Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Was diagnosed with kidney stones by ER and 3 cat scans. Very painful lower abdomen and lower back. Also urge to have bowel movement and urinate is constant. Still after 2 weeks pain continues. Just had x ray and was told I had phleboliths. Is this something that is a sign of something worse my father just passed from stomach and colon cancer. Also the pain is extreme and unbearable. Is that normal what need to be done to correct this and will it go away on it s own ### REPLY: Hi, Thanks for writing in. Kidney stones can be confused with phlebitis on X-rays. Phlebitis are benign findings and requires no treatment. This is confirmed by CT scans and does not have anything to do with bowel and urination. It is not something you should worry about. They are literally vein calcium depositions, and represent calcification within venous structures. They are particularly common in the pelvis though can be seen anywhere in the body. This is a very common condition in the elderly when almost half of normal people have it. Since CT scans have been done and no serious conditions like tumors have been found hence there is no need to 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 was prescribed Asthmanex twisthaler .. After 3 weeks of using this med....I started having trouble with my legs.. when I returned to my dr after 3 weeks I had to use a cane to get around.. I have always been very active and this has really depressed me...They said the side affect could cause leg problems...I may be 1 out of a 1000 but it has really caused me added therapy... I hope it helps... thank you for listening to me.. God Bless Dottie ### REPLY: Thanks for your question on . I can understand your concern. Yes, you are right. Asian twist haler can cause similar kind of leg symptoms as side effect. So better to change this .  Don't worry, you will be alright once you stop this inhaler. Don't feel depressed. It is temporary side effects. This will definitely go away once you stop this twist haler. Be positive and stay healthy. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My hip hurts so bad I can hardly walk.i feel shooting down my leg Behind my knee is so tender.I move on my sleep and yell with pain.I have history of l-4-5 s 1 fusion with horrible recovery I go to pain management and am set for neuomuscler stimuli Wed.but feel this new hip pain is possible a broke hop ### REPLY: Hi, I have read your question. You had fusion L4-5 S1 and are having shooting pain on the back of knee and are worried about broken hip. In my opinion, you would not be able to walk in case of fracture around hip. Still I suggest getting an X-ray to Rule out any minor fracture. I think you have pain because of muscular spasm. I suggest you start painkillers, muscle relaxants and pregabalin along with your doctors' recommendation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I have sickle cell anemia and I went to the hospital last week and while there was told that my white cell count is too low and to hold my medicine called hydroxyurea. I want to know is there anything I can do to help boost it or get it back to normal? ### REPLY: Sickle cell anemia disease usually requires lifelong treatment. Chil . Your care team will help you learn more about the condition and work with you to come up with an individual care plan that takes into account all your needs and health concerns main thing you can do to reduce your chances of experiencing a painful episode (sickle cell crisis) is to try avoiding possible triggers. This may mean you need to: ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was born w/ meningococcemia in 1978 at a military base in Nuremburg, West Germany. Because my mother died of Lupus when I was very young, I was never able to obtain much information about my then condition and the surrounding elements. If at all possible, can you please provide me with any details regarding the cause, symptoms and treatments that may have been provided to me 32 years ago when I born with this disease. Also, if you know of anything that may still affect me or any of my children due to my past history with meningococcemia, this info would be tremendously helpful.Thank you so much, in advance, for your time and assistance in his matter, It is greatly appreciated. ### REPLY: Thanks for your querymeningococcal disease is not present on birth ...you have contracted it immediately after birth due to infection with n meningitis. ...you would have been given proper antibiotic and resulting symptoms would have been treated with necessary measures such as blood and plat hey trans fusions. ... Once treated it had no lasting effects....neither it is transmitted from one generation to another after so many years ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 age 16 now and have low self-confidence in my appearence. I m just wondering after age 16 does your face change ?. My face is chubby while I m relatively thin and my nose looks massive. Do you look alot better at age 18 ?. Is there anything I can do to improve my appearence. Thanks. ### REPLY: Hello !! Yes, to a little extent you are right this age 13- 19 years is the age of transformation of a child to a well-developed physically and mentally healthy adult. There are some physical changes as well as some hormonal changes and secondary sexual characters start appearing due to which the teen Age feels quite uncomfortable but once you overcome this period and achieve your full physical and mental development there would be lots of changes in you by that time, and you will feel comfortable with it. All you need to do at present is to take balanced diet, do proper exercises, focus on studies and communicate properly with your parents and friends about your problems. There is nothing to be shy. This is the age where, at many times you would be in dilemma where you have to judge a lot of things , you have to consider lots of things, so proper clarification of your queries is must for overall personality development. Hope you would benefit a lot from this clarification. Any further queries are welcome!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 In 2004 i had a scoliosis operation where i had 2 metal rods put into my spine. I was fine till about 2 years ago where i discovered shingles which was cured, it had recently come back so the doctor i went to said but was internal and nothing can be done about it. For the past month now i have been experiencing such pain in the lower right side just above my hip. i am not sure if this is shingles or if it could do with my back operation i had but i cant bare the pain anymore and dont know what to do. it actually feels like someone is stabbing me in the back with a knife. ### REPLY: Thanks for using . The symptoms described by you looks like a T12-L1 radiculopathy (pain in the distribution of the radicals). This can be due to various causes like early shingles before the vesicles appear, compression of the nerve either related to progressive scoliosis or surgery. T12-L1 radiculopathy is usually not caused by degenerative lumbar spondylosis. Consult a Neurologist or a Neurosurgeon and get started on medicines for reducing the neuropathic pain. If vesicles appear get treated for shingles again with antiviral medicines. Steroids should not be used as it increases the risk of shingles. I think this will guide you for further treatment. Bye ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my gallbladder removed 7/30/12. I am still getting pains like I did before my gallbladder was removed. I had sludge in my bladder, no stones, and it was only functioning 8%. Is this normal? My gastro doctor gave me medicine that I put under my tongue it helps with the pain but I dont want to be on it forever. ### REPLY: Hello have gone through your concerns. If I were your treating physician I would have suggested you to perform H pylori test and upper gastrointestinal endoscopy to look for peptic ulcer. For which I would have prescribed triple antibiotics such ampicillin azithromycin and metronidazole with a proton pump inhibitor such as omeprazole for 14 days. I would also have suggested an electrocardiogram(EKG) to look your heart status. Then I would have suggested serum lipase and amylase to rule out any pancreas related pathology. I would suggest you to take proton pump inhibitor such omeprazole 40 mg for symptomatic relief. Avoid spicy food. Take milk at the time of going to bed. Raise your pillow. Sucralfate syrup. As these . Hope answer is helpful. Thanks. Wish you good healthy life ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 27 years old and have some redness in my gum line where my lip meets my bottom gums. It is pretty sore and there is a tiny, pin sized hole in the area. I do not smoke and rarely drink, eat healthy, and brush twice a day although I could floss more. I have never seen this before and am concerned. Any ideas?? ### REPLY: Thanks for your query, I have gone through your query. The redness could be because of the infection of the gums. The pinpoint hole could be a pus discharging sinus tract secondary to tooth infection or gum infection. Consult an oral physician and get a radiograph done of the related tooth and rule out the tooth infection. If tooth is infected get it treated with RCT. I hope my answer will help you, take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 19 years old now. I have chronic runny nose problem. I feel irritation in nose, then it starts sneezing and continuous nasal flow.   My doctor identified it as " Sinu DNS Ch. Ts +" I started taking medicine " Montelukast sodium 10 mg; Fexofenadine 120 mg; and  Nolone-AQ (Triamcinolone Acetonide Nasal Spray). I got some timely relief but it started again. What should I do in this case. ### REPLY: HI, thanks for using  Allergic rhinitis is inflammation of the nasal passages and allergic sinusitis is inflammation of the sinuses. Some persons may have both. The medications that you are using are appropriate however once are still exposed to the allergen, the symptoms would continue. If you can determine the source of your response and avoid it, it would help. Allergies can be due to dust, different foods, pollen, animal dander. An allergy test may be able to help determine the source. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i fell down the stairs and hit my back on the corner of some stairs. There is swelling next to my spine and it hurts from my neck down. I never hit my neck or head but when i fell i couldn t speak for a good minute and my vision went blurry and i couldn t see well for a few minutes. ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to musculoskeletal injury secondary to the fall.X-ray & MRI of the spine will be helpful in clinching the diagnosis. Symptomatic relief can be obtained by heat therapy, application of analgesic & muscle relaxant gel, intake of analgesics like Diclofenac (to be taken after food) + Pantoprazole (to be taken 30 minutes before meals). Supplements of Calcium & vitamin D can be included in diet which will help in strengthening of bones. Physiotherapy exercise will also be helpful. If symptoms still persist, kindly consult an Orthopedic for proper clinical examination. Till then, maintain adequate HY . Wishing a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am a thirty year old female. am a thirty year old female. I was diagnosed with primary hypertension at age 25. My average reading at diagnosis was 145/110, with peak reading at 185/120. In the past few years, my blood pressure readings have averaged out to slightly above normal with medications, averaging 125/95. However, yesterday I had a higher reading of 150/105 and earlier tonight my blood pressure spiked to 140/115 but has now dropped back down to 135/90. I was diagnosed with Type 2 diabetes at age 25 with a fasting blood sugar of 385. Now my blood sugar is in close to normal levels and is treated with Metformin and diet. My A1C is also in normal ranges. I was diagnosed with high cholesterol at age 26. At diagnosis, my total cholesterol was 310. Now it is down to 210 with medication and diet. At diagnois, my LDL cholesterol was 220 and has now dropped to 135 with medications. At diagnosis my HDL cholesterol was 75 and has now risen to 90 with my total cholesterol level being 210 at my last appointment with my cardiologist which was two weeks ago. I have been obese for most of my life and have been unable to lose much weight even with diet and exercise. At my heaviest, I weighed 285 pounds and am now down to 245 pounds which is about 110 pounds overweight. I take Metformin, Benicar, and Vytorin. Last night, I felt naseous and had waves of slight pain and pressure in my chest. I also felt pain in my jawline and left elbow area, whicChatDoctore and went in waves. I was sweating more than usual and was dizzy, but felt better with rest. Today I went about my normal routine, but felt dizzy when I went on my evening walk and now my left arm is numb. With my history, should I go to the ER just be sure this isn t cardiac related? ### REPLY: Hello, With the history what appears to me that your blood pressure is high of course what appears from the readings. But for now I feel it's not any heart attack for now. If it was then things would haven been complained as different way. As dizziness and sweating can also occur due to low blood glucose levels. Now coming back to the fluctuations in the readings. If you are taking the measurement from any of the digital machines, it can show errors too. Having it done on a traditional Blood Pressure apparatus called sphygmomanometer is advised. Next your blood pressure was high, but which arms that you did not mention? Left or the right? Considering the higher on the left or the right the medication will be advised. Coming to your diabetic profile. Usually, due to sedentary lifestyle, people tend to develop the early high blood glucose levels. Taking part in a regular physical activity like exercise should help it under control without having taking medications on a longer run. For high cholesterol levels this has to be taken care with diet more and exercises equally. As cholesterol levels are increased in most cases because the type of food one eats and doesn't burn out leading to high levels. Avoiding oil completely should definitely give the results in reducing the cholesterol levels. Now your next problem is obesity. Now this is something which definitely needs exercise and diet plan. In my clinical practice of 12 years I have seen cases with obesity, high blood pressure, high cholesterol levels and high blood glucose levels at early ages, but all responded well to diet and exercise well and now all are healthy.  Medicine is of course good but on long run not good for body and especially kidneys. So most doctors advice control of the symptoms mentioned above with diet and exercise. I hope that you start the diet and exercise regime sooner so that you get some excellent results. 30 is not the age to visit medical professionals more often. This is the age to enjoy. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have disc osteophytic bulge at l5/s1 with annular tear indenting the tecal sac and the exciting nerve roots with neural foraminal compromise right.left . what does that mean please?? also alignment of vertebrae reveals minimal retrolisthesis l5 over s1. ### REPLY: Hi, I had gone through your question and understand your concerns. It means there is herniated disc disease on L5/S1 level and also degenerative vertebral disease causing listless. Treatment is conservative or surgery. This should be guided from your symptoms (if severe pain or difficulty walking, neurologic deficit then surgery) if mild symptoms, conservative. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your 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: I have a lot of things that is going on. I have not had my cycle since December 28th. I have continue to take pregnancy test mail come back negative. I have mole that s on my belly that continues itches. I had chest pains that I think it s mostly due to stress . Went to the ER and they sent m e home. Stay out of breath. Littl exercise &I Just a little bit overweight 15 lbs. ### REPLY: Hello and welcome to . Thanks for your query. Stress and anxiety can manifest with not only psychological symptoms, but also with a variety of physical or somatic symptoms. However, a mole or an itchy skin lesion is a dermatological problem and is unlikely to be the direct result of stress. You will need a proper physical examination to determine the nature and cause of your skin lesion.  Irrespective of this, it appears that you are going through a lot of stress, and so, it would be worthwhile to seek professional help for the same. There are effective psychological therapies which can help you acquire better stress management techniques and coping skills. Wish you all the best.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have two polyps in my gallbladder, one is 4mm and the other is 3mm. these polyps were detected through ultra sonogram of my whole abdomen. i feel some sort of pain in my right abdomen near the gallbladder. the report also revealed mild fatty liver. i would be happy if you tell me what to do now. ### REPLY: Brief Answer:You should establish a follow-up plan with your GI doctor. These polyps should be followed-up using standard abdominal ultrasound or endoscopic ultrasound. Detailed Answer:Hello, Thank you for using .First, is a good think that your polyp size is small, because even though in 95 % of the cases the polyps are benign, there are rare cases of cancerous polyps. The size of a gallbladder polyp can help predict whether its cancerous (malignant) or noncancerous (benign). Small gallbladder polyps that are less than 10 millimeters in diameter, as in your case, are unlikely to be cancerous and generally don't require treatment. However, these polyps should be followed-up using standard abdominal ultrasound or endoscopic ultrasound, to look for changes that may be an indication of cancer. In most of the cases they are asymptomatic and are often detected incidentally. However, as in your case, the polyps may cause occasionally pain in the right abdomen, due to intermittent obstructions caused by small fragments of cholesterol that become detached from the gallbladder mucosa. So how to deal with these polyps ? See a gastroenterologist and make a follow-up plan. In case of repeated pain, consider cholecystectomy. In this way you avoid either long term surveillance of the polyps. Hope this is helpful. Let me know if you need more clarifications. Otherwise, please close and rate the answer. Kind  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have blood in my semen. It is quite dark (brown), sometimes with some red blood as well. It has persisted for 2-3 months now. Lab tests show no infection or blood in my urine. Is it ok for me to ejaculate and have intercourse with my wife while this condition persists? I have a referral to a urologist, but it may take 2 or 3 months to see him. ### REPLY: HelloThanks for query. You have not mentioned your age in your query. The hematospermia (Blood in semen) has to be dealt with seriously and investigated to look for source of blood. It may be anywhere from the urethra to testicles.prostate, seminal vesicle. Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to establish the source of bleeding .1) Blood coagulation profile 2) Ultrasound scanning of abdomen and pelvis 3) Urine routine and culture 4) Semen examination and semen culture.In the meanwhile You need to take broad spectrum antibiotic like Definite along with anti-inflammatory . 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 don t know what s going on... I masturbated earlier, then after that I noticed my left leg kind of had a throbbing pain on the back of the thigh. Then I noticed when I touch my penis , or squeeze it, the pain shoots down into the same spot on my thigh. I kind of got bad anxiety so the worst is coming to mind I m thinking of a blood clot lol. However the rational side of me thinks it s a nerve, i don t know it s never happened to me before... Being dead serious here, it s freaking me out. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Please do not overreact. I don't think that the thing pain has to do something with your masturbation of nerve problem. But to have a proper diagnosis of your condition you should consult a physician immediately if you are that much troubled by that pain. Consider anxiety and other contusion that might be reason. If anxiety is the cause, then I shall be of help. Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some Sexology related psychotherapy techniques which should help you cure your condition. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have this little lump in my earlobe, it only hurts if  squeezed andI dont know what it is, I had an odd cut there and that like liquid type pus would come out of it so I am thinking it may be broken cartilage, and that ball is kind of the same thing as colliflower ear, that is just my guess.. ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data, you seem to have infected wound on the earlobe, with pus in the earlobe.Don't guess more. I would advise ER Surgeon Consultation who would treat it with antibiotics / anti-inflammatory for 5 days time. Hope this would resolve your issues. Act fast. So keep cool and Consult your ER Surgeon, if need be, who would treat it accordingly. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to  and be comfortable to resolve your health issues. Welcome for any more query in this regard to . Write good reviews and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 is a 28 year old male suffering from a tight chest for years. He has never smoked before. The 1st GP we consulted diagnosed him with emphysema, the 2nd with pleurisy and now the 3rd one is treating him for asthma. He has never used a inhaler before but now he was given one to use. In some instances when he just drinks a glass of normal tap water then he cant breathe properly and even when he walks barefeet for not even 5 min, then his chest is extremely tight. Do we need to see a pulmonologist for a second opinion or what can we do. It is really freaking us out. Please Help. ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make following suggestions to you:1. Emphysema is very uncommon at 28 years of age. 2. Both emphysema and pleurisy can be diagnosed by simple chest X-ray.3. Pleurisy can be treated and cured with appropriate course of antibiotics.4. Asthma is common at his age. But only . So, in my opinion, it is best to consult a pulmonologist who will examine him may suggest him investigations like chest X-ray, Ultrasonogram or spirometry to reach to the diagnosis. Once diagnosis is confirmed, appropriate treatment can be started. Hope above suggestions will be help you & your husband. Should you have any other query, please feel free to ask at . Wish your husband the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 15 years old and around 54 and I weigh around 100 pounds, Im an occasional smoker and recently ive had a heavy sensation when i breathe. Im afraid of lung cancer but i keep reading it takes years of smoking to develope and Ive only been smoking a couple months. I dont have any pains, just a wierd forceful breathing sensation. ### REPLY: Hi welcome to ... You are having smoking habit and now having forceful breathing .... So some organic cause might be there. . It could be ....1. Chronic bronchitis 2. Emphysematous changes 3. Pulmonary fibrosis 4. Cancer 5. Infection condition... According to cause treatment needed like that by antibiotic, bronchodilator etc... Investigate with ....1. Chest x-ray PA view 2. Spirometry 3.CRP etc... Your auscultation and physical examination will decide which investigation done. . Take care Advise : consult pulmonologist for examination.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey, so last week i crashed my longboard and it was pretty bad. I had tons of pain and my arms were pretty banged up. About two hours later i noticed that i had little to no flexibility in my left arm and hurt to move it. Now i have almost all my road burns healed. But my left arm is still weird. I cant fully straighten it and when i do a bicep flex without flexing (if that makes sense) i cannot pull my arm towards my self. What do you think.. ### REPLY: Hi, thank-you for providing the brief history of you. A thorough neuromuscular assessment is advised. As you are not able to flex the elbow actively you need a thorough assessment. Due to pinched nerve there leads to certain weakness and early detection helps for further management. If the injury is happened by the fall on the neck directly an MRI or NCV will be advised and post which the medical management will be directed. Also, post these if the injury is minimal then with rest, medication and physical therapy you should respond well. 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...i am 20 years old & weight 65kgs,suffering from gynecomastia.i have avg boobs size.i have consult the doctor & he adviced the surgery.i need some information abt surgery.any side effets are there?how many days it will take to get skin fit in chest area.can i get perfect chest shape.is there any chance for again coming of man boobs?how many days i have to take rest after surgery? ### REPLY: Hello, After surgery it takes around 2 weeks to heal the area on average. You need to rest after surgery and wear compression garments. Surgery is generally considered safe however, there are associated risks of infection, bleeding and anesthesia complications. Yes one can have gynecomastia after surgery but It's very uncommon. 90% of the patients after surgery get complete cure. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor good morning , i am  form nepal , i have just come back from  Denmark before one year to do my own business . i have started my business here,it happen 10 month but now i realize that i have done big mistake to return back nepal. because my business is not going on well. i am not getting support from family also .  so now a days im totally depressed , cant sleep properly,  and decreasing my confident level .one of my brother also have depression and he is using nexito 10. and he is doing very well   now a days so i have decided to having same please advise me it makes me good or do i need to have some more treatment thanks ### REPLY: Hi, Going through your query, it definitely seems you are suffering from depression. Next (Escitalopram) is a treatment of depression. But I would strongly advise you to meet a psychiatrist before you start the medication. The dose of Escitalopram may need to be adjusted later on. In addition, you have to remember that you will have to continue Escitalopram for some months even after complete recovery in order to decrease any chance of relapse or recurrence. Best Wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been suffering from mycrocytic anemia for 3 years, I have been treated with a yearly iron infusion, however I spend 6 months of every year, totally exhausted, cold with my fingers turning white,breathlessness, loss of appetite , decreased memory and feeling generally depressed that I can t seem to get anything done. I do take iron tablets, on one occasion my iron levels were so low, I collapsed and had to have blood transfusions. I do not understand why I can t get anything done about the situation until I hit rock bottom. What would be your recommendation? I am 69 and female ### REPLY: Hello! Thank you for the query. The first steps with such anemia should be diagnostics of digestive tract as it can be caused by large intestine polyps or cancer bleeding, stomach or duodenum inflammation or even cancer. That is why, you should have upper GI endoscopy and colonoscopy performed. If any bleeding from vagina, also transvaginal ultrasound should be performed. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband was just diagnosed with esphoguas & stomach cancer, don t know what stage yet, but has every symptom for the eshohagus, so I was trying to find out some info on botChatDoctorbined, don t know yet if it has spread to other places, lungs, kidneys etc, and before treatment what else to look for. my husband says he knows his body, and doesn t feel like he has to much longer, he felt this before being diagnosed. ### REPLY: Hi ! Good evening. I am  answering your query. Sorry to learn about the diagnosis of esophagus and stomach cancer in your husband. It is very difficult and may not be possible to advise treatment on such issue without seeing the patient personally, and without going through the investigation reports including that of the biopsy. However, one can go for some proton pump inhibitor .  Further management has to be discussed with the treating doctor of your husband. I hope this information would help you in discussing with your family physician/treating doctor in further management of your husbands' problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My wifes periods got delayed by 10 days and unfortunately we did a pregnancy test today morning, which turned out to be positive and we are not planing to have a child so earlier, please suggest something by which she can get her periods immediately. Awaiting for your reply asap. ### REPLY: Hi, Welcome to . I am . I will be answering your concerns today. Since your wife is pregnant now, if you do not wish to continue the pregnancy, the only option to start her periods, is by terminating the pregnancy. There are medications available to initiate the abortion process at this age of pregnancy. Before taking these medicines, it is extremely important to confirm that the pregnancy is within the uterus and your wife does not have contraindications for these medicines.  Therefore, you need to consult doctor for the same. If your wife is scared of the pain, she can have a small surgical procedure under anesthesia to abort the pregnancy. I hope this is helpful. If you have further concerns, I will be happy to answer. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I was 15 I noticed a lump in my left breast. I went and got a biopsy and it was ruled as a fibrotic cyst.  Now 5 years later I have another lump but this time in my right breast.  Is this common and is is possible I may have fibrotic breast disease ### REPLY: Hi, Dear Thanks for the query to  virtual Clinic. I studied your query with available details given in your query. I understood your health concerns. Cause of the right breast lump -Though not much information about the location, consistency,size, mobility,fixity of that breast lump is there in the query, On the existing information I would give my opinion herewith. So Don't worry till you get the FNAC Biopsy of the right breast lump, to rule out other causes of such a breast lump. So consult an ER Surgeon. My clinical opinion on your query is-You seem to have Fibroadenoma or Fibrotic breast lump and its possibilities are more-due to following reasons-You already had a history of such a tumor 5 yrs back. Its mostly due to the hormonal imbalance and Genetic predisposition in your case. But still get the mammography and USG guided FNAC biopsy to rule out any chance of malignancy in such breast lumps is needed in your case. If not, Surgical Excision Biopsy with HPR would treat it totally.Don't Self-treat or medicate in your case as the case may go in to further complications. Hope this reply would resolve your query and would help you to plan treatment with your doctor. Hope this would relieve of your health concerns. Welcome for any further query in this regard before final suggestions are given in your query. Wishing you fast recovery. Have a good day. . N. Senior Surgical Specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I m 23 and i have food allergy to the list bellow, its been a year now and I tried homeopathy 6month from now but it makes me worst. plz help me ps. I can send you photos if necessary coldcuts & hotdogs sea food such az fish & shrimp tomato coconut beans banana ginseng aloe vera grape & raisin rice spaghetti kiwi colored foods like not natural juice & jelly bean ### REPLY: Hi, Welcome to  forum.  It appears that you are allergic to the cold cuts, hot dogs, AZ fish, shrimp tomato, coconut, beans, banana, ginseng, algebra, grapes, and raisin rice.  Allergic symptoms you have will decide the doctor you have to consult.  If skin problems like itching, consult a dermatologist, if it is cough and cold consult an E.N.T.surgeon I usually prescribe to my patient with such symptoms any type, levocitrizine, montelukast, and triamcinolone 40 mg injection every forte night.  Wishing for a quick and complete recovery. 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..so wen I was 12 one night when I was sleeping I woke up and had this tingling sensation all over my body that was so enoying and couldnt let me sleep I just had the urge to kinda just streach my body but if I tempted to sleep I couldnt so I would only happen a few times never asked cause its hard to explain so now its been a couple of days and I have the same tingling but now just on my left side and its coming from my nipple and I just noticed I squeeze it and I could feel the tingle but I go to the other nipple and n9t the same feeling so its from my lrft nipple and it gets my arm my leg and I noticed it kinda connects to my clit I even tried having sex to have an orgasm To see it goes away but no it a really bad tingling it s uncomfortable and its hard to sleep wen I stay calm try to see if it goes the tingling just gets worse its like its running thru my left side the tingling please help me ### REPLY: Hi, thank-you for providing the brief history of you. As these symptoms of tingling in my opinion is due to the neuropathic issue. Having a thorough clinical examination and a neurological examination will help understand the causative factors. Tingling in the body or on unilateral side is a symptom of the Neurological problems which may be due to even lack of vitamins or some other pathology. For ruling out the causative factor we need a thorough clinical examination and a diagnostic help as well. In my clinical practice we recommend such patients to undergo a thorough clinical examination and some diagnostic tests to rule out the pathologies. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doc this is xxxxxxx 23 years old i took krimson 35 for pcos past 1 year, after 1 year doc took basic scan and she said the measure of pcos is lesser than before treatement, and adviced me to plan for baby we are trying for baby continously 6 months my period is normal for 3 months (this 3 months i took follic acid as doc advice)4th months i missed 10 day i thought i was pregnent but after 10 days bleeded when i ll be pregnent there is chances to become pregnent. ### REPLY: Don't worry of course you can become pregnant, with PCs there are hormonal imbalances so delay in pregnancy, and when you he taken crimson 35 the imbalance would he decreased it's just the matter of time, be stress-free and try for pregnancy you will get the good news soon. Would advise you to go for plain follicular study to know the status of your egg development and all so that you can plan the intercourse around the time of ovulation because as I said in PCs nothing can be predicted so don't worry and all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my galfriend was using triphasil and the nurse gave her trigastrel now saying its the same, she ended trphasil with a brown pill( Which has meds) and started the trigastrel with a red ( No meds) is the a chance she will be pregnant because of thses changes and how long does she have to wait b4 unprotected sex ? ### REPLY: Hello, Though both the pills have the same combination, the bio-availability may differ and hence, protected intercourse is ideal in this cycle. She may start without additional protection from next cycle onward. It is difficult to say if she has conceived already during this cycle. You have to wait until her expected period and go for further investigation if she does not see her period. Pregnancy can happen if ovulation occurs as there is a change of pills in mid-cycle and not from day 1. 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 hurt in my lower left pelvic area for four years before finally being diagnosed with a 2 cm kidney stone. (had exploratory surgery as well as partial and final hysterectomy , colonoscopy , etc before finally the kidney stone was found. ) Dr. Initially thought pain was not matching up with kidney stones because i hurt in my lower left pelvic area and not in the upper area where kidney stone was at. Dr blasted then removed via basket. Left a ureter stint with string for a week which was removed today. Now I am having extreme pain in that same lower pelvic area. could this be renal colic or my ureter or??????? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you had Kidney stone and has undergone Extra Corporeal Shock wave Lithography.(ESL) followed by removal of stone fragments and D. J stent was putting renal unit. You have pain in abdomen at the same site. This is either due to urethritis that develops after ESL and stenting the ureter. Please take broad spectrum antibiotics like Cefuroxime along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily. And later on switch on to appropriate antibiotics as per culture report. Ensure to .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im 36 wks pregnant im currently 3cm dialated i started having this real thick mucusy string like disharge comming out for 2 days now im having braxton hicks contractions all day with stomach tightness and now i have no appetite and i feel real nasauted is this normal ### REPLY: Hi, If you have passed a mucus plug and feel that intensity of contractions are increasing then it means that you're going into labor, which is why you are getting all these symptoms. You should watch for watery discharge or bloody discharge as it could indicate that your membranes have ruptured, and you have gone into labor, when you will need to go to your midwife /hospital immediately. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am getting discomfort in my chest and also my upper back around the shoulder blade area it also goes into my shoulder and arm on the left and sometimes its like under my arm pit at the side of my breast it is happening on and off. How do I no if this is just anxiety or if more serious like a heart attack or something ### REPLY: I have gone through your history. I need to know following details about your chest pain.1.how does it start ?2.how long it lasts?3.how is it relieved. Our first goal is to rule out heart condition I.e.angina.usually it is precipitated by exertion and relieved by rest. So u may get a testing ECG and stress test done to rule out this condition. If it is continuous and persisting for long time first you may take some analgesic tab. Aceclofenac 100 mg twice a day .if not relieved in a week get x-ray chest and x-ray cervical spine to find out any other cause. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My blood pressure has increased to 151/104 pulse is 65. I ve taken Azor 5/20 and HCTZ (Hydrochlorothiazide) 12.5 for over a year and blood pressure stayed around 125/82. I developed swelling in my hand and middle finger and the urgent care doctor thought it was Gout and put me on Indomethacin 50mg and told me to stop taking the HCTZ. My lab came back negative for Gout, Uric Acid was 6.9 (normal range), but my blood pressure increased. Should I go to the emergency room? ### REPLY: Hello. Thank you for your question and welcome to . I carefully read you query. Well, at this moment, I understand, you are on a triple therapy for fighting hypertension. First, the amlodipine, which is a constituent in razor, can cause swelling of limbs, most commonly the ankle area, but there are cases, although rare, that it causes also swelling of the wrist area and fingers. In my experience, I would also suspect a gout diagnosis. But, since the uric acid is within range, then this is excluded. Second, indomethacin is a non-steroidal anti-inflammatory .  At this time, my opinion is that this is just a side effect of indomethacin. However, blood pressure tends to get higher even if on medication, which controlled it in a pastime. I am certainly not saying that this is case. But, if even after two weeks off the indomethacin, you continue to get these blood pressure figures, then I would recommend you to discuss with your general practitioner or your cardiologist, to try to raise the now used medication dosage and/or add another antihypertensive to your therapy, such as a beta-blocker, which also be beneficiary for your heart, by acting on reduction of heart workload - prolonging the heart cycle - promote a better ventricular filling and a larger amount of blood to supply end-organs. I hope I was helpful with my answer. Wish you a good health. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi There,Im 23 year old guy from new zealand. I have some problem with my throat. i cant get rid of this cough. Amoxycillin doens work for me. i went to local doctor and his otehr antibiotics worked on me before but from last 2-3 months nothing worked. He gave me a medicine, codeine phosphate(15 mg) and that worked. but after 2-3 weeks it came back again. im preparing for police, and now i went to him again and he just cant understand what is happening. blood results are all possitive, chest clear, Xray ok. He said it could be asthma but i cant believe it, i do not have any problem in breathing. im a fit guy i run exercise swim like a normal person and never had this breathing problem so how can i be an asthamatic. im very tensed it will ruin my police career...please help me out...just letting you know, Docs in NZ are not that good. ### REPLY: Hello, You might be having cough variant asthma. This kind of asthma doesn't show breathlessness or wheezing. So better to consult pulmonologist and get done a clinical examination of the respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose asthma, but it will also tell you about the severity of the disease and treatment is based on severity only. You will need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Don't worry you will be alright with all these. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello...ive been admitted in hosp fpr gestational diabetes...so far my sugar level has been good 2 hours before supper my reading was 4.7 after 2 hours before my next reading I had taken my calcium and iron tabs...will these have an effect on my level rising? ### REPLY: Hello, Do not get panic about your health condition, some may get Diabetes during Pregnancy, and it will disappear after the completion of pregnancy provided. One should not be in stressful state, and also you might have been advised by the Dietician to take more of Non-Carbohy . Do not get panic one may need to take Insulin also if required so once you are done with the pregnancy concentrate much on your dietary habit and if you have undergone C-section, then take rest for sufficient number of days and start the sufficient exercises to burn your Calories. If you are a Food Lover, then you need to cut down your Food habits a lot, if not your Diabetes will continue after the Pregnancy also, So take sufficient care. 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 visited a doctor a few weeks ago and he told me I have the Chickungunya jungle virus! I thought it was going away, but I think I m having a bit of a relapse, there is a rash on my foread and my forehead also appears to be swollen! Is the swelling some sort of gland in my forehead that is trying to fight of the infection? ### REPLY: Hello, Thank you for your contact to . Understand your health concern, if I am your doctor I suggest you that chikunguniya virus has no treatment. The rash found is not because of some glandular activity, but it is the reaction of skin itself. I advise you to take analgesics like diclofenac under your doctors guidance and steroid like prednisolone as and when required. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 is 8 years old and I was putting sunblock all over her yesterday and I noticed that she has a lump under each of her nipples smaller than a marble but bigger than a pea.  I was just curious if this is normal?  And does it mean that she is going to start developing?  Or should I be concerned? ### REPLY: Hi, Dear , Good Evening. Thanks for your query to . This is .  I studied your query in-depth and understood your health concerns. In My opinion the daughter -is developing and is entering pubertal changes in her breasts.That's why she has lumps under each of the breast nipples. You should not worry about it to be Cancerous -as these are normal puberty changes in her breasts. So you should not worry and feel concerned for these breast lumps. If it still worries You as parent-consult ER primary doctor who would examine and re-assure about the above NORMAL BREASTS.-Hope this would help you to plan treatment with your ER doctor.-Welcome for further queries for this issue to . Wishing a fast recovery for you. Have a Good day. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been feeling ill for 2 weeks. Started with sneezing , runny nose, watery eyes, headaches , fatigue , temperature elevates mostly in the evening. Now I m still head congested but also chest congested with a productive cough and nausea. I ve been taking generic sudaphed and ibuprofen . Is there something different I should be taking? ### REPLY: Hello, If you are taking sedated for more than 5 days in a row, please STOP as you will get exactly the opposite symptoms since you started. This is called tachyphylaxis, meaning you develop tolerance to the chemical quickly and get the worse symptoms. Antihistamines, nasal sprays for 2 weeks would be worthwhile (antihistamine nasal spray like elastane or combined with a steroid for 6 weeks). Allergy testing by skin prick tests or specific IGE blood test will be worthwhile if these symptoms do come in circles or have a seasonal pattern. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump in the soft tissue between my eye brow and eye lash....what is the cause of this? It has been there for 3 months now. I also have swollen lympth nodes in my chest aswell as a nodule on my thyroid gland. Are all of these irregularities linked? I also have chest tightness and muscle ache in my back arms and shoulders. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have angular Desmond.  Near eyebrows its very common.  You should go for excision biopsy and histopathological examination of that lump. It will give you exact diagnosis. Then if needed to take further treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am taking Erythromycin e.e. Ta 400mg (E-M) - 1 tablet four times daily  for whooping cough. I am an adult but this infection is actually on my chest so will this antibiotic actually  clear up the problem of my coughing which occurs throughout  the night as well as daytime.Thank youHelen. ### REPLY: Hi, Dear,Thanks for your query to . Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Whooping Cough-with Bronchitis.?TB bronchitis? Either of these possibilities with other causes of chronic cough need to be investigated and confirmed by Grams stain with AFB smear testing with other tests of TB(IRA blood test and PCR test) and Pertussis(PCR/ Elisa Tests) Cough. Chest X-ray and clinical examination by Chest Physician also is needed to confirm the diagnosis of whooping Cough. After Confirmation- if Erythromycin does not regress the cough/ Azithromycin /or Azithromycin needs to be kept in mind in resistant cases. Hope this would help you to solve your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! . N. Senior Surgical Specialist. 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: sir, from last 4 days, my penis head s color changes to red from pink. but only half portion of it. its texture become very slippery and some discharge is there all the time even i clean my penis every time i go to pee. i m worried of it and I am very embarassed to reveal this to anyone.Please help me out ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. It is a discharge which arises because of some kind of infection. I advise you to get microscopic examination via Grams staining. It will suggest you the probable infecting organisms and so treatment options also. It looks like bacterial infection, but exact etiology can be known after the report. You can take the tablet Doxycycline 100 mg once a day and pantoprazole once a day till report received. After that treatment should be taken accordingly. Please maintain good hygiene by frequent washing and cleaning. Wash the part clearly with water at the time of bath and subsequently in the day thereafter. Avoid sexual intercourse during the period and if the partner is infected than treatment for both partner simultaneously is necessary. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has moderate to severe pain under his left shoulder a little towards the right. This has been going on for approximately 3 months. It is some what swollen and is also tender to the touch. Motrin 800 takes the edge off the pain, cold compresses do not help but heat seems to give him some relief. He has seen a physician and was given muscle relaxers and narcotic pain medication that really just puts him to sleep. He also has taken steroids which did seem to help him. It is also important to note that on December 5, 2014 he was diagnosed with breast cancer in his right breast and is scheduled for surgery this Thursday 1/22/15. Pet scan, CT scan, MRI, Ultrasound have all been negative for any cancer in the area where he is experiencing the pain in his back. What are your thoughts? Y. Williams ### REPLY: Hi, Thanks for writing in. If not the cancer then it is probable that he is having pinching on nerves taking place along the nerve pathway. The nerves take origin from roots at the spine. Then the nerves travel through exiting nerve root foramina and take the formation of brachial plexus which proceeds to supply the skin, muscles and joints. It is possible that a nerve entrapment is occurring at some place and the pain is felt at the shoulder. Cancer is less likely the cause of this pain. 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 pain under my left rib cage. it hurts sometimes to take a deep breath or even to pull on something that would strain it. lately i noticed ive been very tired and some days iam so dizzy that i have to stay in laying down postion to releve some of the dizziness. i also have pain in my back it is very sharp and feels worse than a muscle cramp. if i try to bend my left arm to go to my back i cant do it cause the pain is to bad. i dont think ive pulled a muscle, and i also have very bad heartburn. do u think i should see my doctor right away or maybe i just strained my left side and dont remember doing it ### REPLY: Hi, Thank-you for providing the brief history of you. A thorough neuromuscular assessment is advised. As the pain is limited to under the rib cage and behind of it, you can get a chest x-ray done. Either the pain can be due to any Cochin .  Since you have not mentioned breathing difficulties like breathlessness it can not be related to something serious. Still an x-ray can help assist. Performing breathing exercises will help reduce the pain and also there are various types of breathing exercises which when performed you should keep hand over the painful area to avoid pain. In case the pain doesn't come down with this, then an abdominal ultrasound scan is advised to see any abdominal pathology. Post that the treatment will be directed accordingly.regards Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have had 3 ct scans to the chest area since feb of this year, i am told i need to repeat it again in sept.  The results show i have a tumour 1 inch big in the lower right lung (under breast) my doctor put me on zithromicin for 10 days as i am bringing up green thick phlegm. Have been complaining of experiencing fullness under my left rib and now have fullness across both ribs, with back pain in the morning. My chest feels tight, trouble breathing even taking two puffs of symbicort, have been on this medication for years for bronchitis, twice daily, as needed.  My doctor wants to wait for the results of my 4th ct scan before seeing a specialist to get a biopsy in case it is cancer.  Im just wondering if i should ask to see a specialist sooner then later. ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion, you should definitely consult pulmonologist. Following are the possibilities in your case. 1. Worsening of bronchitis. 2. Worsening of lung mass (enlargement) 3.  Pulmonary embolism. So you need repeat PFT, CT Pulmonary Angiography. PFT will tell you about severity of bronchitis. According to the severity, you may need additional bronchodilators. CT Pulmonary Angiography will diagnose Pulmonary embolism if present. It will also tell you about size of the tumor whether increased or not. So better to consult pulmonologist as soon as possible and discuss all these. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can you get pregnant by fingering? If you are holding onto a males penis through his boxers and he pre-ejaculates is there any real contact with his pre-ejaculation and the hand considering clothing was in the way? Also could one get pregnany if she fingered herself afterwards? ### REPLY: Hello dairy understand your concernThere is no chance of the pregnancy. No penetrative sex and fingering after touching the pre-cum in your case does not cause pregnancy. To become pregnant penetrative sexual intercourse or intercourse up to vaginal introits with or without ejaculation in fertile period of the cycle is required. So do not worry. Avoid stress, take healthy diet, . Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old was having trouble sleeping through the night without nightmares or some sort of fussing. Melatonin was recommended by my neighbor who gives it to her child per a dr. My Mother-in-Law thinks it will give him mental problems and is freaking out. Is melatonin ok? ### REPLY: Hi, Yes, melatonin is effective in treating sleep disorders in child .  Melatonin is a natural hormone secreted in our body to maintain wake-sleep cycle (the "biological clock"). It is found to improve sleep duration, reduce the time it takes to fall asleep and improve the quality of sleep. It may be given to your child thirty minutes before bedtime. Melatonin is generally considered safe in the short-term however it may cause 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: My friend who is in her early 30s was diagnosed with intraocular pressure. Could this be related to a severe concussion with subsequent unconsciousness she suffered 18 months ago. Her headache is on the same side of her head as where she hit it on a cupboard door and was knocked out in the incident. She woke up in the ED and didnt remember anything after hitting her head. ### REPLY: Hi, Welcome to  forum.  The causes of intro ocular pressure may be the glaucoma, ocular hypertension, blind less etc. It may not be related to the head injury, but as a secondary effect would have effect on the eye and cause ocular hypertension.  If there is no glaucoma, it may be a suggestion of developing glaucoma in 5 years.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to protect the eyes from glaucoma.  Wishing for a quick and complete recovery. 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: Had a ct scan in Nov due to abdominal pain found out i have fluid in my kidney and left kidney is swollen tthought I brought the ct scan that was on a disk come to find out it was the ultra sound I had done in Dec Dr say some dark spots. What could that mean? I also have endometreosis and a cyst on my right ovrey. Had a bladder scope done today as Well Dr says my bladder is fine.but where iI pee from is very small help ### REPLY: Hello and welcome to . As a Urologist, I can fully understand your concern. Fluid and swelling of kidneys, can be caused by many diseases. If you can send the CT scan and the last ultrasound scan report, here to me, as a direct question, I can give you an expert opinion. Kindly include reports of urine culture and blood reports, with medication being taken.  Wish you well. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ... iam XXXXX from XXXX and i had started my father atorvostatin 2-3 years back and now continuing with rosuvastatin for past 6 months and now the liver function test came as sgpt 90 and ggt 190 elevated high but sgot is within normal range.. how to proceed further sir and is the liver permanently damaged? ### REPLY: Statins can cause liver function derangement. A dose-related rise in serum aminotransferase levels develops in 1% to 3% of people who take statins. A minor (less than two-fold normal) rise in the serum ALT and AST levels (without symptoms) is the most common manifestation of liver injury with these compounds. These elevations usually reverse rapidly with discontinuation of the statin and also reverse if therapy is not interrupted. If your father had normal LFT before starting statins and have increased now - statins could be the cause, however they donor cause serious liver problems.  Apart from statins, there is a risk of your father having NASH (non-alcoholic steatohepatitis). I would advise you to get an ultrasound done. If your father doesn't require statins necessarily you can stop it, if not you can continue them and repeat the LFT after 3 months. If the enzymes are increasing then you need to stop the .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 16 years old and have the back problem, scoliosis. I am very aware of the shape of my back and this can prevent me from wearing certain clothes and feeling confident as some people at school can point it out. I also have a very achey back which sometimes hurts so much-sometimes when I bend my back can feel like its locking and standing back up is nearly impossible. Sometimes a heat pack works but I am quite scared about my future! ### REPLY: Hi, Scoliosis is an abnormal curve of the spine or backbone. In most cases, the cause of scoliosis is unknown [idiopathic].  There are several types of scoliosis based on the cause and age when the curve develops. It is more common in girls than boys. It can be seen at any age, but it is most common in those over 10 years of age.  Depending on the severity of the curve and the risk for it getting worse, scoliosis can be treated with observation, bracing or surgery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my son has very itchy patches all over his body he has had these for approx 6 months now and the doctor has been treating him for Psoriasis. However we have just got results back from an Intolenrance test and on his results Pityrosporum Orbiculare is 99% which is very high. Can this be the answer to our problem? He has a lot in his head, chest, knees, arms, back just about everywhere. ### REPLY: HELLO GREETING FROM ChatDoctorI UNDERSTOOD YOUR PROBLEM PITYROSPORUM ORBICULAR IS SPECIES OF FUNGUS WHICH IS MAINLY RESPONSIBLE FOR DAN .  THIS MAINLY EFFECT OIL GLANDS OF BODY, SO THE MOST EFFECTED PARTS WILL BE HEAD, UPPER BODY, NASAL AREA.IN PSORIASIS PATCHES ARE PURPLE IN HUES.IN MY PATIENT I USUALLY START WITH ANTI-FUNGAL TREATMENT LIKE KETOCONAZOLE SHAMPOO FOR HEAD.AVOID OILING IN HEAD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sister in law who is aged 36 years is suffering from Bipolar Disorder. She is under following medication from last 1.5 years: Clonotril 1 mg, Tolaz 5 mg, Parkin 4 mg, Nexito 5 mg all the tablets consumed each every day. At times her face becomes swollen and during that time, she says that is afraid that she is going to die and she loses her self control. Her BP shoots up high. Kindly advise if the medications are under the right directions. Should there be increase or decrease/change of medications? Regards, Thamayanthi R ### REPLY: Hi, It is not in your sister in laws best interest in physicians on this network to determine the validity of any treatment which has already been advised by another physician from whom she currently receives treatment.  It is, however, within the bounds of our knowledge base to tell you that it would be perfectly reasonable for you to encourage your sister-in-law to be honest with her treating physician and relate the side effects you mention (now or at the next visit) so that the physician involved can determine the validity of the medication regimen, the dosages, and the possibility of substitutions or other changes for her to feel better. This is the best course of action your sister-in-law could take for herself. 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 son is only ten weeks old and has been to the er three times. On Zantac for acid reflux very irritable still gagging. I also just noticed he has a blister on his foot and now has rash on his face with pimples. He has clear discharge from his eyes constantly. And also has been making a hiccup sound and twitching in his sleep. Please help me and my son Matthew ### REPLY: Thanks for posting your query at . Clear discharge from his eyes is not a cause of concern. The opening of his nasolacrimal duct might have not yet developed and a certain type of simple massage at the angle of eye and nose over a period of time will give him relief. For his acid reflux continue Santa. But chances are that he is not being burped properly after feeds. Make sure that the child is placed in erect posture, possibly on lap, for about 20 minutes after each feed. In any case, keep his head end raised after feeds. Probably with such interventions his reflux would subside. The blister over his foot is probably unrelated. Apply emollients or moisturizers over they are. Hiccups and twitches during sleep are normal, and you need not worry about it. I hope that helps. Feel free to revert in case of further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 married since 9 months and want a baby soon . I am taking this Tab Fertyl since last month . Could you please help me in helping me to get the good treatment so that I can conceive soon . is it necessary to take a Follic acid tab too ? foe how many months do I have to take Follic Acis and tab Fertyl ? ### REPLY: Dear member, Thanks for using . Fertyl or camphene citrate is used to generate more eggs during each cycle to increase chance of pregnancy. Though safe it is recommended that a cause of infertility is checked first. Clients who come to my clinic with similar complaints I would recommend following,1. Wait for a year before starting treatment most conceived in 2 yrs of marriage.2. Husband semen analysis is compulsory before any medicine given to wife.3.take folic acid tablet. 4. Do basic blood tests, ultrasound.5. Ferry though safe has its own side effects. Also, ultrasound to check for egg growth in each cycle of ferry is recommended.6. Taking ferry without supervision may over stimulate ovaries and cause several problems. Please consult doctor before you take ferry. 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 dear Doctor. I will to ask you real, I have for high blood pressure in 10 years. medicin can not help to my blood pressure. what should i do with this problem. my blood pressure is 150 / 95 / 55. what is the best medicine for my blood pressure. I have not other disease. I have just blood pressure.Thanks for answer YYYY@YYYY ### REPLY: Hello, Thanks for writing to , I am . A blood pressure reading of 150/95 is borderline reading if persistent, you should be having lesser blood pressure, specially when on medication. There is no best medication for blood pressure, blood pressure medication is selected person to person, but ace inhibitors, diuretics and calcium channel blockers are most recommended around the world. A doctor considers many things like age, diabetes status, highest and lowest readings of blood pressure, and race etc. to select the best blood pressure medication for you. My advice for you is:1) First change your lifestyle.2) Use less salt and fat. 3) Stay physically active.4) Avoid Coffee caffeine, smoking (what ever is relevant).5) Lose weight if you are overweight.6) Monitor your blood pressure regularly if it stays consistently above 150/90 for a week instead of all the lifestyle modifications, do visit your doctor with that record to get the medication adjusted. I hope this answered your question, If you have more queries I am happy to answer you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has been experiencing abdomenal pain for approx. 2 years now. Symptoms intensifying with each episode. The most recent episode has lasted 5weeks (and counting) additional symptoms include constipation, pain and numbness in groin area, bloating and green mucusy stool. The pain sometimes alternates from left to right sides (in lower abdomen) but focuses on the right. He suffered a blunt trauma as a result of an accident 2 years ago around the same time the pain originally started. We have done most medical tests (still waiting on a MRi and endoscopy) we have tried naturopathic remedies and elimantinting diets. No answers, no cures.. :( ### REPLY: Hi welcome to , I understand your query and concern. Your symptoms are suggestive of hemorrhoids (piles). I you to get per digital rectal examination immediately by consulting your surgeon.Meanwhile, I advise you to take syrup.south 10 ml daily bedtime, Tab.laser -d twice daily for 10 days. . Take fiber rich diet like oats, chapati,green leafy vegetables every day. If symptoms still persist you may need surgery. Consult your general surgeon for exert management. Post your further queries if any, 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: My grandad is 78 years old and the victim of 6 major strokes. He has a foley which has caused a uti that put him in the hospital. While there we found out that the bottom half of his heart is dead and the part that is still working is only functioning at 20 %. They took him off his blood thinners for the next week so he can undergo surgery to put a catheter directly in his bladder . What kind of survival rate does he have? ### REPLY: 78 yrs old male with diagnosis of stroke, uti, poor LV function planning for supra public catheter things look in very poor condition but still better care and treatment management can make a hope investigation almost done check for multiple organ functioning properly or notional FUNCTION TEST LIVER FUNCTION TEXTBOOK SUGAR TREATMENT OR MANAGEMENT1)POOR LV FUNCTION MEANS MINIMUM IV FLUID ACCORDING TO CENTRAL VENOUS PRESSURE2)CONTROL BLOOD PRESSURE, BLOOD SUGAR3)PROPER HYGIENE CARE OF PATIENT 4)CHECK FOR FEVER IF PRESENT THEN DO FULL WORK OF IT MP, WIDAL, SPUTUM CULTURE AND SENSITIVITY, URINE CULTURE AND SENSITIVITY, BLOOD CULTURE AND SENSITIVITY5)PROPER ANTIBIOTIC COVERAGE6)DAILY CARDIOLOGIST OPINION FOR CARDIAC FUNCTIONING MANAGEMENT ### END