Her creatinine is high. Needs further work up also, to see are there any precipitating factors which are worsening renal function and if any correctable ones are there then her renal function might improve. Better consult nephrologists at the earliest. Hope u find this informative. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 salya every morning when i work have right arm pain and chest discomfort..when i relax around 5 min later...the pain disappear...i already have diagnose ECG for 2 time...but doctor said did not any have sign...so how?? why the pain occur?? should i take angiogram??? ### REPLY: Thanks for your question on . I can understand your concern. No need to worry about heart diseases as your ECG is normal twice. So no need to GA for angiogram. By your history and description, possibility of simple musculoskeletal pain is more. You might be sleeping in bad awkward position which is causing this pain in morning only. This pain improves when you relax. This also favors musculoskeletal pain. So avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Apply warm water pad on affected areas. You can take simple painkiller like ibuprofen if pain is more. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I take warfarin at a dose of 15-18mg daily,, Im 30 and would so so like to have another baby, I had metal heart valves replaced in 2009.  Can I replace the warfarin with heperin injections, and whats the risks involved during pregnancy?Thanks shell x ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that pregnancy in women with mechanical valve prostheses has a high maternal complication rate including valve thrombosis and death. The use of warfarin throughout pregnancy carries a risk of myopathy of about 6%;This risk is possibly lower with a warfarin dose Substitution of warfarin with fractionated or low-molecular-weight heparin from the 6th to the 12th week of pregnancy eliminates the risk of myopathy. Anyway warfarin appears to be safer for the mother with a lower incidence of thromboembolic events than fractionated or low-molecular-weight heparin. So you should make the decision to continue on warfarin, which is more safe but carries 6% risk of possible fetal abnormalities, or start subcutaneous heparin which is more safe for the baby, but not as safe for you. Regarding anticoagulation, required dosages during pregnancy for all anticoagulants can differ from dosages outside pregnancy. The risk of valve thrombosis with fractionated or low-molecular-weight heparin is probably lower when aggressive dose-adjustment takes place, based on monitoring of APT or Antigua levels; They may need to be administered 3 times daily, because the increase of glomerular filtration. Hope to have been helpful! 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: Hello... My 1.9 year old baby can not hold and digest food past 3-4 days. Either he vomits while taking his meal or has loose motion right after he completes taking his meal. Though he has no fever. He has grown so weak n thin in just 2-3 days. This happened twice earlier a few months before too while his new teeth appeared. Even now I feel that some new teeth is about to appear. I was trying to avoid antibiotic this time n was treating him with homeopathy medicine. But now its too difficult for me to wait n watch him suffer n his condition is deteriorating past one hour. I only got Walamycin suspension for paediatric use in a near by medical store n I cant even reach my doctor now. Can u please help me! Should I give this, n if yes what dose? Please reply immediately:(( ### REPLY: Hi, I have understood your sons' problem. The loss of digestion - vomiting and loose motion are not connected with the eruption of tooth. You have already delayed. So don't delay treatment further, I don't know how much deny .  He needs medical attention immediately. Till then avoid milk and give plenty of water or electrolytes if he is able to withhold it. Walamycin is holistic sulfate - the dosage and safety are not proved. So don't give it at this stage. As I told, take him as an emergency treatment and follow their advice Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 9+ week pregnent taking 2 gestrenol tablets per day since last month because of spotting. My TSH level has been found to be 7+. Is there any reason to believe that gestrenol tablets has led to high TSH? I am now taking Thyroxin medicine to control my TSH. Is the above medication proper..? ### REPLY: Hi, Intake of Kestrel tablets is unlikely to increase TSH levels. Kestrel is a synthetic form of female sex hormone progesterone commonly prescribed to prevent miscarriage and prevention of premature labor. It does not cause increase in TSH levels. Pregnant women with hypothyroidism will have an elevated TSH concentration and a reduced thyroxine levels due to increased demand by both mother and the fetus. In view of the dose of thyroxine needs to be increased during pregnancy to achieve a goal serum thyroid-stimulating hormone level less than 2.5 mid per L. 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 cut my leg with a weed eater yesterday - I applied hydrogen peroxide to clean it out and then put neosporin on it. However - tonight it is throbbing with sharp pain. I applied more neosporin, but it doesn t seem to help. It didn t really bleed much, but there is one area that looks like it was cut rather deep. Do you think it is infected or is the pain just part of the healing process? ### REPLY: HI, thanks for using  The throbbing is part of the inflammatory and healing process, does not necessarily indicate infection. If you do not have a recent history of tetanus injection (within the last 10 years), then you may need to consider having this done.Outside this injection, the main aspects of treatment would be to keep the area clean using an antiseptic and continue applying the antibiotic cream. Signs and symptoms of infection are: increased warmth, tenderness and pain, discharge, increased redness (after the initial stage). I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc i am a patient of severe bradicardia with a pace maker for last 10 months...i still have problem off n on inspite of severe changes in adjustment...oflate i have been havibg nagging chest pain with mild discomfort through out the day...is there a reason to worry? ### REPLY: HelloWelcome to . Pacemaker is implanted when the hearts automatic rhythm is too slow. It generates impulses and conducts it to the heart muscle so that the heart contracts effectively and rhythmically. However, it doesn't take care of blockages in the heart of any. Chest pain and discomfort are symptoms of angina which may suggest there are blockages in the heart. Most cardiologists prefer to do an angiogram before pacemaker insertion to see for heart blockages. I don't know if it was done in your case. If an angiogram has been done and there were no blocks then you need not wish about this chest pain. You can take a course of antacids twice daily for 2 weeks.  If there were blockages at that time or the angiogram has not been done earlier, then you must proceed with an angiogram and stenting if required. Also since it have mentioned that pacemaker had to be adjusted several times it is a possibility the pacemaker is pacing the diaphragm. Please call the pacemaker technologist and get your pacemaker checked. Wishing you good healthRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am having problem in quick dicision making in current situation, i give-up very easily in any situation and loose confidence , easly get dominated by second person, cant handle little complex situation, as a result i have poor perfomence in office, less importance in friends, ### REPLY: Dear Şahin, thanks for the query, Your problem is low self-esteem. You need to trust your self first then only others will respect you. Take good sleep, avoid persons who always criticize you, take help of good friends who can help you at times. Read motivational books, do Yoga and meditation which will increase your confidence. Stop listing to people, only listen your inner voice. Try to avoid taking multiple issues at times. When you are thinking of giving up, just hold little longer things will start changing. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is BPS ,I m 74 yrs of age with not any health problem. I m feeling pain on my lower back for the last two days...I have not yet taken any medicine so far... Normally I avoid taking any medicin unless it is essentially required. However I just took one tab of Disprine  after dissolving in water.....and feel better.  Could u please help me out...? ### REPLY: Hello, welcome to  ! Lower back pain can arise due to a lot of causes, and we need to find out the cause before instituting appropriate treatment. Disdain helps any pain but shouldn't be taken for long when the pain hasn't been diagnosed. Common causes can be disc degeneration due to aging, spondylolisthesis, sacroiliacs, muscle spasm, vertebral disorders, etc. So you are advised to see a physician to ascertain the exact cause through a thorough physical examination and appropriate investigations. Get well soon! Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my mum was diabetic i am on a lot of medication mirtazapine quetipine amolodipine duloxetine i have started to go to the toilet all the time my stomach looks blown out and i have a offensive smell i have been eating a lot of sweets and sugary drinks more than usual ### REPLY: Hi, thank you for posting. I have gone through your query and I understand your concerns. Your symptoms are caused by Helicobacter pylori. High amount of sugar has caused odor smell. So I recommend you to avoid minimize the sugar amounts. By doing that you will prevent Gestational Diabetes too. To confirm the diagnosis you need Helicobacter pylori test, complete blood, count, liver function test, urine test and fasting glucose test. Consult your gastroenterologist. 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: Hi.  Approx 20 years ago I suffered an injury to the left shoulder whist at the gym doing chest flys.  About a month later whilst stretching,  I suffered what I can only call a loud popping sound from my 5 rib on my sternum, agsin on the left side, which resulted in excruciating pain in the same location.  A small indentation appeared abouth the size of a 50 cent piece and from that day on I have ebdured a feeling of not being able to get enough air.  I constantly sigh trying to bresyh but to no avail.   Please help ### REPLY: Thanks for your question on . I can understand your situation and problem. You are having healed chest trauma. And healing can cause restricted chest wall movement. And this can be the reason for your breathlessness. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (Pulmonary Function Test). PFT will diagnose restrictive lung pathology. This will also tell you about severity of the disease. Chest physiotherapy and deep breathing exercises are useful in such conditions. So consult pulmonologist and discuss all these. 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: My husband has a lot of pain in his back under his ribs since Nov. He has been to the E.R. and has been hospitalized repeatedly. He just recovered from a bout of pneumonia a few weeks ago. Last night he coughed up a fleshy looking lump.What could be the cause? ### REPLY: Thanks for your question on . I can understand your situation and problem. Fleshy looking thing can be1. Blood clot2. Thick mucus better to consult pulmonologist and get done1. Repeat chest x ray2. Sputum microscopic examination. Repeat chest x-ray is needed to see whether his pneumonia has recovered or not. Sputum examination is needed to rule out blood and infection. So better to get done above reports and 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: My Mother is 90 years old.  Up until 2 weeks ago she was well and could walk quite fast with her walker.  Recently she had a urine infection , was given tablets to cure her but she got very dehydrated and had  to be hospitalised. Now back in the resthome she is really struggling to walk.  She tells me her brain says walk and her legs just will not walk.She is getting very frustrated.  Is this the start of dementia? I realise my Mum is getting old but hate seeing her like this. ### REPLY: Hello and, Dementia is the loss of memory. Dementia will not interfere with walking or any other physical activity. Dementia is characterized with inability to memorize things, objects, conversation, people, etc. The loss of memory can be for things in recent past or for very old memories. The urine infection would have cleared away with the antibiotic treatment. Inability to walk can be due to some other cause, e.g. muscular problems. You need to consult an orthopedic for clinical evaluation to know the cause of inability/difficulty to walk. 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: hi there doctor i have a lump on the back of my head which is full of like some kind of fluid its been there for a year show it too gp and they said it needs cutting out and another said it didnt if squeed it leeks and im getting worried what should i do ### REPLY: Hi ! Good afternoon. I am  answering your query. Most likely it seems to be a sebaceous or Desmond cyst which is a benign lesion. If I were your doctor, I would advise you not to fiddle with it as it might cause infection in it and form an abscess. Instead, I would refer you to a general surgeon, who after a physical examination and necessary investigations, might advise you for a surgical removal by a minor surgery possibly under a local anesthesia. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i went to the toilet earlier and it hurt a bit but not as much as it has done before but there was some blood on the paper after(quite a bit really) and its now been 3 hours since and there is still some blood. this does happen but comes and goes but this is more blood than any other time. i have just had a operation and some of the tablets i have been taking for the pain may cause some issues. i also went to the doctors for this in october but its been fine since and i done nothing once i had been to him ### REPLY: As per your symptoms it points towards internal hemorrhoids and if you are experiencing constipation then definitely it points towards hemorrhoids or to anal fissure but that's bit more painful condition, after reading your case scenario I would suggest you to use laxatives available in tablet and syrups forms. Lactulose is quite a good treatment for constipation and use more liquid in your routine and avoid meet and oily food along with daily exercise this will help you in improving your bowel movements and last but not the least avoid straining while defecation. Do remember your case scenario is deficient in not mentioning the type of surgery you had so the above-mentioned treatment only implies if you are experiencing this thing. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am having skin allergies for two weeks now. I have consulted our company physician and another physician outside, but not dermatologists. I was given steroids for two weeks, but its not helping. The second physician gives my montelukast/citirizine, but nothing happened. Its very itchy. The rashes are flat and reddish, and itch even more if scratch. The rashes appear only in my inner arms, armpits, to my breast and bikini lines. I dont have any known food or drug allergies. I used the same lotions, soap, and other pharmaceutical products everyday. ### REPLY: Welcome to . Itchy red rashes even after taking steroid and cetirizine indicates development of fungal infection. You can apply antifungal and antibacterial cream. Start complete course of oral antifungal like flucanazole-150. Take levocetrizine to subside itching. Take proper local care, use antiseptic soap to clean, avoid tight undergarments, keep that area . Consult dermatologist for better diagnosis and perfect medical management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a stomach bug for nearly 10 days I have been to my gp and gave samples if blood urine and stools ive been in complete agony with my stomach I had to go hospital last night and was put on a drip I was given anti sickness and something for the cramps today I feel worse in fact Im not getting any better the hospital said it the noro virus bug but Im so ill ### REPLY: Hi welcome to  forum.  Thanks for asking a question to . F.  You had stomach bug for nearly 10 days. You are treated for anti sickness, and for cramps and put on a .  Furthermore, you are told it is a nanotorus bug.  Viral infection is a self limiting disease, and to be treated for weakness, and symptoms, it will be cured by its own, in a few days. I advise you to have fruits, juices, and easily digestible foods.  I wish you will be fine soon.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a swollen gland in front of my right ear, almost on my temple, tried popping it but it is definetly not poppable, stuffy nose, mild fever. Sore throat and aches and pains as well as exhaustion for the past 48 hours. This thing by my ears got me worried though,  it throbs and feels firm but im pretty sure there either puss or fluid or something in it? ### REPLY: Hi! Thanks for writing to us and sharing your problem of the temporal swelling that is firm and throbbing and is associated with stuffy nose, fever, lethargy and body aches....! I must admit that if I were your treating physician, I would like to examine the lump carefully as I consider followings in such cases:1. Enlarged lymph node due to acute infection, viral infection like flue or mononucleosis, throat/ear infection or tuberculosis2. Infected sebaceous cyst or Desmond cystTherefore, you need some basic blood tests and a simple needle biopsy for confirmation of the diagnosis and thereafter you may discuss it with your family physician regarding treatment options that would be most likely medical rather than surgical. 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 name is AAAAAA Age (24), Weight 63, height 5.0 and My Hubby name is AAAAAA, Age (27), his weight is 60, hight 5.5. Marriage - 4 years. His health condition is normal. NO baby for me. My health problem is PCO . irregular periods (more than 2 - 3 months). I want baby. I want clear my irregular periods. I like childrens but i can nt. Please any tips for my health ### REPLY: Hi, Tips for your health1. Avoid oily, spicy food.2. Eat plenty of green leafy vegetables.3. Do at least 30 min. Of sweat inducing exercise daily (Walking/Running/Skipping/swimming)Above 3 things will help reduce your weight. Even if your weight is not reduced much, these will help in making periods regular, also help in avoiding diabetes (PRO women are at high risk for diabetes). Regarding infertility problem, you are having irregular periods & mostly not making eggs monthly(an ovulation), for which you can try ovulation induction with simple tablets in consultation with your doctor if your tubes are OK & husbands semen analysis is fine. This advice should help you to get pregnant fast. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a root canal on Friday morning. But my dentist couldnt finish it because it was infected. Yesterday I was in so much pain I couldnt stand it. So I called my dentist and he had me meet him at his office and he re-opened the hole in my tooth and let the infection drain out through my tooth. Then he filled it back in again. Now today the pain and swelling has been gradually getting worse. The swelling and pain is now up around my eye and into my forehead. Im on 2 different antibiotics. Im on Flagyl and Augmentin. I started those 2 this morning. Should I go to the E.R. in case the infection spreads to my brain or will I be ok? Thank you. ### REPLY: With the description I assume you have an upper teeth infection and looks is a dentoalveolar abscess or periapical abscess actually your dentist would have left it open for . You are on antibiotics and still the infection spreads so fast to the orbital or eye area it needs an immediate dentist attention. Infection does not spread to brain so don't worry. Make sure the tooth root tip or apex is not in maxillary sinus. But don to forget to seek attention from your dentist. Sometimes it may need extraction of the tooth if there is any cyst or granulomas. Hope this helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an hsg 3 days ago. The cramping was tough during the procedure but very mild once it was over. However, the last 2 days I have been terribly bloated, to the point I cant  sleep and my abdomen is so distended. It looks like I swallowed a basketball. I am so uncomfortable. Any thoughts? ### REPLY: Hi. Thanks for your query.SG- (hysterosalpingography) is a procedure in which the dye is pushed into the uterus through a canola put into the uterus. The possible cause for distension can be a reaction to the dye or perforation of the uterus and trauma to the intestines. -You need to visit ER/ get admitted -Be nil orally - do not take anything orally.-get investigated by :Standing X-ray abdomen, ultrasonography, Ct scan.-Follow the advice of the Doctors. The treatment will depend upon the findings on investigation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ITCHY RASH THAT STARTED ON MY LOWER RT LEG FOM MY ANCKLE TO MY KNEE. I AN M ITCHING ON MY BACK AND SHOULDER NOTHING D SEEMS TO BE HELPING MY DR GAVE ME RIGHT MANY DIFFERENT CREAMS BUT THEY MAKE IT BURN LIKE FIRE. I M TYPE 2 DIABETIC HAVE ARTHRITIC.AND A LOT OF OTHERISSUES. I M TRYING TO FIGURE OUT WHAT KIND OR DR. COULD HELP ME WITH THIS I LIVE IN EDEN N.C. ROCKINGHAM.thank you Rebecca burnett ### REPLY: Hello, I read carefully your query and understand your concern. The rash in diabetic patients is commonly related to a fungal infection. So, I suggest using Clotrimazole cream for local application. I also suggest using Rifleman for three days. I recommend maintaining a good hygiene and wear breathable clothes. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, My Mother is sufferring from mild renal abscess. Her kidney looks bulky and she is on antibiotics - Magnex and Amikacin for last 5 days. She still has fever. And yesterday night, she has excessive sweating. Please advice whether the treatment is correct ### REPLY: Hey. Welcome to . Mild renal abscess is best treated by Intravenous antibiotics, for a duration of 1-2 weeks depending on the response of the patient. If your mother is on Intravenous antibiotics then that is well and good. Please wait till the course of antibiotics is completed. Once when the course is completed, you can get a ULTRASOUND done to see the improvement. For fever, try to take Paracetamol tablet- 650 mg, every 8th hourly after food, in case she has no known allergies to it. Please wait for few days more. Hope I have answered your question. If you have any questions, then I will be happy to answer it. Take good care of your mother.:)Warm 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 allergies and asthma.  I also have high blood pressure.  All of these symptoms are being treated and normally fairly control.  I now have a sinus infection and so my pulmonologist prescribed Zpack and Claritin D until the congestion gets better.  I am on the 3rd day of the Zpack.  I have a fever and am now experiencing pretty persisitent leg pain.  My blood pressure is good 109/72 but my pulse is high  - 101.  Is this because of the infection or what else would you suggest. ### REPLY: Hello dear thanks for your query at ChatDoctoryour consultant had prescribed Pack that contains azithromycin, its antibiotic used in upper respiratory tract infection.it will take at least two to three days for antibiotic response to come and control the infection. High pulse rate and fever indicate that infection still present it will take one or two more days.carnitine d will decrease cold and cough. For fever take tab paracetamol 650 mg thrice daily, cold sponging if temperature above 100 f. no other medication is now necessary your blood pressure is now under control only. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 18 weeks 4 days into preganancy the anomaly scan shows evidence of mild prominence of the fetal renal pelvises noted bilaterally.AP diameter of the right renal pelvis measures 3.4 mm and the left measures 2.5 mm. what are the consequences.can my baby lead a normal life.is it a kidney problem.is surgery required after baby is born or it shrinks automatically ### REPLY: Hi. It is advised that ultrasound to be shown to some urologist preferably good in pediatrics(children)as you have stated that pelvis of both kidneys of fetal shows little abnormality. It is advised that repeat the scan after every 4 weeks interval for comparing the size of renal pelvis. You should not be that worried as urologist can take care of your baby even in case urologist decide for operation named pyeloplasty. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 periods on 26-4-2014 to 1-5-2014 , after my periods i had sex with my hubby i stil did not get my periods mean while i m taking ovacet and evaserve tablet a/c to my doctor advice , so i just want to knw wheater m pragnent or not wt really happing in me ### REPLY: Hallow Dear, You have not mentioned how many days after the menstruation or on which days of the cycle you had unprotected sex. Usually, 14 days prior to the next expected menses the egg is released (ovulation). A period of about one week around this day is a fertile period; though variations are known. With a history of unprotected sex in child bearing age, if the periods are delayed, pregnancy should be suspected unless and until proved otherwise. To find the evidence of pregnancy status, you have the following options: 1. Perform pregnancy test on overnight morning first urine sample a week after the missed period; earlier the test may report false negative results. 2. Alternatively you may opt for Beta  test on your blood anytime after 10 days of the last unprotected sex. This should provide you clue to resolve your dilemma.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 58 years. As per U/s Report of date:  Prostate is enlarged in size and echotexture measured approx 49x43x35mm, vol. 40cc  Pre void volume 222cc.  Post void residure: 25cc  [ignificant]Impression: prostatomegalyPlease advise all about it.Thanks Satyavrat Kadyanemail:   YYYY@YYYY ### REPLY: HelloThanks for query. Based on the report of your ultrasound scan you have moderate enlargement of Prostate which is common at this age. The modality of treatment for Enlarged prostate is governed by following factors 1) Severity of obstructive symptoms 2) Urine flow per sec s determined by Uroflowmetry 3) Volume of post void urine residue 4) Other symptoms like urgency, nocturnal frequency etc. Normally to begin with we first offer medical line of treatment like alpha receptor blockers Tamsulosin and Finasteride once daily. This helps to improve urine flow and reduce the size of prostate gland. If there is no significant improvement in symptoms with medicines we suggest endoscopic surgery of resection of enlarged prostate TURN .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, i have had implanon for almost a year now but recently i have had pain in my arm and numbness on my fingers of my other arm too and i have been lightheaded and my heart seems to beat faster. I would like to know if this is normal or is my body not liking the implanon. Thank you!! ### REPLY: Hello! Welcome on ! I understand your concern and would explain that your symptoms could be related to inflammation or to implant adverse effects. I recommend consulting with your doctor for a physical exam and performing some tests to investigate for the possible causes: - a resting ECG-some blood lab tests (complete blood count, muscular enzymes, PCR, sedimentation rate, blood electrolytes, thyroid hormone levels). If all these tests result normal, you should consider those symptoms related to implant adverse effects. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In the last three years I have had my gallbladder removed, a hysterectomy, a parotid tumor removed in January, my thyroid problems started in May, now I have a lump on my collarbone and knots on my shoulder? Could they all be related and what could be causeing all of this? ### REPLY: Hi thanks for contacting ... Noted you have many surgeries done . You have not mentioned cause for removal hysterectomy and parotid... It might be malignancy... For parotid, it might be malignant tumor. So it needs to be known. Here from lump FNAC is to be done... If it is suspicious biopsy done to look for malignancy. You have surgery you mentioned for malignancy then it might be metastasis means spread for residual cancer cell. So you should consult surgeon... Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. My new born s original TSH test came back elevated at 32.29. The normal max is 30. We are in close contact with our pediatrician and are awaiting the second test. My question is whether it matters how close the results are to the normal range? Or is the fact that it is elevated the only factor? ### REPLY: Hi.... I understand your concern. You are very much right. As the text value is just above the upper limit of normal you need not panic. I do not think your pediatrician would have started thyroid supplements. Probably this is the reason why he is also waiting for the second test because the range is just above the upper limit of normal. If I were your pediatrician I would repeat the test in another 7 days and if the trend of the TSH is rising then I would prefer to start the child on thyroid supplements. 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 just had my doctor review my MRI, I have a bucket tear of the miniscus in my left knee,(with a flap) I will need surgery for it. He is not a narcotic prescribing physcian, just my luck can I get pain medication if I have documentation of my injury with dates of findings. This is crazy to not to be able to recieve pain meds when it is needed. Can t stand or sit w/o it (knee) locking which causes me a great amount of discomfort. Can I get an on-line RX that is legitimate from you? ### REPLY: As per physiotherapy treatment do ice packs 10 mins twice daily, do knee isometrics(lie straight on your back roll a towel put under your knees and press hold for 5-7 counts repeat 8-10 times and do 3 sets), VMO strengthening is also needed. Apart from this ultrasonic therapy, IF Twill also help you. And remember while climbing stairs use good knee and while getting down use bad knee you can also take mild painkiller like aerosol if there is a lot of pain. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My son is 22 mths old, his weight is 11kgs,height is83 cms...He is not eating properly. He dose not like milk in any form.He still breast feed.I would like to know complete diet for 22 months old kid and how to stop breast feeding him.Thank you.Jyoti ### REPLY: Hi, Thanks and welcome to  .22 months child can eat the normal diet taken by adults except the food must be thoroughly boiled and soft and free from spices and chilies. You can give rice with mooing DAL, rice with curd or buttermilk, soft bread, smashed potato, fruits and boiled vegetables or veg soups. Boiled egg may be tried, mutton or chicken soups can be offered. Gradully breastfeeding is with . Hope this reply is OK for you. Please feel free to ask further queries if any. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, I had a cbc and my blood work was normal except for a platelet count of 95...I was tested years ago and had  bone marrow test, which resulted in very large platelets so my count was lower, however, never under 129.  should I be worried and should I see a hematologist.....thank you ### REPLY: Hi there, above report are suggestive of Idiopathic thrombocytopenic purpura (ITP), if someone's platelets are above 1 lac with ITP then there no need to worry or consult hematologist, In ITP platelet count decreases because of autoimmunity of body so chances of bleeding increases and no treatment is required if platelets are above 50000 and there is no bleeding, one need to see hematologist only if there is active bleeding, rashes or very low platelets(less than 50000) otherwise one can lead a normal healthy life with ITP 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 ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am Having pain where the gallbladder is located, and in my back behind the gallbladder. The have told me it is a distended gallbladder. My gallbladder is still functioning, and I hate to remove it, but that is all they say they can do to relive the pain. Is there any way to save the gallbladder? YYYY@YYYY ### REPLY: Hi.it is best if you consult with a general surgeon and schedule for clearance if needed to be, for cholecystectomy (gallbladder surgery - laparoscopic or open). It is not an emergency, but there must be a sense of urgency. From your description of gallbladder distention and frequent occurrence of pain, the only definitive treatment is surgery. Anti-spasmodic medication only offer temporary relief of pain. With the increasing severity of your symptoms, you do not want an elective surgery to be an emergent one, as difficulty of the case and outcome might ensue. Diagnostics and management (medical and surgical) will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 34 weeks pregnant today and when i went pee and wiped there was a little dot of red blood on the toilet paper so i wiped two more times and the same thing. I put a panty liner on to see if anything would get on it to assure my to call the doctor. This is my second child and I was just wondering If there were any suggestions. ### REPLY: Hi dear, I have gone through your question and understand your concerns. Bleeding or spotting at 34 weeks of pregnancy can be due to low-lying placenta (placenta prefix) or due to hemorrhage beneath the placenta(abrupt placenta) or can be due to any local lesions in the cervix or vagina. I will suggest you to consult an ORGAN specialist to get properly examined, investigated including ultrasound and get treated accordingly. Hope you found the answer helpful. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I seem to have a hard bump on the base of my penile shaft. I have had it for about 2 weeks, and at first thought it could possibly be an ingrown hair but i could not find anything when i attempted to extract it with a sterile needle. I have noticed today that it does reduce size with heat. I m thinking it could be a sebaceous cyst. Any ideas? ### REPLY: helloThanks for query. Painless bump at the base of the penis is mostly a Sebaceous Cyst (as rightly thought by you) however it needs to be confirmed by clinical examination by a qualified General Surgeon. The skin in groin and near genitals is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If it is too big may need to get it excised in Toto (Completely along with the sac) under local anesthesia. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.. good morning.. may husband had xray interpretation of suspicious infiltratres on upper apex of right lobe.. suggested apicolordotic xray? is this serious?and 2 years ago he also had xray which had result of ptb? im afraid of this situation. pls. help me.. wat we should do next? ### REPLY: Thanks for your question on . I can understand your concern. Normal chest x-ray is taken in PA (posterioanterior) view. In this view, upper lobes are not clearly visualized due to overlapping by ribs and clavicle. So any lesion in upper lobe can not be seen and hence reported perfectly. So apicolordotic view is done. In this x-ray is taken in such a way that ribs and clavicle don't overlap upper lobe and hence upper lobes can clearly be seen. So any pathology in upper lobes is easily visible in apicolordotic view. So for your husband, get done apicolordotic view for better visualization of lesion. Possibility of pneumonia or tuberculosis is more. So consult pulmonologist. 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: hi, i am 26yrs old and known pcos for past 4 yrs. i am now planning for a baby. My doctor put me on tab.siphene 150mg (twice daily) + metformin sr 500 mg (twicw daily)+ fol 123 (noon time). I want to know does this treatment work for me..?? and does my periods be regular for 28 or 30 days.. ### REPLY: Hi, I think you should consult your doctor regarding the dose of sphere. I think 100 mg once a day will be fine for you. 150 mg 2 times a day is a bit higher. After taking it, track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months.  Metformin also helps in increasing the chance to get pregnant.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello , I Had c5 & c6 antr. fussion in 09. I had mild to moderite & discs with moderit  DDD . I also Was in a 60 mph crash 3 months after surgery.  I Have for 3 years now pain , spasms . I know I will need surgary again . How bad can my cond. have gotten in 3 years ??? ### REPLY: Dear patient had your accident in any way affected your fusion at c5c6? Was any investigation like X-ray done at the time of accident to see the condition of your cervical spine? If that was not done, and now you still are suffering from pain and spasms I would like to advise X-ray of the cervical spine anteroposterior and lateral views. I would also like to advise MRI of cervical spine with screening of whole spine if possible. You need to consult your operating surgeon with both reports, and he can guide you better. Present condition of your spine can be assessed with both above investigations and prognosis will be given only after seeing reports. Hope this is useful. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I was recently in contact with an individual who told me afterwards that he had HSV2. We kissed, rubbed penises together for no more than 20 seconds, and performed mutual oral sex only on each other. He told me his symptoms always present anally and he hasnt had an active outbreak in over a year. Unfortunately, at the time, I also had Oral Gonnorhea without knowing. I suffer from severe OCD about STDs so became compelled with the idea i had HSV2 especially given i broke out in a few spots around my lip line a week later. I had a sore throat, fever, chesty cough, congestion, aches, fatigue, headache, and even now over 3 weeks on im still not 100% back to best, still suffering from some symptoms. I was swabbed both anally as i was worried about inflammation in my anus (Hospital put it down to diahrrea which i d been having for over 3 weeks) and also orally - though on a mouth crack rather than one of the weird spots. BotChatDoctore back negative for HSV2 in swabs. My penis has been inspected numerous times as i commented it felt hot and itchy, and nothing has been observed. However, i kissed a gentleman 48 hours ago and performed oral sex on his anus and he is now complaining of a sore throat. I am very concerned that i could be carrying HSV2 even though people in clinics and hospitals keep telling me that its unlikely and i dont have symptoms that they would be worried about, even though infection can be asymptomatic. They ve told me its highly likely i d already have HSV1 anyway. ### REPLY: Hello, Short answer: Detailed answer: Herpes viruses (type 1 and 2) spread in all possible ways, including kissing, although HSV1 is usually spread orally and HSV2 through sexual encounter, fingering, oral sex, anal sex and so on. Also, HSV1 and HSV2 could be present simultaneously in the same person. Herpes viruses are the most common viruses in human populations and there is no definitive cure. HSV1 has affected more than half of global population whereas HSV2 has infected about 500 million persons worldwide. All you can do is maybe to use antiviral medicament in order to ease the symptoms associated with it. The good news is that the virus gets activated from time to time, and for very long periods it could be dormant, and it will not give any discomfort or cause any concern to you. Hope I have answered your query. Let me know if I can assist you further. ### END