Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28, weight 50 kilos height 1.55m has high bilirubin.  Can this be the cause of her fatigue ?  She is not on diet but eats very little.  Sometimes she says that she is too tired to eat and just skips the meal or just nibbles on a biscuit.  How can high bilirubin be reduced to normal?Thanks ### REPLY: Hello, Thanks for using . I had gone through the data you have posted. Jaundice can be because of two causes Hepatocellular jaundice: where there is infection in liver, so there will be raised liver enzymes as well as jaundice. Obstructive jaundice: in this there may be obstruction to the .  For differential, we need to do complete liver function test and ultrasound abdomen. There will be fatigue in both of these conditions. Kindly consult your nearest doctor for further evaluation of severity of problem and evaluation of etiology and management. For now avoid oil foods, give fruits and vegetables, soft diet, ADÍLIO 300 mg Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was on a cruise and got bronchitis and went to a pharmacy in Europe and the druggist gave me Broncoliber for my cough. Is there any place in the US that I can get this without a prescription. If not is there anything like it or can I get some thru the mail. ### REPLY: Hello dear, thanks for your question on . In my opinion you should consult pulmonologist and get done1. Clinical examination of respiratory system. 2. Chest x-ray. 3. PUT (pulmonary function test). Better to first diagnose yourself and then start appropriate treatment. Chest x-ray is needed to rule out lung infection. PFT is needed to diagnose bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and antihistamine .  So better to first diagnose yourself and then start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi dr,as i my mother who was 52 year old..was suffer from cervix cancer. she has no other problem before..just she was affected with this nw she was suffering from vomiting,weakness,nausea and decrease in mental alterness she has an scattered rales on the lungs bases.bt she have clear cough and blood pressure increase in supine ### REPLY: Hi, Thanks for writing in. It is important to know at what stage cancer cervix was detected in your mother and what treatment she is taking for it. Cancer cervix is a disease that occurs due to uncontrolled proliferation of cells in the cervix of uterus. It is important to know if she has early stage cancer or a later stage. Treatment differs as surgery is best for complete treatment at early stages and chemotherapy and radiation therapy can prolong survival in those with late stage disease. Vomiting and weakness can be treated with maintaining a proper diet and also correcting any deficiencies like anemia. During treatment, patients are known to have anemia and reactions to medicines. This needs to be carefully evaluated and if required regular anti vomiting medicines need to be taken. Please take measures to improve her diet and give her small frequent meals of her choice. Scattered rales in lungs need to be evaluated by doing a chest X-ray. If the lungs are clear then no treatment required for it. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have several symtoms which suggest cyclical hyper thyroidism but blood tests do not confirm this diagnosis (symptons: hair thinning, weight gain, odd attacks which occur every 28 days - these are not really panic attacks, but a feeling of detachment which last about 30 seconds and continue for about half a day). I am due to have a MRI scan shortly. ### REPLY: Thinning of hair and weight loss might suggest hyperthyroidism. Weight gain is usually seen in hypothyroidism. However, you have mentioned that blood tests (including thyroid functions) are normal. Your feelings of detachment lasting 30 seconds may be an epileptic phenomenon and an EEG will be more useful than an MRI. Do these monthly episodes occur around the time of menses? You may consult a neurologist or neuropsychiatric for your symptoms to make sure these are not panic attacks. Further investigations will be advised by him. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 back lower molar (in front of wisdom) removed under sedation 5 days ago. I am taking Metronidazole antobiotics. I had a reoccuring infection prior to the extraction. For the last few days I have had a foul taste in my mouth and have been cleaning with corsodyl and salt water. Whilst the socket looks better and the taste in my mouth is improving, I am suffering from diarrhea, sickness, hot & cold sweats, dizziness and generally feeling unwell. Is this the last of the infection clearing or should I ask for other antibiotics? ### REPLY: Hi, Thanks for asking the query, I would like to tell you that pain, swelling, fever, malaise, dizziness are common complications after extraction of tooth. You don't worry about the symptoms as they will subside after sometime. Follow the post-operative instructions given by the Dentist properly. Use Lukewarm saline gargles 3-4 times and antiseptic mouthwash gargles twice daily. Diarrhea and abdominal upset is due to the use of antibiotics prescribed to you. If you are uncomfortable with that, I suggest you to visit the concerned Dentist and get it changed. Hope this helps out. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I ve been coughing for nearly two months now, i don t feel sick at all. I ve just been coughing. No mucus or anything out of the ordinary. Breathing is also difficult when my coughing spells are bad. As time goes on, I m cough much less frequently, but I still have a pretty heavy smoker-like cough. Is what I have serious? Why am I still coughing? And what would be the best thing to do next? Thanks, Mateusz Majka ### REPLY: Thanks for your question on . I can understand your concern. You are having chronic cough (cough since 2 months). We should definitely search for the cause of this chronic cough and treat accordingly. Common causes for chronic cough are 1. Bronchitis 2. Asthma 3. Chronic lung infection like tuberculosis or fungal infection. 4. Lung cancer. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray 3. PUT (pulmonary function test) 4. CT thorax if required. So your next step should be to consult pulmonologist and discuss 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 am a psotrate cancer patient , andmy l2l3nd l4 vertebra is also wprn out , i had sciataca psin of the left leg , and every thing was well , last week i had viral fecer andtook dolo650mg tablets 3 times a day , the fever has subsided but my left foot and ankle are swollen ,  please advice me as to what to do , i am having slight burning sensation on the foot when exposed to the ground , kindly advice me ,,,,,GOD bless you uo ### REPLY: As you say L3-4-5 vertebra are worn out---what does radiological X-Ray or scans say, is it due to invasion from metastatic spread from prostate?much depends on spinal diagnosis. Chemotherapy, radiotherapy shall help in that case in suppressing spread. In meantime Wear a lumbar brace, avoid forward bending, and apply anti-inflammatory cream to foot and ankle and keep the foot elevated while sitting or lying down. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tendonitis in my lower leg caused, I assumed, by having just completed a very long mountain walk in Wales. I assumed that the insect bite in the affected area was coincidental. However, the Physio, also a runner, had suffered an inflamed Achilles caused by an insect bite. My tendonitis has now cleared up, after 6 weeks, but th3 nite is still visible. Could there be a link - and what sort of insect could cause it? ### REPLY: Hello I have studied your case. As per your history and symptoms possibility of cellulitis with secondary infection due to insect bite. Primarily you can take enzyme to decrease swelling like Tab Trypsin and chymotrypsin. Consulting your doctor infection /cellulitis can be confirmed, antibiotic can be started according to examination. If required you may need to do blood investigation for prognosis and recovery. Take precaution to avoid spread of infection. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has a brain tumor. Healthy otherwise. Playing ball w the kids and hit his leg on her toe, a big blue lump appeared. He has has a blood clot 2 times so Im unsure if this is dangerous. Hubby will say no its fine. Trying to be safe. Surgery in 2 weeks ### REPLY: HI, Dear,Thanks for the query to .1-I have studied your query in depth.2-DEar,IN my opinion, this blue lump on the leg, is mostly due to the hematoma-traumatic cause in your husbands case .3-REcurring 2 blood clots is worrisome event and needs -investigation if-2 blood clots are creating consumption Coagulopathy-or the clotting factor deficiency, leading to the blue-leg hematoma, needs to investigated.3-Hence I would advise prothrombin time and other clot tests 3-a- and team consultation of the brain surgeon and the hematologist doctor to treat our husband effectively.Don't plan hasty surgery in 2 was for the safety, this would risk your husband more and leave it to expert doctors.4-Hope this would solve your query to your satisfaction.5-Wellcome for more queries to me On .6-Thnks once again for your inquisitive query. Have a Good Day.!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Yesterday I depilated my arms, and chest area with Braun epilator and got itchy, red bumps. I use epilator often and I do get red bumps but they are never itchy and usually go away in couple hours. I used Aveeno afterwards, thinking it will help with irritation. The rash keeps getting worse and they spreaded on areas that I didn t epilate. They are not constantly itchy but often. Is there any over-the-counter lotion I can use? I ve been searching for a remedy online and read creams with cortisone will provide relief but might leave permanent marks on the skin. Is that true? ### REPLY: HI, Dear,Welcome with you query to  Virtual Clinic. Reveiwed your problem after messed up emulation. You seem to suffer from Chronic Acne witChatDoctoredones mostly, which is causing its recurrence along with neglected chest cleansing and hygiene. Suggested Remedy plan for you is as follows-Consult your Dermatologist-Control messed up chest lump infection after dedication of the arm/chest, With Topical Antibiotics Only. Steroid combination if need be and leave it to your doctor to plan. Zincovit to supplement your healing power. Good Diet with Fruits for 2 weeks. Maintain Good digestive system and stoolsEnough liquidsContact after 2 weeks time with a Followup Premium question to ME. Will appreciate your Hitting, thanks. Will appreciate review with your excellent review write up comments. Welcome with any other further query in this regard, if need be. Good Day!! . S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just got the results of my blood work and it said my thyroid level was 4.81 and my liver was at elevated levels. I see they may be related and want to know if it indicates aproblem. I also have been loosing hair since Dec or Jan. I am 70 year old woman. thank you ### REPLY: Thanks for posting your question on ! I can understand your problem. Decreased function of thyroid gland (hypothyroidism) is associated with elevated liver enzymes. Most common causes for the elevation of liver enzymes are chronic alcohol intake, liver disease like fatty liver, hepatitis, cirrhosis, etc., gall bladder disease like cholecystitis. Other causes are heart failure, obesity, muscle diseases. Hair fall could be due to hypothyroidism. You are advised to consult your doctor for the treatment of elevated liver enzymes and hair. Wishing you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I recently gave birth to a beautiful baby boy. He s perfect but I am really concerned that he has a slow resting heart rate it could go all the way to 65bpm when sleeping.. When he is up it goes up to 110. He was in the nicu for about 3 days. They were monitoring his heart and they did a EKG on him and said his heart rhythm was normal so they decided to discharged him with no diagnosis. I am so concerned i don t know if to take him to another hospital for a second opinion or to just let it go. He was put on antibiotics due to an infection I had. I m not sure if that s what might have cause it to slow down or what.Could it have been the antibiotics? ### REPLY: Hi, Thankyou for your query. Brief... He needs to be evaluated thoroughly for different factors causing slow heart rate. Detailed answer... Since normal heart rate in newborn is 125 to 150 and below that heart rate may need thoroughly for different factors. For example. Congenital systemic lupus erythematous, cardiomyopathy,some medicines used by mother like tetracycline, and some genetic problem like long QT syn . For that he needs second opinion by cardiologist. Hopefully my answer is 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: Can Absolut 3 G be taken continuously as a supplement after Gall Bladder removal surgery?I have read in the net that Omega 3 and 6 fatty acids along with green tea need to be supplemented in the diet after gall bladder surgery as they help the patient in a positive manner which is present in the Absolut3 G capsules.My email id is  YYYY@YYYY ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. It can be taken but I don't think this is required. After gallbladder removal there is no digestion disorder or lack of nutrients since bile is still excreted from the liver and fats and fat acids are absorbed normally for lifetime. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...my husband who is now 66 just noticed a lump on the ride side in the sac close to his leg.  He says its sore but doesnt want to see anyone.  What should I do?  I guess hes afraid it may be cancer.  He did have a lump removed about 15 yrs ago on the right hand side up higher it was benign. ### REPLY: Hi there, I would have your husband undergo an ultrasound. In most cases, masses that are painful are NOT associated with cancer. It sounds like a painful mass would be consistent with something more like an abscess.  An ultrasound is a quick and non-invasive test that can be done as an outpatient. I would reassure him and try to encourage him to get an ultrasound. I hope this is helpful. Feel free to contact me if you have any further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hii have a small tiny concretion of stone in my left kidney and having pain in both side just below to ribs.i have gastric problem too,found excess gas in ultra sound.i have been advised to take alkacitron.please advise,how it wil help  me to dilute stone.i am taking pantop-d in morning i dont have digestion well too,every time i found a bubble of gas in my stomach.need your view . ### REPLY: Hello, You have 2 problems1) Tiny stone in the left kidney2) You have gastric problem - which may be hyper acidity - leading indigestion and gas formation. Moreover, Gas inside the stomach is a normal one. Only excessive gas is an abnormal finding and mostly diagnosed by X-ray. The tiny kidney stone is not a problem at all. It may produce pain from the kidney area to the lower middle of the abdomen on that particular side and not on both sides. The urine alkalizing agents is useful, but along with that Antibiotic, painkillers and diuretic as per your treating . Take treatment for your Hyper - acidity, That timely bland diet, avoiding hot  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 13 yr.old daughter, and shes now has her menses. Last night she bei.g complaining about being dizzy, and she almost fell down. I put cold compresses on her head and chest. Today it happened twice. Could these because hed period is much heavier than it was last month? ### REPLY: Hello and welcome to  There is a hormone produced in body known as prostaglandin. Ithe is responsible for dizziness and other symptoms of menstrual periods like cramps headache nausea etc. You can give paracetamol for all these symptoms as paracetamol is prostaglandin blocker. It can be due to heavy periods roused that she completely soaks more than 5 pads per day than take her immediately to Obs/gone Er. Hope you find this answer helpful. Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr. My son is 9 years old and he isn t taking food properly.He brings back lunch from School.He says he is not feeling hungry.He is 27kg in weight and 138cm in height.Can you please suggest multivitamin tablets or syrup to catch up the required nutrients. Regards Mom ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query your son have symptoms of lack of appetite. Well the symptoms you mention in query can occur due to many reasons like slow growth of the child, sickness, stress, depression, anorexia nervosa, medications like antibiotics, anemia, intestinal worms and irregular bowel movements. Need not worry. For now .  You should give child proper rest and diet rich in multivitamins. I would suggest you to consult pediatrician for proper diagnosis. Doctor may order blood test, stool test and physical examination. Doctor may prescribe  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i just moved to Toronto from Jamaica where its more warm ... i am however currently experiencing the winter here and i realized I have some amount of dry bumps on my legs and balls and backside ... they aren t painful but they hitch ... i had gotten heads from a few guys around town i am not sure how serious this is... please help me ### REPLY: Hello, Thank you for posting on . It seems you are suffering from Tina courts and corporal, a kind of fungal infection. I would suggest you to consult your dermatologist for proper management of the condition. I usually recommend proper course of oral antifungal .  You can additionally use antifungal dusting powder containing ketoconazole during daytime and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistamines for itching as required. Maintain hygiene over those areas and avoid wearing tight undergarments. Hope your queries are resolved and wish you best of health. Kindly spare some time to rate my answer and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lesion on the inside of my mouth, on the inside of my jaw at the very base of my gums, where my gums and the bottom of my mouth meet (under my tongue). It started a couple of days ago, and now my ear, cheek, jaw and neck on that side are hurting, as well as the side of my tongue. Ive also started getting a low grade fever/chills. Do I wait it out? Go to the doctor? Are there any measures I can take to help this heal faster? I am a 34 y.o. female with lupus SLE that is well-controlled with Plaquenil. ### REPLY: Helloas per your query. Direct involvement of the oral cavity by lesions of lupus in the mouth may indicate active disease. The only way to reliably distinguish whether an oral lesion is associated with active disease is by means of a biopsy. Oral lesions associated with active disease are usually red ulcers surrounded by a white halo and white radiating lines. Oral lesions may respond to treatment with topical or intraluminal steroids. The control of active systemic disease will usually aid in the control of oral lesions, as well. Hope this ans helps regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A very dear friend of mine was having some LUQ pain, so he went to the doctor and they found his spleen to be slightly enlarged. In addition to that his UA shows 2-3 RBCs in his urine, a slightly elevated anion gap and I think his MCVs were a little high as well. All other results on the CBC and Hematology were normal.  He also consumes at least one energy drink everyday, and takes no medicines. His BP is borderline. I am concerned that it may be some kind of lymphoma. ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. It is not likely to be lymphoma since in this case there would be focal legions seen and not just enlarged spleen. He should do CT scan and liver evaluation to see is there mononucleosis or portal vein obstruction, Also, this is in most cases caused by infections, but some benign hematologic diseases should be considered. Malignancy is the last thing to think of... I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had dissolvable stitches to suture up extraction of broken molars on November 6. It s now December 16 and the stitches have dissolved, but something is now protruding from the gum cartilage near where the stitches were placed & I m thinking it could be a hardened, undissolved stitch. Is that possible & can I pull it out with tweezers if I do it carefully? ### REPLY: HelloWelcome to ChatDoctorI would like to tell you there are dissolvable stitches that are composed of silk & processed collagen. These stitches are made of materials which our body can absorb after they get dissolved. Additionally, the time for dissolving may be shorter or longer, depending on the stitches, again, depending on the recovery of the wound itself. One type of these stitches is created from processed animal collagen. This material is capable of holding the wound firmly for at least 7 days, getting dissolved through the course of 2 months. I don't know what material has been used in your case. So I would suggest you to wait for 1 more week & then consult your dentist but don't try to anything by yourself. Take Disregards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor I had problem regarding my foreskin . Generally my skin is over my penis & when I am not in stage of erection i was able to move it back but last month i got infection and cracks on it which later i treated with some soap and cream . right now i am unable to move my skin back and unable it to clean with water which i generally do while bathing. I am feeling little itchy inside it. I am practicing it to move back it is not so and feeling uncomfortable while sitting and relaxing ### REPLY: This is a condition of inflammation of foreskin, as per your explanation. Possible causes can be contact with any allergens, fungal or bacterial infection etc. It is very important to diagnose the problem exactly. Sometimes if you have this issue, using of soap and other creams can aggravate the issue. It is advisable you contact a dermatologist and get treated as soon as possible, and if it is due to any allergy (some people will even have latex allergy), avoid the contact with such allergens, and if this particular problem started after a sexual intercourse with a particular person, inform that person also to get treated. TC ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a subarachnoid bleed and coiling of brain aneurysm last year. I am having some major bilateral temple pain along with numbness that comes and goes in my left arm/hand/fingers. I have had headaches since the aneurysm, but this is different. Also, my moods have been horrible for the past few weeks. ### REPLY: Aneurysm in brain causes headache due to compression of pain sensitive structure in brain. But pain is usually unilateral not bilateral. This pain will not radiate in both upper limb. Bilateral upper limb pain may be due to cervical spondylosis or other causes. You have anxiety of aneurysm, so due to anxiety your mood is horrible because aneurysm does not cause horrible mood change. So your headache may be chronic tension type headache. You may relieve by antianxiety .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 43 years old my problem is i was problem in  angar starting on teenage i am angry like small think my highpertion is go up level and i have family my wife and 2 daughter one is 11 year and other is 7 year  2 days before i started to arguments my wife and children and voilence i cant control it . and i will decesion to devorce. i am very upset. so please give me suggestion and help u!ThankyouRegards.sunny. my emails addres is  :-  YYYY@YYYY ### REPLY: Hello, Sunny. Thanks for the query to . Forum. Anger, develops high blood pressure, high B P develops many, many diseases, including rupture of an artery (arterioles) and paralysis. Violence and anger are responsible for every thing. In my opinion this is not a disease. This is the nature of an individual. Today divorce from this wife, tomorrow from next wife, next time from next and so on, this is not an end. In my opinion consult a psychiatrist and get his counselling and treatment. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is Gamma gt level of 66 very injurious to my health ? What problems will this create ### REPLY: Welcome to  .... Elevated GGT levels signifies liver injury, could be alcoholic liver disease or liver disease secondary to congestive cardiac failure or Biliary tract obstruction. Is it injurious to health ??? Actually elevated GGT levels just tell us that there has been some liver damage or damage to biliary tract. So what is that damage and what caused it can tell us how injurious is it to you. Get your LFT Liver Function Tests, the levels of SGPT and GOT will tell us the exact amount of hepatic injury... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor I am 22 year old i am doing masturbating at the age of 18 every second day. please help me how I leave it i think it effect my health and also on my face . please giva me a right solution. ### REPLY: 1.**MASTURBATION is always a bad activity because it is a sign of mental disfaction and cause depression problems if continue in the future...MASTURBATION is harmful with patients of depression and stress because MASTURBATION always load your body of mental intoxication. It is always mentioned that MASTURBATION is a healthy sexual behavior. Like other behaviors, when over practiced or addicted it can lead to really serious psychological and physiological imbalances overall in body...MASTURBATION and ejaculation seriously activate nervous functions excessively just due to which excessive sex hormones are produced, so there is a big change of body chemistry all due to very frequent MASTURBATION... One should eat products like Soybean/ Spirulina and try to avoid excessively consumption of coffee. It is always recommended to intake more seafoods and seaweed, vegetables. Avoid and then minimize red meat and dairy product intake;use orange juice;One should also raise the intake of pure .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 30 year old female and i have been having left sided abdominal pain right under my lowest ribs for months now. The pain is usually dull with occasional sharp stabbing pain. I started noticing that I am having lots of fluid retention in my lower abdomin for about two days now. Im scared and don t know what to do. when i reach above my head, the muscles in my stomach start to charlie horse. everything feels very tight. Can you please help me? ### REPLY: Hi there, I understand and appreciate your concern for your health. Going by the symptoms you have reported I would suggest seeking consultation with a Gastroenterologist/internal medicine specialist. A thorough physical examination, a few blood tests and an ultrasound or a CT scan would pinpoint your problem with great accuracy. Be brave and put your faith in modern medicine. All the best on your road to 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: hi i m 23 yrs old girl suffering from androgenic alopecia and i have pollycystic ovaries.i am lossing my hairs in front and nothing is of help plyssssssssssss sugeest me wat to doalso do sugest me medicines and shampoo oil to help to regrow my hair.. ### REPLY: Hello, I have gone through your query and would recommend you to apply minoxidil 2 per cent lotion on the affected areas of the scalp twice daily and take hair supplement containing tablets once daily.  This needs to be continued for 4-5 months to see significant results. Also, consult an endocrinologist and take treatment for POD. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m a 27 year old female with pain in my right flank. I went to the e.r. and they took a urinalysis. They said that it s only a UTI , however I would like to know if I could possibly have a kidney stone that they were too lazy to even look for. They put me on Bactrim DS but there is still slight pain in my kidney. please help me with finding out what s wrong with me. my urinalysis came back as this: Urine color: Amber Urine Turbidity: Clear Urine Specific Gravity: =1.030 Urine pH: 6.0 Urine Leukocyte: negative Urine Nitrite: positive Urine Protein: 3+ Urine Glucose: Neg Urine Ketones: Neg Urobilinogen: .2 Bilirubin: Neg Blood: 3+ WBC: 10-20 RBC: 20-30 Squamous Epithelial Cells: 0-5 Urine Bacteria: 2+ Urine Culture Indicated: Cult reflexed &setup ### REPLY: HelloFindings may indicate UTI(urinary tract infection).UTI is indicated due to presence of excessive WBC, RBC,bacteria in urine. RBC may be due to UTI. Ultrasound of abdomen can be done to exclude renal calculus. You need proper clinical examination and routine investigations. Investigations include routine hologram, random blood sugar, renal function test, urine culture/sensitivity. Nitrite test and leukocyte esterase test can be done for confirmation of UTI. Proper antibiotics should be based upon culture and sensitivity report. You should . You may need alkalizing syrup. 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: hello my name is marie, i have a two year old little girl who has been very sick sience the day she was born,she has always had horriable rashes and bite like sores on her arms and legs and ive been told by several different doctors that she is haveing allergic reactions to red dye so for the past year she has been dye free and still has break out so bad they turn to mrsa and she had tohave several surgerys and is badly scarred! i have recently moved into goverment assisted houseing and recieved a notice that my building has bed bug so i looked them up so i knew what to look for and how to fix it many of autum s (my daughter) symptoms seem to fit the bed bug descriptions but ive never had problem with them before and me and my son matthew have NO bites, i cant bare to see my baby go through this hell anymore what can i do, to get the right answers as to whats wrong with her and how can know for sure that im fixing the problem with out all the needles and test ?? it breaks my heart ten times over for my baby girl to ask me to help and i dint know how to help her......please help ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  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: my 3 month old boy has a small lump on his back about 40mm away from spine. It is soft not red and he does not seem to be bothered when it is pressed. Any ideas what this may be. Cant get in to see Dr until next week so wondering if we should take him up to the hospital? ### REPLY: Hello and welcome to , A painless lump on the back of the baby could be a soft tissue lesion. Various soft tissue lesions like lipoma, fibrous, hematoma are usually soft and painless. Since the lesion is not red a possibility of infectious or inflammatory lesion is ruled out. Imaging study of the back can be done to assess the character of the lesion. Aspiration of the cytology of the lesion can be attempted. This investigation will sample the cells of the lesion and thus origin, nature and character of the lesion will be known. Management can be done after diagnosis is made. Consult your primary health care provider for clinical assessment and investigations. 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: Well, I used to be on the depo shot. Only received 2 injections. My last was the beginning of december. I started on a regular cycle (for me) in march. At the start of may me and my partner have started to have unprotected sex. At the end of may (26th) I got what should have been my period. It was more of a brownish pink discharge and really only saw it when I wiped. I had that for about 4 days. Two weeks later I had some more of that discharge which lasted 3 days. With that one I started to get weird symptoms. My breasts feel sensitive, nausea, light cramping, back ache, uncomfortable to sleep on stomach, can t even wear tighter jeans around the waste, weird feeling in uterus, and some pulling more in the upper stomache area. I took a hpt last tuesday (negative. Then did a blood one at the doc (negative). Now the 21st close to when I m suppose to start my period, I m getting the same discharge. Still having those symptoms. But now with gas, and an increased appetite. I don t want to say I m pregnant, that would just get my hopes up. So what do you think? ### REPLY: Hi, I have gone through your query and understood the concern. Your symptoms can occur during a very early pregnancy or during the premenstrual phase of the period due to progesterone effect. The vaginal discharge however, is abnormal and most likely due to hormone imbalance. Since you had both blood and urine pregnancy tests negative, pregnancy can be ruled out. A trans-vaginal sonogram will help to know the status of the pelvic organs. Weight disturbances, infections, stress, polycystic ovaries and certain medications also can create this clinical picture. Please get further help from a specialist in person. 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: Yes, I have all the was describe, in the 10, i have has breast cancer in 03, redo striking on 05, in 08, ling cancer, which part of my right lung was cut off due to cancer & chemo again, I have these system of bronchitis since, late jan, All of the Feb, I got sick again in March Went to ER, they did X-rays, blood work, car scan, they said it was positive for bronchitis! Same symptoms, etc; last time in 08, they found lung cancer, the ER doc didn t show me the X-ray etc; he said I needed to get with my primary doc & referred me to a pulmonary doc.... That s the same thing that was done when I had lung cancer.... I m out of breath, tired, coughing, & mad because I didn t see the X-ray or scan... What the heck is wrong with me? ### REPLY: Thanks for your question on . I can understand your situation and problem. You had primary breast cancer and mostly secondary spread in lungs. Lung metastasis in breast cancer carries poor prognosis. The only option left is chemotherapy. And the relapse rate is very high. Bronchitis is also seen together with lung cancer.  It is due to continuous inflammation in the lung. The best option for you, at this stage is to consult oncologist and get done1.  CT thorax 2. Pet scan. These will give you exact idea about lung cancer. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister was just taken to the er by ambulance her son found her purple with blood coming out of her ears and mouth unresponsive she was given a shot early this morning for she has copd and her body has been swelling up a lot as she is over weight can you give me some clues she is also a smoker the doctor gave her a pain shot this morning she slept all day they found her this evening are you kidding no body will help anyone any more without that all mighty dollar ### REPLY: Treatment for COPD includes Short acting bronchodilators such as Albuterol inhaler, long acting bronchodilators, inhalator corticosteroids, Oxigen if respiratory failure and when a patient has an exacerbation he may need systemic corticosteroids and even antibiotics if the reason of exacerbation is a lung infection. And the patient sometime need even noninvasive ventilation in the form of Bi PAP or CPAP. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Trouble catching my breath after stairs or walking 20-25ft. Stomach feels like I ve done a lot of sit ups and tightness is causing me to walk bent over. Longer I go or further I walk worse breathing and I ve got to stop and take a deep breath and start again. ### REPLY: Thanks for your question on . I can understand your concern. You are having breathlessness on exertion. This is commonly seen with heart and lung diseases. So better to consult doctor and get done ECG, 2d echo, stress test, chest x-ray and PFT (Pulmonary Function Test). If all these are normal then no need to worry about lung and heart diseases. Don't worry, you will be alright, first diagnose and then start appropriate treatment. 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: mine is a problem of hair loss. i pirmed my hairs about 8-9 months ago. and now i am facing hair fall. dont know why is it happening.. i recently also shifted from india to singapore. is it change of water or wat else. i never had this type of problem before..need your expert guidance...pls help..age:22height:5,1weight:43 kgsmedical history:all fine,just migraine pain sometimes ### REPLY: Hello, Thank you for posting on . I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, acute or chronic medical conditions, . Since you have not mentioned relevant history and description like pattern of hair loss(patchy/diffuse), family history etc., It's difficult to put a definitive diagnosis. Still, it seems you are suffering from either An ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, Two days ago I received an Epidural Steroid Injection, and lastevening I just happened to monitor my B/P, and was somewhat surprised. What normally used to read 138/67 was 185/90.Could this have been caused by the shot I received. This morningit is still 170/78 after taking my meds. Thank You,Gary E. ### REPLY: Hello, An epidural steroid injection would only cause a transient rise, if at all in blood pressure for about twenty-four hours depending on which steroid is given. It is more likely that your blood pressure not adequately controlled. Keep monitoring regularly morning and evening to check for variability, and consult your physician if it is still high. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my brain doesn t seems functioning well .ican t think of anthing deeply. while studying ,reading newspaper it just like reading simply some words and also while reading there doesnot come anyting about the subject or the word iam reading nobetter howfa I try concentrate ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. You must be able to understand Concentration, attention span, recollection and distraction. If you are able to watch a movie for two hours continuously, if you are able to play a game for an hour, then you do not have any concentration problems. You can't be attentive towards your reading because you may not be interested in it. You are able to watch movie and play game because you are interested in it. Human cannot be attentive towards anything for more than 10 minutes. Then you should read in such a way that your attention is continued and make sure the subjects are interesting to you. Effective reading techniques should help you. Recollection depends on anxiety, stress and other physical and circumstantial factors. Distractions while reading are plentiful. You should be able to overcome distractions or avoid distractions. Please understand the above. In your case, there could not be any issues of concentration. It could just be obsession and related stress. Ignore it. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. 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: what natural product helps lactic acid? I m 72 my weight is good. for my5 4 medium frame. I eat fairly well fruits veg. but when I ride my bike my legs just seem to run out of energy. I feel good and still have energy. I will stop for about 2minutes and off I go. I read this article about. The lactic acid and think this describe exactely what I feel. thank you I would like a fitness doc. ### REPLY: Hello, I understand your concern. I am , infectious disease specialist, answering your concern. Lactic acid arises from the glycogen stored in them muscle. When we use muscle it uses glycogen anaerobically and produces lactic acid. Being acid in nature it causes pain and numbness. The problem of this solution is regular exercise viz. running. Exercise for short time and relaxation for short time causes lactic acid to absorb in the blood circulation and pain gets relaxed. Absorbed lactic acid is than converted to other products in liver. I will be happy to answer your further concern you can contact me here, or you can contact me on bit.ly/ .  Thank you, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sunday my head, neck and back ached badly. I went to bed at 5pm and did not get out of bed till 9am Monday. I spent all day Monday in my reclinder with a heating pad and slept 90% of the day. I woke up today, Tuesday, to take a shower and goto work, but back hurts badly and i felt weak. I dont know whats wrong. ### REPLY: Postural back pain is the most common cause of back pain. Analgesic(diclofenac etc., ) and other supportive medications should be taken for a certain period. Hot fomentation and local diclofenac jelly are good measures for pain relief. Then, exercise, lifestyle modification etc. should be started. And if the condition is not improving and impairing your activities of daily living then you have options like epidural injection and ultimately surgery. You need an MRI of LS spine to have the diagnosis pinpointed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 medium discomfort from below ribs to belly button this happens fairly regularly but is more painful this evening and I have had pain around my belly button. I have received treatment for acid reflux over last 9 months but have found that having stopped the tablets that it is improved, but still get abdominal pain. Any advice would be appreciated, thank you. ### REPLY: Hi, Thanks for your query. Firstly the pain under the left side of the rib cage may be due to Gastritis(Inflammation of the stomach). I advise would be to avoid spicy and greasy food. Prescribe proton pump inhibitors like omeprazole. A gastrostomy will help in the diagnosis. Secondly it may be due to pancreatitis(Inflammation of pancreas). Stop smoking and alcohol if any. Blood tests like serum amylase and lipase will help in the diagnosis. Thirdly kidney stones. X-ray of the PUB will help in the diagnosis. Antispasmodic for pain. Increased intake of water is advised. The size and site of the stone determines whether the treatment is medical or surgical. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Pelvic ultrasound with transvaginal shows dominant follicle in  The right ovary...tiny amount of free fluid in the pelvis . Myometrium and endometrium are heterogeneous...am 52  yrs old..still ovulating..pain in right abdomen for last 6 months or longer. Any suggestions as to what might be occurring? ### REPLY: Hello, thank you for writing in to . Certain things I'd like to know before getting closer to figuring what might be occurring.  Do you also notice any vaginal discharge or blood stains after coitus Your symptoms show possibility of Pelvic Inflammatory DiseaseOvarian cyst with secondary infection, fibroid, polyps,Endometriosis or adenomyosis or simple hyperplasia of endometrium?I'd suggest you to get an abdominal MRI along with a Pap smear cytology and serum hormonal study done, done to rule out malignancy and get back with the reports to us. Till then, you can start with antibiotics for possible infection(aerobic and anaerobic combination)with analgesics anti-inflammatory. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 right knee makes a squishing noise and at times a lot of pain going up and down the stairs. At times also I could just be standing and my knee just pops similar to cracking your knuckles. I have pain with just walking and I am unable to bear wear weight. ### REPLY: Hello, I have studied your case. According to your symptoms and findings there is osteoarthritis of your knee. You can start cartilage protecting medication like Chen . I will advise doing X-ray knee and if required MRI knee can be done and if there is severe destruction of menisci then arthroscopic shaving can be done. Physiotherapy like ultrasound and tens will help, along with knee exercises.Lifestyle changes will help in reducing pain which include, LOAD REDUCTION : Protecting the joint from excessive load may slow down the rate of cartilage loss. It is also effective in relieving pain. The heavier you are, the more stress you put on your joints. Weight reduction for obese patients, wearing shock-absorbing shoes, avoiding activities like climbing stairs and using a walking stick are worthwhile. ACTIVITY MODIFICATION -It is important to maintain as much activity and joint motion as possible, but impact activities will aggravate arthritis. Running and jumping will often accelerate cartilage loss from the joint. The key is to focus on low impact activities, such as swimming or cycling.  USING CANES: Assistive devices can make it easier to go about your day without stressing your painful joint. A cane may take weight off your knee or hip as you walk. Carry the cane in the hand opposite the leg that hurts. ANALGESIC MEDICATION : Simple over the counter medications like acetaminophen is sufficient in most cases. If this fails to control pain, a non-steroidal anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a 32 woman. I have a healthy lifestyle. I do not smoke or drink. But for the last week or more my chest Bone hurts and occasionally pops. I also have pain around my heart and shoulder blades and sometimes my neck, like I am tensed up. It comes and goes. It usually worsens when I sit down and rest. I feel good and then I don t. ### REPLY: Damage to connective tissue of one or more joints located adjacent to spine, where the ribs attach to vertebrae, usually during end of range bending, twisting, side bending, arching or lifting movements or combinations of these forces. Typically, causes one-sided upper back pain that may occasionally radiate along the ribs as far as the chest. Pain may increase with certain movements of the spine (particularly rotation or side bending), during deep breathing, coughing or sneezing and on firmly touching the affected rib adjacent to its attachment to the spine. Occasionally there may be no upper back pain, with only symptoms along the ribs, in the chest or down the affected arm. Pins and needles or numbness are occasionally present in the chest or affected arm or hand. Symptoms often increase with repetitive or prolonged sitting (especially slouched sitting or during computer use), bending, lifting, shoulders forwards activities, coughing or sneezing and are often worse first thing in the morning. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: does the combination of black elderberry, ginger root, echinacea root, andrographis paniculate leaf, raise ones heart rate?  I am on no medications but took this Quck Defense herb with above ingredients for flu like and cold symptoms Im feeling.  i got up to an Extremely low blood sugar reading this AM and thought tht might also be to these herbs?? ### REPLY: Herbs are good in isolation but not in combination. So before taking any herbs please read the details of both the effects and side effects before ingesting them. There may be cumulative toxicity when you take herbs in combination. What you have to remember is not all herbs are created equally. There is a lot of poor quality herbs in the market, and they create more harm than good. So use herbs wisely after making sure they are of excellent quality and after checking their effects as well as side effects .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, itz maryam khan from india.. sir i wanted to confirm that my mother who is 48 yrs old if suffering from kidney infection as well as she is having 07mm stone in her right kidney. our doctor has been prescribed her FLOTRAL 10 mg tablet .. would it will be suitable for my mother? ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern for your mother looking to the given history here I could say that if this is stone in the kidney then the site of this in the Renal region is matter if this is to be removed then this does not need any treatment and with kidney functions the stone comes down in the bladder and sometime expelled out with the urine and if this does not move then surgery is the only option remained, take care and have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have a rash on my groin, spreading onto my testicles and penis. i feel as though i have prickles in my testicles and its extremely sore and irritating. i sometimes get heat rash as i wear 4 layers of clothing for work, but this is different and far more raised and lumpy. what could it be? ### REPLY: Hello. Thanks for writing to us at  It is extremely difficult to be absolutely sure about it without having had the opportunity to examine. I will have to keep a few possibilities: It could either be a fungal infection or it could be intertwine (which is inflammation of the body folds). Sweat and occlusive clothing predisposing to both of these conditions. If it is bilateral, it is more likely to be one of these. A unilateral rash such as this, goes more in favor of Herpes Zoster, specially if it is sore and painful. Herpes Zoster later on forms fluid filled lesions and is characteristically located on one side of the body. Visual inspection would be the best way to determine the true nature of the rash and I would suggest that you visit a doctor for the needful. 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: If Ive had CHRONIC (not cold) urticaria. Are there any risks in getting pregnant for myself and or a baby? I already have 2 kids. I didnt get chronic urticaria anywhere near my previous pregnancies, but just recently, 2.5 years after my second child. On the fence about a third & want to know about any red flags... ### REPLY: Hi there, I have understood your concern and I will suggest you the best possible treatment options. Please get in touch with your treating skin consultant and gynecologist. Please give clear idea to dermatologist about your pregnancy planning, and please let your gynecologist know about the medicines given by dermatologist. Pregnancy is a bit immune lowering condition, so you need to consider this. Else, start with Folic acid and vitamin B 12 supplements. You can very well. Go ahead to get pregnant. I hope this answer helps you. 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 had pizza on last night and after that my face has become swollen with rashes in forehead, chicks. Initially I thought it may be because of the pimples I have for which Doctor has prescribed me antifungal ointment. But now I feel it is because of the food.26 yrs old-female ### REPLY: Hello, Thank you for posting on . The condition you have referred to is called Urticaria or hives with swelling of soft tissues called Angioedema. It's an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up. You may have to go for specific tests like patch test, food prick test, IGE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various antihistamines for long duration(at least 3 months) with or without oral corticosteroids. For non-responding cases there are many other .  Hope this will help you in resolving your query. Thank you  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i just got back from a trip away for new year where all we did was get drunk for 3 days. i vomited a couple of times but there was a little bit of blood in my vomit this has happened a couple of times before but im now have other symptoms almost like a chest infection and have had a couple of sharp pains in my chest that only last a couple of seconds thankfully because they were very sore. also my stomach isnt feeling to good. and my bowel movements have been random. I dont have enough money for the doctor so if you let me know what i should do that would be great thank you. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion you are having mostly HERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms like vomiting, burning chest pain, stomach problems and bowel problem. It is aggravated by alcohol ingestion. So HERD is likely cause in your case. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. 7. Avoid alcohol .  Also avoid smoking if you have this habit.Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 am a 33 year old male who is morbidly obese and who recently started having pain in my lower right side of my back. Pain is sharp and roughly a 7 or 8 on a scale of 1 to 10. It is made worse by trying to stand, move, stretch or move my arm in various ways. The area of pain also feels stiff and tight. I ve taken pain killers and its done very little to help. Is this serious enough to warrant a trip to the ER? ### REPLY: Hi I am . .  In my opinion I think you have a kind of sciatica due to nerve compression, sometimes such neuropathic pain subsides simultaneously with rest and even without medications.  You may try to avoid heavy lifting, bad sleeping or sitting postures, over weighing, obesity and vigorous movements will be helpful.  Physiotherapy sessions with a good chiropractor, spinal straightening exercises, hot massages and even yoga are of very good value in most of the cases also decreasing your weight prevents further pressure on your spine and thus lowering the compression on your spinal nerve roots.  For my patients I recommend painkillers like Advil tabs when needed, hot massaging with topical gels of anti-inflammatory, B12 vitamin supplements, muscle relaxants will be helpful in most of the cases, in more severe cases steroid tabs or injections are prescribed.  If pain persists after physiotherapy and medications I recommend MRI on spine to exclude disc herniation or any spinal injuries and follow them up with your neurologist for proper evaluation and management. Please click and consider a 5-star rating with some positive feedback if the information was helpful. Wish you good health, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...i hav mild pain in right side of my stomach and mild back pain.doctor suggest me to take scan,urien test,blood test and xray,but i all  was normal,finaly doctor suggest me to take zintac,nimusulid and cifran 500,there is no redusing of my pain.still i hav pain,what to do ### REPLY: Hi welcome to ChatDoctorI understand your query and concern. Your symptoms are suggestive of Castro esophageal reflux disease. I advise you to get an Upper GI Endoscopy and Crease test, complete blood picture, stool culture, per digital rectal examination to confirm the diagnosis. . Pantop once daily before breakfast, Syp. Gelusil and Di gene chewable tablets. Avoid strain and coughing as it may lead to Diaphragmatic hernia. I also advise you to get investigated for H.pylori. You may also need to take Qua ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sania ,im hav completed my 3 yrs of my married life, i got pcod, my tretment is going at mumtha infertility centre frm last 8 mnths,bt no result.im very much eagar to conceive.Last mnth they hav done my EB Test which i came to know abt TB  cells for which im taking medicine 4 that,its a 6 month. plz advise me. ### REPLY: Hi Santa. The course of anti-Tb medicines are almost finishing. You may go for further tests like Hysterosalpingography to know the status of the Fallopian tubes, if they are open or blocked. POD may cause a problem if there is no ovulation. Stop junk foods and have a healthy life-style to improve on POD along with the medicines your Gynecologist gives you. Also go for ovulation studies with ultrasonography. If the above tests along with the semen analysis of your husband are normal the chances of conceiving are more. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 My mother, 66, his patient since 2006, dealing with Parkinson s disease medication to 375 mg Avukar a rate of half a tablet every 6 hours Now, the drug does not work effectively where he became a drug effect 12 hours a day any stage reached the end of the dose Now facing the problem in the movement, as has become unable to move, stiffness in muscles and in some cases, difficulty in speech and disturbances in sleep and thinner Are there any medications to help levocar (levodopa+carpedopa) medication to assist in drug delivery to the brain and be effective and their side effects are mild? I want to ask for neupro patch Is it effective and whether its content and served in this case and does not have serious side Itar? I hope that I find your reply soon Nader Ali Sudan ### REPLY: Thank you for writing about your mothers Parkinson's disease (PD). PD is a degenerative disease of the brain, and main symptoms include tremors of hands and feet, slowness of all movements, rigidity of limbs and postural imbalance. Unfortunately, it continues to progress and medicines become less effective over time. Regarding euro patch, it can be effective in this stage of PD. Euro patch (rotigotine) should be used in addition to levodopa-carbidopa combination. It is fairly safe except that it may cause BP to fall in some cases. Please start euro patch under the supervision of a neurologist. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 servely anemic and I am very nausa and have no appetite and weak and my head feels like blood being drianned out of my brain and I have my period the 5 day i am usually almost over it s the worst I can t even do anything but go to bathroom once I do that it s even worst then I feel I could pass out and get thristy ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have iron deficiency, vitamin b12 deficiency, blood loss or some other cause. You should go for complete blood count and peripheral smear examination. If needed go for complete anemia profile. Find out the cause of your anemia and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been TTC from past 1.5 years. The blood test resulted all normal for me and for my husband, it is Hepatitis - B positive. Will this is the cause for not getting conceived (Wife being HBV - negative and Husband being HBV - positive) ? What is the solution if we want to conceive? ### REPLY: Hi, Hepatitis B positivity doesn't have any effect on conceiving. What you can do is to go for a GUI with washed sperms because chances of transmission of hepatitis B is high by normal intercourse. Also get yourself evaluated at intervals for hepatitis B. You can try ovulation induction in which you will receive medicines for growth of your eggs and when egg matures, injection will be given for rupture and GUI will be done that means after processing semen of your husband it will be directly put into your uterus. 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: hello I m concern about my knee two days ago my family and took a drive and on the way I started peeling off the scabb I have a bad habbit taking off the scabbs well the next morning woke up and had pain on my knee later on the day it got swollen and hurting more I put ice packs on it and today its the secobd day and its still the same its hot and swollen can you tell me whats going on and if I need antibiotics ### REPLY: Hi, thank-you for providing the brief history of you. As you had a scab, and you tried peeling it off which was not the need, as it is the normal healing process, and it heals on its own and falls away. Since, now the symptoms are hot skin and swelling, continue performing icing and do gentle massage near the area to improve the healing process. Also, kindly avoid any peeling of the scabs in future to avoid infection due to nail injury. 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: Hi, When I brush my teeth and spit there is usually brown stuff in my spit and it doesnt feel like i have clean my teeth properly. Also I can feel some distasteful stuff in one location of my tooth, its always there and i go to brush that area and more brown stuff appears. what is this brown stuff? and how can i permanently remove it? ### REPLY: Hello, Everyone builds up daily plaque that you should remove with good dental hygiene. Your diet, health, habits and medications contribute to the composition. Smoking, coffee and tea are examples of stain causing culprits. If you are not effective in getting your teeth clean, consider a professional cleaning. Consider changing dental product choices. Have a complete dental exam. I suspect a tooth with decay and the hole builds up with debris. Some bacteria can cause discoloration on your teeth as well. Your dentist can check for this and any oral infections present. Have you had a recent dental check up? Think of any recent changes that you can attribute to the timing of the build up. A . Thank you for your inquiry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: May you please explain to me what this is: Exam: MRI brain and sella with and without contrast History: hyperprolactinemia galactorrhea irregular menses Findings: the pituitary gland is slightly heterogeneous in signal. There may be a tiny, 1mm hypoenhancing lesion in the posterior pituitary gland just right of midline. Microadenoma is a possibility given the history the pituitary gland is otherwise unremarkable there is no parasellar or suprasellar mass lesion the pituitary stalk is midline The ventricles are normal in size and morphology there is no hemorrhage infarction and demyelination there is no midline shift or extra axial collection Mild mucosal thickening is noted in the left maxillary sinus ### REPLY: Hi, I am .  I have read your question with care and understand your concerns. Let me try to help you Question : What does mild mucosal thickening in the maxillary sinus mean? Answer : For your Complaints of hyperprolactinemia galactorrhea irregular menses, the mild mucosal thickening in the maxillary sinus does not mean anything. So you need not worry about that However, what is important for you is the "tiny, 1 mm hypo enhancing lesion in the posterior pituitary gland just right of midline" which can well be the cause of galactorrhea and irregular menses. I would suggest that you evaluate this further Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care ! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, Im a typhoid carrier and I got infected once again. My doctor told me to get some rest, gave some medications. Im a habitual coffee drinker and I find coffee helps my digestion. While under treatment, can I drink coffee to help me with constipation? ### REPLY: Dear Friend. Hi, I am , I have read your query in detail, I understand your concern. As far as your query is concerned, you can .  It won't cause problems as such in typhoid fever. But I must tell you that Carrier state of typhoid is relatively rare. In case you are being guided by your Tidal Report, they have no significance. I would advise you to take a second opinion. This is my personal opinion based on details available here.  If you still have any query you may please ask me. Stay Healthy. , MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Why do my fingers tingle during my sleep and now my fingres HURT so bad i cannot sleep all night. I wake uo and the pain goes away but my hand is tingling and feels tight. And my feet seam to feel swelled up and tingling too. sometimes feels like something is crawling on my feet. ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern looking to the history given here I could say that the tingling sensation in your finger could be due to poor posture that could be compressing the never root in cervical region, maintain the good posture and this could around, for the leg problem this is the hallucination, you need to keep the stress level very low, take care and have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a mass in my right breast, I did a sonogram and a mamogram and the finding where abnormal. My Primary Care physician believes it might be cancer after reading the report from the radiologist. He reffered me to a surgeon, I met with him yesterday and he found another smaller mass in my left breast, but told me not to worry, it is small and he found a relatively large mass in the lymphnode under my right under arm. I asked him if it could be cancer and he said he doesn t think so. I am scheduled for a surgical biopsy this Friday. I asked him if it is not cancer what could it be and he gave me no answer. I nipple secretion , my nipple is inverted, the mass does not hurt and now I have another mass in the left breast (small) and my lymphnodes have a mass. If it is not cancer then what could it possibly be? Any ideas? ### REPLY: Dear Ma'am, Sorry to hear about your problem, but the management plan decided by your surgeon is correct. Would it be possible for you to tell me the BIRDS score mentioned in your mammography report? It is a good indicator whether the lump is benign or malignant.a biopsy will give a definitive answer, and you will have to wait for 5-7 days for the result. Was you nipple inverted since childhood or is it of recent onset? Recent onset nipple retraction is a warning sign. As you have not mentioned your age, it is difficult for me to tell you the various differentials, but the main thing is to rule out cancer. If you would like to clarify any other point, please feel free to ask me. Rohan KhandelwalBreast Surgeon ### END