Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went to the dentist a few months ago to get a retainer (the clear plastic one) and it creates big ulcers so bad that i cant put it back in. So after a few month i went back and hes letting me try again, but the ulcer has come back in the exact same spot. Is this because of the retainer? ### REPLY: Hello, Welcome Thanks for consulting  I have gone through your query, as you are wearing retainer and ulcer develops on same point again, yes ulcer can be due to retainer may be due to sharp edges or any sharp point on retainer causing ulcer.  Don't worry you go to dentist and get trimming of that sharp point or edge are there.  You can apply ointment McCoppin or Pans oral on ulcer twice daily for healing.  Take one capsule vitamin B complex once daily for 7 days. Hope this will help you. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The MRI report shows mild straightening of lumbar lordotic curvature with degenrative changes of lumbar vertebrae in the form of marginal osteophytes at multiple levels. There is partial loss of T2W hyperintensity seen at L5-S1 intervertebral disc- suggestive of disc desiccation. Concentric diffuse disc bulge with posterior central propensity and annular tear and mild ligamentum flavum thickening is seen at L5-s1 invertibral disc level causing mild lumber canal stenosis and resulting in compression of bilateral traversing nerve roots. Mild lower lumber ligamentum flavum thickening is seen, Screening of spine reveals straightening of cervical curvature with maintained dorsal curvature with degenrative changes in the form of small anterior marginal osteophytes from C4 to D1 vertebral bodies. There is partial loss of T2W hyperintensity seen at mid cervical and upper dorsal intervertebral disc- suggestive of disc desiccation. ### REPLY: Hi, These MRI findings are consistent with degenerative spine disease with subsequent moderate narrowing of the spinal canal and compression of the nerve roots at L5-S1 level. The condition seems that may be treated conservatively with NSAID .  These are necessary steps to improve and to avoid surgery. Discuss with a spine specialist about these issues. 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 recently fell through some wood and hit my right breast on the edge of something (it all happened so fast I don t remember what I hit) and now my breast is swelling and my ribs hurt like crazy. Is it possible I broke a rib or did i just really hurt my breast? ### REPLY: Yes, indeed, you could have hurt both your ribs and breast It could cause # fracture of your rib and soft tissue injuries to the breast leading to tenderness and swelling I suggest you get a Chest Ray PA View and start taking Tab Dicloxacillin 500 mg +Definite 200 mg combination 1x2, Diclofenac potassium 50 mg 1x3 with Choral forte 1x3 till you visit your physician with Chest Ray report. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i got dumped surfing in some big surf on thursday causing a twisting strain i think it is a intercostal strain i have been to hospital taking endone and anti imflam naproxen 500 iam 55 years old have to sleep sitting up have alot of pain tablets help how long does this last ### REPLY: Hi, thank-you for providing the brief history. As you have intercostal muscle spasm this will last for about a week or two. As there will be inflammation of the muscles and may be Cochin . I will advise you to undergo some simple breathing exercises like -1. Deep breathing exercises 2. Diaphragmatic breathing exercises 3. Costal breathing exercises 4. Pursed lip breathing exercises 5. Abdominal breathing exercises. As doing this breathing exercises will help improve the strength of the muscles of respiration and improve the lung capacities as well. Kindly note that when performing this exercises you Need to place the hand on the injured area, so the pain will be avoided. 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!!For the last 10-12 yrs my father is having knot kind of thing in his body,i dont know the exact word for that but it is like a lump. . .thing that threatens me most is he has got two on his waist from the beginning, two on right arm, two or three on back, my father never complained or cried bcoz of pain, its just there . . . Im worried whether it is cancer or in future he might get in trouble . . . ### REPLY: Hi Dear, Welcome to . Understanding your concern. Thanks for your query. The most probable reason for lumps on your fathers body is lipoma. These are growth of fat cells in a fibrous capsule under the skin. Generally these lumps move on application of slight pressure by finger. These lumps are harmless and are not cancerous growth. The cause for there occurrence is unknown, but they are hereditary in nature. They do not required any treatment until they cause any problem like pain and continues growth or change in shape. I would suggest you to to consult doctor or surgeon for proper examination to rule out and malignant growth. Doctor may perform physical examination, order biopsy or ultrasound to confirm diagnosis. Doctor may recommend there surgical removal, liposuction (as they are made up of fats) or steroid injection. Hope your concern has been resolved. Get Well Soon. 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 am 33 years  old from last one month i suddenly started having pain in my stomach then it stopped but from last one week its non stop. even my periods got delayed by 7 days. now i got my periods but pain is still there in lower abdominal . sometime its in upper middle  right below burst. doctor say its cyst . can it come out in periods. we are trying to get baby will this cause problem in getting that. ### REPLY: Hi. Thanks for query. Noted your history of started sudden pain in the abdomen for the last one month, a long period to suffer without any proper diagnosis. Also noted that you are 33 years old female trying for a baby and periods were delayed but ultimately got them. I would advise you the following:First get a consultation of a General Surgeon for clinical evaluation and examination and go for the investigations of the blood, urine and stool. Ultrasonography and if required CT scan of the abdomen can tell you the proper diagnosis and a plan for treatment. Cyst can be well diagnosed by this. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, My name is aslam and i have dry skin by birth, since iam using Moisturex cream from the age of 10, now iam 28. As my age increases the price of moisturex also increases from 100gms-15Rupees to 50gms 135Rupees. For me it is best suited cream for my skin among all available moisturisers in the market.Kindly suggest is there a cure for dry skin, or any alternate for Moisturex cream ### REPLY: Hi Islam The price should not be the only reason to change - specially because - it is best suited as you say and you're having been using for a long time.  There is no obvious cure for the .  There are a few similar creams or lotions - the basic constituent is propylene glycol... EacChatDoctorpany adds some component like lactic acid, liquid paraffin and so on.  Your dermatologist - at times any pharmacy - may offer alternatives / they can be similar - not the same / it will be a trail and error stating a new application In SHA Allah, let your income increase to meet your demands! 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 there. iv had irregular periods for as long as i can remember. just recently, in March and April 2013 my periods came right on time. this month if i get it on time again thats three months of regular periods. my partnaer and i have been trying for almost 10 months now. is there a greater chance of conceiving now than the previous months iv had with my irregular periods? ### REPLY: Hi, Thanks for the query. Yes, regular periods usually indicate ovulatory cycles. So you are having better chance now. In this month you tract your ovulation with ovulation kit and plan unprotected intercourse around that period. This will increase the possibility of pregnancy. Start taking folic acid prophylaxis from now-onwards. For more details you can ask me through: http://www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 18 now.Recently i felt very weak, that i couldn t concentrate on my studies..suddenly last weak i lost my balance and fell down in my class room. i thought i was weak and so i left it without consulting with a doctor, but after two day i continuously fell down when ever i try to walk or stand, i couldn t balance myself.. im afraid whether it could result in a serious health problem...help me out. ### REPLY: HelloWelcome to ChatDoctorSudden falls in a young person can occur due to a number of reasons. One possible reason is nutritional deficiency. Low Vitamin B12 or folate levels in blood may cause dizziness and falls. Even iron deficiency anemia may present with dizziness like symptoms. Other possible reason is hypotension due to either decreased cardiac output or due to syncope. These type of symptoms may occur due to some neurological condition or due to some seizure. If symptoms reoccur please visit a Doctor for expert evaluation and don't take these symptoms lightly. Thanks, Hope it helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been in painful gum... no signs of any cuts nor bleeding... it always attacking consistently specially every morning... i decided to have my two upper teeth be removed because of the pain i was experiencing.. but to my surprise the pain is getting stronger... i dont think of any causes because the teeth near the pain already removed... my question is --- what is the pain all about? thank you ### REPLY: Hello and welcome. As per the history posted here it appears you have gum problem called as periodontitis. Do you also have loose teeth and decay in your mouth?please get them examined clinically as it is best to start the treatment early for gum tissue. Damaged and infected gums cannot hold teeth longer. Later on, Upon following good oral hygiene measures can help you retain teeth in mouth for longer. Let me know for further doubts please. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , I had a lipo and abdominoplasty 2 months back . I am recovered from stitches but my abdomen around belly button has become very hard and darker with very less or no sensation. My PS open my incision to see if its hematoma but could not extract anything through vacuum. What it might be it s the size of football and hurts sometimes. What it could be? ### REPLY: Hi. Thanks for your query. Read the history and understood the problems. Lip and abdominoplasty is an extensive surgery of the abdominal wall where-in many blood vessels and nerves will be cut as a part of surgery. In your case the cutting or stretching of the nerves cause numbness around the belly button. The appearance of the hard and darker appearance can be due to an organized hematoma or Serbia, hence can not be aspirated as tried by your Doctor. I would advise you for a high resolution ultrasonography to see whether there is a subcutaneous collection or organization of the hematoma. Take Multivitamins for early recovery. Father treatment will be as per the clinical picture seen on actual physical findings and that found on ultrasonography of the abdominal wall and the abdomen ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear doctor iam from hyderabad since 25 years iam eating 25 packets of gutkas per day now i realise to quit my habbit even dreams also iam feeling that i was attacked with cancer till now gods grace i dont have any problems in future also i want to be healthy please suggest me what i have to do  YYYY@YYYY  is my id ### REPLY: HelloWelcome to ChatDoctorGood to know that you have realized that you need to quit gut. Apart from being the most common cause of oral caner in India, it also causes multitude of problems in body like hypertension, cardiac problem, liver and kidney disease as well as reproductive problems. Best way t stop in quit completely. If you are highly motivated about quitting you are likely to succeed. Will power is the most important thing. Some people find meditation to be helpful when they are quitting. Another option is chewing something that's harmless like chewing-gum, AMLA etc. Hope you become successful in your endeavor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 strange sensation as if a ping pong ball is lodged between my buddocks.  There is no pain just this discomfort and strange sensation.....when I am walking a feeling of a pin pong ball ...not. Heavy sensation  I have been moving heavy furniture which for a female is not a good idea. But now I am concerned about bowel cancer ### REPLY: Hi.here are the usual signs and symptoms of bowel problem (i.e. in cancer): changes in bowel and bladder habits (change in color, size, frequency), presence of blood (old or fresh) in the stool, abdominal pain or discomfort, abdominal enlargement, constitutional signs and symptoms such as fever (usually of unknown origin), significant weight loss. These are the most common signs and symptomatologic. Presence or absence of one doesn't necessarily rule in or out a cancer pathology. A consult with a physician is best for complete medical and physical examination. Diagnostic examinations and management (medical or surgical) will be done accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir, i am yash 11years old suffering from spinal cord atrophy since 22june2010.due to viral fever about 20days.ihave no power& sensation below rib.before illness i was quite well.doctors says there is no treatmnt of this disease in the world.some one says there is potiential to treatment through stemcell but my father has no such huge amount of money.plzzzz help me. ### REPLY: Dear Cash, You are right in saying" As yet no proven treatment is available for spinal cord atrophy. There is potential for treatment for this condition with the use of stem cells". You are 11 years old. You do not have to be rich to be taken of. Prevent bed sores, prevent infection in short, have someone to look after your nursing needs including nutrition and prevent complications. It is matter of time when comfort of affordable or sponsored by research groups of Medical Colleges / Medical Institutes for research purposes to begin with is available. You have to maintain yourself and keep your will power up. Positive thinking is the key. Find a vocation and thank God that your problem starts below ribs and both of your arms are functional. A specially able person you can afford to wait till a time comes when treatment is available. Keep in touch with neurology departments of nearby medical colleges and with internet to connect you to research group. Do ask around your neurologists about genuineness of research group, some day soon, you will find a way out of this condition you find yourself in. You have everything to gain and nothing more to lose. 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: the patient is a pregnant(7 weeks 4 days). During the scanning it has been recognised that there is a free form of fluid in stomcach and enlargement of ovaries is seen(approx. 7cm). on two sides of ovaries masses have been observed in ultra sound scanning. ### REPLY: Hello dear, I understand your concern. In my opinion presence of ovarian cysts need evaluation. The presence of ovarian cyst might have varying presentation:-1)Asymptomatic-There might be no symptoms.2)Some might have complaints like pain abdomen due to infection or bleeding or torsion or rupture of cyst. Ultrasound helps to know the details of ovarian mass. If at all any operation is needed it needs to be planned between 14-18 weeks. But the need of surgery will be decided basing on your symptoms and physical examination. So relax. Nothing to worry. Hope this helps. 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, I am 33 yrs. old male. Got detected with High BP 150-110.  the doctor advised me with salt restriction in diet and in the mean time asked me to undergo medical tests.The Blood report was normal other then the below.1) VitB12 was detected to ABOVE50.2) Uric Acid was detected as 7.9.  he has advised me to take medicine for B12 - for 1 year - Homecheck.and Uric Acid medicine for 2 months.I wish to know, hope this report is not very scarry.  The doctor seems good, but a bit worried.  He confirms that the high BP is detected due to the above-mentioned problem.  pls. confirm.  thanks for your help. ### REPLY: Hello, Your it b12 is certainly low for which you must be taking oral supplements like tab ME12, also, milk and dairy, meat are the only source of this vitamin. Uric acid is borderline, not very high and diet modification alone suffice. You should avoid meat to decrease Uric acid.  This may not cause high BP.  You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If BP is persistently more than 140/90 then you should have treatment for it. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once.  You being a young hypertensive you'll first evaluation for cause of blood pressure. You should undergo test like kidney function test, renal artery Doppler, Sr cortisol and 24 hr Urinary metanephrines. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 daughter complains usually at least a day about her stomach hurts but then don t complain about it no more. When she goes poop she has a hard time getting it to come out she cries and get out of breathe and sometime says I can t breathe cause of the pain while she is going when she finally gets it to come out it doesn t look hard and she usually goes once a day and one day she went like six times and hurt bad. She has asthma and tons of allegries problem. ### REPLY: Hi dear Welcome to the . Constipation is itself a cause of pain in abdomen. Diet changes are of importance to get rid of the constipation at this age. Fibre diet like excess fruits. Act like a good laxative. Excess sugar can also be used in milk. Maida to be avoided. Bread should be full of wheat husk. Apply some local anesthetic jelly or cream in and around the anal opening to relieve the pain and relax the traumatized sphincter by the hard stool. Hope the query is answered. 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: Ive been having severe upper abdominal pain for 6 months, I have diverticular disease. Ive had a chest xray, ultrasound of abdomen  all clear. The pain is worse after eating and when lying down. Nothing makes it better and it is getting worse. What could be causing this pain? ### REPLY: Thank you for your question! Pain in your case is due to Peptic ulcer. It will be burning in nature in the epigastric region. Pain is due to excess amount of gastric acid production and ulcer formation in stomach or duodenum. Take pantoprazole tablets twice daily for 10 days. It gives symptomatic relief. Avoid alcohol, smoking, caffeine and late night dinner. These measures will keep your esophageal sphincter in a good tone and prevent gastroesophageal reflux disease. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I ve undergone follicular study and the doctor said the eggs in the left ovary have ruptured on 4th june. So from next day morning onwards my doctor adviced me to take Naturogest 200mg for 10days., and i am even taking oviduct regularly. What is the use of these medicines? and do they help in the chances of me getting pregnant.. ### REPLY: Hi, I understand your concern. Both naturalist and oviduct NC tablet will help you in conceiving. Naturalist contain progesterone. It will make uterine environment favorable for implantation and support pregnancy. Oviduct NC will help in ovulatory dysfunction. It induces ovulation, decrease insulin resistance. So it will help in maturation of ovarian follicle. So it may increase chance of pregnancy by 50%. Take these medicines under the advice of infertility specialist with monitoring by USG scan and ovarian follicle study. Avoid stress, take healthy diet, . Hope this may help you. Contact further if follow up needed. 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: Hey ..well I am 2 months pregnant and when I urinate I see blood and I get worried I have other children 4 to be exact and my youngest is about to be 7 I didn t experience no problems like this with my others I m just concerned and confused could you help me out? ### REPLY: Hi, Thanks for posting your query. Firstly, I would like to suggest that you confirm where from this blood is coming, from the urethra or from the vagina. If it is from the urethra and if this is a fresh bleeding, it is likely to be from the urethral lining, mostly due to some infection. This needs to be treated as it can lead to a miscarriage if left untreated. If the blood is coming out of the vagina, you should inform your health care provider immediately, take absolute bed rest and avoid all strenuous activity. A sonogram should be taken to note the state of the pregnancy. Further management is accordingly planned. 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: My son, 10 yrs old is suffering from wheezing and cough since the age of three. He is on budecort and asthalin rotaher as advised by the doc. Recently the doc prescribed montair LC for period of two months. He has this problem during april and may especially. I have changed the city but the problem still persists. Please advise best remedy. ### REPLY: Hello. Thank you for asking at . The medicines that your son is currently seemed appropriate to me. But most important thing I want you to know is that correct technique of using inhalers is the most important aspect of asthma management. So if your son is comfortable with inhalers (MDI), please make sure he follows every step of using MDI every time, i.e., shaking the inhaler, expiration, pressing inhaler with deep inspiration, withholding breath and rinsing and gargling. If the technique is not proper, . I would personally suggest to use spacer device with inhaler as it increases the amount of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 yesterday s blood test result showed 160 Sgot , 87 SGPT , D. bilirubin - 0.3, T.bilirubin 1.3 and uric acid 8.4. Before a week result was 126 Sgot , 89 SGPT , D. bilirubin - 0.8, T.bilirubin 1.9 and uric acid 9.5. Except for SGOT and SGPT my other results have improved. How can i make improvement for those two result. I am taking my food very carefully. and i haven t taken alchol since 2 month. Is it due to uric acid and liver problem ? or other factor can make those two result high? What other test i have do do ? ### REPLY: Hi ts Your SGPT and GOT levels are showing signs of a mild liver inflammation. This is often seen with following conditions 1. Long term alcohol intake2. Some viruses involving the liver like hepatitis B and C3. Obesity or metabolic syn .  HbsAg2. Anti HCV antibody. 3. ultrasound of abdomen SGPT and GOT takes time for improvement.  You need to continue to be abstinent from alcohol. On an average it would take 2-3 months to resolve with continued abstinence and medications. So continue on the path of a good lifestyle, and you would surely see good results. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My boyfriend and I had sex last night, but unfortunately, the condom broke. I took the plan b pill about 20 minutes after, but it dissolved in my mouth before I could swallow it. Of course, I drank water with it until the taste was completely gone. Will it still be effective? Should I be concerned? Will taking another plan b pill be necessary? ### REPLY: Hello misunderstand your concernDissolution of Plan B in the mouth does not affect the efficacy of the pill. And you took the water so do not worry, all the tablet composition goes inside the body. So there is no requirement of the another pill. If you had sexual intercourse in the safe period of cycle then chance of pregnancy is nil even if you do not use plan B pill. After taking plan B pill, breakthrough bleeding may occur after 5-7 days and next period may be delayed/earlier. Hope this may help noncontact  for further query. 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, i ve been on the Noriday pill for 10 months now (i was on the Depo Injection prior to it), i started having heavy periods at the start of December and i m on my fourth period now. Is this normal for this pill? The reason i went on this particular one was because it was similiar to the Depo Injection. I didnt get any periods with the Depo. ### REPLY: Hi, Thanks for the query. Holiday pill is a mini pill containing progesterone. During the usage of contraceptive pills some amount of irregularity in menstrual flow is common. If you are having heavy bleeding, you can take symptomatic treatment for that and can continue the pills. If same problem repeats frequently better to think of changing the contraceptive method. You discuss this with your doctor and proceed according to her advice. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 23 yo graduate student studying for my DPT with a decent amount of knowledge of basic medicine. I am having an acute episode of bacterial vaginosis. I am using OTC remedies that have helped in the past because I am broke and out of town right now and only have coverage at my student health facility back home. Id prefer not to go on antibiotics unless necessary anyways. I will go to a doctor if the condition persists or worsens. I have pain in my lower abdomen, yellow-green thick discharge, foul odor, and severe itching and burning. I have had this on and off in the past. I am on NuvaRing, which I have been told can contribute to why I have this problem, but I do not wish to switch back to oral contraceptives and would rather use other methods to prevent this from happening. I am about to use medicated wipes and a rephresh vaginal cream to help balance my pH. Should I remove my  NuvaRing during this episode even though it has a week left? What can I do to prevent having bacterial vaginosis problems in the future? Eat more yogurt? Take folic acid? Take vitamins or even prenatal vitamins? And what about acidophilus pills? I know all about how sex can affect this and how condom usage is important but I havent had a sex in a while so thats not what brought this on. I shower twice daily and use hypoallergic non-scented Cetaphil soap for that area, so my hygiene is good too. Please help me ASAP! Thank you! ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. If you are getting recurrent vaginal infection then it is wise to avoid Nearing. For bacterial vaginosis I treat my patients witChatDoctorbination of antibiotics like clindamycin or metronidazole with clotrimazole in the form of suppository or oral tabs. I also recommend them to use intimate wash regularly to normalize vaginal bacterial flora and PH and thereby prevent further infections. You can continue all other measures like using hypoallergenic non-irritating soaps taking Yogurt folic acid and vitamins also. Hope this may help you. Let me know if you have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 34 year old women who just started working out again. I have sharp shooting pain in my right lower abdomen while doing sit ups. The pain continues after working especially when I go from the horizontal to the upright position. Could this pain be caused by a hernia? Or is the pain caused by a feminine issue such as ovary cysts? ### REPLY: Hi! Good morning. I am  answering your query. The pain you have described could be due to both of your suspected reasons. This could be simply due to a muscle sprain as well. However, to arrive at a diagnosis, you might need to get your self evaluated by your family physician clinically, who might also advise you for some investigations like an ultrasound of the abdomen and pelvis. Depending on the diagnosis arrived, he might advise you for some simple anti-inflammatory .  I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a knot under my left ankle an it is numb all the way from the knot to my little toe to about half way across my foot. There is swelling too an alot of pain. I don t know what i did. All i know i lifted my grandbaby up to put her in her car seat an it started hurting an thats been almost 2 weeks ago an still numb an hurts ### REPLY: Hello, It looks from your details that most probably you may have stretched a nerve supplying to your foot on inner side of your ankle. At present, you should do following to have relief in this:- Start wearing a below knee brace.- Do rest. Avoid excessive movements.- Keep your limb elevated on a pillow.- Take some nerve supplements like vitamin B12 PREPARATIONS.- There should be improvement in next 5 10 days. If your foot still continue to numb then you should consult to your doctor. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 20 year old female and I have started to have some numbness on the lower left side of my back. It started a couple weeks ago gradually, feeling kind of like a sunburn, but there is nothing visably wrong with the skin. Over the past week, Ive had some pain in the area as well. I also feel that it has started to spread around to the front left side of my stomach. I have tried to do some research, but cant find anything that really matches my symptoms. Please help? ### REPLY: Hi, From history it seems that you might be having urinary tract infection giving rise this problem. There might be having renal colic producing burning sensation and pain in that area. Go for routine urine check up for infection. After report go for treatment accordingly.Meanwhile, take some antispasmodic medicine like Metal spas or Cyclops as needed for burning and pain. Take plenty of water. Keep local hygiene clean and . Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having a hard time breathing for 2 weeks now I have been using albuteral treatments and my inhaler it feel like a grown man is standing on my chest. I have a stuffy nose and a horrible cough but no sore throat. What can I do to help my breathing? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of bronchitis or lung infection (pneumonia) is more. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray 3. PUT (Pulmonary Function Test). Chest x-ray is needed to rule out lung infection. PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need additional .  Chest physiotherapy and deep breathing exercises are also useful in your case. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir,My sperm motility is just 29% and the Rapid motility sperm is 0. Normal form sperm is just 2%. slow progressive rate is just 20%. I have undergone left varicosile operative before one and a half year. Still the rapid motility sperm rate doesnot increased. How to increase it. Please tel me the answer. is it can be improved through diet.Please answer me in detail. my contact number is 0000 ### REPLY: Hi, It will take a minimum period of 3-6 months after the varicocele operation to get an improvement with the seminal parameters. Presence of varicocele for a very long term would have spoiled the spermatogonia cells near totally, then you can not expect very good results. If the varicocele operation had not been done adequately, that may be another reason. You had this operation on left side. There is a possibility of minimal varicocele on right side, which also should be corrected. Usually it had been done on both sides together even if it is minimal on one side. There is no separate food recommendation for to improve the quality of semen. Co Q 10, Lycopene, L Carnitine and other vitamins and minerals have been recommended to improve the quality of Semen. Wish you a speedy recovery.  . Morgan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last year at my physical I was advised to try for 6 months... We just recently started few months ago. I just turned 43, I have never had children. I have regular periods. They last 3-4 days. And I have been right on target with my cycle 28days to the day... I was told to try from day 10 on... I m currently trying and want to make sure I m having sex during the correct time...and how often? Every other day? What are my chances getting pregnant? I don t have the resources for much fertility and really want to have a child. I had put life on hold to career and waiting to meet the right person... I m afraid my time has passed and don t know how to proceed....or if I should just keep trying... My last cycle was June 21st....day one.. we have been intimate the 29th day 9...july 4th and july 6th... and based on the calendar dates should have ovulated the 7th yesterday... I usually never feel anything when I ovulate so I m not sure.. per calendar todays my last fertile day.... would you continue to have sex into wkend and next week?? I m so unsure with the best times.... Please advise... Thanks ### REPLY: Hi, Welcome to  Forum. Having a Kid is after 35 will take a long time as you have crossed that Period of conceiving easily, and every woman will be born with a limited number of eggs. As you age, the quality of eggs decline, and you may ovulate less often even if you have regular periods and your eggs may not be fertilized as easily. Since you have been trying it for 6 Months, you should be considering yourself examined by a Gynecologist and get an Opinion. But don't panic, as you will conceive, but it will take longer, it also depends on your partners age. The Younger the partner, the better chances. Continue having Unprotected sex every alternate day starting from 10th to 20th day of your cycle. Eat healthy nutritious balanced diet which should include fresh fruits and Green leafy vegetables. Avoid smoking and alcoholism. Avoid stress and Practice relaxation techniques like yoga and meditation. Once you conceive, schedule regular check up with your Doctor to see if the baby is doing fine. I Wish you All the best and Very 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: 70 year old male anerexic! chronic runner, intermittent dizziness, vertigo, Normalekg, normal blood work, normalecho cardiogram. dizziness occurs at rest only! Heart rate can fluctuate from a low of 37 bpm to 57 bpm. no sinus bradycardy. again poor nutrition !! could there be a possible connection between the Thyroid and possible metabolic dysfunction. and sub clinical electrolyte imbalance? additionally, the Pt. is always anxiety ridden ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that a thyroid dysfunction may be the cause of your symptoms. Nevertheless, a cardiac disorder can not be excluded. I recommend consulting with your GP for a careful physical examination and some tests: - resting ECG and cardiac ultrasound to examine your cardiac function and structure-chest X-ray study -blood lab tests (complete blood count, thyroid hormone levels, blood electrolytes, fasting glucose, vitamin B12 levels, kidney and liver function tests, fasting glucose, PCR, sedimentation rate). An ambulatory 24-48 hours ECG monitoring is necessary to examine your heart rate trends during the day. You should discuss with your attending physician on the above issues. Hope to have been helpful! Greetings! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, uhm. I have had my belly button pierced for a long time and I wore a dangly belly button ring and I kept it in for a couple days and my belly button started to hurt. I put my regular ring back in and now my belly button has swelled and has a hard lump under the skin right behind the middle of the ring. I do not know what I should do. Please help. I tried to squeeze what ever it was and puss and blood came out. ### REPLY: Cellophane You for contacting . Your navel skin has been infected which has caused abscess formation (accumulation of blood and pus). I would suggest you following things:> Avoid touching the area with dirty hands.> Clean that area 3 times a day with spirit> Avoid using ring till you become healthy again.> Apply poly fax plus ointment after cleaning with spirit.> Use acetaminophen for pain> keep the area clean. You will be needing an antibiotic cover if condition does not start improving in 3-4 days. Report to hospital if:> Condition remain same after 2-3 days> Any unusual symptom appears> Condition deteriorates. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes my boyfriend has kidney stones and recently had an insertion of a stent to remove same , however they removed the stent two weeks after inserting it only to realise it was still there... he is now in alot of pain since removal... to the point where its unbearable... he cant stop urinating and is very uncomfortable.. what shall we do? ### REPLY: Dear User, I would suggest performing a renal ultrasound. I suppose that the stent was removed by urinary tract. US is helpful to be sure that there is not an ongoing HY .  Also, a complete renal screening (serum creatinine, academia, sodium, potassium, calcium and blood gases) is recommended. However, if negative, the pain may be due by the procedure itself which is invasive (remember that purines are acid, and ureter may be a little stretched by the instrument and the stent itself). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am 32 and I have been taking prednisolone, starting from 40 mg then tapering gradually, for over an year (last dose taken in July-11). Recently I underwent a semen analysis. In this test there were no sperms detected and there were 30-35 puss cells. I have been potent and have 3 children. Could you please advice. ### REPLY: Hi, Thanks for writing in.1. The decrease in sperm count can be a side effect of steroid treatment.2. You have not mentioned but are taking treatment with steroids for 1 year and this is a long duration.3. If you have 3 child . 4. Pus cells can be seen in infection of the bladder and prostate from urinary infection. Please get investigated and take required treatment.5. Please discuss with your doctor if you should continue steroid treatment for any other problem. 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: dear doctor my baby is now 12 weeks old and was born with no visible mark on his nose. he has cradle cap which is a bit brownish. i have noticed in past 10 days a flat light brown mark on his nose and am soewhat concerned, i have checked if he has more than one, and at present no. could this be a cafe au lait mark? is it true that they dont dissapear? can these be removed, and at what age? i appreciate your feedback. many thanks maria ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Well I recently discovered a rash on my genitals. Particularly on the shaft of my penis, at the base, and just under the tip. They look like pimples of all different sizes. And some have a black circle in the middle of them. They are very painful and developed over a matter of days. I do have sex on a regular basis with my wife but she has never had these. Do you know what this could be? ### REPLY: Hi, it seems that you are having molluscan contagious. It is a viral infection. It spreads after close contact with affected person. Some lesions may be infected with bacteria, as you complain of pain... Take antibiotic with anti-inflammatory .  Then, you may go for electron cauterization. It is one of the best OLD procedures... But, all this should be done under expert dermatologist. Ok ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, 6 months ago I accidentally inhaled a full bottle of very strong bleach over a period of a week ( a bottle had spilled out of sight in the bathroom. I had been asthmatic in my teens but not used inhalers for over 20 years. My asthma is back and I now have the blue inhaler 2 puffs twice four times daily, but worse is my hypersensitivity to smells, particularly chemicals, but also food, clothing etc etc. I am unable to put the central heating on, cant travel (car smells of petrol, metal rubber), have in the last month got used to the smell of myself, any suggestions, my quality of life is zero ### REPLY: Hello dear, Asthma is caused due to bronchoconstriction (obstruction of smaller airway passages) which is indicative of Hyper-responsiveness of air passages to an allergen. Management involves:1. Stalin & Budesonide inhaler-provide symptomatic relief by causing bronchodilator (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs)Can be used during an acute attack.2. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma.3. Antihistamine preparations for symptomatic relief.4. Maintain adequate HY . 5. Also make sure that you are well protected from cold, dust & other allergens. If symptoms still persist, kindly consult a Pulmonologist for proper clinical evaluation. Investigations like X-ray of chest & Pulmonary Function Test will be helpful. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: it feels like i have bubbles on my left side of heart with heart palpitations and also abit of pain in my left arm i have pain in different sides on heart. I am 24 and recentely have been diaganosed wth stomach disorder. I also feel diziness can i know whether it is heart problem or not?? ### REPLY: Hello! Thank you for asking on ! I understand your concern, and would like to explain that heart palpitations feeling is the most common complain ever encountered in normal and diseased individuals. Regarding your pain, there are sufficient components to classify it as atypical chest pain (that is a migrating chest pain "in different sides of your heart" is much unlikely to be extra-cardiac).  From the other side, alternative responsible factors should be sought, such as a muscular-skeletal implications, pleural involvement, articular inflammation, even a digestive disorder, etc. To investigate the above options a careful physical medical exam, resting ECG, chest X-ray study, some lab tests 9like complete blood count, ESR, PCR, etc.) are necessary. Adverse psychological involvement should be sought too. You need to discuss with your attending physician about the above-mentioned options. Hope to have been helpful to you! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I AM A CKD PATIENT NOW ON CAPD. NEED TRANSPLANT. MY KIDNEYS NOT BEEN DONE ANY BIOPSY BUT MY DR. IN KUWAIT IS TELLING KIDNEY FAILED DUE TO ANTI GBM ANTIBODY.I HAVE SKIN DISEASE FOR 35 YRS AND I THINK THERE IS RELATION BETWEEN THIS SKIN DISEASE AND KIDNEY DISEASE.IF I GO FOR TRANSPLANT, DOES THIS PROBLEM AFFECT MY NEW TRANSPLANTED KIDNEY? ### REPLY: Hi, A lot of research is going on the topic of anti-glomerular basement membrane (anti GBM) antibody disease recurrence after transplantation. Anti-glomerular basement membrane (GBM) antibody disease may progress to end-stage renal failure, requiring either dialysis or renal transplantation. There are only six reported cases of symptomatic recurrent anti-GBM disease in the literature. The incidence of recurrent linear Immunoglobulin G (Egg) staining in the transplant may be as high as 50 percent. However, most patients remain asymptomatic. You may discuss this point with your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello my name is cheyena.I been having issues with back pain,leg pain. every sense ive had my son by C-SECTION, ALL THESE pain gottin worse. the doctor I see is trying to put me on anti-depression meds and that not gone help ive tryed it and im still in pain. what could i do or take for this, when the meds they giving me is not helping/ i need something for pain not depression. ### REPLY: Greetings from . Thanks for posting your query.  It could be due to Inter vertebral disc prolapse or due to a nerve pinch (compression) in between lower vertebral bones. The other possible cause is Kidney stones or Infection inside your abdomen.  I advise you to get an MRI Lumbar spine and ultrasound abdomen scan done. This will help us in establishing the diagnosis and once diagnosis has been made your doctor has to give proper medication as per the diagnosis.  Kindly revert with scan reports. Hope this information is useful to you. Any clarification feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 6 year old boy has been very fatigued and complaining of stomach pain. He has had no fever, vomiting, or rashes of any kind. He has an appetite . We took him to the doctor and they swabbed for flu , strep , and took blood. All tests were negative. He also had a Cat scan for the bellly to check for internal bleeding and/or swollen glands- again negative. Any thing else we should test for? ### REPLY: Hi. Abdominal pain is very nonspecific symptom. It can be caused by organic diseases or by functional diseases. In his case it is obvious functional disorder because diagnostic tests that you have mentioned would rule out any organic disorder. At this age pain can be caused by food allergies, IBD or psychogenic. Also, any infection of respiratory or urinary tract can lead to abdominal pain. I suggest waiting and see are symptoms going to persist and getting worse. If yes then complete garment. Workup needs to be done. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My husband has a metal plate and screws in his ankle since 2005. Shortly after the broken ankle, he developed insulin-resistant diabetes . He had eczema on the ankle in 2006, but it went away. Now, there is a dark red rash directly over the plate and it is getting worse - started out as pink then got darker. The outer part of his ankle is fine even though there is a narrow plate there. Do you have any idea what this can be? ### REPLY: Hi, After reading your history it appears that your husband might have lignification or purpura over the ankle. This can be due to trauma to local area which is causing damage to the skin day by day. I advise you to not pinch or pop the area. You can apply a mild steroid cream such as Cortisone cream. If itching is present then can take Ben .  Consult a dermatologist for checking the aggravating factor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 joint and body pain for more than one month. I am taking treatment for crohn s decease and having medicines following medicines. Pentasa granules 1gm 1-1-1, azoran 100 1-0-0, and sysfol 0-0-1. Is this body pain because of side effects of any of these medicines.??/ I am 33 years old male with 5 9 ht and 65 kg wt. ### REPLY: Hello, There are many medical conditions related to the joint and body pain. I suggest doing some examinations for further evaluation. I recommend a complete blood count, PCR level, rheumatoid factor level. Meanwhile, I suggest using anti-inflammatory medications such as Ibuprofen 400 mg three times a day to relieve the pain. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife EF was 15 to 20%in Sept 2016. It suddenly dropped to that level. Doctors suspected viral or stress cardiopathy. She also developed hypothyroidism after MVR in Jan 2016 but that time her EF was 55% and was put on amiodrone plus dirutics. Her Thyroid is normal Can her EF improve now..pls also tell how her EF can be improved. I m writting from India. Thnx ### REPLY: HelloWelcome to Ask a Doctor service. I have reviewed your query and here is my advice. EF 15 to 20 % is indicative of left ventricle failure it is the medical emergency, it can not be due to infection (Viral) unless it is the life-threatening and severe infection condition demands the immediate medical attention, second it has to be correlated with the clinical condition, if patient is doing well then report of echo need to be repeated on another echo machine. Hope I have answered your query, let me know for further assistance, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hy, i am 26 years old,y height is 5.3,weight is may be 51kg,and i am a patient of depression from last 8 years...sir from last 3 days i am feeling that my boody suddenly get very cold,i am very sleepy today i went to doctor he checked my fever which is normal and also check my blood pressure which is also normal,if every thing is normal then what is happening with me,sir i am also a patient of depression and using tofranil150mg daily..i am really worried ...can you please guide me properly ### REPLY: Hi dear, as you are suffering from depression since last 8 years, and also you are on treatment, so you are known that in depression there are chances of anxiety features in between you feel like body suddenly get cold and sleepy and anxiety due to that. So not to worry it may be due to any upcoming anxiety, or it may be due to some underlying thoughts. Consult your treating psychiatrist and ask about sucChatDoctorplain. And if needed change medication. Not to worry much. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had four surgeries on a broken humerus, the head was snapped off the bone. First, a plate was put in to hold together, then removed because a screw broke and caught on plate. It was fused with cadaver bone. Three months later, it broke again from an auto accident. The third surgery put another plate back in and my own bone was used for hip, but prior to surgery a muscle test was done and at the time, I had lost over 30% of my muscle. Infection set in and after a month of iv antibiotics of Vancomiacin, the plate was put back in. This last surgery was done a week ago. There was always hardness, like a rock was in my arm, after the second surgery. I was wondering if it s possible that I have myopathies and if so, how do I know? Four of the five tests for infection were positive prior to the third surgery when the plate was put back in. ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, yours is a tragedy story where some doctors feel only that only operation is the answer to fracture, had it been kept in cast, things would not have been that bad, but to be frank, it's you also who has to be blamed, as you have had repeated insults to the bone. The hardness you talk of if it's only in the limb where you were operated so many times could be due to fibrosis of repeated surgery and infection, but if this is throughout the body then other causes has to be sought out. I hope that answers your query. If you want any more clarification, contact me back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, good evening, Im been diagnosed with tuberclosis menengitis for last 2 months. Consulted specialist doctors, taking streptomycin injection, t levecetracyin, moxi flaxin 400 mg. Im also been diagnosed with jaundice. Its now improving. Questions is, what are the symptoms of TB decreasing? ### REPLY: Thanks for your question on . I can understand your situation and problem. Following are the signs and symptoms of improvement in case of TB meningitis. 1. Absence of fever and headache. 2. Absence of seizure and vomiting. 3. Improved appetite. 4. Weight gain. 5. Not worsening cognitive and behavioral function. So assess these signs and symptoms in your case. Don't forget to take anti tb .  Don't stop before this duration. TB is 100%curable, you need to follow proper 6-8 months course of treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can calcification in the achilles tendon be caused by meth use. The ankle/foot has never been fractured. He is a 29 year old male who uses methamphetamine and probably injects it for at least five years now. Went to have a radiograph of the ankle because we thought it may be broken. ### REPLY: Hi, Thank you for providing the brief history of you. As you have calcification in the Achilles tendon, it can be due to multiple factors and if methamphetamine has really been giving any side effects it is very unsure to comment on it. This might have lead to the symptom of calcification, or it might not as well. After a thorough musculoskeletal assessment things can be understood better. Also, trying out physical therapy like, Therapeutic ultrasound therapy will help the calcification to be loosened up and followed by slow stretching to activity induced exercises, this problem can be taken care off. 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 have a rash all over my arms and legs. Its very red but not itchy or sore.  It looks more red after showers or work outs. My dr that manages my blood pressure says he thinks it is the medication that is causing the problem so he changed the meds couple days ago and when I visited my glaucoma specialist today he said it could be the drop that I use - it being a beta blocker.  What do you think? ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. Any medicine can be allergic. So it is difficult to say which one. If you recently started a . So it is advised to stop the suspected one and replace that with an alternative by your treating doctor. I treat such allergic rash with antihistamines like cetirizine. If itching and rash is more severe I give short course corticosteroid also. I recommend calamine lotion for local application on the rashes. Hope this may help you. Let me know if you have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 29 year old/ male, an occupational health nurse working in UAE on a construction site. I was recently married and  rejoined here 2 months ago.  Suddenly one day I was having sciatica pain on the left leg for 2 days and it shifted its location to right side after 2 days and it continued for another 5 more days. I underwent an MRI as per my orthopedic doctors advice and the report shows that i am having degenerative disc disease on the lumbar region. This is the MRI report:- MRI OF LUMBAR SPINE Indication: Low backache radiating to bilateral lower limbs (R>L) Technique: MRI of Lumbar spine was done on 1.5 Tesla Scanner in multiple planes and using multisequence technique. Patient given Soft copy of MRI study Findings: Straightening of lumbar spine noted. Marginal osteophytes noted at L3-4 level. Transitional vertebra noted (sacralization of L5). The vertebral body heights are maintained with normal marrow signal intensity pattern. Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. Rest of the intervertebral disc normal. Facetal joints normal. Pedicles, laminae and spinous processes are normal. Visualized spinal cord, conus medullaris and thecal sac are normal. Both psoas muscles are normal. Both sacro-iliac joints are normal. Pre and paravertebral soft tissues are normal. Opinion: Degenerative lumbar spine disease with Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. I am not on any medication because the pain was lasted only for 7 days. Now i am absolutely pain free and i am able to do anything. I am over weight and it is 112 Kg with 60 height. But I would like to know more about - 1) the problem what i have..??? 2) what will be managements ..?? 3) what are things i should take in consideration to avoid further damage..??? 4) Is there any cure for the disease..??? 5) What are the things i should keep in mind before intercourse...??? 6) Will sexual intercourse make further damage to the said problem...?? Please help.... ### REPLY: I read your query carefully, and I understand your concern. The report indicates diffuse degenerative changes of the lumbar spine and a herniated disc at the L3-L4 level which causes narrowing of the neural foramina thus compressing the nerve roots bilaterally, data which corresponds to your symptoms. The first step in treatment is physical therapy and painkillers like Ibuprofen. If symptoms don't subside local injections with corticosteroids and anesthetics are the next step. If still no success surgery could be considered, at times even earlier if there are new signs like motor weakness, saddle-like distribution sensory changes and micturition problems which could indicate caudal equine compression. You should also avoid heavy weight lifting if that is the case in your line of work. I hope to have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY 3 YEAR OLD SON COMPLAINS OF HEADACHES EVERY 2-3 WEEKS. WITHIN 2 HOURS OF COMPLAINING OF HIS HEADACHE, HE VOMITS AND THEN APPEARS TO BE COMPLETELY FINE. tHIS HAS BEEN GOING ON FOR THE LAST SIX MONTHS. SHOULD HE BE GEETTING A REFERRAL FOR A CAT SCAN OR AN MRI? ### REPLY: Hi... Thank you for consulting in . Headache in kids need to be considered serious only when the below symptoms are there -1. Vomiting continuously2. Seizures/ Fits3. Watery of bloody discharge from ears and nose4. Unconsciousness5. Altered sensorial or behavior. Without the above red flag symptoms, just feeling low energy levels points out towards Migraine and other sorts of tension headaches which are on the rise in current scenario due to excessive academic and peer stress the kids are experiencing. I have a few questions for you -1. How long has the headache been there?2. Does it always occur on forehead or keeps changing?3. Is it associated with blurring of eyes or double vision or giddiness?4. Is there any family history of migraine or single side headache?5. Is he very angry when he gets headache and does the ache get better after a good sleep?6. Does he vomit when there is headache? Kindly get back to me with the answers to above questions and also mention his weight so that I can suggest you the formulations which are good. But as of now - you can give oral Paracetamol in the dose of 15 mg/kg/dose(max ceiling dose 500 mg) every 4-6th hourly. You can approach me at the following link. Please find the link below -www.yyyyyyyyyyyyy.com/doctors/ .  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m a 55 yr. old female, diabetic last 35 years and am experiencing sore like pain in my mouth, gums, tongue, throat although there are no visable sores. I m on Zolpidium, Tramadol, Hydroxyzine and Omeperozal. My teeth enamel seem to be thining and some teeth are very thin close to my gums. What can it be ? ### REPLY: Hello, People with diabetes are more susceptible to developing infections, as high blood sugar levels can weaken the patients immune system defenses. So, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. At the other side, as with all infections, serious gum disease may cause blood sugar to rise. In my opinion you may have a periodontal disease. This is the most common dental disease affecting those living with diabetes and your pain can be a sign of mouth problems caused by diabetes. My advice for you is to consult your dentist as soon as possible and keep your blood glucose numbers as close to your target as possible. 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: im 16, ive never had sex. i get a burning senation when i pee and ejeculate. after both i seem to a little left behind in the end of my penis. i have had a small amount of blood in my urine twice now, in one week only. sometimes a little semen comes out during urination. it is red around the hole of my penis ### REPLY: Hello, From the given symptoms it seems that your penis is inflamed. This is common and could happen due to some mild infection or masturbation. Burning sensation could be due to the inflammation of the urethra. It is most commonly due to bacterial infection of the urinary tract affecting the bladder. Therefore, there is nothing to worry, and you should .  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: 52 year old male. Have a lump in my liver. Biopsy came back  "suspicious for cancer". What in the world does that mean? Had a PET scan today waiting a week to see the doctor.  How likely is this to be cancer?  I have not had a liver function test in about 3 months and thosse were mostly normal. ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. There are more chances to be cancer than not, but it should be confirmed with repeated biopsy and then therapy may be planned. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a really bad cavity in the back of my mouth that is throbbing. My mom suggest putting dentek in the cavity as a temporary fix. Is this a good idea? I dont have insurance or the money to go to the dentist. If this is not a good solution (which something tells me, its not), do you have any recommendations? ### REPLY: Thanks for your query, I have gone through your query. The cavity has to be cleaned and filled with a permanent restoration if there is no pupal involvement, if pupal involvement is there then it has to go for root canal treatment. If I am your treating doctor I would suggest you to get a radiograph of the tooth and see the extent of involvement of the decay and plan the treatment. It has to be filled as early as possible otherwise you might have to lose the tooth. Then the expense of the treatment also doubles. 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: I have a small rash that itches on my face. It had originally looked like a ring worm my husband thought. It never made a complete circle but it did get a little discolored in the middle. I have not treated it with anything and I have had about 1 month. I am in the sun alot. Any suggestions? ### REPLY: Hello. Thank you for writing to USI suggest a possibility of either Tina facial Or a Polymorphic light eruption/ POLE. Fungal infections have a typical morphology i.e. peripheral expanding, raised, red and scaly rim and central clearing. The ring may be partial or complete.POLE may present as an eruption of red bumps or patches over sun exposed skin. The lesions in POLE are usually itchy but lack a characteristic ring shaped morphology of fungal infections. However, it may be difficult to distinguish Tina from POLE on clinical examination. Confirmation of diagnosis would require a clinical examination and may also require a lab test, if doubtful. KOH wet preparation made by scraping a small amount of scale can be examined under the microscope to look for fungal elements. Treatment would be guided by the diagnosis. Fungal infection would require topical antifungals with or without Oral antifungals whereas a light eruption would respond to sun protection along with topical steroids. An OTC oral antihistamine e.g. cetirizine 10 mg once daily will provide symptomatic relief from itching. I suggest that you visit a dermatologist for a confirmatory diagnosis as well as for the needful. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My two Grandson s were playing and one was carrying the other. My 6 year old Grandson felt backward and hit the close to the crown where hair sticks up on a concrete floor. We put cold pack on it immediately. He has quarter size knot that came up. I gave him childrens tylenol ,1teaspoonful. He ate and drank milk and so far is doing okay. making him rest and keep ice on his head. Pupils look fine. No vomiting or anything. just trying to keep him still and lay down for awhile. Do I need to take him to ER? ### REPLY: Thanks for posting your query at . I understand your concerns. Look out for the following ominous signs of head injury:* Torrential vomiting* Severe headache* Unconsciousness* Convulsions any of these are seen, take the child immediately to a hospital and get a CT Scan of brain done to rule out any hemorrhage. But if any of these are not present, you can ignore it. Some amount of pain is acceptable. Stay relaxed. The dose of paracetamol/Tylenol seems inadequate, but I cannot comment unless I know the actual weight of the child. It is given in the dose of 15 mg/kg/dose at intervals of a minimum of 3-4 hours. Hope that helps. If you get back to me and I would try to help 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 have been having nausea, back pain, headaches, bloating, throat itching, period 7 days late. I just had thyroid cancer surgery and my periods have been for 10day for the last 2 months. I don t know if it is the l-thyroxine that s causing this or what. Could I please get feed back ### REPLY: After total thyroidectomy, your thyroid levels need to maintained by thyroid harmony replacement. Any increase or decrease in levels beyond the harmony level range can cause problems. It is possible that your symptoms can be due to excess thyroid harmony levels since your menstrual cycles are also prolonged. But your other symptoms can also be because of viral illness. It is better you see you doctor and get your levels tested ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: anshu (26YEARS,F) YYYY@YYYY rohtak(haryana)Indiai am suffering from primary fertility.there is no issue from last five years.i am having bicournate uterus with one cervix. one side hytometra collection n other side proper functioning.i m looking 4 prper  advice. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes, having a biconcave uterus is the reason for infertility. You have to go for surgery.1. Do surgical reconstruction of biconcave uterus to one. I suggest you should first reconstruct your uterus in the manner that it becomes capable of gaining fertility. Once you are done with your surgery then you can try for natural pregnancy. You will be succeeded surely if not than you can step for second part that is artificial insemination. Please do not worry much, because worrying can cause reduction in fertility. 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: I had a heart attack a few months back and had an echogram taken which measures your valves and muscles and other parts of your heart. The results I received was that my heart is funcitoning at 25 percent at this time and my muscles are dead. I had 36 sessions of cardiac rehab also and if I walk a short distance I get shortness of breath also. Can I live a normal life with my heart at 25 percent and am I a high risk of living a short life. Thank you ### REPLY: Hello, This is a serious heart problem, and you need to take more care of yourself by taking regularly your treatment regularly consulting with your cardiologist.  Should not force yourself with physical activity a special diet with low salt, so you need to be the doctor of yourself too, and there is a hard job, so it is not like a normal life, because you have so many new rules now. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END