Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Sir,My wife Chaitali Prasad, age 37 yrs old she is suffering for joint pain since one year. Sometimes his finger and leg are swelling and she does not any work and movement this time. So, I request kindly proper advice us. Thanks & Regards Sanjay Prasad (Husband) ### REPLY: Hello sir, As per the history u gave consult an orthopaedician and physician. Your wife might require blood investigations, xray of hands and leg. She might be having systemic illness that is affecting joint of her hands and feet. Need to evaluate certain conditions like gout, pseudogout, rheumatoid disease ... Etc.and depending on diagnosis treatment will reduce her problem.I hope she will get well soon. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 12 yr old son has a temp of 36.4. He has been sleeping 12 hrs a night, getting up, not eating, going back to bed, sleeping on and off all day. He picks at food, but nothing more. He is on 18mg Atmmoxetine for ADD. We are at a loss. He seems depressed. Any thoughts? Kathy ### REPLY: Hi, I had gone through your question and understand your concerns.  You should be worried but not too much. You may easily get her back to normal range if you will stop giving her Atomoxetine. I see similar cases amongst young people who visit my clinic. Decreased appetite, nausea or vomiting, dizziness, .  If you see such symptoms you should give her Charcoal 3 tablets daily for 5 days. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you and child good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello today i have got my semen analysis report. i am 38 years of old. report said astheno teratozoospermia. in sperm morophology normal forms 05%, head defects 88%, neck mid- defects04% tail defects03%. please tell is it good or bad. sperm concentration 111m/ML, total sperm count 333M. ### REPLY: Thanks for asking .  I have read your query & I understand your concerns. Following are my comments & suggestions: 1. Your total sperm count is normal.2. Your sperm morphology is low. Means the normal looking sperms are very loss. Majority are with defect in sperm head. This report shows some defects in sperms, but your sperm counts are fine. I suggest you start taking antioxidant medicines after obtaining prescription from your doctor. Repeat the semen analysis after 3 months of treatment. I hope it helps. 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: Hi there,I been married for one year and I am not able to get pregnant. I have been to the doctors and they told me I have PCOS syndrome which is hormone imbalance. I have my periods every month but some months my period would come twice in one month I think because of nurves because I never had a problem where I would have my periods twice in one month. Its not like that every month but some months are like that. I am taking medicines that the doctor perscribed which is Diana 35 which I take only when I have my periods and also another medicine called DOSTINEX can you help me tell me what to do please. ### REPLY: Hi, Welcome to . PCs occur due to hormonal imbalance. So you are suggested to continue your .  Along with this I suggest you to start metformin which helps in combating insulin resistance which is seen in PCs after consulting your doctor. Get your follicular study to know you are ovulating or not. If you are ovulating you can try naturally for 3 months. If not ovulating then you are advice to take ovulation inducing  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir,My self Pawan Kumar Singh date of birth 20.07.1978. I was doing gym in year of september 1999. I had lifted 110 kg weifgt call bench press.I got back pain and it is converted into leg pain,I had meet a lot of docor in Gorakhpur,Lucknow KGMC,PGI,Sahara,Neera Nursing and other local hospital,Delhi,bangalore,Nimas,Hosmet,Apolo,also ESIS indiranagar,I had taken a lot of medicine but situtaion is same,last treatment taken throuh Ayurveda baba ramdev, Homeopath and other, Currently i am taking treatment of Nuero in Lucknow by Dr.Atul Agarwal but situtaion is same.Kindly help me.Thanks & Best Regards Pawan Kumar Singh 0000 ### REPLY: Hi, From your history it seems that you are suffering from disc slip which now is pressing any nerve due to which you are getting pain at your legs also. And in medical terminology it is diagnosed as sciatica. In this condition, physiotherapy stood a good chance to relieve you from your pain. Do consult any physiotherapy clinic. Your physiotherapist will help you out. In the meanwhile use hard bed for rest and put a pillow under your knees to relieve the stretch at your nerve, and it will decrease your pain also. Use lumbar corset while traveling to prevent any travel shocks, .  Take vitamin B 12 supplements (vitamin b12 is considered as nerve tonic). In physiotherapy there are various pain relief and machines which stimulates the nerve like tens and it. Along with patient centered exercise program can work wonders in relieving the pain and discomfort. Hope you find the answer useful. 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: Are there any natural foods that I can eat that may help me fight off an infection? I have a brownish discharge from my penis. It drips a bit in my pants but when i feel it I try to help it come out my pushing. If I leave it it because hard or pasty . I have minor pain when I urinate. ### REPLY: Welcome, Discharge of brown color from penis can be due to herpes infection or any other venereal diseases. In rare cases it can be due to Atlantis or epididymitis. More over painful micturition strongly indicate infection. Since how many days this problem arise?? U should have a check for microbiological examination of that discharge. Result of that test can identify the organism which can be treated by proper antibiotic .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hie doctor. I have a lump under my skin in my inner right thigh. Its not very big abt the size of a bean though it feels like it has a thicker and bigger base further in. Its not painful, but at times i have spasms of pain from my foot terminating just abt where this lump is. What is it Doctor. Worried ### REPLY: HI, Dear, Thanks for the query from you for your painful lump in rt inner-thigh .1-I am happy that you are serious to know why this leg -lump is having painful spasms?2-In my opinion, I would more info from you before I would tell the answer to this query.3-Its very unusual lump -beans sized, with bigger base.4-Hence in this situation I would advise you to get the ER-Surgeons opinion, who would work on the differential diagnosis5-Still In my opinion-possibility of femoral hernia-with neuritic pain is to be ruled out, from the facts provided by your query. Though I would advise Surgeons opinion as it's his area as clinician i/c doctor.-6-Other possibilities of academic interest for which rely on your ER surgeon and should not worry much.7-Hence You should be panicky and worried, and go Ugly go to ER -Surgeon doctor as there is probable strangulating femoral hernia-which is the worst complication to happen-till which you should not wait.8-You should have USG of the area and the Doppler to arrive at the cause of the painful lump in the inner rt thigh.9-Hope this would solve your worry of the painful lump in rt inner thigh.10-So ugly take -the advice from the ER Surgeon.11-Wellcome to  for any more query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a mirena IUD placed on January 4th. This morning while I was still asleep I had a watery discharge . When I woked I thought I had urinated at first. I had a baby in November and have had some bladder control issues since. However, I found that my pajama pants were wet, and there was a slight fishy smell. It was almost the smell I get with a yeast infection , but I am showing no other symptoms. Then after going to the bathroom I stood up and had another, smaller gush. It is definitely the consistency of water. Should I be concerned? ### REPLY: Hello thank you for your query. You could be having urinary incontinence, however the smell you described doesn't fit in. Yeast infection would be a thick curry discharge, not the watery gushy kinds you describe. The appropriate cause here could be BV or Bacterial Vaginosis, which is also a kind of vaginal infection, characterized by profuse, watery discharge, which typically has a fishy odor. You need to consult a Gynecologist, and have appropriate testing along with swabs to pinpoint the precise infection. Do not leave pelvic infections untreated. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been getting a pain in my RHS hip. Sometimes it is a constant pain but more often it spasms, or feels like a twinge when I move. It started after I started doing reverse leg lifts, and I am a cleaner, so I m not sure which of those are were the problem came from. ### REPLY: Hello, What I understand by history is this is related to your job profile. As using the hip in all different and awkward position is possible without one's knowledge. Try doing hot water fermentation to improve the revascularization, so the healing of tissue is optimum and also try doing simple core and hip muscle strengthening exercises. This should help you. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I have slight pain in upper abdomen,mostly under left ribs.I also get dark stools in the morning.I visited a doctor 10 days back when i saw red blood in my stools..Doctor gave me few medicines diagnosing it as bacterial infection and  had conducted stool test whicChatDoctore out to be negative today! Red blood in stools has stopped but not the above. ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You have got pain in upper left abdomen. Dark stools, sometimes blood in stools.  It appears that you have some infection in the intestines, most probably amoebic infection, or a combination of bacterial and amoebic infections.  There could be simultaneous gastric irritation due to irritant foods, or peptic ulcer.  I advise you to consult a gastroenterologist for diagnosis and treatment. You may need to use a combination of antibacterial and amoebicidal .  Wishing for a quick and complete recovery.  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: is this real? i slammed my lip onto a table, bit through my lower lip... it bled and seemed to heal fine. a month later... it is still hard like a blood clot feeling.. it is red and there is a white-ish bump. i ve tried to pop it before but it just bled more. either way it is hard, not painful but uncomfortable. wondering what this is... if i should go in for a visit or if it will reabsorb? ### REPLY: Hi. Thanks for your query. Read and understood your problem. The appearance hard red and white bump in the lip after a trauma caused by hit on the table can be due to the following reasons:-This can be a Cyst -Organized hematoma appearing hard-Acquired Hematoma. You should go for a Visit to the General Surgeon or an ENT Surgeon for clinical evaluation so that the removal will be easy. Since this is more than a month you have this problem, it is unlikely to be absorbed by the body. There is no point in waiting for more. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with Hashimoto s Disease in December and wasn t put on any medication or anything but recently I have been experiencing a fluttering feeling in my upper chest and throat. Is this something that happens? Or should I be worried? I couldn t get an appointment with Dr until August 5th. ### REPLY: Thanks for your question on . In my opinion you should first get done thyroid function test (TFT) which includes T3, T4 and TSH. Hashimotos thyroiditis can have hyperthyroidism spells. And hyperthyroidism can cause palpitation which gives feeling of fluttering in chest. So get done TFT to rule out this. If TFT is normal than get done ECG to rule out cardiac causes of palpation. So get done TFT and ECG. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 for over two years spinning in the head and giddyness and sickness and has had head scans inner ear scans eye scans been to balance her suffres every signal day he sufffred for so loong know let him can some body please tell me aremedy or cure for him he can not go any longer like this ### REPLY: Hi, Thanks for writing in. Moments of dizziness can happen due to decreased blood flow from heart to brain. When it happens, the blood flowing through the vessels from heart to brain might have a reduced flow. These are by the carotid and vertebral arteries on either sides. This is more significant when you are standing upright and doing any moderate to heavy physical activity. Since he has got scans for inner ear and brain done, it is confirmed that there is no abnormality in the vestibular system in the ear or any serious conditions in the brain. Since his CT scan or MRI scan brain is normal, it can help if he gets Electronystagmography (ENG) or videonystagmography (VNG) done to record abnormal eye movements while the head is placed in different positions or your balance organs are stimulated with water or air. For this he might consult the ENT specialist. The best way to analyze if the reduced blood flow to the brain is causing your dizziness is by doing a carotid and vertebral arteries Doppler ultrasound. It will show the flow of blood from the heart to the brain and if it is adequate. Dizziness can also occur due to stress related anxiety or overflow of emotions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my mum who is 42 years of age and 4ft 11, has just started suffering with chest pains. she explains its quite hard to swallow and breathe. She looks very uncomfortable, and has now become very emotional. She suffers with lupus and arthritis. Would you have any idea why these chest pains have occured? Could it be stress? Or something more serious? thankyou. Kerry. ### REPLY: Hello and thank you for asking. In the situation of your mother that she suffer from lupus and arthritis the doctor should be very careful with the complaints she has. Difficulty in swallowing might be one of the complication of the lupus diseases. For the chest pain and the difficulty in breathing it would be better to do a chest X-ray, Spirometry with DCO in order to see if the lung tissue is compromised. So I think that a reconsultation with the rheumatologist specialist should be done. Thank you .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I went for a 4D morphology ultrasound and after seeing the images my mind is playing tricks on me as to if the baby could possibly be a downs baby... our risk was 1:309 whick scares me and during yesterdays ultrasound results of, femur length 51.7mm BPD 71.2mm HC 261.7mm does this seem normal or should i get a second oppinion? ### REPLY: Hi, Please do not worry. A 4D ultrasound helps identify structural defects in the baby and since none are identified, do not be worry. Sometimes the scan look different from what we expect them to show. The radiologist would have definitely informed you if he felt any concerns. Also, a risk of 1:309 for Downs is a very low risk, and you need to worry only if your risk was less than 1/100. The measurements you have posted if with the estimated gestational age, it would have helped better understanding. Any gross abnormality in measurements is generally commented by the radiologist. Do not worry. Ultrasound make it easier to identify abnormalities, do not get anxious because of it. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a small lump behind my 2 front teeth it is so veryc sore and stopping me from bitting into anything and closing my mouth properly, it is slowly pushing gum through a tiny gap on my two front teeth, it is soft but not to soft to touch. everytime my tounge or anything catches it it is very very painfull, i have not cut it with any food or anything. it has now been here for around 2 weeks and tried all sorts of pain relief but it is not working at all ### REPLY: Hello, Thanks for sharing your concern with us. The first thing you need to do is to stay away from any hot or spicy foodstuffs. Keep gargling with cool water if you have sores due to burns. Swishing milk in your mouth will help soothe the affected area, and prevent it from further damage. Intake of vitamin B-complex supplements can also help in healing the sore roof of the mouth faster. If you are having fever blisters, then take lysine tablets and apply ice to the affected area. You can perform yoga or meditation every day to control your stress level, and reduce the occurrence of sores in the mouth. Use a soft toothbrush for brushing. Replace your toothbrush every month for better dental hygiene. You can contact me again directly through my profile. Regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am feeling so much regret about telling my story to you.My age is 22 years and 6 month.I have been masturbating excessively since 12 years old.I started masturbation unintentionally from childhood.When I came to know about masturbation,I was addicted to masturbation.Now I try my level best to quiet this habbit but I cannot because when I use computer and internet I go toward sexy videos thats why I have to masturbate.Now I am suffering from some urinary problem,premature ejaculation problem and my body has become so much thin.Please guide me,what should I do to solve my urinary problems,premature ejaculation and to recover my physical fitness.I shall be very thank full to you. ### REPLY: Hi, Thanks for posting in . I understand your concern. Masturbation is a healthy and normal physiological phenomenon. Excess practice is not recommended. When practiced properly, it doesn't cause any harm like physical weakness, urinary problem, premature ejaculation, decrease in sexual performance or fertility. It is all there in you and with will power, you can decrease the frequency gradually. Usually, doing it once a week or thrice a month should be alright. You can get engaged in other activities, physical activities and meditation to get diversion from masturbation. Hope the information provided would be helpful. 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: trouble with breathing-     When I breath I breath normally, but the only diffrence is I feel like I dont have enough air coming into my lungs. I would have trouble breathing every once in a while but then it started to happen everday throughout my whole day. i would also get a little light headed from trying to get that full breath. and it all started with simply yawning more than usual. ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed query. Based on facts of your query, You seem to suffer from-Seasonal Asthma-with Bronchospasm. You need to check for Bronchospasm with eosinophilic. You need to check for Stool -Ova / Cyst with secondary -Eosinophilic- which could cause such a bronchospasm, if its occasional and if with no past history of Asthma. Acute laryngospasm with Aerosol reg urge (ALRD-acute laryngeal reg urge disease)needs to be ruled out also. Chest X-ray / Flexible Bronchoscopy / ENT Surgeons Second opinion is suggested for complete work up before treatmentsRemedy-Plenty of fluids-for proper HY . Bland diet / PPI like pantoprazole with domeperidone to reduce HERD induces spasms and Bronchial Suction-with Oxygenation - for ALD may be considered if needed. Welcome for any further query in this regard. Good Day !! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a pinched nerve between l3 and l4 - what treatments are available and do you recommend an epidural shot? ### REPLY: Hi, thanks for query. The need of treatment depends upon your problem and effect on your day-to-day activities. In case of significant problem you may need surgery also. In minor cases you may get away with rest, medicines and exercise later on. Epidural shot is an option when the pain is there and doctor thinks that there is swelling at the local point which can be taken care by local steroid. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I slipped and fell on some ice on Mondaybut I felt fine that evening. On Tuesday and Wednesday  my lower back and left buttock was quite sore. Since yesterday evening my right leg has been very uncomfortable with tingling. The General discomofort goes from my foot to my buttock (almost like restless leg). I have no bruising and no swelling. Is it possible that I have pinched a never somewhere? ### REPLY: Hi there, thanks for your question. Yes you are right. Such Pattern of radiating pain with tingling sensation after fall on your back, would suggest a nerve pinched in your back. If the pain is not severe and there is no weakness or numbness, rest and analgesics will help relieve pain over a week But if there is very severe pain, area of numbness or weakness u should see your physician earliest for further work up, which might include X-Ray and if need be an MRI. Hope this helps. All the best. Regards.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have a daughter whom i think might have adult adhd but not sure she is being treated for anxiety but i never had a diagnosis that i really believed in . she has been going to seveal theripists over the last 20 years and i see improvement . she is 47years old and she shows some signs of adult adhd primarily with relationships and holding a job.what would you suguest i do? ### REPLY: Hello, You need to see an expert in this field as various symptoms overlap in illnesses. When we search our symptom online, it does not pop up question like do you have this symptom as well? Diagnosing illness is not just making a tick mark on what we have but to rule out what you do not have? Adult ADHD is diagnosed when retrospectively you had such symptoms in childhood. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from cough for the past 20 years. No allopatChatDoctoredicine works out. Only some home medicine cures the cough that too only once. The same remedy does not have any effect the second time. All tests have shown everything normal. Once I get cold, immediately cough starts, and continues for four five months though cold gets over in a week. Please tell me what I should do to get rid of this problem permanently. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you are mostly having asthma or bronchitis. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis or asthma, but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you 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 fell over eleven days ago landing on my bottom. My left arm went back but didn t hit the ground however i had immediate pain and couldn t move it due to pain. X-ray showed no break. Had an ultra sound yesterday plus more X-ray which showed over the neck of the humerus there is a small break in the bony cortex consistent with a fracture I have very impressive bruising down the inside of my arm. My question is why can t i move the upper part of my arm i can t move it forward or if lying down i can t left it up. Thanks ### REPLY: Hi, thank-you for providing the brief history of you. A thorough musculoskeletal assessment and Neuromuscular assessment is advised. As you are having difficulty in lifting the upper limb up whole sitting, standing and lying a thorough assessment is advised. Also, you have a small. Break at the neck of the humerus undergoing a CT scan can help us understand better the bony strength and weakness. As the muscles of the shoulder girdle are weak Due to pain, you may face the issue with not able to lift the hand up. Performing slow isometric exercises under a physical therapist should help you regain the strength and ROM of the shoulder joint. Also, as the session proceed further the exercises will be changed from isometrics to isotonic. In my clinical experience this should take about a week or two to get rid of the problemRegardsJay 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: I need to have puestow procedure I have had stones that gety stuck in my bile duct. I have had 2 surgeries one was to bang it loode than suck up the stones @ seattle Wa.teaching hospital. He said he got them all & I will never have this problem again. Not! My bile duct now is 1/4 " swollen my liver is  going bad I have lost 8 dress sizes.They say that I have more stones than before. I live in Brookings Or 0000. Please help me find the right place and surgeon to go to.They are trying to get me into Eureaka Ca hospital. It does not have a good reputation.email    YYYY@YYYY ### REPLY: Hi and welcome to , thank you for your query. Puestow procedure is used to treat pancreatic diseases, not bile duct obstruction. You should do ERCP first to see can it be fixed without surgery. If not, then you need to do choledcohotomy and choledochojejunoanastomosis. Puerto is used for obstruction of pancreatic duct and in some cases of chronic pancreatitis. Wish you good health. 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, sma y Is ansower you health queries right now ?  Please type your query here... my mother is suffering from chronic liver disease which is liver cirrosis. her age is 52 years where should i take her for better treatment. iam not getting what should i do? ### REPLY: Hi, This is serious disease and quitting alcohol is the most important thing that should be done. Also, medications which are hematologic should be avoided. This is necessary to prevent disease progression which is lethal in most cases. At early stages it can be treated with these measures but in case of progression, only liver transplantation may help. Diet should be balanced and healthy and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had fusion back surgery 5 years ago - no problems until last year bending over something poped in my right side -  have had chronic back pain since.  I have had 9 sets of injections in my back and just had 6 weeks of Graston, slowburn excerise and dry needleing - the Graston, etc. has helped with the pain some but still have the deep sore pain in the middle of my lower back - any suggestions. ### REPLY: Hello sir You have a valid question to which I want to answer with a simple illustration our spine is like a snake it is flexible and can bend to a great extent. What spinal fusion surgery does is it makes two units into one, so they ease the pain, but what it also does it make the back stiff, so now the load on the adjacent vertebra is more on bending. The .  Earlier in the spine were 33 units each unit contributing to the flexibility now after fusion surgery at one level renders two vertebrae into one unit, so now only 32 vertebrae can bend. It also increases the load on the vertebrae level one above and one below the fused vertebra.  So in long run they also we'd start paining, which has started now with what u need to do now is taken care of your back, avoid straining it. Take your doctors opinion and get a MRI done to see the status of disc prolapse on adjacent vertebra and get treated 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: Been on lutera for 8 months now and I have had regular periods that last 4-5 days, this month I started spotting on my active pills this has lasted for 5 days and now I am on my second sugar pill and I am still spotting, I take my birth control properly everyday at the same time what could this mean? ### REPLY: Hi, Thanks for the query. Hormonal pills can present with side effects like intermenstrual spotting, irregular bleeding etc. Usually they will subside soon without need of medication. So, possibly in next months you may not have the problem. If the problem persists, you once consult gynecologist and take symptomatic treatment with anti-fibrinolytic .  And along with them, you can continue with pills. If the spotting persists or increases, better to go for higher dose hormonal pills with your doctors' advice. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello. m a 22 year old female. was feeling feverish yesterday,felt better this morning only to suddenly start coughing up blood. went to see a doctor,n he said i was probably coughn too hard n irritated my throat,loxaclav 625 was prescribed for me. but i dnt think thats d case,cos i dnt cough hard. came online n checked it out n discovered other diseases d@ could be the cause of this. dnt rlly know wht to do. I get easily cold,was diagnosed of respiratory infection 2 years ago,whch was treated,usually get a headache on the left side of my head,wht could be wrong? and wht shld i do? ### REPLY: Hi thanks for contacting ... Here you have blood in sputum.... In bronchitis or pneumonia blood can be split in sputum.... Chest x-ray done.... If show prominent bronchvadcular vascular marking then bronchitis or viral interstitial pneumonia can be there.... If consolidation seen then lobar pneumonia suspected..... Take full course of antibiotic... Straining while coughing avoided..... If weight loss or anorexia present then tuberculosis can be there...... For that sputum examination needed.... If you are known case of mitral stenosis then also bleed in sputum can occur... For congestion relief antihistamines . ....If you want to use herb product then one tsp ginger juice with honey useful...it is useful in resp causes.... With keeping this in mind consult physician. Take care.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello any OBGYNE doctors or other doctors knows this question pls answer me thanks.. what is the success rate of to prevent pregnancy when using Nordette as ECP ? when took 4pcs within 60 hrs of unprotected sex then 4pcs after 12 hrs of the 1st dosage. thanks ### REPLY: Hello, Thanks for sharing your health concern with us. I have gone through your query and would like to offer my opinion. The efficacy rate of an emergency contraceptive pill depends on the time delay after the intercourse before the pill is used. When the pill is used soon after, the protection offered is 98-99 % while it decreases as time goes by. At 60 hours, the protection offered is around 80-85 %. Corvette is shown to have the same efficacy as any conventional emergency contraceptive pill. Please contact your health care provider for further help. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister is having cancer in breast,throat area,c1,c2,c3,c4,skull,ribs.it was found a week ago.stage 4.radiation 5 sittings over.chemo is yet to start.whether we can increase her life through chemo and radiation.approximate cost of treatment can you say ### REPLY: The radiotherapy has probably been given to the spine area. This will not affect her life span but will decrease the chances of the spine fracturing due to the disease and also decrease the pain. The chemotherapy however, will act on cancer throughout the body and if there is response (which occurs in 60% patients), then it will increase her life span. Cost is difficult to say and will depend on which country you belong to, the .  Your treating oncologist can give you a better idea. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain pressure only in the center right above the pubic bone and some lower back pain ...was thinking its uti but tested fine and they thought i may have a bacterial infection but my question is if it could be constipation ...would it hurt in that spot ?? i was thinking constipation would bother more up higher in abdomen but just checking and if constipation could effect the feel of having full bladder ### REPLY: Dear madam, constipation is a symptom with many causes and if you have some of these signs it could be the right diagnosis: infrequent bowel movements, difficulty during defecation or the sensation of incomplete bowel evacuation. Pain can be associated with that, also you can have fatigue, nausea, bloated stomach. Usually pain is not in that spot, it would be more around umbilicus or colicky pain. The pain you're describing sounds more like urinary, gynecological problem or musculoskeletal disorder so focus on these 2 except u have more abdominal symptoms i ve mentioned.  Wish you good health. Ivan Comic ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I am 17 and I have this really really sharp pain right under my left breast and everytime I take a short or deep breath I am in excruciating pain! It has been over an hour and Ian s getting any better! I don t know why to do! I looked it up and people re saying that it called periodical catch syndrome but I don t know. Please gelp ### REPLY: Hi, Thanks for posting your quarry. After reading your symptoms I feel that you are suffering from muscle spasm. These generally do not last long. I would advise you to apply any local analgesic ointment at the site of pain/catch while breathing along with any anti inflammatory painkiller .  Hot fomentation may also help relieve the discomfort. If the pain does not subside then you must see a physician for a. examination as he will then prescribe the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hlw sir,I m Sajol.I want to know, how to solve hepatitis B virus / HBS(ag) positive.....My pathology report 1)B.suger-Random = 6.02 mmoll/L 2)S.Bilirubin (total) = 0.6 mg/dl 3)S.GPT (ALT) = 26.2 u/l 4)HBsAg = positive(pts. OD- 3.50) 5)HBsAg ( ict method) = Negative ### REPLY: Dear Major, you are having Bag positive test. That wants you to have got hepatitis B infection. To understand whether you have cleared this virus, or what level of your viral infection is, you need to undergo complete hepatitis B profile tests including various Hepatitis B (He, HBC) antigen and antibody testing and hepatitis B viral load. Based on all these, you would/ would not need anti-viral treatment. 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: we removed tumor from liver right lobe doctor said this is a cancer tumor.we have done surgery and removed right lobe liver along with tumor  but after one month we have checked CT scan liver is growthed along with new tumor (A case of he[atocellular carcinoma ) . Next what type of treatment we have to do.Please . ### REPLY: Hi, How are you? My name is .  I am a Liver and Pancreas cancer specialist and I hope to answer your question today. I am so sorry to hear about your patients' diagnosis. The best treatment available for HCC is surgical resection. I understand that within a month of first surgery, there is recurrence of the tumor. This could either be due to incomplete surgery the first time, or due to rapid occurrence of a new tumor. The treatment will now depend on how fit the patient is, How much liver is left behind and what the quality of the remnant liver is. If the liver is normal (without cirrhosis), then I would do a repeat surgery to remove the tumor, provided the amount of liver left behind will be sufficient to carry out the functions. If by scanning, it appears that the remnant liver will not be sufficient, then there are various techniques like RFA, RACE, TARE etc. which can be considered. But still Surgery will be the first choice. Hope this helps and hope your patient starts to feel better. Please do not hesitate to contact me for further details. rxsuresh@gmail.comHave a great day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I m 26 yrs old now and married for three yearsI conceived in 2010 March and had a cyst in my right ovary but had a miscarriage.After that I again tried for conceiving in 2012 Jan but since then hav been striving to do so.Just came to know that I m suffering frm PCOS. Now.Now in my follicular study came to know that my egg size is not good so my doc gave me sitrodin - hp 150 ui as an injection for 5 days.Have to go again for follicular tmr i.e. my 11th day.What is the probability that I will conceive with injections ### REPLY: Hi, Thanks for writing to . The probability of development of follicle with nitrogen is high around 85 to 90%. But for your conception other factors matter like normal ascend of sperms, sperm penetration and implantation. Since you are pregnant before then these factors are good in you. And the only problem must be with ovulation.  So chances of your becoming pregnant is 80-85%. You will conceive soon . Be stress-free. Street is Mani cause for infertility. 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 months ive been getting hot flashes and chills on and off and also a dry annoying cough. ive had body aches since i can remember ex: i always have to crack my finger, back, neck, everything. but the past week or so ive lost my appetite, my stomach is upset or hurts at times during the day, i wake up like 50 times night and cant get comfy but the worst thing is even if i eat or not the acidic stuff in my stomach when i lay down makes me sick and goes to the back of my throat. its like that most nights. and ive been going to the bathroom more often just to have an upset stomach. i feel sick and run down but i still have to go to school cause im 17. whats wrong with me? also idk if this has anything to do with anything but i was diagnosed with bi-polar depression about a year and a half ago and anxiety later on and lately we found out im ADD and take no medications for anything. oh also last summer i got strep guttate psoriasis for 3 months until i got my tonsils out- medicine was no use. ok ive said a LOT so whats wrong :(? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Lifestyle changes, change in thinking pattern, relaxation etc. are as essential as medicines. Psychotherapy can help you to change your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my son caught his ribs on the left side he reached down and banged his side .He s in pain and it really hurts when he breathes .He s been to see his doctor and he said just to take paracetamol and ibuprofen .Is there anything you could suggest .Thanking you . ### REPLY: Welcome to  I have gone through your query and understand your concern. It is most likely muscular pain. Your doctor is right in prescribing ibuprofen and paracetamol. You can continue with these .  In addition to this you can take vitamin B and C for early recovery. Rest will be useful in recovery. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I live in S. Fl and the mosquito problem this year is really bad.  My daughter repeadtly gets bit during school.  Im not allowed to send her with any type of cream, spray or wrist band and its too hot for long sleeves.  Is there anything she can eat that will keep the bugs away from her naturally. Thanks ### REPLY: HI, thanks for using  There are mosquito repellents that can last 8 to 9 hours. If she applies one of these prior to school, it would last the entire day. One of these repellents would be readily available at your local pharmacy or supermarket. The school should also take a look at their surroundings to see if there are areas of water collection that are encouraging breeding of mosquitoes. It only takes a bottle cap of water. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I injured my right ring finger about 4 months ago......a crush injury between the just distal of the 1st knuckle. I still have problems with range of motion and lack of sensation. Can a serratiopeptidase supplement help with both of these problems? ### REPLY: Hi, As for the range of motion you need to meet up a physiotherapist who can help mobilize the joint and help regain the range of motion. As range of motion of the joint cannot be improved with the oral supplement medication. It needs a muscle elasticity to be regained and joint to get free of stiffness and mobilization of the joint will be a right thing to look for. Regarding the sensation, we need to assess if any nerve damage has occurred. As mentioned by you about the ring finger than an ulnar never testing may be needed.  Oral supplement to improve the sensory functions of the never can he is helpful but as mentioned, before beginning any dosages we need to check on clinical basis for better results. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Done semen analysis. Trying to have a baby. Help Hi Doctors I am 30 year old got married on april 2012 and i am trying to make wife pregnant since 6 months i know her ovluation period it 12th o 18th day from menstrual period. I have arthritis since 10 years and i m taking 25 mg diclofenac sodium t.i.d. .. Even while having sex you put pillow below the buttocks and have correct in ovulation period. and My Semen analysis report is Vol : 1.5 ; Appearance : Turbid ; Reaction : Alkline ; Fructose Test: Positive ; Sperm count : 32 ml; Liquefaction time 30 mins Motility Actively Motile : 30% Sluggishly Motile 20% non motile 50 % Morphology 45 % and my Semen impression says : Normal Sperm count with decreased Motility and abnormal forms But according semen normal analysis report the active motile should be above 50% but mine are only 30% and even normal sperm count is 40 ml and mine is 32 ml and also morphology is 45% Is this is causing infertility. Please help RJ I have done my wife follicular test on 14th day of menses it shows normal and folic are present.This is my 10th month i have tried in ovulation time ie. 10-22 and also i do have daily intercourse.Is daily intercourse cause problemHaving 25 mg of diclofenac sodium trice a day ie 75 mg is not causing problem. ### REPLY: Hi, According to the latest WHO criteria, your semen analysis is normal. (WHO 2010). For conception to occur, apart from your semen & her eggs(ovulation), normal open tubes are required. Also, after 6 months of trying, chance of pregnancy is around 70% (85-90% after 12 months). So you have not tried enough & also tubes are not yet checked. If you are very anxious for pregnancy, you can consult infertility specialist, who will investigate & guide you; otherwise you can wait for another 6 months. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from Allergic Rhinitis with Sinusitis for the last 10 years or so. I went through almost all types of medication i.e, Allopathic, Ayurvedic & Homoeopathic. But, haven t got any relief till date.I went through a minor surgery for biopsy but found nothing serious. But, I suffer from stuffy, runny and congested nose almost 12 months a year and this affects my job. Right now I am going through Homoeopathic treatment.But whenever, allergy increases I have to go for allopatChatDoctoredication. Please advise me if there is any permanent cure for this. ### REPLY: Hello Protush, Welcome to . Your symptoms are suggestive of allergic rhinitis and rhinosinusitis, that if it remains like this may develop into allergic asthma. You will need to know what the allergies are by either skin prick tests or specific IGE tests to aeroallergens such as house dust mite, animal dander, mold allergens etc. A complete blood count, IGE level, TSH fT4, It D levels are additional tests that help n understanding why the allergies have become severe. Long-acting antihistamines such as fexofenadine 180 mg taken once daily with Alone nasal spray 1 spray per nostril once daily for 3 months is recommended. The allergy tests will help in determining which season you should use the treatment. Failure of medical treatment means immunotherapy over 3-5 years remains the last option that will also be decided on the basis of results of allergy tests. I hope that was useful. 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 keep having headaches just above my left eye,lower abdominal pains, feel nauseous ,weak at times, limbs feel numb and sharp pains in the left side in my chest and back . I had a missed abortion about six months ago at 10 weeks. used the ortho evra patch for 2 1/2 months  , I stop cause of a rash I kept developing.the doctors  cant seem to find anything. i did two home pregnancy tests and they are both negative . the doctor did tests of my sugar , liver, blood count and it was fine. They did an ecg and t was also fine ### REPLY: Hi. Thanks for your query. After reading the history you have provided, the occurrence of headache above the left eye may not be associated to other symptoms and can be due to Supra-orbital neuralgia. The lower abdominal pains, nausea, weakness, numb limbs and sharp pains on the left side of the chest with normal sugar, ECG liver and blood counts can be due to intestinal infection or IBS giving the symptoms of inappropriate absorption which lead to other symptoms of weakness and all others. Missed abortion might have instigated the changes and enhanced the problems. I would advise you the following :: Remaining blood tests for Typhoid, thyroid and relevant as per the clinical findings of a Doctor on examination. CT scan of the abdomen to rule out any changes. Colonoscopy and Gastrostomy. The Clinical examination and reports of the investigations will tell us the proper diagnosis and lead to the correct treatment. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is studying MBA in a University in Andhra Pradesh. Since he was of 15 years of age, he was easy going and not concentrating on his studies and spending most of his time with friends. Chating with friends, phone calls with his friends.... He has become so lazy that he is dreaming like he will complete the studies even if he do not read the books. He was well up to his sixth standard. He has completed  WWW.WWWW.WW degree after +2. He has tried to pursue Chartered Accountant course. He has completed Foundation level and one group out of two in Inter level of C A course. Because of his not devotion of adequate time and effort only he could not fare well in the C A. After observing his performance I have suggested him to step out of C A course and do MBA. Now too his attitude has not transformed and not paying much effort to excel in his class.More over he creatiing mess in home if we suggest him any action like to do meditation, concentration practice, reading etc.,his mother is sick of his attitude. He donot have any habits like cigarette smoking, or drugs or any of its kind.During his early education years he was very clever that he can reproduce even on hearing once in his class. Because of friendships during 7th standard onwards he has become so easy going and lazy and not paying serious attention to his studies or any aspect. He is having more ambitious dreams towards his career but he is not paying concentration and patient reading, etc., Please suggest me a remedial measure on this issue.M. L P. Rao,+0000 ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Attitude changes from motivation and never from advice. Motivation comes from so many sources, but the most prominent source is his own desire. If he is not desiring about his future, no one can help him other than a trained motivation trainer of a trained psychologist. Please do not try to advise your son for the time being, because you are doing it for years, and there is no change in his attitude. Let the motivation part done by experts. Consult a psychologist. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed techniques. 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 am just after having pilonidal sinus excision surgery with disposable sutures and currently have the vacuum dressing and in the days following I have had severe pain in my teeth, worse when chewing food to the point that it is unbearable to chew. I was on antiobiotics for a cold- sore throat, cough, blocked nose at the time. I have extremley dry mouth no matter how much I drink and following the surgery and painful tongue also. ### REPLY: Hi, Thanks for asking the query, I would suggest you to visit the Dentist and get the checkup done, take an x-ray of the infected tooth after complete healing of your surgical wound you can start with the dental procedures. Follow the post-operative instructions properly, maintain a good hygiene. Xerostomia makes the oral cavity susceptible to any kind of infection consult your treating doctor for detailed clinical examination. Maintain a good oral hygiene avoid alcohol, carbonated .  Hope this helps out. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In 2010 I drove to CT from Columbia, SC and since that time, I have had this pain in my pelvic and lower abdomen area and my bottom hurts sometimes.It start after I excerise, walk for a period of time and when my bladder is full. However, I don t get this pain all the time. I have had two pelvic ultrasounds and an MRI. Tubes have fluid & some scar tissues. My OB/GYN suggest surgery. I am 66 years old had a hysterectomy Nov 1978. No pregnanices. My email address: YYYY@YYYY . Thank you so very much, Henrietta Harrison 11/03/2012 ### REPLY: Hello mam, Your symptoms seem to be increasing in a sitting posture and with exercise. And also the pain is intermittent. But do you get intermittent fever?and do you have problems with your bowels? And do you get any discharge per vagina?your symptoms with a degree of fever if any indicates a pelvic inflammatory disease...well-supported by the USG report. Associted bowel disturbance if any also supports the same condition due to pelvic muscular involvement. The presence of scar tissue and multiparous status also points towards previous endometriosis.However, its recommended that you get a detailed GAEC check done with a routine pap smear and blood checks and then take a call from there... All the best. Tc ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 6 year old daughter that has been bothered with a really bad caught since she s been about 2 years old. They tested her for asthma they did blood work on her and found nothing wrong and even tho she don t have asthma they prescribe her the blue and orange inhalers but no matter if she s taking them or not she still can t get ride of that nasty all night caught that leaves her drained of energy caused by lack of sleep due to this horrible caught she has.The pediatrician also told me to start giving her vitamin C and vitamin D3 400 IU and after a year of taking them still no difference.We have minimal problems in the day but horrific caughing all night long so bad it makes her vomit. We also had allergy test done on her and she has no alergies. I like to try and help her with giving her lemon water to drink at night and I give her saline water droplets up her nose to keep her sinuses clean daily I also give her organic honey to help sooth her throat from the cought and a humidifier in her room at night and I elevate her with5 pillows in her bed to try and help her breath better and still no success. I m trying everything I possible can think of to help her but as the years go by she just keeps getting worse. If you have any suggestions for me or think of any test we could possible get done on her to help me understand y my little baby doll is always so sick with this horrific cough I would truly appreciate any help I can get. Feel so helpless seeing her this way and not being able to help her or even know Y she is this way. This is from a truly concerned and worried Mom. I seen this site and though maybe just maybe I could find answers to her problem on here. ### REPLY: HI... I understand your concern. Nighttime cough could be due to hyper-reactive airways disease. But there are other reasons for this. Possibilities - 1. Gastroesophageal reflux disorder.2. Hyper reactive airways' disease. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?7. Does the cough get aggravated a spicy or heavy meal or after lying down on bed? Kindly get back to me with answers to above questions and I will be glad to help you. You can approach me at the following link. Please find the link below.www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is 9yrs old. general epilepsy due to high fever when 11mnths ,3yrs and 5yrs old.on valporin 7.5ml twice a day since 3yrs. e.e.g. is normal. guide me effect and side effect of this medicine.will epilepsy be cured permanently or r therre chances of reccurring? ### REPLY: Hi, Thank you for posting your query. I have noted the symptoms of your child. Epilepsy can not be cured, however, with medications, it can be kept under control. Valprain (sodium valproate) is a safe and effective anti-epileptic medication, and can be used for long-term. Common side effects of Valarie include weight gain, tremors of hands and hair loss. In rare cases, liver damage may occur. Seizure-freedom for three years is good news. Please discuss with his neurologist regarding tapering and stopping medications. I hope my answer helps. Please get back if you have any follow-up queries or 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: Im 36 year old male. I have a half tooth from decay which has gotten infected. I have slight facial swelling & when I eat I can feel the food hit something in my throat when I swallow. It shoots a tingle sensation to my ear. Also Im having head pressure. I saw a physician assistant today & she put me on amoxicillin. Will this be enough until I see a dentist in a few weeks? ### REPLY: Hello, Thanks for writing in this forum, From your symptoms I feel your tooth is grossly carious.and infection has reached towards the apex of the tooth causing pus formation and swelling... Whatever pain you are getting in the ear, forehead is due to same nerve supply...it's common.don't be worried about it... Proper x-ray is required for the tooth and the treatment plan will be decided on the basis of it... You have to go for root canal treatment or extraction... You can continue the antibiotic... Do warm saline rinses 4-5times /day...you will get relief....Don't apply any hot compress from outside that may worsen the present condition... Consult with Dentist and get your proper treatment.... Wish you good health... 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 kid aged 2 yrs 10 months is suffering from loose motions. Infact all in my family had this prob since yesterday morning after we had a chicken biryani prepared at home. My kid started suffering from loose motions since afternoon today. I tried to give him gramogyl suspension but he is continuosly vomiting the syrup.we tried close to five times but he vomits it everytime we give him. can u suggest some tablets instead of gramogyl ### REPLY: Hi, He got a food poisoning / acute gastroenteritis. If he don't have fever and stool is not blood stained, no need of Grammy, which is combination antibiotics that is not at all recommended routinely for childhood diarrhea.Instead, you can give ondansetron syrup 5ml (or half of 4 mg tab) now, and then 2-3 times a day for 3 days. This will control vomiting. Wait 1 hour after first dose before giving food / .  Also give ORS solution or salted rice water after each stools in small frequent sips. This will prevent 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: What would cause shortness of breath on exertion of any kind , unable to sleep after a meal in evening Had 4stints put in right coronary artery a year ago  Have been back to heart doctor and they say they cant find anything wrong, Pulmonary test say nothing is wrong GI say I have a hernia small and some esophagitis but nothing that causes SOB,Sometimes at night my ankles and feet turn blue and edematous and I cough a lot and on occasion pass out from coughing Now something is wrong and I want to live a quality life. I am 72 years old and use to walking 6 miles a day. ### REPLY: Greetings. Welcome to , and thank you for your question. I understand your concern. Well, in the scenario where your cardiologist and lung specialist say that everything is fine, we have to seek for other causes of this situation. My first assumption was that you had these stents placed in a terrain of an acute myocardial infarction. In that case, a certain part of the heart muscle would be damaged and produce decreasing of the left ventricular function - rising of pressures in lung circulation - shortness of breath. My assumption is also based on the fact that your legs get swollen. If this is the case, then you should restrict your physical activity, to activities that do not produce shortness of breath, restrict salt from your diet. As about the cough, many patients that were subject to stent implantation or any cardiovascular disease, usually have angiotensinogen converting enzyme inhibitor (ACE-I) in therapy. These are very effective, safe .  But, up to 15% of cases they exert a side effect -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hiI am 23 yrs old I have been I have been experiencing slight paing in my left testicle and lower abdomen sometimes it pains slightly in the lower back left side simultaneously, went to the doctor he gave me medicines(homeopathic) and its been a week or so now the slight pain has gone sometimes it used to shift from left to right. But now I feel that the left testicle hangs horizontal and the right one vertical. I am extremely scared, please give me your feed back on this.Thanks a lot. ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have pain in Lt Testicle and pain in lower abdomen on left side. This could be most likely to be due to Varicocele. Please consult qualified Urologist for clinical examination and get following test done to confirm the diagnosis,1) Ultrasound scanning of Scrotum 2) Color Doppler study of scrotum. Further treatment will depend upon the results of these tests and final diagnosis. You may take painkillers like Diclofenac twice daily. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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....after watching a horror film i started feeling fear from darkness and there was so much negativitity in me for everything....my doctor prescribed me nexito plus..i hav been taking it for past 2 months..i feel better but still some part of fear left...please help me for the same.. i am getting married in october ### REPLY: Hi, I can understand your concern regarding your condition. You seem to be having anxiety disorder resulting in your fears. It's good to note that you are already on treatment and have responded favorably to it. Now, Next plus is a combination of two medicines, Escitalopram 5 mg and clonazepam 0.5 mg. Escitalopram is a selective serotonin reuptake inhibitors and an effective . However, since you have only responded partially, I feel the dose can be increased. The effective dose will be 10 mg/day and the maximum can be increased up to 20 mg/day depending on your response. I would also recommend that clonazepam should e tapered off, as long term benzodiazepine use will make it difficult to taper it off and can create dependence. You can discuss regarding these with your psychiatrist. In addition, you should also start exercising daily as that will help you relax. Relaxation exercises like deep breathing and progressive muscular relaxation will also be helpful. With proper treatment, I am sure you manage to do well. Wish you a speedy recovery and a great married life ahead. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 18 month post da vinci prostatectomy cancer survivor. My 18 month psa was negative. My issue is that I still have depression from post surgery issues. Especially sexual issues. My PCP has perscribed welbutrin which I have been taking for two months now. I am looking for advice on SE MI support groups or forums. ### REPLY: Hi, Good to hear that you are doing well post cancer surgery. Can you elaborate your symptoms of depression? To the best of my knowledge & experience, Wellbutrin (bupropion) is a very good .  & it doesn't cause sexual dysfunction by itself per se. But if symptom profile is predominated by anxiety & allied symptoms which I guess are the source of your troubles & probably sexual dysfunction also; then switching Wellbutrin to a more specific antidepressant alternative like Mirtazapine which works superbly for anxiety & allied symptoms, gives you good sleep as well & is neutral on sexual dysfunction as a side effect. Hence, do discuss this alternative with your doctor for symptom relief. 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: Yes, I am a 47 year old woman who is concerned lately about my overall health.  I have been seeing a urologist for the past 4 years regarding gross hematuria or blood in my urine.  He has run all sorts of tests to rule things out and cannot determine where the blood is coming from.  Upon a recent ultrasound of my kidneys, they found that I also have hemangiomas on my liver.  The blood in my urine was originally found by my primary care doctor during a physical.  I had been feeling overly tired and still do.  I am also hypothyroid.  During an MRI of my neck for an unrelated injury, they found I had tumor on my left thyroid gland.  It was removed and I was placed on Levoxyl.  About a 8 months later and having neck surgery for 3 ruptured discs I began having swallowing problems, a larger tumor was found on my right thyroid.  A gastroenterologist removed the gland and said everything was contained and other than trying to regulate my thyroid medicine I am doing well.  I then developed a rash on my face.  I have been tested 3 times for lupus each time the results are negative thank goodness.  My primary care doctor is in the process of checking my thyroid levels again to see if my medicine needs adjusting which seems to happen quite frequently.  I am a very active and busy lady and attribute my aches and pains to getting older however lately, I am totally exhausted even after sleeping 7- 8 hours.  I have been having chest pains that come and go...it almost feels like a charlie horse in the middle of my chest.  My hair is falling out, my bones hurt if that is possible, I am cold all the time, Ive been getting night sweats, my color is pale.  I am waiting to be seen this next week by my doctor.  I was just curious if a lupus test can show up negative and a patient actually has it or signs of it.  Any input or advice would be greatly appreciated ### REPLY: Your symptoms suggest that you probably have anemia, and it would be ideal if you could consult hematologist to look for the cause. Also, fatigue can also be related to hypothyroidism. A negative lupus test does not rule out lupus, about 2% have a negative lupus test. That is if you have done a ANA test and is negative do go ahead and get antihero/SSA, antiphospholipid antibody if not done earlier. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes, thank you. As of yesterday, I started having dull & sharp pains in my left pelvic/abdominal area. I have been experiencing for a month or more now, some dizziness/headaches and continue to. Im going to have labs done this Friday. Im wondering if i should make an appointment with my gyno. ### REPLY: Hello! Welcome to . This can be due to either infection & inflammation of bowel or a stone in urinary tract. Do you have fever? Any urinary complaints? In my clinic, to such patients, I advise ultrasound abdomen & pelvis, X-ray PUB, renal function tests, urine & stool routine, CBC & BSL. Treatment is done accordingly. If all these tests are normal, it can be musculoskeletal pain, in which case you should consult your Orthopedic surgeon. Hope this helps. Wish you speedy recovery. Thanks. 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 Sister and Kidney and Paralysis problem. She got first paralysis attack 6 years back. After that she has paralysis attack 3 times. (This was mostly in WInter season) Which was on her legs and hands. Her creatine level is 2.8. Yesterday She had 4th Paralysis attack. Please suggest us what to do. we are in tense ### REPLY: Hello, Thank you for your question. From the explanation that you give it looks like a central neurological problem in year head. It may from many causes such as encephalitis, meningitis, stroke, aneurysm in the brain, tumor, epilepsy etc. etc.Also, another cause may be from kidney problem that you have since creatinine level is high. I recommend you to see a specialist in neurology, and he will order blood tests and imaging test such as CT scan, MRI, ultrasound of kidney etc. If neurology specialist clears your sister he may send you to nephrology specialist to ad . Wish you quick recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was recently diagnosed iwth Hepatitis C . I strongly believe I got it this past summer the month of August 2012. I was checked last year oct. 2011 and wasnt detected. But now I have it and I have symptoms of clay like stool, darkening of the liver , fatigue , tiredness, acne , loss of apetite. Is it possible to have symptoms approach this fast? If so, what can I do to change this reaction within my body? ### REPLY: Hello, Amanda, Hepatitis- C can be contracted by a number of means. This occurs by coming in contact with contaminated blood.  .  Blood transfusion or blood products prior to 1992 (We did not have blood tests for Help -C then). Other things that are risk factors include Tattoos, body piercing, sharing tooth brushes, razors etc. Accidental needle prick and exposure to contaminated blood (Lab technicians etc., surgeons )I am giving you all this background to let you know, you can be completely well till the virus starts multiplying in the liver cells and causes damage. Now that you have been confirmed with blood tests, you need to get HCV -RNA viral count and the Genotype of the virus because the response to treatment or cure depends on this. Good news is, there are very effective treatments using a combination of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have hep c and cirrhosis, and I am going through the process to be placed on the transplant list. Since last Friday,I have been experiencing a very large abdomen, excruciating pain, nausea and my urine looks very dark. I met with one of the surgeons Friday and told him what was going on,and was told that if my symptoms got worse or not better by Monday to call. I live 2 hours away and wanted to research before I call the hospital. What is your opinion? ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern, of course the symptoms you described here are because of the liver pathology and your doctors' opinion is very right, I agree with this opinion, clinical sing and symptoms are very crucial as long as the liver pathology are concern and this has to taken seriously, take care and follow the instruction given by your doctor, good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 40 years old and is having a sericous bone problem, He s having growth growing in his joints. His right wrist was cleaned twice in surgery and then the third time they removed the bone in his wrist. Now he has a growth in is elbow on the right side again. No one will tell him what it is or how or why it s happening? They just what to do surgery and leave it at that..Because he doesn t want surgery he wants to know what it is and how to fix it. He believes he has Paget s desease? is there any way you can help us..He has Delaware Physician Care insurance. He has several growth in his body and one is in his rib cage? He s having sever pain from all this and the Dr. won t give him even tylonal for the pain..Something is really wrong with the Doctors here in Delaware...They lost their passion for the patient and greed for the green. I m sorry but I don t have the money right now. I can t do anything til the first. I lost my husband a year ago this month and it s been hard..I m sorry for wasting your time.. ### REPLY: Some people suffer multiple exocytosis for no specific reason known yet. All exocytosis needn't be removed unless hurting, painful,overgrowing, interfering with movements and not responsive to pain meds,anti-inflammatory . Get serum calcium and vitaminD3 levels tested in blood., if some results not in normal range may be supplemented. Also get parathyroid tests done, parathormone levels in blood at times are correlated with bone growth issues. Hypercalcemia due to this is treated with bisphosphonates like Osama plus D once a weeks an endocrinologist also ### END