Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a severe cough that comes and goes every few weeks for around 3 months, am also experiencing pain in the left side of my neck which has been there for the same amount of time as well as severe pain when I breathe or cough which lasted for about a week, are these symptoms related to some sort of chest infection, or cancer? ### REPLY: Hello dear, thanks for your question on . In my opinion you should definitely consult pulmonologist and get done1. Chest x ray2. PUT (pulmonary function test). There are few possibilities in your case.1. Lower respiratory tract infection (LETI)2. Bronchitis. So chest x-ray is needed to rule out LETI (pneumonia). Possibility of cancer is very less. But chest x-ray will help in ruling out cancer also.PFT is needed to rule out bronchitis. So better to consult pulmonologist and first diagnose yourself and start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have swollen knuckles and wrist and swollen tendons in both arm with redness following also have swelling on back of my head where spine connects also on both of my sides and upper chest area and on the bottoms of both feet usually on the ball of the big toe and my heel and between on the pad of my my toes and with all this comes with itching to but it doesn t really itch when I scratch it. And in my groin area lots of swelling and it s turning purple. These thing can move or go away in a couple of days but this has been going on for about 2 weeks and now. ### REPLY: Hi, thank-you for providing the brief history. As per the history this looks more of either of the condition like RA or a nerve root entrapment for which we need a thorough clinical examination and some diagnostic tests to confirm the diagnosis. As this is just the beginning we will be able to assess it at the earliest and guide the proper treatment. Usually with RA or Nerve entrapment with a combination of . 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 , My wife is 37 years old and we are trying to have a second baby through IVF . Last two times she had tubular preganancy and our doctor is doubting she may have TB. But in culture check no Tb found. Still the doctor is insisting for AKT3 tablets and my wife is taking the same from last one month. Now we are going to do IVF next month and doctor is telling to countinue the AKT 3 also along with other medicines. Is this will affect the health of the baby ? We are really worried. Kindly advice. Our doctor is telling AKT 3 doesnt have any side effects. ### REPLY: TB isn't easy to diagnose, but strong clinical suspicion may help start some therapy. TB is important cause of infertility, if not treated properly, risk of TB even to baby may be much more than risk with antibiotics. The patient may need to continue on folic acid and pyridoxine supplements while on AKT3 and also keep a close watch on the list of side effects on a monthly basis. It does have side effects, but they may not be in your case, to a significant seriousness to stop the medicines. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 all of my upper teeth removed.  I saw the surgeon for afollowup about 2 weeks and everthing looked good.  Today I noticed my upper cheek next to nose is puffy.  What do you feel caused this?  This is first time I have ever had this.  Thank you for any advise you can provide.  Kelly ### REPLY: Hello, The puffiness of gums post extraction of teeth may be due to-unhealed socket or bony projections on the socket, root or tooth pieces remaining within the socket. A thorough clinical evaluation by a dentist is necessary. Gargle frequently with warm saline. Irrigate the socket with Betadine solution. Root pieces if remaining within the socket has to be extracted. Apply colonel on the swollen gums. 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 constantly hot and then chilled, my hands are cold, I get clammy, very uncomfortable. I do no sweat, heat stays inside my body, at times my forhead aches. I take 40M blood pressure pills, right now my b/P is 163/83 Something is wrong. I called my Doc. he says I am OK?? ### REPLY: Hello, Pheochromocytoma is a possibility, in view of fluctuating BP and other somatic symptoms. Alternatively, you may be having paroxysmal hypertension without obvious provocative factors & repressed emotional trauma causing condition called pseudopheochromocytoma.  You may go for plasma levels of free metanephrines as initial test. Thyroid function test (Free T3, Free T4 & TSH) also won't be out of place. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I get the depo medrol 80 mg injection for my allergies, and i got one recently a day before my cycle was due to start, which is always on time, and my cycle came a week late, and its been on every since for almost 3 weeks. Is this a side effect? Im 44 years old, no fibroids never had any complicatios with my cycle, no chances of pregnancy. ### REPLY: Hello, Thanks for using . I read your query and understand your concerns about delayed periods. Although delay in periods is not a prominent side effect of steroid use, but it is one of the side effects commonly observed among middle-aged women. This happens because the menstrual cycle is regulated by hormones which are steroidal in nature. The use of demo me .  I hope this answers you. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am experiencing pain in one toe on my left foot. It is the toe next to my big toe. The pain comes and goes but on this occasion the pain has lasted approximately three to four days. I have recently suffered a stroke in the month of October. I have been told my medical personnel any experience with tingling numbness or pain it is imperative to have my vital signs checked at a hospital. The pain has kept me awake for a good part of tonight. ### REPLY: Hi, It may be due to peripheral vascular disease where the blood supply to your leg is reduced and causes pain. We have to rule out other causes before commencing the treatment.  Consult a general surgeon and get an ultrasound Doppler to assess the blood supply to the feet. As of now you can take analgesics like Diclofenac or Tramadol for 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: I have a smelly tooth when i floss. The dentist says some bone loss causing space for bacteria to grow. I have been very ill for 6 weeks now and have been diagnosed with a polyp in my sinus adjacent to the tooth. What came first the polyp or the smelly bone loss tooth? Which caused which? ### REPLY: Thanks for your query, I have gone through your query. The bad breath or halitosis can be because of the gum infection or pus discharge secondary to the deposits between the teeth or below the gums. Consult an oral physician and get your teeth cleaned and use mouth washes after that and maintain oral hygiene after that. The halitosis can also come from sinus polyp also. But first get your teeth cleaned, and later you get the sinus problem solved. 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: At the end of November I had head conjestion, lot of drainiage, took Clariton D and it subsided.  Then I got a horrible cough end of December it then subsided.  Then my husband got sick had a cough.  I watch my baby granddaughter, she is in daycare 3 days a week, she has congested lungs and lots of nose drainage and a cough.  Now I got back my horrible cough, I took a CF expectorant, cough seems productive.What can I use right now to help relive the symptons, I do take supplements daily.  What prebiotic should I use to gain a strong immune system. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of recurrent viral infection is more. Spread of viruses is common in family members. Amongst viruses, Influenza virus is the most common cause for these symptoms. So my recommendation is to take annual Influenza vaccine. This will provide immunity against Influenza for one year. You should also take raw green leafy vegetables, fruits, pulses, milk etc. Also start protein supplements, multivitamin tablet, probiotic (antioxidants) .  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: I have a sister who had acromegly, which was undiagnosed for many years. She eventually had an operation to remove the tumour. And, had radiotherapy as all the tumour had not been removed. Over the last couple of years she has slowed down a lot and, has shown signs of confusion and what seems to be dementia . She is on lots of medication. Do we know the prognosis and mortality rate for my sister. She is 68 now and, it s about 20 years ago since acromegly was discovered. Concerned sister AAAA ### REPLY: Hi, Thank you for posting your query. The prognosis of a benign tumor of pituitary is quite good. So, if you have gone through the biopsy report of the tumor, and it is benign, then the chances of long term survival is quite good. There could be mild decline in her memory and cognitive functions due to her tumor and radiotherapy. However, we should investigate whether she has any other reasons for the same. This would include checking for vitamin B12 deficiency, thyroid dysfunction, etc. Proper treatment of her dementia would help her recover to an extent. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: .I had my gall bladder removed 2 weeks ago. Every time I eat anything larger than 1/4 cup of food, I have intense pain within 30 minutes. It continues for hours and is the same type of pain as before the removal. Today I had my third stool which was clay colored. I also had repeat liver enzymes done which are still elevated. Is this to be expected? ### REPLY: Hello, The pain after cholecystectomy is called post cholecystectomy syn .  I suggest you take low fatty foods and less food for few days. The bile reservoir gall bladder has been removed from your body, so obviously digestion difficult. If your liver enzymes value increased more than twofold than only you need to worry or else not. So kindly attach the report. The Celestial can be prescribed for your pain after operation. If no improvement than consult doctor for detailed evaluation and MRCP like investigation if needed. Hope I have answered your query. Let me know if I can assist you further. Take care.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sometimes my heart feels like it all of a sudden is pumping extra hard like a surge of adrenaline or something and i have to take several deep breaths before it stops. there is no usual time it happens, just periodically throughout the day. It kind of feelis like air bubbles passing through my heart. do you know what may cause this? i m 23 years old, 5 8 and about 130 lbs. ### REPLY: Hi, It could be because of extra beat which happens sometimes called as PVC or APC. It occurs due to sleep problem, anxiety, stress, alcohol, smoking, and thyroid problems. To confirm you'll need ECG and if its normal then holder monitoring, echo and later may need thyroid test. Most of the times they are benign And not a matter of worry. Treatment involves the treatment of cause and avoid smoking if any. If disturbing too much then you can get tab Collar LA prescribed from your local doctor. 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.  My name is Ken.  My blood sodium has been low (130) for about a month.  My internist has asked me to see a nephrologist.  I havent spoken to him about this (just spoke with a tech on the phone), and I am very curious about why I would see a nephrologist.  Are there renal diseases associated with low sodium?  Do they only treat the problem symptomatically , or do they look for an underlying cause?  What might the causes be?  My appointment is not for a couple of weeks, and I am not good at waiting to be educated when it comes to my health!  Can you help?  Thanks. ### REPLY: Hello and welcome to , The levels of sodium and other electrolytes are maintained by kidneys. So, kidney abnormalities will lead to alteration in the levels of sodium, potassium and chloride. This is the reason that your doctor has referred you to a nephrologist. Thus, you will need to consult your nephrologist for clinical assessment and relevant investigations and thus treatment. I am afraid you will have to wait for clinical assessment and investigation before exact diagnosis can be made. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is an alcoholic and smokes up to 3 packs of cigarettes a day. He has just had a large cancerous tumour removed from his mouth as well as part of his tongue and lymph nodes which the surgeon said looked cancerous although he is awaiting pathology reports. He has been very confused since the opertion nearly three weeks ago and had a CT scan today to see if the cancer has spread. Since this was a large tumour does this mean that he might not survive for long after his treatment? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Treatment and prognosis depends on many factors.  Size is not the only parameters that he had good prognosis or bad.  It depends on stage, grade and spread of cancer.  If your tongue cancer has distant metastasis then it has poor prognosis.  If no distant spread and margins are clear then it is a good prognosis.  Further treatment is chemotherapy according to need. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Small lump has appeared on surface the tip, just off to the side of right nipple, Not on breast or areola on the actual nipple.  There is no head like a pimple, have tried to squeeze it in case it is, but nothing.  It can be uncomfortable at times but not often. It is basically the same colour as the rest of my nipple but is paler and more white on the top of the bump. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have nipple adenoid, cyst, some benign breast lesion or cancer.  You should go for mammography and biopsy of that lump.  It will give you exact diagnosis. Then you should take treatment accordingly. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have had a dull ache on the left side of my neck and a dull ache in the left side of my face (cheek mouth and eyebrows. I went to doc today and she could not figure out what this could be can you help me. I am a 35 YO female overweight, my bp was 110/76, heartrate was also normal. ### REPLY: Hello, As the pain in the neck radiating to the face can be involvement of the PNS and CN. We need to perform an MRI. For now, you can use the cervical collar and use hot water fermentation for the neck region. Any disturbance in the peripheral Nervous system may lead to the symptoms of pain in the neck. The radiating pain towards the face can be a cranial nerve symptom.  In the case with a neck collar and hot water fermentation over the neck the pain comes down and the radiating symptoms then we may not have to worry about as it could be an accessory symptom. But if it doesn't we need to examine the cranial nerve in separate. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 11 years old.. she is having a lump behind two years.. its slightly fleshy over the bone.  too blood tests.. haemoglobin - 12.4gm/dl;  total wbc count is 7090 cells/cmm; diff wbc count neutrophils- 53.10% lymphocyte-38.10%; eosinophils - 3.50%; monocyte-4.50%; basophils-0.70% immature granulocyte 0.10% ESR 1 hr - 67mm ; Smear study is normal; otherwise she is normal; she has mild adenoid englargement and mild tonsilitis.. she is eating normal; normal weight gain; what could be reason for elevated ESR? should I take the test again? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. There are many causes of high ESR. Tuberculosis, infection, anemia, autoimmune disease are the common cause of high ESR. She should go for fine needle aspiration cytology of lump.  It can be due to tuberculosis.  Then she should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 52 years old, male, active in sports. I got sick couple days back, fever, I went to my doctor for a check-up. Had an x-ray done as well. Results show that I have a well-defined ovoid opacity in the left lower lung overlying the 6th anterior and 9th posterior ribs. Is this ok? Is this life threatening? Thank You.. ### REPLY: Thanks for your question on . There are many causes for ovoid opacity in left lower lung. Like1. Benign cystic lesion (oncogenic cyst)2. Malignant mass3. Rounded pneumonia etc. So we need to rule out all these. CT thorax with contrast is needed in your case. As CT will give you better idea about the lesion like exact size of the lesion, its shape, borders, necrotic or not, associated with lung lesion or not, mediastinal lymph nodes enlarged or not etc. And all the above points are important in deciding etiology. And you may need biopsy also for proper diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a couple MRIs lately as a control subject for several memory and aging studies (I appear to be aging normally without dementia , huntington s disease, etc.) After a recent MRI, I got a call from my doctor that he had gotten a report from the imaging center about an anomylous result. This is what the report says: Sagittal T1 3D IRFSPGR, axial DTI, and axial HARDI research sequences were obtained at 3 Tesla. Limited research MRI demonstrating apparent T1 hypointensity of the visualized cervical spine which could be related to anemia or infiltrating marrow process. Recommend correlation with patient s medical history. I recently had a routine physical and follow-up blood testing which would eliminate anemia as a problem. My doctor is unclear about what the cause of this result could be. I looked around online and noticed the other people who have had MRIs have had some underlying physical problem they have been trying to treat. However, while I have had arthritis in my neck for some time and have a limited range of motion, I feel great, and have no symptoms like pain or anything else. Can you help me understand what this MRI finding means and what my follow-up actions should be? Thank you! ### REPLY: HiT hank you for the question. As the MRI report rightly mentions it may be an infiltrating marrow process. In the absence of any history of pain, stiffness of neck it is difficult to comment about origin of the lesion. If you have any symptoms like chest pain, cough, fever, pain in abdomen, blood in stools or weak urinary stream please see a doctor for evaluation of those. If there is any back pain, MRI of rest of the spine is recommended. In the absence of these symptoms or signs and with no suggestive history repeat the MRI at 6 months or earlier if symptoms develop. Hope this is helpful. Let me know if I can be of 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: I have a sharp pain that shoots from my left chest through my left neck around my left temporal area behind my left eye and in my left forehead sometimes light sometimes aggressive and when aggressive sometimes causes me to rapidly clutch my left chest area immediately following I have a few seconds of blurred vision and dizziness and a rush that runs from my neck and head into my arms and my chest and my hands on both sides I have had an echo cardio gram of my heart and caradid artery with clean bill of health by general physician I have seen a neurologist with a clean bill of health I am seeing a back specialist and bone and joint specialist regarding a pinched nerve in my lower vertebrae that we are correcting but is not believed to be causing the problem I have had three emergency room visits for the same problem and all clear bill of health as well for my heart I always have regular blood pressure and the problem seems to occur more often when I m sitting rather than standing or laying down typically if I m sitting in a recliner or a vehicle seat or something of that nature I don t know who else to talk to. I m not sure if I should I see a heart specialist or if it s another problem I m currently overweight at 380 pounds live a very high stress life personally and professionally and I am concerned if maybe this is a gas problem rather than a heart problem and I am going the wrong direction. ### REPLY: Thanks for your question on . I can understand your concern. Since your 2d echo and carotid Doppler are normal, no need to worry about heart diseases and hence no need to consult cardiologist. In my opinion, you are mostly having stress and anxiety related symptoms. You are living very stressful life. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright. Avoid stress and tension, be relaxed and calm. Try to lose some weight. Stay fit and healthy. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been masturbation since 7th grade. I am now 22 years old and have not masturbate for 2 days. Have I over masturbated? Because at times when finish my sperm would be runny. Can this be reversed? How long is recovery? And will it effect me having children later in life? One more question, Will my penius get bigger? ### REPLY: Hi, thank you for using . I can understand your concern.First I would like to inform that masturbation does not affect men health in any form. So you need to be relaxed and whatever you are thinking would be increasing your anxiety. Do not trap your self with myths of masturbation. I am not seeing any possibility of having trouble in future life regarding your reproduction. Regarding penis size, 4 to 6 inch penis while erection is good enough for sexual activity. At age 22 as you have passed puberty, chances increase in size of penis is negligible. Again do not trap your self in myths of penis size. Hope this will help you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi there, 3 days ago i accidentally scratched my bfs glans while having sex. He has 2 little wounds, one of them was a superficial scratch (more like a skin irritation) and the other one bled when it happened. Both look red right now, and the wound that bled has a scab on top. I would like to know if glans wounds heal properly as any other wound on other parts of the body, and dont leave a scar. He is afraid this wounds would create permanent scarring. Also, do you recommend use of vaseline or any other moisturizer for the healing scab? Thank you! ### REPLY: Thank you for your question. I don't think these scratches and abrasions are deep enough. Glans is highly sensitive and vascular structure, so it bleeds on minor trauma. This superficial wounds heal predictably in 7-10 days. Don't peel off the scab already formed, use an antibiotic ointment preferably Aureomycin group in thin film until scab separates itself bridging the wound with regenerating mucosa. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffering from thyroid but it is normal now by taking tablets of thyroxine. my periods are so much irregular i have my periods on 26th of may i have done follicle test also till 13th day only n it shows ENDOTERIUM 9.7mm on 13th day & both ovaries are MSF can i get pregnent ### REPLY: Hi, it is very unlikely to get pregnant with irregular cycles and MSF in both ovaries.  For pregnancy to happen, ovulation is a must think to happen.  Ovulation happens when your follicles is more than 17 mm. So, I think you should take some medicines like camphene for the growth of your eggs.  Track your follicles' growth by repeated ultrasound and when your follicles is more than 17 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  Take progesterone for next 2 weeks to support the pregnancy.  You can try like that for 3 to 6 months.  Hope I have answered your question.  If you have any other query I will be happy to help. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been using Betnovate 1/5 cream on my hands and arms for approximately 4 years to treat an eczema/ psoriasis type rash. I have noticed resently that the pigmentation has been stripped in those spots and I now have white patches. I have stopped using the cream and the rash seems to have improved but not disappeared. Will the pigment regenerate or is the damage permanent?  I am a 35 year old female in good health.  Thankyou for your assistance. ### REPLY: Hi thanks for writing here. Betnovate is a steroidal preparation which is used for treating eczema, it is a potent steroid and has to be applied under the observation of a dermatologist. Common side effects are skin atrophy, secondary bacterial infections like bacterial or fungal, loss pigment leading to white patches, steroid induced acne etc. Based on your history I can assume that you have got loss of pigment, stop applying cream now apply placenta gel two to three times over affected part, which will help faster repigmentation.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 planning an IVF cycle next month and my doctor has currently put me on Duphaston 10 mg. She had asked me to be on Evatone and also start Duphaston from day 18 but I by mistake started it on day 15, do you think this would be an issue in any way? Am anxious as the IVF injections are planned end June and do not want that to be imapcted because of this 3 day early start of Duphaston ### REPLY: Hi, Thanks for writing to . There is no major problem in starting duphastone 3 days early. It won't cause any problem in conception and IVF.  But do inform your doctor regarding this. Don't stop duphastone in between. Complete its course.  Once you conceive it will help for maintenance of early pregnancy. If you don't conceive you will get regular periods. I suggest you to go ahead with your IVF plan. Hope I have been helpful. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a sore collarbone at sc joint. Pain up neck and across shoulder. Could not turn head. Been going to physio and now a lot more movement. Still living with a lot of pain. Collarbone slightly swollen at sc joint very clicky and bumpy when you rotate shoulder. Collarbone used to be sore but not now. Muscles around collarbone get tired and sore. ### REPLY: Hello, You may need CT guided or C-ARM guided local injection shot in inflamed jointly may need investigation like MRI spine, EMG-NCV [nerve conduction study], I will advise consulting orthopedic surgeon for further treatment. For these symptoms analgesic and neurotrophic medication like pregabalin can be started consulting your doctor. Till time, avoid lifting weights, you can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. Local blocks or laser treatment may help you. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take disregards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have 2 nonmovable lumps behind my left ear for weeks now. They hurt at first so I just though it was my lymph nodes swelling up, then I realized they swell up more at night and when I push on them I get a slight headache up to my temple. I noticed today that it feels one more is trying to form above the two and one behind my right ear also. What should I do? ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data, you seem to have scalp infection which is causing these lumps behind both the ears.I advise you to consult ER Surgeon, who would treat it accordingly as per the need of the clinical condition. Hope this would resolve your issues. Act fast. So keep cool and Consult your ER Surgeon for opinion, if need be, who would treat it accordingly. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to  and be comfortable to resolve your health issues. Welcome for any more query in this regard to . Write good reviews and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a tight foreskin because of which I masturbate in the prone position. Recently I tried to have intercourse for the first time. The foreplay hurt because of the tight foreskin and there was a loss of erection just before penetration. Is it because of the tight foreskin or the prone masturbation or both? Please help as this is becoming a problem in my relationship.Anonymous ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The problem of tight foreskin is very normal and is found very common nowadays. But the masturbation and its position has nothing to do with lack of erection. Tight foreskin could be a disturbing factor while intercourse because it is supposed to move back and forth along with the pumping motions. If it doe snot move, there is reason to be intercourse being painful. I suggest you to consult a general surgeon and get circumcision done. The procedure is very easy, and it could give you a pleasurable intercourse experience. For sexological and psychological counseling, visit http://psychocure.webs.com/Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey, My name is Josie. I was exercising last night, lifting a 15lb weight above my head. I didn t notice any pain or cause for pain at the time, but about 20 minutes after resting I went to change and raising my arm produced a dull pain in my clavicle. The pain is also produced by pushing on the part at the base of the neck and moving my shoulder front and back. There s no swelling from what I can tell. Any ideas as to what it might be? ### REPLY: Hi, Thanks for your query. From the description that you have provided, it seems that you have suffered a muscle sprain. You need to provide rest to the neck and shoulder. Avoid massaging the area. Doing a hot fomentation will be helpful. Avoid all overhead activities and do not use a pillow. In case the pain is persistent even after taking a mild painkiller, then you might need stronger prescription medicines like muscle relaxants after consulting your orthopedic. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have OCD of cleanliness.... firstly I usually washed my hands 1 time. In the May this year I washed my hands 4-5 times after having contact with dirt. Then this begun to increase and wherever the dirt touched my body, I washed that place 4-5 times. such as, if hairs - shampooing for 4-5 times, hands or legs - washing with soap for 4-5 times, lips or mouth - toothbrushing for 7 times...!!!!! Most of the times I wished to commit SUICIDE. I want to get rid of this.... I want to become normal as I was earlier... Please HELP me... ### REPLY: Hi. I understand your concern .OCD is obsessive and compulsive disorder. Excessive cleaning is compulsion in response to obsession of dirt contamination. You have to compulsion to avoid anxiety. It is time-consuming and lead to impairment in social/occupational life Secondly it is comorbid with depression. It can be treated with medicine and psychotherapy. In Medicine combination of the SSRI and benzodiazepine will be useful. In SSRI fluoxetine and fluoxetine is anti OCD medicines. Anxiolytic will help to reduce anxiety. Psychotherapy like exposure and response prevention can be useful.Nowadays cognitive behavior therapy (CBT ) become choice in OCD. So consult psychiatrist and get further assistance. I hope I have answered your concern. Feel free to ask. Thank you. Get well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was recently working out with a trainer for the first time. During the workout I felt fine. It was after the stretching that I felt my heart rate up and my arms tired and tingling. When walking to the car I felt a bit nauseous. I am still sore from the workout a couple days later, but are fine otherwise. Is this just from a lack of activity? I am 47, weigh 178 and have no health issues nor have had any. Last physical 2 years ago showed everything fine ### REPLY: Hello, After going through your medical query I understand your concern and I would like to tell you that heart rate is ever-changing phenomenon depending on your physical activity, stress and physiological changes. After workout, you might have low blood sugar levels, and you felt a rapid heart rate, so it is recommended for you to have 2 digestive biscuits or a cup of juice before workouts. 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: At 1:30 AM today I woke up feeling very hot with abdominal pains. On the toilet I soon felt faint. Experienced a mild need to puke but didn t. I had a normal (solid) bowel movement. Stayed up and soon felt fine. Returned to bed about 4AM. At 5:30 AM woke up with abdominal pain again. Not hot this time. On the toilet I felt mild light-headedness. No puking feeling this time. Had a generous solid bowel movement. At 6:05 had abdominal pain again. Third solid bowel movement. Very mild fainting feeling and mild feeling I was going to puke. The abdominal pain felt just like it does when I am very gassy. On those occasions I pass lots of gas and fell better right away. This day I did not pass any gas. I feel okay the rest of this morning. However, I m concerned. ### REPLY: Hi. Thanks for your query. With the history of pain in abdomen and passing motion every time but without gas this time indicates that it was just loaded colon may be a with a mild amount of colitis of whatsoever cause. Since you are concerned and with the past history of gases trouble it is better to undergo a few tests under the guidance of a Gastroenterologist: Viz. Colonoscopy and CT scan of the abdomen. Other tests of blood, urine and stool, particularly to rule out diabetes and intestinal infection. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What kind of neuropathy is it and what is neuropathy and what can a dr. give me to make all this pain stop!!! I had a nerve conduction study done by a Neurologist ,When I went back for the results, I was told I had sensory Neuropathy , when I aked him what that was he said to look it up on the net when I get home. I have applied for Disability because I also have ADHD and herniated disc s in my neck. I requested a diagnosis for Social Security but I do not understand what it means, could someone tell me please? Here it is: IMPRESSION: Sensory neuropathy involving bilateral ulnar and median nerves. Clinical correlation indicated. ### REPLY: Neuropathy is degenerative changes in the nerves in your case the most probably the herniated disc is causing root pressure and responsible for the changes it is better you consult orthopedic surgeon and get treatment for the herniated disc and that may result in improvement in your case earlier the treatment better the result, so please do not delay getting definitive treatment hoping early recovery ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im 16 years old about 5"7 and weigh around 150. i know i shouldnt, but i dipped some tabacco 2 days ago and a white sore formed in between my gum and teeth..what im more worried about though is that today i noticed an average size lump underneath my right side jaw. do you know what this could be? ### REPLY: Hi, Dear don't worry. I understood your health concerns.-You suffer from acute sub mandibular lymphadenitis due to oral infected tobacco ulcer you had.-Don't worry about that lump to be Cancerous lump, as its infective lump. Tratment- I would treat it as follows -- tb NSAID x5 days antibiotics from Er doctor or GP.x5 days.- bland liquid diet for 1 WK- no hot tea or . - Byte gel locally 2 times a day. This would resolve the lump and oral ulcers in 1.5 was time. Hope this attends your query.-Welcome to  for any more help you need. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was using oxy elite pro as fat burner for two weeks and felt great,i stopped cause i just wanted to try.However the last 2 days i feel dizzy,vision issues,anxious and it is not going away.I exercise regularly and i would say it is cause of this product????? ### REPLY: Hi, OXY elite pro is a multi-ingredient nutritional supplements claimed to be effective for weight loss, bodybuilding, and performance enhancement.  Its use has been associated with increased blood pressure and heartbeat. There are reports of cardiac arrest and death also. It is also known to cause liver damage. Because of these adverse effects, it has been banned by US FDA. Based on the history you seem to be suffering from the with .  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i am suffering from dry khashi and fever since last 30 days ,before this i was treated for ITP in the month of august 13.with omnacortail. now my platelate is fine.what to do for dry khashi. my TB gold test is negative . now my Dr.Advised for Motec test which is under process ### REPLY: Hi, Thanks for writing in. You might have recovered from ITP completely and taking omnacortil was necessary for that. Omnacortil is prednisolone which is a steroid. It was important for you to take omnacortil but when taking it for a long duration, there might be certain side effects including weakening of immunity. Since you are having fever and .  Gold TB test is a method to see if there is or was Tb infection anytime in the past. Since your immunity is weak therefore the result gold test needs to be taken judiciously. Manitou test is done to know the reactivity of your immune system to TB. I suggest you also get an X-ray chest and if required CT scan done. Blood culture might also be done. This will detail any focus of infection causing your fever. Treatment should be started after confirmation of diagnosis for your situation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just experienced a sudden swelling of jawline and puffing in front of left side of face, but none in the write. I just returned home from a holiday party where I had different foods - peanuts sauses, lobster sauce - which I have never had a problem with. In addition I had red wine, which I normally don t drink. Could this be an allergic reaction? I took a Benadril and it seems to have helped , but still feels strange, But swelling is going down. ### REPLY: Hi, Thank you for posting your question here, I will try to answer it to the best of my abilities. Yes, it does seem to be an allergic reaction. Sometimes the combination of food you eat can also cause the reaction. But anyhow I recommend you see a doctor and have them figure out what exactly you are allergic to. It is pretty dangerous to about life oblivious of your allergies. I hope this answered your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi dr i feel too much weakness,and almost completly lose of appetite.my skin are dry scary and have whiye rashes.the blood vessels like spiderslegs u can see the bloodveseells in my hands.and i feel very lesy and mentally disturbd and.irritating and quickly become paniccccccc sir plzzz recomend meee ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  From the description itself it is clear that you a victim of too much thinking/ obsession. Here you're thinking / obsession is towards your health. But proper diagnosis needs a lot of information and of course you age. Panic attacks are commonly due to panic disorder or anxiety. Treatment towards that spectrum can reduce the health related anxiety. Please consult a psychologist soon for further assistance. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister in law has early onset Alzheimers.  She is in stage 7.  She is currently on risperidone.  Nonetheless, she appears to be hallucinating and she screams all day long and awakens several times nightly screaming as well.  Why is she screaming?  How can we help? ### REPLY: Hello thanks for asking from ChatDoctorI can understand your concern. Hallucinations in Alzheimer's disease patient develop because of some organic issue in brain. Even medicines used for Alzheimer's especially Semantic could lead to development of psychosis and consequent hallucinations. If on Risperidone her symptoms are persisting then other .  Olanzapine can become a good option. The  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, Ive been getting red spots on my inner upper gums for the last few months.  They come and go, they are not raised, are not canker sores or blisters, but they are bothersome, its like a burn like sensation.  Its like if I ate something acid and my gums sting a little.  I thought that it could be burning mouth syndrome as I think I got this for a few weeks a few months ago, but these small red spots are really only localized on the upper inner gums.  What could they be?  Im a woman in her 40s. ### REPLY: Thanks for your query, I have gone through your query. The soreness can be a recurrent herpetic ulcer or recurrent authors dermatitis. Nothing to be panic, consult an oral physician and get it evaluated. Meanwhile, If it is authors ulcer you can take topical anesthetic and analgesics like lidocaine and analgesic like choline salicylate gel and topical steroid like triamcinolone acetone. If it is a herpetic ulcer, you have to take a course of antiviral . Do saline gargling. If the lesion does not heal in 5-7 days then consult an oral physician and get it examined. 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: Dear doctor:t am almost 22 year old male patient with free medical history of any diseases,no drugs and surgery, i take all my vaccination,and no family history of any choronic diseases except diabets and hypertension for my ankle and my grandma, and right side hypertrophy for my granmother...my cheif complaint" recently for one month ago i start feel tightness on my chest without pain and it seem like my chest cant hold my lung inside it with a liite pressur to my heart,these feeling start with heavy excersion like football game, swiming... and last for 20-25 min,although i am athlete and i am practise on regular manner for ten year at least,please  just if you can help i will aprociate that.                                        thank you ### REPLY: Hi welcome to the  You are doing cardio exercises daily esp swimming is very good exercise I don't think you will have any problem at such young age.... But as chest tightness complaint present after workout for safe side I suggest you to investigate with EKG and CBC.... If no Abnormality found then no need to worry If problem increasing then detail evaluation by pulmonologist with Auscultation and chest x-ray like investigation needed To Take care Hope your concern solved ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 29 yo female fillipina with a history of PVC for many years. Her cardiologist in the Philippines wants to put her on Cordarone (amiodarone HCl) and PLETAL (cilostazol) Tablets. Is this the gold standard therapy for a woman of her age? ### REPLY: Hello, PVC's have a lot of causes which can be both benign and fatal. Patients with PVC's have to be evaluated for a possible structural heart disease which will necessitate urgent management.  Depending on the cause, some PVC's may only be observed, but PVC's in the background of heart disease will require antiarrhythmic(like Amiodarone) and treatment of the primary heart disease (like antiplatelet for ischemic heart disease).  The treatment depends on the cause. And I suggest a consult with a cardiologist for proper workup (which may include 2D echo, ECG, checking for electrolyte imbalances) and management with appropriate medications.  I hope this enlightened you in how PVC's are worked up and managed. Hope I have answered your query. Let me know if I can assist you further. Take care .  Dion, General & Family Physician ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 IVF patient. Embryo transfer happened on 22nd Nov. For the past 3 days plus today, I am having fluctuation in the body temparature. Today afternoon, it is 102. What is the reason. Having Dolo 650 - half from today - morning, afternoon based on my Drs advice. ### REPLY: Hello, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, body temperature never rises after IVF, but it can be monitored during the IVF procedure. Once the IVF is success there won't be any fluctuation in temperature. I advise you should look for the other causes of the temperature. Some other infection can cause rise in temperature. You can take paracetamol for the fever under your doctors' guidance. But please consult once to doctor for this fluctuation in temperature. 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: Left abdominal pain localized to lower to mid front. Loose stools with gas every morning. Pain has been chronic for about 4 months. Feel inflamed inside that area. Bothers me when moving on particular motions. Sometimes walking or sitting down. Am seeing family physician. CBC and Complete Metabolic Panel within normal ranges. Digital Rectal Exam stool test showed no blood and physical area was stated by doctor as feeling fine inside. Seeing GI doctor Aug 21 after follow up with family physician. I m just at a loss for what is happening to me. The pain is daily and only see relief when laying down at night. Sleep is pretty much undisturbed. Symptoms start after I wake up and become active. ### REPLY: Hi. Read your history and understood your problem. Since you are suffering for 4 months, I hope you have undergone all the investigations other than the ones you have mentioned. I would advise you the additional ones other than those which you have already done. CT scan of the abdomen and Colonoscopy. These will give a diagnosis, and you should get a follow-up. I also hope that you have already undergone a course of an antibiotic and metronidazole. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has a big black and blue mark on the back of his calf, doesnt remember bruising it, can barely walk on thart leg it hurts so much, any idea what this is? My son is 11 yrs old, woke up this morning with the mystery bruise, cant even apply pressure on leg withhout hurting, what is this? ### REPLY: Hello, Such bruise mark can be due to following- -Insect bite-Due to soft tissue injury. If he is not having swelling in foot and leg & there is no fever then there is little to worry. I shall advise you following to have relief in this- -Take rest.-Take an analgesic preparation in child doses like acetaminophen.-Keep limb elevated on pillow. Most probably this will go away with in 3-5 days. If it does not disappear, or he has fever or swelling then please consult to your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am babysitting my grandson, 4 y/o, ear ache promptd visit to pediatrician.  She stated he had a heart murmur and that he should be evaluated by his hometown pediatrician and she also recommended a workup by cardiologist.What signs and symptoms should we be aware of. ### REPLY: Hi, Chil .  Anyway you should see a cardiologist to be in the safe side. In pathological heart murmur other pathological signs may be retardation of child grow, cyanosis during or after crying, eating and exercising, in such cases you may notice that a child turns blue or white. If your child has none of these symptoms, then most probably there is nothing serious. Take fearsome back if you have any further questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I ve been experiencing a bit of discomfort involving pain in my shoulder neck and head for around the last 7 days. It seems to start off gradually and get worse as the day goes on,moving from the back and of my head, to the right side of my neck and then my right shoulder. ### REPLY: Hello, As this sounds to be an issue with the cervical spine disc Degenerative changes. Using cervical collar, myofascial release to trapezius, static neck exercises, hot water fermentation to neck, shoulder and upper back, static shoulder exercises should help improve the overall symptom and avoid progression of the degenerative changes. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello.  My husband has osteoarthritis and depression.  He has had this for at least 5 years and takes tramadol, co0codamil, codeine phospate and amitriptolin, Sorry about the spellings.  5 years we applied for DLA and was turned down.  I have got an unhelpful doctor and my husband will be 65 in February.  His depression wouldnt allow him to go back to the DLA and fight and we are living on pension credit.  How can I get some positive help for him.  He spends 90% of his time sitting up in bed or sleeping but we need some help for him.  I do what I can to cheer him up but he is gets very grumpy and falls over a lot if I encourage him to get up.  Thanks.  My email is  YYYY@YYYY . ### REPLY: HiT hanks for using  I think, he is in severe depression and in that case, he needs combination of antidepressant. With amitriptyline, he could take duloxetine. It would help to control depression as well as somatic complaints. Better to consult his physician or psychiatrist for proper management. You can also take help of psychologist for CBT. If you need further help, you can ask. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been suffering with anxiety for 18 months, which has lead to some depression . I am taking pregablin and xanax and have just started to feel quite odd in the past hour - lack of mind focus and I now have tingling in one side of my face - much like when coming round from a dental anaesthetic. Is this most likely a nervous problem? Thank you ### REPLY: Hello and welcome to . Thanks for your query. Your symptoms are likely to be anxiety-related, and don't seem to be typical of specific medical problem. Now, it is important to understand that anxiety can manifest itself with not only psychological symptoms, but with physical symptoms also. If you are having recurrent such symptoms or having difficulty managing your anxiety / depression, then I would advise you review with psychiatrist for further treatment. There are other effective medication like SSRI antidepressants which can help you with both your anxiety and depressive symptoms. In addition, there effective psychological therapies like CBT (Cognitive Behavior Therapy) which can help you deal with your problems. Trying relaxation techniques, like deep breathing, and engaging in regular physical exercise can also be benefit in controlling your symptoms.  Wish you all the best. -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is turning eight months old...last night we tried creamed corn for the first time from a can for a table food. within a 1/2 hour, we noticed little red dots underneath the skin on his face . He doesn t have any other symptoms. They spots are still there today. Could this be an allergic reaction and should we call the doctor? ### REPLY: Yes, this could be an Allergic Reaction to any of the Contents, which may include egg. Read the contents carefully. Watch particularly for swelling of the lips, eyelids, hands, feet, rapid breathing or breathing difficulty. They usually develop within a few minutes of ingestion of the Allergen(Offending food), but again the 2nd or subsequent episodes may be either more extensive or quicker to occur. Seek Medical help of these signs. In the future, after consulting your Doctor & ensuring that Emergency help is at hand, try only one of the contents, i.e. separately, one at a time, keeping an anti-allergic Syrup, like Cetirizine at hand. Be particularly careful if the child has earlier had, or you, your husband or your families have a history of Skin Allergy (Atomic Eczema), Nasal ("Dust")Allergy or Asthma. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: our otherwise healthy 11 year old daughter has had a severe rash from head to toe covered with welts and complaints of profuse itching. This has been going on almost continuously for over two months and we are just now finally coming to the end of our wait for appt with an allergist-appt still 5 days away. Before this, she had NKDA NKA. She has been treated around 6 times now at intervals when her medication regimens would come to an end and/or at height of symptoms during this nightmarish 2-3 month time period. None of the anti-histamines, steroids, etc seem to work completely with significant relief of her symptoms (welts may fade somewhat but do not go away and itching reduced only minimally) and any small amount of relief of symptoms does not last long. This is really taking a toll on the entire family (and oh, yes, we have changed detergents, soaps, etc, etc, etc made lists trying to track possible causes) . . . please HELP!!!! ### REPLY: Hi, If I were your treating Doctor for this case of severe pain under the left rib cage, I would come up with three possibilities, these include:1. Hypoallergenic diet, elimination of allergens. Diagnosis can be confirmed by allergenic food tests.2. Absorption of allergens by giving Charcoal 1 tablet trice a day for 10 days.3. Stool culture for flora to exclude symbiosis. For normal flora you need to give Darla 1 capsule twice a day for 1 month, enzymes syrup during meal for 2 months, albendazole-for elimination of helmets. In addition, try Allegra-the the strongest antihistamines 1 tablet for night for 14 days. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your child 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 Doctor , My sister aged 56 was suffering from urinal infection since last 2 years on and off.. She has been taking medicines for the same . Today her Nephroligist says her left kidney is totally dead non functional and has to be removed within 2-3 months .. My Queries : 1) How come all of a sudden we come to know of this , inspire of regularly visiting a renowned Neohroligist. 2) Can there be any chances of revival of the dead kidney ? 3) If not , then should it be removed / when ? 4 ) what should we do ? Please guide us ? Awaiting an early reply , Thanks and Regards , Santosh Shah ### REPLY: Good Day, and thank you for being with  ! A non-functioning kidney can be due to chronic obstruction or chronic infection. non-functioning kidney cannot be revived anymore. If the non-functioning kidney is the cause of your recurrent UTI then it should be removed to prevent UTI and preservation of the remaining good kidney. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ .  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 , Dr. My daughter in-law is in her 34th week of pregnancy. Recently, she had been suffering with lot of cold /cough with some breathing discomforts. Her dr has advised he rto take Cepodem & Deriphylline. I am just worried if that is ok. Is there any other way than taking the antibiotics? Pls suggest. Thanx. ### REPLY: Hi, It is best if she takes the Code and the Deriphylline as prescribed by the doctor. She is already 34 weeks and the Code will not cause any harm to the baby. The Deriphylline will help her breath more easily. It is very important that she takes the medications as breathing discomfort and chest infection in pregnancy can harm both mother and baby, if not treated promptly. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 21years old, i have had real bad lower back pain on my right hand side which twinges and sometimes twinges my right hand leg. Some days im in agony when i try and move my back, even bending slightly. This has been happening for a few months now but the doctor insists its nothing. I also used to go to the gym 3 times a week and i believe alothough not diagnosed, i got shin splints from running on the tred mill then about a week after this the back pain started and i havent gone back since. Please help. ### REPLY: Hello, Thanks for your query. After going through your query I think you are having muscle generalized pain all over the body. In my opinion these pains are likely to be due to vitamins and trace element deficiency specially that of vitamin D. I will suggest you to got following test to see cause .1. Serum Vitamin D2. Serum Vitamin B123. T3,T4,TSH(Thyroid profile) 4. Blood sugar fasting and PP5. HbFurthermore Empirically treat my such patients by:-1.EVIAN LC2.VITAMIN D3(if it is low)3.VITAMIN B COMPLEX AND VITAMIN C 4.CALCIUM5. Mecobalmine 6.ANALGESICS SUCH AS DICLOFENAC for pain relief. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 12 year-old brother has mild abdominal pain in the umbilical region that is localized above the belly button. The pain was felt yesterday about 30 mins after eating fried chicken and dessert that contains milk. Later that night he vomit. Up to this time, he felt mild pain still in the umbilical region accompanied with a 37.7 C of fever and mild headache. He only vomit once. What is it? Could it be gastroenteritis or an early sign of appendicitis? Thank you for your help. ### REPLY: Hi ! Good morning. I am  answering your query. Yes, this could be a gastroenteritis, but as doubted by you could be an early sign of appendicitis specially a pelvic/post ideal appendicitis. This can be differentiated not without a clinical examination and related investigations. Therefore, I would suggest you to report to the ER of a nearby hospital in your area, so that appropriate diagnosis and management could be instituted. 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: Dear doctor , my brother s wife, aged 38 yrs, presently suffering from LUMBAR SPONDILITIS, in her lower limbs . she recently visited 1 very good hospital in Bangalore, India, but found no result for any cure. She is now getting difficulty for any work by her both feet, though it is little better till now, for her right leg. Medical History: Gait difficulty, Lower limb weakness, suspect more gap betn L1 - L5 Loss of Lumbar Lordosis Vertabrae shows Ostrophytic change Several disc shows loss of signal on T2 L1 - L2 disc shows postero-central disc bulge with thecal sac indentation and compromise of both exit formina Haemoglobin - 10.9 gm/bl Total Erothrocyte count - 3.77 m/cu.mm Total Leucocyte count - 6800 cu.mm Erothrocyte sedimentation rate - 12 mm Neutrophil - 61%, Lymphocyte - 36%, Eosonophil - 2%, Basophil - 0.0% Urine culture: colour - watery, App. - clear, Sediment - Nil, Sp. Grvty - 1.005 Is this disease curable? Pls help. ### REPLY: Hi, Your brothers' wife has lumber spondylitis with few complications in the vertebral canal resulting compression of vertebrae and protrusion. There is also degenerative changes in the spinal canal and osteophytes formation causing more problems. This can not be cured but further damage can be prevented by following. Sleep on hard bed, Do not bend forward Avoid weight lighting physiotherapy regularly, do back extension exercise. Take more calcium and multivitamin supplements. Xray and MRI should be done to evaluate the case. Consult orthopedic surgeon, surgical intervention may require. Ok and bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I wanted to ask a question about the patch as a method of birth control. I started my period on May 5th, and applied the patch last friday (May 16th). Is it going to be affective in 7 days, even though I didn t apply it the day my period started, or the Sunday afterwards? I am worried because the Ortho Evra instructions only provide those two days as starting points. ### REPLY: Hello, Thanks for trusting us with your health concern. Your current cycle may not be well protected since you started using the patch well after the last period. So, you need to use additional protection. Also, you have to continue using the three courses of the patch followed by a patch-free week. This means your cycle is rescheduled. Do not use grapefruit and grapefruit juice while using the patch as norelgestromin and ethanol estradiol have interactions. Avoid using skin creams, lotions etc., to the area of the skin where the patch is applied since this may lead to detachment of the patch. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell a few days ago and a ladder bar went between my legs and must of hit my tailbone , I was very on the ladder so I was more concerned about hanging on than any injury . I didn t notice any pain at the time . But now I have a small bump on the side of my tailbone. It is semi painful , it s uncomfortable to sit in some ways . I m asking whether or not to go to see doc or can I just ride this out ### REPLY: Hi, thanks for writing to  .you seem to have tail bone injury, not necessarily a fracture since you didn't have immediate pain. Please take following treatment:1. Avoid sitting on hard surfaces.2. In fact for sitting you should buy a ring pillow or doughnut cushion which has a hole in between, so when you sit on it, your tailbone area keeps hanging in the air.  You can also buy a coccyx cushion for this purpose.3. Avoid sitting for a long time4. Till you get hold of one such pillow you can manage by alternate sitting on each side of your buttocks5. Do sat bath-take warm water in a tub and dip your bottom in it. Do it 3-4 times a day.5.take a mild anti-inflammatory like ibuprofen or naproxen.6. Avoid constipation- take high fiber diet. This will avoid strain on your tail bone while passing stools .it should improve in 2-3 weeks hope I have answered your query .if satisfied, please rate my reply 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 Doc I had unprotected sex during my fertile period, the guy didnt have sex for 4 days prior to our session. He was only inside me for a short amount of time and didnt cum or orgasm at all inside of me. Is it possilbe that his pre cum could have sperm in it ### REPLY: Thanks for contacting ChatDoctorYou are concerned that you may become pregnant from a man though he did not ejaculate inside you. The semen prior to ejaculation can contain sperm though not in huge numbers. But the chance is there, and I would recommend that you do Plan B to help reduce your chances of getting pregnant. Hope this answers your medical question. Please contact us again with your health care concerns and questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife has a lump that has appeared just below the skull on the back of her neck just to the left of the spinal column. It is about golf ball size and she has had a on again off again headache occurring all week. She says the lump appeared about 3 weeks ago. what are your suggestions. ### REPLY: Dear thanks for sharing with us your query. It difficult to find the cause with that lump without examination. First two examination you should do are blood tests and an ultrasound of the neck region. After the result perhaps a cervical MRI need to be done! You have to worry but no too much, it can be even from a dental infection so no need for alarm, but examinations need to be done. Hope I had helped 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 am working with ammonia, hydrogen peroxide and hair dyes as part of my hairdresser training. I have asthma and allergies to certain foodstuffs and allergens. I have noticed itchiness in my throat and ears when exposed to ammonia and dyes. I have also heard that they may reduce my natural immunity. I feel like giving up my course. What is your advice? ### REPLY: Hi, I am .  If you are allergic and working in that environment, it naturally leads to weakening of body and less immunity. You can also opt for desensitization to specific allergen that is causing problem to you, if it is essential to continue same work. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questionsTake care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a lobectomy 4yrs ago. They removed the right love of my liver and a 4.3 x 5.0 tumor. Needless to say recovery has been long and difficult with a lot of pain. Naturally I have a left lobe which is fully involved with cirrhosis. So far my left lobe has not shown signs of failure. I would like to nurture any function and regrowth possible. I have taken methadone 120 mg in 3 divided doses per day. Is this the optimal pain reliever or would something else be as effective but gentler on my lobe? ### REPLY: Hi and welcome to . Thank you for your query. I understand your concerns and I will try to help you as much as I can. This is serious disease if cirrhosis is present and quitting alcohol is the most important thing that should be done. Also, medications which are hematologic should be avoided. This is necessary to prevent disease progression which is lethal in most cases. At early stages it can be treated with these measures but in case of progression. Diet should be balanced and healthy and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 boyfriend has experienced impotency issues. He has been drinking 2-3 protein shakes a day I heard this can cause problems with achieving and maintaining erections. He is a healthy 35 yr old mail. He had his prostate checked and its fine. Any suggestions? Shouldnt h stop taking the protein altogether? ### REPLY: Hi, The protein intake is not related to erectile dysfunction. I suggest you check his sugar level and measure blood pressure to exclude diabetes and hypertension. He needs to lose weight if obese. Investigate with his testosterone and prolactin level as well. He can use Tadalafil for short duration. Advise him to practice more foreplay while doing sex. Hope I have answered your query. Let me know if I can assist you further.  ### END