Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HiWhats thet solid thing comes out of my peenis after masterbation? when I masterbate, and I masterbate again after 10 minutes for example, this solid thing comes out! its like CUM but it has no water. and not always this is happening to me!thank u for your answer ### REPLY: Degree understand your concerns went through your details. That has to be your semen. If you do masturbation frequently, the water content will be less in your semen. But the produced sperm quantity could be same. Don't worry. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. 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: i have a hiatal hernia to start. for a week now i have been in a lot of pain in left ribcage going around to my back,had diahrrea for the first few days! now i go 4 to 5 times a day and my guts hurt to do so! my neck hurts my left arm aches i have heartburn and a lump on my middle chest bone that hurts! even to wear my bra hurts! i am going in for back surgery in 2 days! i have asthma and even using my inhaler i feel that its hard to breathe. is all this from my hernia or something more servere and should i go through my back surgery feeling this bad? ### REPLY: Hi Sherry, Thank you for writing in. I am a medical specialist with sub specialty of Cardiology. I assume that hiatal hernia has been diagnosed by a specialist. Most of the symptoms of hiatal hernia are due to acid contents of stomach spilling into your food pipe. Therefore, your heartburn, pain in the middle chest are due to this.  As part of stomach occupies the space where the lungs are therefore feeling of hard to breath occurs.  What can not be explained is Diarrhea, therefore, consult your primary doctor, I am sure he would like to rule out Guardians, Amoebas and Irritable Bowel Syn .  I assume asthma is well controlled with inhaler for when you have the episode of hard to breathe, is there whistling sound or wheeze. Meaning thereby perhaps you need more prescription  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i had a mi two years i has two sents fitted in the lad but the pain has never gone i was told i had three layer of damage i still get very bad pains im still taking loads of medication i was diagnosed with diabeties to im still getting sharp pains constant inbetween the shoulder blades central and center of the chest and the right hand side to can you enlighten me on the problem please ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* Stent insertion does not guarantee you of further life without chest pain, it will take care of the pain only associated with coronary blockage, other so many reasons are there responsible for the chest pain as - Muscular or ligament related - Neurological issues - Lung pathology, rib conditions - Constant acid reflux of stomach - Cardiac other conditions giving ischemia * Needs expert evaluation with physician, thorough clinical examination series of tests as x-ray chest, 2 D Echo, Pulmonary function test, CT or MRI thorax according to the concern of the consultant. Hope this will help you. Welcome for further assistance. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have lower abdominal pain.  It feels as if somethinbg is tight or stretched .  But it is continual --not letting up.  I have taken Flagyl and Cipro,  i believed for treatment  of diverticulitis.  Could something actually be lodged like a nut or something that wont dissove in a divertulii?  I have some p;ain in my left hip and my rectum. What is going on? ### REPLY: Hi. Thanks for your query. It looks you are a known patient of diverticulitis and as you have suspected rightly this can be resurgence of diverticulitis with peritonitis causing all the pains in the abdomen, hip and rectum. This can be just a severe form of colitis too. The best way to get a diagnosis is to undergo a Contrast enhanced CT scan of the abdomen, colonoscopy and relevant blood, urine and stool tests. Once the diagnosis is made, it will be decided whether to continue the medical management or to go for excision of the colon bearing diverticula. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 stepchild is 5 years old and according to my wife who is brazilian the child is a funnyh cough which she has expericed before while in brazil only to establish that this is worms..apparently common in brazil.Will she have to take him to the doctors or can she just go into a chemist to obtain a tablet. My step child of course lives in england ### REPLY: Hi Dear, welcome to . Understanding your concern. As per your query your child have symptoms of cough which is due to upper respiratory tract infection due to poor immunity of body. Need not worry. I would suggest you to avoid spicy, hot and sharp food substances.  Do warm saline gargles. Gargle with an antimicrobial mouthwash. You should take antibiotics like Augmenting or Azithromycin for 5 days. You should take anti-inflammatory painkiller Ibuprofen for relief from pain and inflammation. Furthermore, you should avoid taking outside food. Avoid cold carbonated beverages. Visit pediatrician once and get throat culture and sputum test done to find out exact cause and start treatment accordingly. Hope your concern has been resolved. Get Well Soon. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife had a generalised seizure few weeks back and it was diagnosed with meningioma. She got operated successfully. The meningioma was grade 1. Now Doctor has advised livipil for 1-2 year. Kindly let me know how the doses will be reduced. Any other things i need to take care? ### REPLY: Hi, seizures after meningioma surgery can be due to brain handling .when there is damage to the brain (from the surgery or the original tumor) the brain will always try and repair itself. This is where the seizures come from, the brain is misfiring and not repairing properly. These seizures will probably never go away, and You will always have to be on medication. You will have to take antiepileptics for long times. In addition, avoid the precipitating factors. 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: periods of light headiness of gradually increasing intensity and frequency over 2 months growing from 1-2 seconds to1-2 min without loss of conciousnes but progressing deminsished conciousness,Strong normal cardio pulmonary health.No unusual activity or intake.Is it a serious indication? ### REPLY: Hi, There are a few possibilities. One would be hypoglycemia due to improper release of insulin and/or suboptimal eating habits (which could also include deny .  Another could be headache aura perhaps most likely related to migraines vertigo where the spells you refer could be part of the vertigo portion of the disorder.  A 3rd possibility is that of orthostatic hypotension that may be occurring inappropriately or in response to overactivity/oversensitivity to medications used to control blood pressure, etc. The only way to know for sure would be to have a thorough examination by your primary doctor followed up by a specialist as indicated if the primary is unable to figure out the problem. 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 had a mistaken unprotected sexual encounter this weekend. Way too much alcohol and realized I woke up with someone that i had unprotected sex with. The Head of my penis is very sensitive to even my silk boxer shorts rubbing against them and on the upper side of the rim of the penis head are very tiny red spots. They are not bumps or warts, just look like red spots but also sensitive to the touch. Just really worried now as I have never done anything so stupid before. Just wanted a opinion before i make a actual Dr. Apt. ### REPLY: HelloThanks for query. You have developed infection of the glans penis (Atlantis) following unprotected sex. If you do not the woman whom to had sex with It is always safe to get basic screening tests for STD and HIV done to be rest assured about acquiring STD or HIV.In the meanwhile take broad spectrum antibiotic like Čeferin along with anti-inflammatory . Along with topical antibiotic ointment like Newsprint twice daily. Ensure to wash your genitals with warm water twice daily. Ensure to avoid sexual encounters till it heals up completely. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 R Y Babu from Bangalore. My right feet near the middle and little toe was injured in a road accident on 1st october 2011 when i was pillion riding on a two wheeler.I was fallen down when a van hit my foot on the right side. I wore strong shoe at that time. My feet at the injured portion was swollen like a small ballon with bluesh and blackish colour with pain. I consulted a doctor and no fractute found. I was given some pain killers and drug for healing the injured foot.Later the injured portion became a wound and recovered.But still there is swelling at the injured portion and i feel pain when i try to move my toes of my right foot. My age is 30 years hight is 166 cm and weight is 68 kg. I am attaching the photograph of the injured foot. Kindly advise how my feet can be cured?. ### REPLY: Hello, It looks from your details that you had a very old injury, and you are suffering from swelling after injury. You should do following to have relief:- Apply a compression bandage from below upwards from foot to leg.- Keep your limb elevated on a pillow whenever you are in a position of rest.- Take a good analgesic like diclofenac for relief of pain for only a short period of time (3-5 days).- Do contrast bath. You may take help for this from your physiotherapist. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last Thursday I had an Upper crown prep on a tooth number 14 molar, just as soon as injection was given I felt like a golf ball size swelling at the injection site, I did swell and now have major bruising and uncomfortable not from crown prep but injection, swollen up to eye area. Could the needle have nicked the maxillary artery ### REPLY: Hi. Thanks for the query. It looks like due to deep placement of injection needle there has been piercing of Steroid plexus of veins, and it has led to Hematoma formation. Due to deep penetration in the mesh of veins there is blood leakage from the blood vessels, and it gets accumulated in the soft tissues and there is hematoma formation. Due to Hematoma formation there is swelling and bruising. It is a self resolving condition and gets better on its own. You can do cool compresses over the swelling to let it reduce faster. If there is pain take anti-inflammatory painkillers like Ibuprofen. 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: My father is 74 and has rectal cancer.He was given a new medication yesterday.They gave him Oxycodone 13mg capsules.I am a nurse and have never heard of the 13 mg.,But what concerned me,there is no manufactures markings on it.When I opened one to mix with his food the capsule is clear,but the medication is pink.Have you ever heard of this.I just dont want to give him something if I am not sure that this is what it is.Thanks ### REPLY: Hello and welcome to , Oxycodone is not anti-cancer . It is an opioid analgesic. Probably your father is suffering from extreme pain secondary to rectal cancer. This preparation is used to control pain not controllable by NSAIDs. This is a part of palliative care. To dose of analgesic varies from patient to patient depending on the extent of disability caused by the cancerous process. To know more about the dosage, you will have to consult your oncologist. 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: Last week afelt very ill, had dizziness, high heart rate & diarrhea with nausea. Discontinuation of 120mg of dulexotine. Symptoms were high BP 155/100, tests results were LFT ALT = 36 and elevated ESR = 46. No anaemia present and platelet count was fine, urea test was good also. I am quite a big drinker but doc says ESR probably wouldn t be elevated if we were talking about alcoholic liver ? Do I need to worry....he wants a re-test done in 4 weeks? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. ESR is an inflammatory marker.2. Diarrhea, nausea are all secondary to inflammation and could have given rise to raised ESR.3. Nothing wrong in repeating. Alcohol, not only damages the liver, it can affect multiple organs. Inflammation involving these organs could have cause raised ESR. Repeat the test. If not due to diarrhea, possible due to alcohol. You need to reduce alcohol intake. Hope it helps. Any further queries, happy to help again ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is Firoz Iqbal ,age is 52 y male ,from India, health is good, weight  59 kg, it is an operated case of achalasia cardia , operated in 1982, dilation done in 1991, baloon dilatation done in 2005, but have still problem. Is there is any permanent treatment  or solution at you. ### REPLY: Hi Fir oz, The details about the initial operation done on 1982 is not mentioned. The type of surgeries that can be performed depends upon the severity and the condition of esophagus. Now, if you consider economy versus balloon dilation, economy has better outcomes. You can consult your surgeon about economy with additional procedures that can have better outcomes. You need to undergo investigations to check for feasibility. Hope this information helps. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your queryHi,I am Shwetha, i guess i have some mental disability, because i am not normal as others are. I wont think normally as others. My thinking will be different and it will be wrong for everyone only for me it will be correct. I want to know why it is so. ### REPLY: Hi Shanghai understand your concern. But only basis of it we will not guide you exact what you want. Thinking process and thought formation require detail evaluation. Detail history is must in what area and how much it affects to you. So revert with detail of your thinking and how it will affect then I will guide you further. Or consult psychiatrist and tell him about all do you have, and he will assist further. Thank you. Happy to 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: My ankles have been swelling up toward evening and I am not sure if it is water retention or a food allergic reaction. This has only started about 3 weeks ago. I drink a gallon of fluids every day. I live in Oracle, AZ. (Just moved here.) I am a vegetarian. ### REPLY: Howell come to ChatDoctorI really appreciate your concern, if the swelling is forming pitting impression then it could be edema (Pitting edema) then it could be retention phenomenon could be due to renal pathology, in absence of associated symptoms it is less likely, more it could be pedal edema without renal disease, anemia may be the cause, get done the hemoglobin test, avoid standing position for long time, try to keep the leg in elevated position during sleep hope this information 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 have a fairly deep dent starting in the center and going all the way to the back of the skull. Its almost canyon like if u can picture that and everyone who feels it seems shocked. I am a 41 year old female with epilepsy (well controlled with deplore) and I have bipolar 2 disorder with many personality traits (impulsiveness, black and white thinking etc) associated with borderline personality disorder. Ive had headaches in the past but dont now; however, Im also on serequel which, amongst other psychotropics , makes me more relaxed. No stand out head injuries but several ski accident hitting head and neck (no loss of consciousness) and played soccer 12 years. Protruding discs both in cervical spine and lumbar. Intelligent, grad school and professional job but poor emotion regulation. In just giving you all the information I can think of so u can help me in assessing possible diagnosis and next steps. As an infant there may have been some neglect in care by my mother (I understand babies have a soft spot on head which should fuse). This has never been a big deal to me so never asked a doctor but realized if I were a guy with a shaved head it would be very noticeable to the naked eye and Ive never seen this in anyone . Given this information can you provide me with possible diagnosis and respective prognosis. Many thanks. ### REPLY: Hi, Thanks for the query understand your concerned have multiple medical problems, and it is not possible to give a singular diagnosis. You have epilepsy, mood disorder, cervical spondylosis and the dent could be related to old injury. Just stay relaxed and get examined by a local doctor. Further, I advise you to consult medical university hospital as you will see the team approach for the problem with better solution. 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: there is a growth of wisdom teeth in right lower jaw. Its hurting me alot.. One of my friend who is working in medical shop suggested me to use AmoxyRite Plus + AcecloRite Plus tablets. Can I use them for temporory pain relief.. Please help out me in this ### REPLY: Hi. Can understand your concern. As per your complaint it seems that you are suffering from PERITONITIS which is inflammation of gum flap over the wisdom tooth and is caused when there is no maintenance of proper oral hygiene and there is deposition of food debris in between the gum flap and the wisdom tooth or the gum flap is bitten by the opposite jaw tooth. It is a very painful condition and pain can radiate to entire jaw, ear, eye,throat and head. There can be enlargement of lymph nodes below the jaw. You should consult a dentist and get an x-ray done and if the wisdom tooth will erupt itself and is in correct line of eruption you can take a course of antibiotics and painkillers and once the pain subside the gum flap can be surgically removed. In case if the tooth is impacted and will not erupt completely by itself extraction of the wisdom tooth should be done. As for now Amoxapine Plus(Amoxicillin 250 mg + Dicloxicillin 250 mg) and Accelerate Plus (Diclofenac 100 mg+ Paracetamol 500 mg) can be taken for relief. Along with it do saline gargles also. But consulting dentist and getting treated can only solve the issue permanently. Hope this information helps. If you find the answer helpful kindly write a positive review and click on found this answer helpful as a token of appreciation. 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: For the past few years I have had a problem with prolonged coughing fits, particularly after meals, in cold weather and when I m out walking. My doctor sent me to a specialist who said it was just an allergy. Then I had a follow up visit with another specialist and he said it was dry skin due to old age (I m 62). My doctor tried me on anti-histimines, steroids and asthma inhalers but nothing worked. Then I read online about GERD and she gave me a losec type drug which which while not curing the problem, gave me relief when nothing else did. After a while, they didn t work any more and I tried cider vinegar, which worked for an ever shorter time. I read about an operation to repair the oesophageal syphincter. I don t know if that would help me. I get no heart burn, just the coughing. ### REPLY: Thanks for your question on . In my opinion you should first try lifestyle modification and .  Surgery is the last option. Lifestyle modification needs following things to be done.1. Avoid oily, spicy and hot food.2. Avoid large meals. Instead, take frequent small meals.3. Avoid stress and anxiety. 4. Go fir walk after meals.5. Keep 2-3 pillows under your head in bed. Along with all these, you should take proton pump inhibitors and prokinetic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had affair 18 months ago, and got gonorrhea , he recieved medication , today he went to clinic and they told him he has a mild gonorrhea and did he go back for a follow up when he first got it in 18 months, he said he didnt as he thought the tablets cleared it , he told them he has only has sex with me since the affair, obviously i have gone mad over this and dont believe him but he insists he hasnt has intercourse since only with me . The clinic says he might not have cleared up , is this true ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that your husband has acquired Gonorrhea after having sex with other woman which was treated with antibiotics.However, during his recent visit your . This is known fact that infection remains dormant for a couple of months and recurs again without any sexual contact especially if the Gonococcal infection is incompletely and treated  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosed as having an irritate meniscus in my right knee. in June of 2013,I was up some steps and banged my foot into the step on the way up. I couldn t walk, had multiple times where my leg almost gave way under me. I m finally gaining some stability almost a year later. My question is how long does an irritated meniscus normally take to recover? ### REPLY: Hi, thank you for providing the brief history of you. A detailed musculoskeletal assessment is advised. As the injury cured in 2013 and now all fine, I will advise you to undergo physical therapy as it will help you regain the strength in the muscles which supports the knee for locking and unlocking mechanism. Usually after a week of injury, physical therapy is started, but in your cased it is made delayed, so taking a proper care and undergoing physical therapy will be good to save the knee joint from early degeneration. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is age 70 with late stage CLL. No current treatments other than weekly blood transfusions. I live far away and am trying to determine when to go home. I d go now, but I have kids who are sick with a fever and respiratory virus. He is not hospitalized or under the care of hospice, but sees the oncologist weekly. My mother is caring for him at home. He has had fluid inside and outside the lungs, and today was told he has hemolytic anemia, with a hemoglobin level of 3.? and wbc over 400,000, platelets low, but I don t have a number. He appears yellow and has blood in his urine. My mother plans to take him to the ER in the morning for a transfusion. This may be the last transfusion. Any guess as to a timeline? ### REPLY: Thanks for your question on .CLL is chronic lymphocytes leukemia. It is blood malignancy.  Involves mostly bone marrow and liver. It causes blood hemolysis and decrease blood production due to bone marrow infiltration. So his hemoglobin is reduced with low platelets. Due to hemolysis, he is having high bilirubin and this causes yellow appearance of him. Low platelets can cause spontaneous bleeding, so his urine is having blood. And sever anemia (He 3) can cause pulmonary edema and pleural effusion. So all these are definitely not good signs for survival. In my opinion he has less than 1 month. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was doing sex on 7 december with my gf and she take i pill on 8 december. but on 15 december we again doing sex and again my gf take i pill within hour after sex. means she take i pill two times in amonth then what you say that she will be pragnant or not?? ### REPLY: Hello, In the current scenario, the chances of conception are very less since she took the emergency contraceptive pill on both the occasions within the stipulated time interval. However, there is an expected delay in the next natural period by a week or two since the hormone milieu is disrupted due to the pill intake. Please see your health care provider for further management if she becomes overdue by ten days. Prefer regular contraception. Avoid using more than two emergency pills in a year and definitely not in a single cycle. 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: It has been requested that I go in for a vision field test after my eye exam this morning.  Several things were listed for diagnosis.  One of them being the optic neuritis.  Im really scared at the moment and dont know how to react or what to do.  I have that test in 3 days.  However, I was wondering, if a brain tumor, how fast do tumors typically grow?  If malignant, is it months, years, weeks or what that is considered rapid growing?  What time frame is considered slow-growing? ### REPLY: Hi, Thanks for writing in to us. Optic neuritis is an inflammation of the optic nerve which carries impulses from the eye to the brain through the optic tract. This is usually a limited condition and is treated with steroids. Brain tumors are of many types and categories. Most benign tumors grow very slowly and stay stable for years before they cause symptoms. In contrast, malignant or cancerous tumors grow violently, and it might take 3 to 6 months for them to grow into a mass of cancer cells. In conclusion, a tumor is slow growing if it takes more than a year or two to double its size and is a fast-growing it there is double in tumor volume over 3 to 6 months. You likely do not have a brain tumor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 abdul wahid i am suferring from a mental diease i am facing a compulsive thoughts. sometime one sentence alawaways in my thoughts i think but i donot want to say these compulsive thought always with me some on says that i am suffuring from a madical condition that affact the balance of my thoughts and mind please give me answer ### REPLY: Hi. I had gone through your query. I understand your concern. Compulsive thought or obsessive thought may indicate OCD.OCD is obsessive and compulsive disorder in which repeated and persistent intrusion of thought occurs, and you have to do compulsive behavior like repetition in response to it. Detail Psychological evaluation will give more confirmatory diagnosis. Scales like YB OCS can help to find area of compulsion and its severity. Evaluation of mood/thought processes are also necessary. It can be treated with anti OCD medicines like fluoxetine and fluoxetine and clomipramine but selection is depended upon type and severity. Exposure and response prevention is also helpful psychotherapy in OCD. So consult psychiatrist and get help. I hope I have answered your query. Thank you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have completed a course of treatment for hepatitis c(type 1) I finished a 6 month course of medication  6 months ago and am waiting for the results of a 6 months post treatment blood test.I have had for ongoing pale loose stools ,and  tire quickly.II am 52 years old,it is thought I had hepatitis c for about 30 years ### REPLY: Hello! Thank you for the query. Pale stools are caused by lack of bile secretion to the intestines. In normal condition, bile gets from bile ducts to the duodenum and gets digested by bacteria. This digestion causes stool color. When there is no bile secretion to the stool, it becomes pale. So the most probable reason of pale stool is bile ducts obstruction. You should also get dark urine and skin itching. Such bile obstruction can be caused by gallstones, pancreas cancer, liver cancer. I suggest you to have some tests done. Blood work, liver tests (AST, ALT,GTP, AP), amylase, bilirubin, abdominal ultrasound should be done at first. If GGTP and AP will be elevated, ERCP procedure should be performed. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello im just wondering i av a lump on my right side just under my breast near the rib cage on my right side it hasn t got bigger nor is it painful wen i press it i get a feeling like a massive cramp and it does hurt but not for long could u tell me wat it is plzzz ### REPLY: Hi ! Good morning. I am  answering your query. Lump in or around breast should be properly examined and investigated by the specialist concerned for a proper management to avoid complications later. Therefore, I would advise you to consult a general surgeon in your area soon to avoid any delay in the management plan. 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: My nephew has emphysema with fluid on the lungs the doctor wanted to put him in hospital to put dye in his body to run tests.  What would this test find?He is 165 cm tall and weighs 90 kilos.  Has an enlarged heart, is on fluid tablets and patches. He uses an enebliser to help him brealth. ### REPLY: Hi and thank you for asking in . Fluid in the lungs means fluid in the pleural space. Emphysema is a land diseases that usually it is encountered in smokers, or it is an inherited disease. It is better for him to stay in the hospital for doing some tests. The enlarged heart might be related with the pleural fluid. The main test is the laboratory examination of the fluid taken with a procedure called thoracentesis. It is very important for the origin of the fluid from the heart or lungs and from this depends on the treatment too. Wish good health for you and your nephew 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: The sole of my feet are very itchy. It makes me scratch a lot with results in peeling and dry looking skin. I have this condition for years now and nothing works since I always end up scratching them and they look bad again. What is wrong with my feet? ### REPLY: Hi, Most probably you may be having Tina FEDIS. The skin becomes mild scaly and the feet nails may be affected. But, to confirm the diagnosis, you consult dermatologist personally for firm diagnosis... He would thoroughly examine for feet and would come to some diagnosis. Allergic contact dermatitis, irritant contact dermatitis, lichen simplex chronic us, palmoplantar pustular psoriasis... ...etc. may the differential diagnosis Still, I would suggest as follows. - antihistamines to relieve itching-antifungal like ketoconazole for few weeks-antifungal cream like clotrimazole cream-cleanse the feet with detail liquid hope this would help you. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am a 43yo male and have just had a ct scan in which it showsi have  3 lesions, 1 right heptaic solid hypoechoic lesion measuring 3.3mm x 2.5mm and 2  hyperechoic lesions right lobe measuring 1.0 x.8mm and 1.9 x 1.6mm hypoechoic lesion with peripheral achogenic rim.Post contrast scans were performed, durind the portal venous phase. All thrre lesions show a similar appearance being hypodense with lobulated  peripheral infilling during the portal venous phase. All become isodense with liver on delayed phase scans. Appearance are typical of hepatic haemangiomata. I have now been advised to have another ct scan in a years time as well as a blood test in 6 weeks time. What are your thoughts on my precautions? My GP has advised me to stop drinking alcohol until my blood test is done to see if there are any improvements, I consume 8std drinks per week. ### REPLY: Hi, Thanks for writing in. Going by your report findings, lesions measuring 3.3 x 2.5 mm, 1.0 mm x 8 mm and 1.9 x 1.6 mm are very small. Also words hypoechoic and hyperechoic are terms used in ultrasound scan. Please re confirm size and words used in your report. Even if we take the findings of post contrast scan to hold good, you really need not worry about these lesions. Meningiomata of size mentioned by you are always benign. A blood liver function test can be done, and ultrasound scan can be done after 6-month intervals. If felt necessary (increase in size and number) then a CT scan can be done. Alcohol might be temporarily restricted to get proper blood test results. Please discuss you blood test results with your doctor. 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: Can asthma bronchitis cause nose bleeds? I have been getting frequent nose bleeds and I dont get them. In fact, I think my entire life Ive only had about 3 total. Waking up every morning now and its concerning me. I was diagnosed with bronchitis on Monday and had this cough for nearly a month. I am a smoker. ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. Asthma bronchitis is usually not associated with nose bleeds.2. I usually suggest my such patients to consult an ENT surgeon who will examine the nose from inside and may decide the cause of bleeding. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day I have a colic baby. She is two and a half months old and her biggest problem is winds. Most can be expelled via burping however she often has winds/gas in her intestines which causes her great pain and discomfort. Would milk of magnesiun or any other remedy for indigestion help? ### REPLY: Hi, I had gone through your question and understand your concerns. It is normal for two and half months baby to pass gas.  But it can make baby uncomfortable, the best remedy is proper burping of baby. You have not mentioned is baby breastfed or bottle-fed, If bottle-fed, you can check opening of nipple, it should be neither too large (risk of aspiration) or small (taking more gas than milk). Try be feed baby in sitting (mother) or reclining position with head on upper side. No milk of magnesium is not recommended for such a small baby. You can try Caspar .  Hope this answers your question. If you have additional questions then please do not hesitate in writing to us. 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: okay to make a long story short, i had a miscarriage on April 02. by doctor said that i could try again after my next period. there for my husband and i have tried again. But now my belly is killing me with sharp pains all over like as if i was really gassy. on top of the pains in my belly, i have a headache in the front part of my head. also ive had on and off hot flashes; mostly when i raise my hands to wave,or even put a shirt on. do you know what i might have or what the cause of this is? ### REPLY: Hi ! The symptoms you have after a miscarriage tends to some kind of pelvic infection which you might have developed. I would like to know if you have any history of discharge per vagina. If yes, it points more towards this diagnosis. At the same time because you and your husband have tried for a baby again, one has to exclude any abnormal placement of the fetus (ectopic pregnancy) which might be giving rise to this kind of abdominal pain. So far as the hot flashes, etc, I would like to know if you had a biopsy of the miscarriage part / curette or not. There are a few conditions where miscarriage is a possibility along with hot flashes and headache. I would advise you to consult your physician again who may advise you for a serum  level and an ultrasound abdomen apart from routine urine and blood tests. I hope this information will be of help to you. Wishing you an early recovery. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my baby is four months old she is suffering from loose motion 4 times a day i have already visited two doctors to get rid of loose motion but still it is not controllable she is having normal urination some people says due to gum formation i have given following medicines enterogermina, OF than azithral what to do doctor please suggest???? ### REPLY: Hello, I just read your query. If baby is having mothers milk then usually 6 to 8 stools(whether solid or semi-solid) are considered normal as long as baby passes urine normally and feeds normally. Because loose motion causes deny .  * Gum formation has nothing to do with loose motions.* As your baby is 4 month old now, you can add foods like curd, banana, apple to the diet of your baby because they will help in making solid stool and curd is a good source of intestinal friendly bacteria which will help in maintaining normal intestinal movements. Start from small quantity. * If you give baby milk other than yours then do maintain hygiene. Boil bottle and nipple before use and change nipple every 7 to 10 days.* So do not worry about the number of stools baby passed a day and no need to give medication as long as he is not deny ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im 37 and trying to get pregnant,how can i boost my chances? i was told by a friend that taking a hot bath relaxes you and can help,i did have the implant taken out justb4 christmas and have now having regular preiods i am a smoker but have cut down alot ### REPLY: Hi, Thanks for the query. I understand your concern.  Taking Bath would definetelyhelp my improving your mood. More scientific things to help conception are- -Folic acid 5 mg pill to be consumed by both the partners for 3 months before conception.  -Have a nourishing balanced diet/Avoid any illness (for both the partners. - quit smoking 3 months before conception -A regular & ovulating cycle normal semen reports are to be confirmed. (by semen analysis after 3 days of abstinence USG ovulation study) - Monthly ovulation day can be confirmed by LH surge test.....have an unprotected sex daily for 6 days from +ve surge test.  *All the things strictly followed. There would be conception within few months.  Test by urine pregnancy test after 8 days delay in periods consult to start treatment immediately after +ve test.  *Go for detailed investigations .if no +ve result in 6 months consult a sterility doctor.  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: Respected Doctor, My son aged 18 yrs is under allopathic treatment for OCD for the last two and half years. Recently he was showing some symptoms of Schizophrenia also and was given medicine accordingly.Since in allopathy they are treating the symptoms, I am in doubt about its efficacy in long run.While taking allopatChatDoctoredicine he has become very dull and weak emotionally.Kindly guide. A.K.Gupta Jaipur ### REPLY: Hello Thanks for your query. Schizophrenia and OCD are psychiatric illnesses that have effective remedies for symptom control in the allopathic system of medicine. The medication are aimed at normalizing the level of neurotransmitter chemicals in brain that are hypothesized to have gone haywire in these illnesses. However, the medication can have side effects which can be discussed with your treating psychiatrist so that medication can be adjusted in dosage accordingly or even substituted with another medication. Hope you found the information useful. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor This is sravani.. i am 25 years old. married of 1 & half year.. i have an irregular periods.. and also have un wanted hair under chin, chest etc...i consulted gynacologist.. she said it is PCOD.. and i am planning for pregnancy.. she suggested me OVAFORCE tablet for one month..to use from 3rd day of menstrual cycle.. is it enough to get pregnant sir ? ### REPLY: Hello dairy understand your concerns is very complex disease and cause hormonal imbalance, insulin resistance, menstrual irregularity and infertility problems FORCE does not help as to have menstrual irregularity. I would suggest to authorized gynecologist and undergo reproductive hormone analysis and USG scan for better management. Following additional treatment will help metformin: for maintain glucose homeostasis and weight, induce ovulationProgesterone pills: regular the menstrual cycleTopical eflornithine: for abnormal hairClomiphene citrate can be used to induce ovulation and maintain fertilityDiet: take small frequent meal rather large metalloid fatty/spicy/salty foodsAvoid excessive sweetheart regular exercise for 45-60 minutes in the morning and reduce 10-12% body weight if you are overweight. Hope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi dr samuel, firstly thankyou for your time, iam a male my name is ben 42 years of age 6 months ,ago i caught pneumonia, which in short gave me gave me heart arrythmia, take anitbiotics, i.v. which fixed the pneaumonia , but then had cardioversion , heart back into normal rythym now, never had high blood pressure , but doctor put me on beta blocker and bisosprol and coversyl, iam experiencing side effects from , the tablets anxiety , impotence, and just not feeling myself, iam wondering why i need them if my heart is in normal rythm and dont have blood pressure , he said just as a preventive , to keep your heart healthy, so it never happens again , i was very active and it has just slowed me right down , lost alot of drive and enthusiasam , is there any natural alternatives , should i seek a 2nd oppinion , he said we dont have any journals or references we can look up to c how people go off them , so just keep taking them , ### REPLY: Hi, Arrhythmia especially Atrial Fibrillation (irregular heartbeat) is pretty common, especially during Pneumonia.  The episode is generally paroxysmal i.e. it occurs during that time only and mostly doesn't recur back. If it is treated at that time we generally do not give any medication but if there are certain risk factors like dilated heart chamber (Left Atrium) or heart dysfunction we continue it for prophylaxis. You can stop the medication if you don't have risk factors or the arrhythmia has never recurred again. If it has, and you are feeling side effects of beta-blockers than for such patients we can start on another type of anti-arrhythmic called calcium channel blockers (Tab Diltiazem). For BP, you have to check your BP daily and if it is normal on medication than you definitely need them if the BP is lower than 110/70 you can try tapering the dose to half tablet and gradually stop it. 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 a 42-year-old female who weighs 120 lbs.  I normally weigh 128 lbs. but I lost 8 lbs. over the last fours weeks because Im on an elimination diet (basically a vegan diet) to try and identify food triggers for my chronic migraines.  Three weeks ago I had horrible pains in my upper chest and back that I attributed to heartburn and that were somewhat relieved by TUMS.  Since then I have continued to have sensations of discomfort in my upper chest, something like your chest feels when doing exercise at high altitudes.  The discomfort is pretty constant and doesnt seem to coincide with eating.  A couple days ago I discovered a bony lump on the right side of my sternum, an inch or so below my collarbone.  Its about the size of a marble and it feels uncomfortable when pressed but not painful otherwise.  Is the lump related to the chest pain and should I have it checked?  When I breath in deeply, I feel the most discomfort at the top of my sternum and so Im wondering if the lump is related? ### REPLY: It could possibly be related to this mass.  Sometimes, we can get bony non-malignant growths - stomas (which is a new piece of bone growing from another bone).  This is usually benign, but can cause discomfort.  I would recommend a CT scan of your chest, and I'd have them scan your abdomen at the same time.  The other test I would recommend is an endoscopy, which can be done by a gastroenterologist.  Finally, a right upper qua .  Hope this is helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my sisters husband has been diagnosed with cancer just over a year ago and he has now refused chemo and radiation . His cancer is in his lungs in 7 spots and he has a 9cm on wrapped around his aeorta, he moans in pain every day and his doctor wont tell him how long he has or if hes going to die. He cant eat or sleep he also has a tumor by his shoulder blade. Could you please tell me if he has a chance of beating this. ### REPLY: Every human being has the right to live in peace and without suffering. Basic principle in palliative care is to make the patient feel comfortable and free of suffering and help him live comfortably as long as he survives. He can be made comfortable with good pain relief. Sometimes palliative radiotherapy or palliative chemotherapy would do great help. If he is totally against the idea of chemotherapy, good pain relieving measures alone would help him ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mantaux skin test report is positive, erythema 16mm induration 14mm..my chest xray report done today says both perihilar and lower zones show bronchovascular prominences. The hila, medial aspects of lower zone of right side, are congested. Costophrenic angles appear clear. Domes of diaphragm are regular. Cardio-thoracic ratio is normal. I am 24 years old male. My weight and height are respectively 60kg and 5ft 3inches. I am suffering from cold for 3days after staying wet for considerable amount of time and have been taking medication for that. Otherwise I am healthy. So, should I worry about my mantaux report?? ### REPLY: Hello, thank you for your contact to . If I am your doctor I suggest you that manitou test is not a diagnostic test. It is a prognostic test. It s positivity indicates that you are allergic to tuberculin protein. Furthermore, it does not mean you have tuberculosis. Furthermore, it is positive of other conditions also. But you should be investigated for sputum for ZN stain. If you want to know anything else you can contact me. Thank you. . Infectious disease specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i m a boy of 24 yrs old.n i am suffering from asthama sicce past 7 yeats.in past i use to take drugs but now i left it.n now m abroad from my country and i am still using asthalin inhaler.but sometimes its really hard for me to take breath.what shud i do? ### REPLY: Hello. Thank you for asking at . I went through your history. If you are feeling hard to breath in spite of using Stalin, in my opinion you should start daily montelukast and inhaled corticosteroids at least for next 2-3 months. Depending upon your response, the . I would also suggest you regular breathing exercises. Please stay away from smoke, air pollution and dust exposure as much as possible. Hope this will be helpful to you. Wish you the best of the health. Should you have any query, please feel free to ask at . Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has had 3 attacks of vertigo this week.  They all came early in the morning while in bed.  This morning it was 3:30.  This attack has lasted for hours.  We originally thought they were triggered by reading or looking at the computer.  He suddenly has had many attacks in the last 4 months since we moved and he took a new job.  Does stress bring on attacks?  He hadnt had an attack in 10 years!  Will this pass?  It seems very serious right now. ### REPLY: Hi, Thank you for posting your query. Vertigo is not caused by stress, the common causes are related to ear or brain dysfunction. Severe cervical spondylosis can also cause it.First, get him evaluated by a neurologist, to look for any abnormal findings on neurological examination. Then, an MRI of brain may be ordered if any abnormalities are found to rule out brain ischemia (lack of blood flow to brain). Secondly, your husband would require an ENT evaluation to exclude BPPV-benign paroxysmal positional vertigo, which is the commonest cause of recurrent vertigo. There is no need to worry, as all these are well treatable with medications. I hope it helps. Please get back if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother had a massive heart attack 3 years ago, and because of the severity of the damage and other complications she was not able to have surgery and was told that medication was the only way to help her now. For about a week and half now she has been getting pain in her chest and she tells us that it is heartburn. She is now admitted into the hospital, she is getting bad headaches and sweats. What do you think could be the problem and what could we do? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should rule out heart diseases in her case. She was already having heart disease in past and current symptoms like chest pain, sweating etc. favor heart diseases more. So get done blood pressure monitoring, ECG, 2d echo and stress test (trade mill test). She may need Coronary angiography if required to confirm heart diseases. On the basis of these reports, she will need cardiac supportive .  Don't worry, she will be alright. 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 woke up on the 1st with a fever that lasted 3 days and was sneezing til 2 days ago. since the day the fever started ive been coughing nonstop and all day today each time i cough i get a sharp stabbing pain in the back/side right under my ribs and also have a dull pain in the same area when i breathe in deep. What is wrong and what can i do to help? ### REPLY: Thanks for your question on . I can understand your concern. Fever, constant cough and chest pain are more suggestive of lower respiratory tract infection (LETI) (pneumonia). So better to first get done chest x-ray. If chest x-ray is showing pneumonia then you will need antibiotics, antihistamine and paracetamol. If chest x-ray is normal then only antihistamine and paracetamol are needed. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 daughter is 16 and yesterday she started complaining about a sharp chest pain on her left side but she said was hurting when touching took her to a walk in clininc dr checked her lungs heart beat and blood pressure he said all was good and told her to take some advil or tynelol...what could it be since she never has health problems ### REPLY: Thanks for your question on . I can understand your concern. Possibility of musculoskeletal pain is more at her age of 16 years. Heart diseases are very rare at young age and her blood pressure and pulse are normal, so heart related diseases are extremely unlikely. She is having tenderness (pain on touching), this is characteristic feature of musculoskeletal pain. So ask her to avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Avoid bad postures in sleep. Painkiller and muscle relaxant .  Application of warm water pad on affected areas is also helpful. Don't worry, she will be alright. 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 drank alcohol for the last 3 days. Today I went to emergency room for stomach issues. They said I have elevated liver enzymes. They told me I need to take Prilosec, if I continue to bing drink while I take the Prilosec will the liver be harmed more than drinking alone. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your liver enzymes are elevated.  It is due to liver damage caused by alcohol.  It is called as alcoholic liver disease. You should avoid alcohol.  Alcohol leads to further liver damage and causes serious issues.  Continue your .  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: in have diagnosed that i have been suffering for hapatitis b virus..but my doctor said that my liver is healthy and doesnt have any damage..he said that im a healthy carrier..can i ask if this virus can be treated and can i win=ll become get well soon..because im studying now and i am worry oif i couldnt find any job in my futre if it is cannot be treated. ### REPLY: Hello, I have gone through your problem. You have been diagnosed as having Hepatitis B virus in your body. This condition is known as HBS Ag +ve. First you need to know something about your condition. Many people may get affected by this virus. Usually the mode of transmission is by using infected needles, blood transfusion and may also be transmitted sexually. In many patients the virus persists in the body for less than 6 months. If the virus persists for more than 6 months then we call that person as Carrier.  Healthy Carriers are patients in whom the virus persists but will not affect the liver. So the chances of these patients landing up with Cirrhosis of liver is almost nil. In some Carriers the virus slowly attacks the liver and this is known as Chronic active hepatitis. This can cause Cirrhosis of liver. Overall if you see, out of the patients affected with this virus only 2-3% may have this Chronic active hepatitis and may land up with Liver Cirrhosis.  As you have been detected to be HBS Ag +ve, you need to be further evaluated with some more blood tests to check the viral DNA load. If its in early stage the chances for a complete cure might be there with Interferon injections. But they are very expensive. My advice is you need to consult a Gastroenterologist or Hepatologist so that he can further evaluate you and can suggest you regarding the use of Interferons. Good luck to you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from abdominal pains for months in the middle off my stomach around my belly button in the right side off stomach and lower down towards overies region. I also become very hot and bloated when I get theese pains and become very tired ### REPLY: Hi. Since you are suffering from such a problem for months, I would advise you to undergo an Ultrasonography at the earliest to see the condition of the ovaries, uterus and all other organs. This may give a diagnosis. Also go for an X-ray of the abdomen in STANDING POSITION during the pain as this only can tell about the intestinal obstruction. Get an opinion of the Castro specialist, particularly during the attachment as a clinical examination also can give a better diagnosis-remember the investigations are to support the clinical diagnosis and not a substitute. As I noted - yo may have a recurrent intestinal obstruction, may be an internal hernia (so is missed many times). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 grandchild is 3 days old when they did a blood test on him the same day he was born they said his white cell count was low. Another test they did where his count is suppose to be at 0 it was at 4. They put him immediately on an antibiotic. Yesterday they said his blood count is perfect but where his number was high at for now it has gotten higher it is now at 10.5. They don t know what s caused this whether it could be an inflammation or an infection. He is in NICU ### REPLY: Welcome to the  I have gone through your question and understand your concerns. As per your description, your grandchildren white cell count were definitely low at birth. Most common reason for this is early onset sepsis. But it should ideally also be supported by C reactive protein, blood culture and sensitivity. The neonate so usually respond well to a course of antibiotics as per the sensitivity pattern of the suspected bacteria. The good point is that the count of 10.5 is perfectly fine and acceptable. If no other symptoms are present, it suggests that your grandson is responding to the treatment. Hopefully everything will be fine. For any further questions, you may contact me. 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 daughter has a small round ball under her neck,las week he had taken antibiotic because of upper respiratory track infection,but right now its three days after he had done her med,her upper respiaratory track infection was healead already,her xray is clear,shes eight years old very active,im just worried.but compare last week its getting smaller already.thank.jho ### REPLY: Thanks for your question on . I can understand your concern. This ball is nothing but an enlarged neck lymph node. Lymph nodes are commonly enlarged in infection. Neck nodes are enlarged in upper respiratory tract infection (URI).  So her URI is causing this ball like swelling in neck. No need to worry about this as you are saying that the size of lymph node is decreasing, and she is improved in URI. So this swelling will also subside by its own in 1 week. Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. 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: Wife just told has Mrsa, in hospital for unrelated reasons. Artical say in one place that gowns and goves don t really help and in another place says they are used. ??? Is a mask required when she is visited? She may come home tomorrow, I should not allow visiters? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Mupirocin ointment can be used to clear up the residual MRSA from the wound. You can apply it on the patients' maxilla, groin and umbilicus. After a weeks treatment of mupirocin we can check with the swab. If it shows the bacteria than you can apply mupirocin again till you got negative report. No, it won't spread by respiratory route, but it will be spread by contagious route. Sharing of towels, handkerchief etc. can spread the MRSA which I advise you should not share with your family members, sharing can only be possible after successful mupirocin treatment. Please maintain healthy lifestyle as it can help you prevent infection from such a bad bug. Healthy lifestyle include daily exercise, cleanliness and good diet. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is a patient of cancer prostate with bone met. Now has as underwent TURP surgery with this surgery his front urine has stop. He is on SPC. One month back has UTI Infection and bleeding in urine, doctor suggested Radiation so that his bleeding will stop. But unfortunately it is still bleeding now his Hb is 6.0. Can Orofer FCM injection 500 ml is advisable for his . If yes how many days ? How much his Hb level raised. Please advice ? ### REPLY: Hi, Thanks for writing in. Since you have said that he is on supra public catheter, I understand that he is unable to pass urine through the normal urinary passage after surgery. Unfortunately he has developed complications causing bleeding and his hemoglobin is low if it is 6.0 gm/ DL. This cannot be treated by self-medication and in my opinion, after consulting your doctor blood transfusion might have to be given to increase hemoglobin to 10 gm/ DL. Giving roofer only may not increase hemoglobin levels sufficiently therefore it can be given after the hemoglobin increases following blood transfusion. With all measures the target raise in hemoglobin must be at least 10 gm/ DL. The bleeding area also has to be checked and treated if there is no relief after radiation therapy. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr Prasad. This morning, after my shower, I noticed a red rash on my legs around my groin (no rash on my testicles or penis). I also had a rectangular patch of rash just below my armpits on the upper arms. I took 2 tsp benedryl and went to work. All seemed fine, but on the way home the itching came back. The rash under my arms has now spread to my chest and around my nipple region. I have a more pronounced rash on upper legs, and behind the knees. Small rash developing at the waist line. Basically wherever there was rubbing with clothes or watchband. I have not changed soaps. I have not changed laundry detergent. I DID cut down some branches from my tree and there was sawdust everywhere (not on my groin though). I also noticed a lot of some sort of fecal matter on top of the roof where I was sawing branches. ### REPLY: Hello. Thank you for using Ask doctor service. I have gone reviewed your query and here is my advice. You seem to be having Hives. Hives present as itchy welts and redness/flare. They can be localized or they may be widespread. Common causes include allergic reaction to food, food preservatives, infection, .  Consuming alcohol may also cause Hives. I suggest you to take an oral antihistamine e.g. cetrizine10mg tablet once a day for a few days. You may use a soothing lotion e.g. calamine lotion for to calm down the rashes. Hope I have answered your Quertle me know if you need any further assistance on this. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So about 4 years ago, I fell on my tail bone while rollerblading. Went to the my doc and he said that itll go away with time. It hasnt. 4 years now and nothing has improved. I have two kinds of pain. A sharp one, that usually happens when Im mensturating or constipated and a dull one, usually when Im sitting on the floor or on a chair. In addition I that, I have back pain (mostly lower) when Im standing for too long or when I lift something heavy.  I have no idea what is wrong and I have done all kinds of tests, from x-rays to MRI. Almost every possible test. And nothing! I just wanna know what is causing this pain? And what I can do about it? I try not to take medication unless I absolutely need it. ### REPLY: Hi, When you fell on your tail bone, you have damaged the bones and muscles and nerves passing by. Coincidentally, the nerves and muscles are related to the internal organs like uterus or bowel. So, when you menstruate or strain due to constipation, you are putting more pressure to the affected area, thus, increasing the pain. I'd suggest to - do vaginal swab testing to exclude vaginal infection-urine analysis to rule out urinary tract infection-try to avoid being constipated everything is ok, then, it is most probably due to fall. So, have patience and your everything will be over Can take painkillers (locally or orally) and . All the best! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. i am 42 years old. and 2 years back after i stayed in hospital to help someone suffering from dengue.. i am having serious health concerns.. the heamo told me i have Idopathic thromocytopenia. Now since two months i have heavy bleeding..1st it started on 29th august ( after 1 month gap in july where i did not get periods) it was v heavy  and went on for 12 days until  i went to gyneac she gave me pause mf . again  the bleeding started on 22nd sept and is still going on. the dr told me to take harmone tab which i am very reluctant to do so.  but  i am at loss what should i do.. today i took pausemf again to stop bleeding. thou it is not very heavy. but still so many days .. i am worried.. what should i do. ? ### REPLY: Hi, you may have ITP plus some the problem also. Definitly you bleed more with ITP. But ITP bleeding generally not stopped fully with pause mph tablets. For ITP steroids or Iv IG is required. Moreover tell me what is your platelets count. So consult gynecologist to search cause of your heavy bleeding. If they find any other cause then take treatment of that. And if only ITP i there then start treatment of that according to your doctors' advice. Thanks for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 helping a co-worker push a car out of the snow and my right leg felt like it was kicked in the side, but it was not. today when i woke up my leg from my pelvis to my lower knee is VERY stiff and tense to the touch, its hard to apply pressure, its numb, does not really hurt at all. i am walking with a cane now it only really hurts if i push on my leg between the top of my knee and pelvis ### REPLY: Hi, The symptoms that you depict after doing strenuous work are indicating towards disc problem. But usually that has pain in the back. The second possibility is that you have hurt yourself, First take rest, do not lift any heavy weight, take analgesics thrice daily keep leg elevated see if this gives relief in a day or two if not you will then need to consult your doctor to diagnose the condition and treat appropriately ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has been complaining of pain in his right heel. For several months now he has been saying his ankle hurts, especially when getting up from sleeping , but also after sitting for short periods. Now I minimized his complaint because he has a tendency to overreact to pain but tonight I finally took a look.... It appears to have a somewhat movable lump roughly the size of a golf ball, more towards the inner side, which is slightly red and warm to touch. I told him to go to the ER to have it looked at because he says it hurts very badly. What could this be and should he be seen immediately? ### REPLY: Brief answer:Planter fasciitis needing pain medications and steroid shot. Detailed answer:Hello, Based on what you told about your husband, it can be said with fair certainty that you husband is suffering from planter fasciitis. Plantar fasciitis mainly results in pain in the heel and bottom of the foot and is seen often in clinical setup. The pain is usually most severe with the first steps of the day or following a period of rest. Improvement of pain is usually seen with continued walking. The condition usually builds up slowly and cause intense pain. Your husband is most likely doing a job which require long periods of standing, and he may also be obese. If I were your husbands doctor, I would first do an x-ray foot which usually show a heel spur, although an absence of spur does not rule out fasciitis. An ultrasound heel also aids in making diagnosis. I usually advise the best rest to patient to see whether the condition improves. Along with rest, painkiller like:Diclofenac K 50 mg twice daily is advised to aid with bed rest. If this is not sufficient, a steroid injection is advised which is injected at the site of maximal pain on heel. Most of the patients improved in clinical setting after this remedy. Surgery is considered only after conservative treatment has failed to resolve the issue after six months and has rarely been needed. I shall be happy to assist you if you need further help. Wishing a safe and swift recovery for your husband ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am taking Zosert 100 mg twice daily. This has been prescribed by an Physicatrist due to my nerves pain in back side and neck. I am not comfortable taking medicine since there is no depression. I would like to drop the medicine Maxgalin 75 mg,Etilam is taken along with zoset. Please advise to stop taking these medicines need your advise on thisThanks ### REPLY: hello are on the highest dose of Robert right now. Whatever be the reason if taking it, but it should be tapered slowly over time and then stopped. Sudden stoppage may cause you huge problematic issues. Try with reducing 25 mg at a time, wait for 2-3 weeks and if you are ok then further reduce it by 25 mg. Continue to do so after a gap of few weeks till you are ok. But if there is any problem in between then you will have to discuss it. You can discuss this gradual with . Wish you 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: Had spinal mylegram 2 weeks ago had pain and numbness for 1 yr right cervical spine degenerative disc disease bone spurs arthritis since mylegram left shoulder blade has hard thumping sensation that comes and goes and can last for hours and causes severe muscle spasms and bilateral elbow pain immediately following thumps. Can you explain this. ### REPLY: Hi, Thank you for providing the brief history of you, as you mentioned you have been diagnosed with cervical spine degenerative disc disease, at what level the disc is degenerated is the first thing to know. Also, due to the disc degenerative disease the pain radiates of pain is felt with abnormal sensation like, numbness, tingling, sharp shooting pain etc. based on the nerve getting pinch and its course as well, it can be armed, elbow, fingers etc. Spinal nerves carry two functions - motor and sensory. Due to the nerve pinching in the cervical spine there will be changes in the motor and sensory functions. Also, you mentioned the pain in the shoulder blade, this is a pain due to trapeziums, the release of the trapezius muscle will help further to get rid of the pain. I can surely understand this pain, as i myself had this pain in the past. Also, many of my patients complain the same pain and MRI history. The simplest treatment line i advice is - posture correction and physical therapy. With therapeutic ultrasound therapy and TENS therapy the pain levels are brought down and inflammation as well. Post this, exercises to strengthen the muscles of the neck, upper back, shoulder, arm, Forearm and hand helps a maximum benefit. Till date this protocol has been 99% successful on myself and on my patients. I expect the same recovery from you. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wifes ERS is too high Around 107. we have been taking antibiotics for last two months (since 01-jun-2013), but it seems to get higher. now her doctor has suggested Ceftriaxone Sodium twice aday but he has also suggested that it reflects presence of Cancer.her widl test and typhoid test are negative I just wana know does ESR higher then 100 indicate Cancer. I have attached her reports A well. would appreciate your help in getting second opinion ### REPLY: Hi and thanks for this query.I am so sorry to hear about what is going on. I am sorry this service cannot accept reports but if you should ask it as a premium question, I will be able to add ore information in addition to this. Feel free about this. Increased ESR simple indicates that an inflammatory process is going on. It could be an infection, arthritis, cancer related, osteomyelitis, arthritis, anemia etc. A very detailed questioning, clinical and laboratory exams have to be done. This will orient and give a sense to what else should be done. I will not conclude that high ESR is diagnostic of cancer unless there are some other arguments in this light. Hope you find this helpful. If you can forward the report, I may provide more details. Otherwise, simply giving brought antibiotic say not be the easy way out. Investigate and get the cause before rushing to treatment. What is problematic and not the treatment and unless you know what you are treating, you are treating nothing. I wish you and your wife the best out of this. ### END