Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 9 year old daughter is complaining that it feels like something is poking her in arms, legs, and tops of her feet.  She says it feels like theres something in her clothes poking her, but when she checks her clothes there is nothing there...and it is in multiple places.  She says it comes and goes and it is more annoying than it is painful. I checked her skin and there doesnt appear to be any bumps or sign of irritation.  She was recently diagnosed with Celiac Disease, and I have no idea if this has any relationship, but thought Id mention it.  Not sure if I should be worried about this...or maybe its just dry skin or something???? ### REPLY: Hi, I had gone through your question and understand your concerns. Symptoms of celiac disease vary among sufferers and include:Digestive problems (abdominal bloating, pain, gas, diarrhea, pale stools, and weight loss)A severe skin rash called dermatitis herpetiformis. Iron deficiency anemia (low blood count)Musculoskeletal problems (muscle cramps, joint and bone pain)Her senses are called paresthesia, because muscles cramps and lack of Vitamins B. Try to give her B complex with lysine 5 ml daily for 1 month and consult her neurologist.  Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your daughter 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 Im Jonida. I am 34 years old and i have no children. I have had a miscarriagie a year a go, and since that time i have has some let say episods of chemical pregnancy, september 2012 was the last and at 3 weeks I miscarry. I have done a hysterosapingography and my left fallopian tube has a blockage in distal part (even 2 phlebolite over the distal tube). My husband had done spermogram and total sperm count was 53 mill/ml but motility was 5%-very fast, 15- medium and 20 - slow. Please have you any advice how to procede? ### REPLY: Dear JonidaBoth of you need proper treatment for a few months to get the desired results. In the present state of affairs chances of pregnancy are a bit on lower side. There are herbs which are known as uterine tonic. With their use the uterus becomes receptive to host a fertilized egg. You will have to rule out presence of any added infection. Blockage of one tube matters a bit but chances of getting pregnancy still remain fair. The condition of your husband calls for more vigorous treatment. Use of spermatogonia herbs and known herbal sex tonics that increase the quantity and quality of semen are recommended. Perfect health of both uterus and semen is a must for healthy baby. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mothers echo shows that  her aortic valve is so calcified that it could even hardly move. My mom has periods of shortness of breath. She has no other symptoms. She is 74 yrs.old. She had hx. of rheumatic fever when she was 14. yrs. old. Would you recommend valve replacement for her?Should she restrict her activities, Would you recommend that she should be in a wheelchair? Would you recommend red wine for her?Thank you. ### REPLY: Howell come to ChatDoctorI really appreciate your concern, Aortic valve if affected by rheumatic fever, so it can be managed with medicine but later of sooner valves becomes calcified, at the age of 74 it is risky to change the valve, other cardiac parameters are matter of concern, even if the patient is physically fit still the procedures carries some risk, in my opinion it is better to manage the case medically, complete bed rest is advisable, but she can move around in house just for routine purpose hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 45 year old height is 163 cm,weight 74 kg and my bp 140/95.i tried  atenol and amlodypine but no control to B.P.then i took 1/2 tablet daily of ditide  .now my B.P remains normal..ie 120/80.how long can i take this medicine ? should i increase the dose after some time.how can i control my weight ? ### REPLY: Hello, Thanks for writing to , I am . A blood pressure reading of 140/95 is borderline reading if persistent, you should be having lesser blood pressure, specially when on medication. There is no best medication for blood pressure, blood pressure medication is selected person to person, but ace inhibitors, diuretics and calcium channel blockers are most recommended around the world. A doctor considers many things like age, diabetes status, highest and lowest readings of blood pressure, and race etc. to select the best blood pressure medication for you. My advice for you is:1) First change your lifestyle.2) Use less salt and fat. 3) Stay physically active.4) Avoid Coffee caffeine, smoking (what ever is relevant).5) Lose 10 kg weight to be in good range6) Monitor your blood pressure regularly if it stays consistently above 150/90 for a week instead of all the lifestyle modifications, and medications, do visit your doctor with that record to get the medication adjusted. You can use divide for long time but It's advised to discuss it with your cardiologist first. I hope this answered your question, If you have more queries I am happy to answer you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been experiencing tightness and stiffness in my legs. I do regular exercise by means of walking my dog and have recently found this quite difficult. I feel my legs getting really tight almost as if they are going to burst. They also feel really stiff as if I cant open them properly. Could this be related to my heart? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have tightness and stiffness in legs. Well there can be many reasons for symptoms you mention in query like nerve compression, diabetes, neuropathy or multiple Sclerosis. If condition doesn't get well then consult orthopedic surgeon for proper examination. Doctor may order blood test or RH factor, CT scan or MRI along with physical examination to confirm the diagnosis. Doctor may prescribe methotrexate, anti-inflammatory, gabapentin long with nerve supplement and recommend physical therapy. I would suggest you to do light stretching exercises along with gentle massage, apply warm compresses on entire leg and take muscle relaxants like orthodox MR. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with a prosterior fossa meninganoma 2.7 x1.5 cm. I am going to the Mayo Clinic in AZ this week to discuss prossible surgery. What can I expect with the recovery for such a surgery? Im 47 and in otherwise good health. I exercise regularly and dont drink or smoke. Im hoping for a quick recovery but Im not so sure that its in the cards considering the location of the tumor. Any advice? ### REPLY: Hi, Thank you for posting your query. I agree with you that posterior fossa is not the best place to get a meningioma, as the surgery needs precision, as well as recovery is delayed. However, meningioma is a benign tumor and long-term outcomes are very good. You may take 10-14 days after surgery to recover well. Please get back if you require any additional information. Best wishes, . 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: What is 1. levoconvex lumbar scoliosis and moderate lumbar spondylosis with small multilevel broad-based posterior intervertebral disc protrusions and moderate multilevel facet arthropathy, with out central spinal canal stenosis. 2. severe loss of height of L4-L5 intervertebral disc space. The residual intervertebral bilateral L4-L5 neural foraminal degenerative narrowing. 3 additional findings of lumbar spondylosis ### REPLY: Hi, Welcome to  .com I am .  I have read your question with care and understand your concerns. Let me try to help you.  Levoconvex lumbar scoliosis : Means the Spine is not straight. It has been curved. The Convexity of the curvature is to the leftModerate Lumbar Spondylosis : Means that there is degenerative changes (wear and tear) in the spine Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Best Wishes for Speedy Recovery Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend is taking Lamictil for bipolar disorder. She "weened" herself off the medication several months ago and "weened" herself back on it within one week.  This sounds dangerous and she has had a few bouts of tantrums with excessive irritation since the self described "weening" back on it this week.  Is she in trouble? She has definitely had some major stressors going on, but nothing like death or moving.. ### REPLY: Thank you for asking on the . It is not recommended to stop or start such medicines at patients end. As she is having irritability and there have been significant stress on her, she might be going into the high phase (Manic episode) that has not fully established yet. Irritability can also come with the depressive phase of the bipolar disorder. Therefore, I would suggest her to see her Psychiatrist as acute treatment of mania or depression is different from the maintenance treatment that she was taking. I hope you find this helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 31 mos and has always been the gassy child persay. At times we are very concerned about the bloating and bulge. She would rather drink than eat. Her stomach gets very large and firm to the touch. She is the child that gets sick very easily and goes rounds with bronchialitis. We have discussed this with her pediatrician a few times and did xrays but nothing further. Should we push for a specialist. She is just a little peanut and I don t want to miss something if there is an issue. Thank You Rebecca Z. ### REPLY: All the symptoms you describe are not an unusual combination for the child. While the glassiness and bloating may all be due to what is commonly called "lactose intolerance", repeated attacks of bronchiolitis are not related to the abdominal problems in any way. Please get a stool tested for lactose intolerance. If this is discovered, she will need lactose-free formula and lactose-free dairy products. This will help her reduce the stomach bloating and glassiness and enable her to put on weight. This, in turn, may improve her immunity sufficiently to protect herself against repeated attacks of respiratory illnesses.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i m having a weird chill sensation at my knee at times, and i don t really know why. normally it occurs like after an hour of sitting. then when i stood up i can feel this weird chillness at my knees. almost like something cold is poking my knee. what does it imply? ### REPLY: Hello, As what I feel that you need to get an x-ray or an MRI of the knee joint. As this may happen due to any tissue involvement which is damaged. But the usual feeling complained by many is hot and cold is something very much rare. If we knew your age and any other past medical history it would have allowed us to provide some diagnosis. But as its missing we need to get the knee assessed for some soft tissue involvement and later may be an MRI will be of help to understand the extent of the involvement. 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: About 2 weeks ago I was diagnosed with mono and had my blood taken a day before I was diagnosed. I had a decently high liver enzyme count that day. I then went to my actual doctor to have more blood work done. The results to this were a little higher.  Just yesterday, 2 weeks after the last blood test, they had even gone up a little more. Besides being able to sleep all the time I feel fine. My doctor says that the high liver enzymes is more than likely the mono. Just wanted some more input! THanks ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. Yes, mono typically causes certain liver damage and high liver enzymes are expected even several weeks after mono is cured, so you should not worry about this. There is no specific treatment but resting and taking painkillers. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I kicked a stone trash can out of anger with my toes up hitting the ball of my foot. When I kicked my foot went numb and I couldn t move my toes at first. Pain comes and goes but pains shoots up sometimes. I can t tell if there is any swelling or bruises. What did I do? ### REPLY: Hello, I have studied your case. There can be hairline fracture to toe due to injury Also there can be injury to terminal branch of nerve. Another differential is mortars neuralgia in which there is neuroma formation between webspace of toes. I will advise you x-ray foot. For these symptoms analgesic and neurotrophic medication can be started. I will advise checking your it B12 and it D3 level, and uric acid level nerve compression becomes severe later on then surgical decompression will give permanent relief. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having pain in my upper stomach area after I eat.the pain does not go away and I have to take some meds to try to cqlm it cqlm it down.  Do I have a ulcer or gall bladder?  I am suppose to have surgery for transvaginal tape in the bladder area soon. I am on vesicare and it is not helping. I have beening on this surgery and have read a lot of negative on it lwhat do you this.  The ves9care 9s j0t helping me at all since she doubled the dose   Jackie in Ohio ### REPLY: Hello, Welcome to . There are many causes for upper abdominal pain. As you are waiting for surgery, it is essential to identify the cause for upper abdominal pain. Causes are indigestion, peptic ulcer, Gastroesophageal reflux disease, cholecystitis. Most probably it could be due to indigestion or gastric ulcer. Proton pump inhibitors like Pantoprazole and antacid syrups are helpful. Antibiotics may be used if H.pylori is suspected. But if it is associated with vomiting, belching, dark colored stools need a investigation. Usual investigations are Upper GI endoscopy, H. Pylori test, Occult blood in stools. Etc. Consult a Gastroenterologist. Hope this Helps. 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 found a small lump on my right breast and it is small and its kind of blueish.. i went to check it with my doctor she said its a mole but its under my skin. I have never had a mole like that, it does not move.. Should i go for a mammography.. and iam 18 years old. ### REPLY: Welcome to  .1. At this age with the history suggest - possible cause could be some infective etiology.2. If your doctor has examined and said normal - probably it's superficial.3. In this case if you still doubtful then you can get an ultrasound scan done that will give you a clear picture - weather lesion / lump or not, source of the lump, its nature (cyst, abscess, mass) and where all its extending will be clearly said.4. Mamogram in your age is not recommended - Not advised.5. If there is any lump / mass - an FNAC will be advised for cell nature to assess. (fine needle aspiration cytology). Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 55yrs of age I have been on metodone 27 yrs I went down to 25 problems started I went to gi doctor he took blood said I have hep c mild cirrhosis now he said my billrubin for liver was fine I have to have endoscopy for varessets veins I think I am right he said he wants to check for cancer or tumors I have lost weight worrying and I think I am yellow and I have abad smell could that be bad ### REPLY: Hi, dear. Hi I have gone through your question. I can understand your concern. Symptoms related to cancer are weight loss, anorexia, weakness, any mass lesion, symptoms of mass lesion etc. You have chance of hepatocellular carcinoma. SO you should go for ultrasound abdomen and if any mass lesion is there then go for FNAC or biopsy. This will clear all your doubts. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with a benign pituitary tumor & secondary empty sella syndrome.  I have cerebral atrophy, nerve damage, cloning in my right leh & my right side is weaker then my left. I also have visual impairment & am  getting glaucoma from the pressure.  Over the past several weeks I feel extremely drunk when I havent been drinking this feeling continues all day. My doctors have been of no help so far & have no answers for me. Any ideas for me on what I should do & what is the cause? ### REPLY: Hi and thanks for the query, Treatment options in this case generally depend on the intensity of the symptoms. In very small tumors, with slight hormonal problems, treatment is mainly symptomatic with hormone replacement therapy and management of other associated metabolic abnormalities. Very large tumors could cause pressure in the brain to rise, and would require at times surgery and radiation. The decision depends on severity of clinical symptoms. I suggest you consult a neurosurgeon. Kind 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 was admitted to the hospital 4-1/2 months ago with sepsis a result of bacteria in the sac around my heart. I had heart ablation that burned a hole in my esophagus. I was on IV antibiotics for 6 weeks and since have taken clindamyacin 3/day. I am taking omeprazole 2/day and still have severe heartburn, reflux, and indigestion. In addition my hair seems to be falling out though I have not seen hair loss as a side effect. I am supposed to take the clindamyacin for another 2 months. Is that standard of care? ### REPLY: Hello, most likely you developed bacterial pericarditis, because of the complications of the ablation procedure.  The antibiotics are standard of care and which antibiotic to be taken depends on the organism isolated from the fluid they must have aspirated from the sac.  The duration and type if antibiotic depends on the , but generally its at least 6-8 weeks, sometimes more depending on recovery.  When you are on so many antibiotics in high does, some hair fall and indigestion are known to occur.  A pantoprazole /omeprazole till you are on antibiotic is highly recommended.  You may upload the reports for any further assistance. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I BEEN ON THE DEPO FOR 10 YEARS MY LAST SHOT WAS IN MARCH I SUPOSSED TO GOT IT IN JUNE 7TH BUT I DIDNT MY HUSBAND WANT ANOTHER BABY I WANNA KNOW IS THE DEPO OUT MY SYSTEM I HAVENT HAD MY PERIOD YET IT WASNT NEVER NORMAL I WENT TO THE DOCTOR SHE GAVE ME FOLIC ACID TO START TAKING WEN I TOLD HER I WANNA HAVE ANOTHER BABY MY QUESTION IS CAN I GET PREGNANT BY BEING OFF THE DEPO FOR A MONTH ### REPLY: Hello, I would be happy to help you with your question. The demo shot is associated with more irregular cycles for the first few months after it has "worn off".  It actually lasts longer than 3 months, so it probably is not completely out of your system.  Your chance of pregnancy within the 6-12 months is slightly less than the average because of this cycle irregularity, but this should resolve over the year. I hope that this helps and 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: Dear Dr., Good Afternoon... Since last 4 days I am having severe pain in my right arm, which started like a muscles cramp. After applying volini, i felt better on my lower neck, but the pain is getting severly painful on my upper arm. Earlier I had done a X-ray on my LS spine due to lower waist pain which causes pain on my left leg. kindly suggest some medicine it get rid of the pain. ### REPLY: Dear Sir/Madam, I thank you for having faith in  and for seeking help on your issue; I have gone through your symptoms, and in my opinion, do not worry, take some rest, Take Tab Paracetamol 500 mg three times a day with water, if pain is not controlled you can take Tab Tramadol 100 mg one SOS. Wait for 5 to 7 days on these . Special note-Any medication prescribed needs to be taken after consultation with your personal doctor only. 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 have been experiencing testicular pain for a while now (about 2 years). My urologist says it might be varicolese and that it is difficult to diagnose so I had a varicocelectomy which did relieve some of the pain however there is still some pain remaining. It is especially noticeable when blowing my nose, the left testicle experiences more pain the harder I blow my nose. I planned to see my urologist again in 2 weeks (4 weeks after my varicocelectomy) and mention this but what do you think the problem could be and what should I look out for and ask my urologist? ### REPLY: Thanks for asking in  forum In short: Varicocele is difficult to treat & it recurrsExplanation: There are many reasons for acute(sudden) and chronic(long duration) testicular pain. As you have seen urologist he would have investigated you thoroughly for these things. Usually .  If the pressure in vascular system(laciniform plexus) increases pain may aggravate. So only you are having more pain during blowing nose. As you have been operated blowing nose can cause pain after surgery due to the same reason. SO, visit your urologist when due for visit and take rest till then.  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 48, 52 200lbs.  I am being treated for high blood pressure.  I had a lump show up 8 days ago on my neck, just above my clavicle.  I went on a series of 2 antibiotic shots a day for three days and then a 400mg oral antibiotic for 2 days and the lump has not changed one bit.  It is still tender to the touch and I can still feel a lump in it. ### REPLY: HI, Good Evening. Thanks for your query. I studied the query in-depth. I understand your concerns. Your 8 days lump is inferior cervical amenities. Antibiotic trial failure indicates its mostly TB lymphadenitis-as it is little sore also. It could also be-Lymphoma-HL or NHL. Consult with ER-Surgeon and Oncologist-as your team doctor.-Excision Biopsy would relieve you of the worry you have with this lump.-Anti-TB treatment or the anti-lymphoma treatment would receive the patient of the disease.-Wishing you early recovery and good health. Wellcome again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My 2 yr old son is having mucus seen in his stool. 15 days back he was having cough, cold and fever and then he had medicine for it after that he had his motion....and now cough cold is gone and even there is no motion...but he is having mucus in his stool...can u plz answer me... ### REPLY: Hi, There are many causes of excess mucous generation in child .  You need to be alert if the child is having any other symptoms like fever, blood in motion, decreased food intake etc. In your case it might be normal unless the stool is smelling very bad which indicates some undigested food and some infection. See for a few days about any change in the nature of the stool and then reach out to a pediatrician if the problem persists. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, I am suffering with joints pain for last three years, in earlier stages once the treatment was not available with orthopedic, I have approached with rheumatology doctor in the first month in which the pain was started, but even after 3 years of this decease, my doctor is still not able to identify the decease. In the first stage they have started my treatment with SAZO 500MG (for delayed sulfsalazine release) + Nucoxia 90 MG on s.o.s. basis. But after analyzing my attached report now they have started the treatment for enthesitis, please suggest whether my treatment is going on a right direction or you the different view in this case. Please help me out to provide the proper direction to enable me to get rid of continue joint pain. Your early response in this regard will be highly appreciated. ### REPLY: Hello, I read carefully your query and understand your concern. Your symptoms seem to be related to an arthritis. I suggest doing a rheumatoid factor level for further evaluation. Meanwhile, I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. Cold compresses can also help in relieving the pain. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing an array of symptoms for some while now but especially severly in the last three weeks. I have face and jaw tightness, chest aches and upper back aches. I sometimes get fluttery feelings in my legs. I have had an ECG and no problems were detected. Does anyone have any idea what might be wrong? ### REPLY: Thanks for your question on . I can understand your concern.You're all symptoms are more suggestive of arrhythmia. ECG can be normal in arrhythmia (rhythm disturbances in heart). So normal ECG can not rule out heart diseases in your case. So get done 2d echo and Holder monitoring (24 hours continuous recording of ECG). If both these are normal then no need to worry about arrhythmia or other heart diseases. Sometimes undiagnosed stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relaxed and calm. You may need anxiolytic . 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: hello doctor, am 15 years old. and i have had severe pimples .. and i still have them, mostly on my forehead , and cheeks . It is very embarassing for me. i cannot concentrate on anthing. i also have acne scars on my face . mainly in my forehead and cheeks. How can i get rid of them quickly? ### REPLY: Hi....., Thanks for choosing ., Why You're worrying this., It is common in Your age..., If U take care of Your Skin., It will control easily..., This is called.ACNE VULGARISM...., It is due to Hormonal action....ok.,1) Frequent washes with Triclosan soap...2) Tab Isotretinoin 20 mg daily for 2 months.,3) Topical apply ZYCLIN-NANO, or CLINTON., 2 times daily.,4) Take plenty of vegetables and fresh fruits..., ok...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: 42 y male admitted with pericardial effusion,dilated cardiomyopathy,noted to be icteric bilirubin 150 mmole LAST112,ALT 170,NORMAL ALP,U.S abdomen hepatomegaly 17 cm span,normal texture,hepatitis serology -ve ,autoimmune work up -vewhat is possible diagnosis ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Difficult to comment on the diagnosis with only the examination findings and test results. Many history aspects have to be inquired. However, the possible causes coming to the mind are Tuberculosis, Cystic disease, Substance related side effect etc. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.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: i fell down steps and my leg bent underneath me and the front part of my calf hit concrete steps and formed a knot.  i have been putting ice on it from wednesday thru saturday and bruise has spread about 9 inches by 6 inches. are there ways to tell of signs of a blood clot.  i have no pain walking on leg or anything like that. ### REPLY: Signs and symptoms of excessive blood clotting depend on where the clots form. For example, symptoms of a blood clot in the heart or lungs may include chest pain, shortness of breath, and upper body discomfort in the arms, back, neck, or jaw. These symptoms may suggest a heart attack or pulmonary embolism (PE). Signs and symptoms of a blood clot in the deep veins of the leg may include pain, redness, warmth, and swelling in the lower leg. These signs and symptoms may suggest deep vein thrombosis (DVT). Signs and symptoms of a blood clot in the brain may include headaches, speech changes, paralysis (an inability to move), dizziness, and trouble speaking or understanding speech. These signs and symptoms may suggest a stroke. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from neck pain and it has gotten severe in the last one month, got an MRI done and :C5-6 disc shows mild posterocentral protrusion indenting the thecal sac, can you please advice on the possible cure to this, to get the disc back in its original position. Also how long will be the process and precautions if any that i should take. ### REPLY: Hello, I think that cause of your neck pain is the cervical herniated disk C5-C6 compressing the medulla. Once the disc is herniated from its original place it does not come back where it was. Since the pain has got worse last month, I would suggest you to consider surgery to remove the herniated disc as it may continue to compress the nerves and cause paralysis. Physical therapy does not help on this situation. Your neurosurgeon will give you the pros and cons of the surgery and decide together. Wish you quick improvement. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 completed 17 weeks of pregnency. During my internal examination I was told by my doctor that my cervix is small. Its length is 3.3 cm. The doctor has suggested stitching the cervix For now, I am told to take bed rest and come again after 15 days for examination after which she will decide whether to give the stitch or not. Please tell me if having a small cervix can cause some problem and is stiching/ operation is compulsory. Also what are the risk associated with this condition. ### REPLY: Hello, and I hope I can help you today. Cervical shortening (it is the length of the cervix that is measured) can be a risk factor for preterm labor as well as preterm delivery.  It should be measured accurately with a transvaginal ultrasound not just with a digital examination. However, the cervical length at which intervention is recommended and where we have real concern is a length of less than 2.5 cm. Cerclage (or placement of a stitch to close the cervix) really should only be performed if the length shortens to less than 2.5 cm.  The procedure itself has some risks including breaking the water at the time of the circle and infection of the cervix. However, the most effective treatment currently available to prevent preterm delivery with a short cervix is vaginal progesterone.  This is given as a cream or suppository and does not have the risks associated with circle placement. So in summary, I would not recommend any treatment if your cervix is longer than 2.5 cm, as a length of 3.3 is not considered a significant risk factor for preterm birth.  If your cervix shortens to 2.5 cm or less, vaginal progesterone is a safer and more effective means of preventing preterm delivery over circle. Furthermore, be . I hope I was able to effectively answer your question today and that my advice was helpful. Best wishes for the rest of the pregnancy,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So on my right breast my areola turned darker it itches it has patches like dry patches I went to a clinic and the Dr said it was milk but I ve had it over a year now it just itches real bad and it s super annoying I put hydrocortisone and seems to get a bit better but if I stop putting it , it start again the itchiness the dry scalpy patches what is it and how can I cure it ? ### REPLY: Hello, Thank you for posting on . It seems you are suffering from Tina corporal, a kind of fungal infection. I would suggest you to consult your dermatologist for proper management of the condition. I usually recommend proper course of oral antifungal .  You can additionally use antifungal dusting powder containing ketoconazole during daytime and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistamines for itching as required. Maintain hygiene over those areas and avoid wearing tight undergarments. Hope your queries are resolved and wish you best of health. Kindly spare some time to rate my answer and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good morning doctors. my name is anand i am 25 years old male i am suffering with Kidney stones . Areas noted in lower pole of right kidney measuring 5.8 mm and upper pole of right kidney measuring 5.3 mm. so i consulted doctor he said that both stones are in right kidney but these stones are not in urine bladder they are located in kidney. so now i am panic what to do, sir please suggest me what kind of medicine i should take and what kind of food i should take. Regards, A.Anand kumar. ### REPLY: HI, Mr. ANAND KUMAR, the kidney stones are the excess of mineral in body which are excreted out via kidney, but due to less water the become stone/crystal instead of a solution which normally should occur.  The stone in your case can be because of 1) .  The stone formation occurs in kidney usually and that where your stone currently is located according to your doctor.  There are different recommendation depending upon the state u live as well as the doctor u see, but normally most of the doctors agree that that stone smaller than 4 mm/.4 cm can be passed in urine, with some pain while urinating, 1) FOR STONE TO PASS VIA urine u have to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother in law has lung cancer and keeps getting fluid drained from her lungs? They are talking about putting in a tube so she can drain them from home? How serious is this procedure and does this mean her cancer has progressed and she is going to pass away soon? ### REPLY: Your mother-in-law is suffering from stage 4 lung cancer. The tube inserted in her tube is called chest tube. It will help her as the recurrent fluid which will accumulate in her lungs will . A procedure called pleurodesis can be done where a chemical is inserted in the lungs through the chest tube which will cause the fluid not to be accumulated in her chest anymore. She is in stage 4 lung cancer and now the aim should only be basic supportive care. 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 a 29 year old female and I have a lot of allergies-dust, dogs, cats, fresh cut grass. It s winter and I ve been getting random itchy bumps that stay itchy for days. I do use moisturizing cream which does help some, but it s very frustrating. This year I have already got lots of these bumps. I m the only one in the house that gets them and we have had our place Che Jed for bugs-nothing. These bumps appear at any time during th day. ### REPLY: Hello, Thank you for writing to us at . You seem to be getting cold-induced urticaria, that does only partially respond to creams, as it removes the scratching component. Physical urticaria is when you get more lumps after scratching the skin, and therefore you must avoid doing this. House dust mite allergy gets worse in the winter, especially in the western part of the world (due to central heating etc.) and once daily long-acting Allegra 180 mg plus alone nasal spray is recommended for the entire winter. The long-acting antihistamine will also help with the skin condition, and occasionally you may have to resort to sedative antihistamines like HY .  Hope this helps. Best Wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my girlfriend is having some abdominal pain ...its on the right side...she said it feels like its behind the ribs...like a swelling feeling feels like its moving....been to the er 3 times and they have said they have found nothing... have tried gas meds. they worked for a min but she feels the pressure build back up, and that s without eating. ### REPLY: Hi ! Good morning. If your she has gone to the ER three times and the doctors found nothing on clinical examination, apparently she does not have any palpable mass or organomegaly in her abdomen. But to be sure, because her complaint is persistent, I would advise her to go for an ultrasound abdomen to rule out any pathology in the gall bladder/liver. Till that, she can have a proton pump inhibitor, a prokinetic agent, and an anti-spasmodic in case of pain. Further management will depend on the investigation reports. Thanks and 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: Hello: I have a kidney tubular cyst. I do not want to have the surgery. Is there a natural remedy to clear the obstruction in the tubular area of the kidney which causes the enlargement of the cyst, which causes pain plus other possible side effects which I will not go into at this time. Thanks for your help. ### REPLY: Hello and welcome to . As a Urologist, let me assure you, that not all kidney tubular cysts need surgery.  There's no natural remedy for this. Surgery is indicated only if, you're very symptomatic. If you can send the scan and report to me, I can give you an expert opinion. If at all, surgery is indicated, it's done by laparoscopy, and person is discharged next day.  So, don't worry at all. Wish you well. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 12 weeks pregnant. I was prescribed Clarithromycin 500mg at 11 weeks. I took it for 3 days (5 tablets in all) before my midwife strongly advised me to stop taking it. What risk has my baby had as a result of taking this?I had taken Amoxicillin 500mg for 3 days before this but it had no effect on a severe sinus infection, hence my doctor changed over to the Clarithromycin. ### REPLY: Hello, and I hope I can help you today. Azithromycin is in a class of antibiotics that can be used during pregnancy, however the risks of taking it are less known than a penicillin-based antibiotic like Amoxicillin. However, there is no evidence that Azithromycin is harmful during pregnancy, so you do not need to worry about the doses you already have taken. If your infection has not cleared from Amoxicillin alone, I suggest you either finish the Azithromycin or consult with your physician about an alternate choice for an antibiotic. I hope I was able to adequately answer your question today, and that this information was helpful. Best wishes for the pregnancy, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had a cough for about 23 days now after dealing with a very bad cold that lasted for about 2 weeks, where I had a fever, vomited, and had a sore throat. Could it just be that I am just weak after that so I couldn t deal with this cough more quickly? I don t think it s anything too bad like bronchitis since the phlegm has been clear consistently, but I would still like to know if I should be worried. ### REPLY: Hello, it is possible to last cough for 23 days after a severe upper respiratory tract infection due to laryngeal involvement in the episode. This is more in people with atop, viral wheezing, or bronchial asthma. You haven't mentioned in the history regarding any if these. However, this cough should get lesser by time. But if your cough getting worsened with time you have to see your doctor.  Other thing is if you are having fever together with the cough it is a sign, infection still persisting. Other than fever if you are having general malaise, body aches and pains or chills, it also means infection still persists. Then you have to meet your doctor.  If you don't have those alarming symptoms together with the cough you don't have to worry. Steam at least 2 times a day. Take a bucolic like solving. Your problem would be OK.  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: Dr. I am 67, overweight, and diabetic. I have had a left knee revision in 2013. I have been experiencing pain in both knees, right leg a burning pain in my right leg up thigh, an into my right hip and waist. I sometime can t lift that right leg very well without nlifting. I see no redness, pain goes and comes, as well as swelling in my rt. Foot and ankel. Thank you. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have burning pain on the right leg. Well there can be many reasons for symptoms you mention in query, but in your case the symptoms are probably due to neuralgia parenthetical. The cause of neuralgia parenthetical is compression of the nerve that supplies sensation to the skin surface of your thigh. I would suggest you to consult orthopedic surgeon for proper examination. Doctor may order x-ray imaging, electromyography, nerve conduction study, nerve blockade with anesthesia. Doctor may prescribe corticosteroid injections, tricyclic antidepressants or gabapentin. For lose some weight and wear loose cloths. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have one sister and one young brother who are sick from sickle cell anemia at they have 22 and 24 years respectively,we seek for medical manegement of this disease but we ended  by being given penidule is this helpfully for their management of disease symptoms like sickle cell crisis,anemia,and frequent disease.thanks. ### REPLY: Hi, sickle cell anemia is the genetic disease, in that your RBC's become sickle shape in deoxygenated stat. And ended with crisis. Treatment of choice is Oxygen in that situation. Also you should take folic acid regularly to improve your he. permanent treatment is bone marrow transplantation only. Which is very difficult and costly. You should go with maintenance therapy and Oxygen as and when required. Thanks for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. My 8 year old son hit his outter thigh on the corner of my end table rather hard after falling off my bed. Initially, there was mearly a scrap with a tiny bit of discolouration around the wound. About 1.5 hours after the accident, the area swelled about the diamiter of a tennis ball and half the height off his leg. Bruising has reach the top of the skin. My concern is the size of the lump. Should I seek medical attention for him? ### REPLY: Hi. Welcome to ChatDoctorHe is developing hematoma/ blood collection under skin. If he can walk and no pain means bony injury is least likely. If size is increasing persistently and rapidly that means bleeding is active and needs surgical exploration and stopping of bleeding. You should see a surgeon at least once. Mostly it will resolve on its own but will take long time due to its large size. No tablets required. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my wife suffers at the end of each day, some worse than other, directly tied to how many hours she has been on her feet and legs.  The worst pain is just about 6 to 8 inches above the right knee on the backside of the leg, seems to be a muscle next to the femur a little towards the outside of the leg.  Also pain in upper right butt cheek.  When I message it (deep muscle) the pain subsides considerably.  She usually  puts a warm rice bag on it at bed time. ### REPLY: Hi. The pain what your wife suffers us due to lack of stability in glute muscle resulting in loading more on hamstring muscle... Sometimes irritation in the back.facet joint or neural irritation can give rise to similar symptoms... If I were your treating doctor then I would like to be sure with certain things.... Nature of pain whether the pain is getting increased slowly of all of a sudden it started...24 hr pattern of the malefactors that increases the malefactors that reduce her pain was there any investigation done before... I would like to suggest you to-Do lot of icing on your back as well as over the painfully area frequently... Gently knead her painful area at the end of the day...follow that up with icing... Take frequent breaks from standing... Do regular physical exercises like walking.swimming etc.core stability exercises like...lying on your back air cycling.Golding table-top position... and lying on stomach and do back extension.glute stability exercises like Bridging...clamshell.single leg raise while lying sideways...leg kick backs.etc. 15 times each.3 sets...stretching low back. Hamstrings...gluteus and calf regularly... Hope this is helpful for you... Kindly revert in case you need further clarification....wishing you a speedy recovery... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2year old son has a small bump on in head.As far as we remember he never fell hard on his head except once about 10months ago.He then just cried for a little while and was quite normal.He didnt lose conciousness or vomit.But now if we run a hand on his head we can feel the bump as a soft lump.Just today I got the xray done and on the xray I could see a clear crack running from top to the forehead.The radiologists said it is the joint and the doctor would tell if it is in the right position for a 2year old.The reports would be sent back to the doctor in two days.I am too worried to wait for that long so was surfing on the web to see similar articles.Can someone help me with that please?What might be the adverse effects if it is a fracture? ### REPLY: It's very unlikely to be a fracture, toddlers skulls are not rigid like adults, and it contains sutures, which are an anatomic lining between the skull bones, and it Unites together later in life, and this gives the advantage of non-serious injuries if child hits his head .the bomb you felt is a small collection of blood called hematoma and its harmless and body will absorb it in few weeks .don't worry at all ? Even if it had a 1 % chance to be a fracture, linear skull fractures in child .  I hope this was helpful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am writing from tx actually I have a question about navicular bone I have so much pain cannot walk too long or standing long period time so i went to se doctor check on my ankel do I need a surgery to get better help ### REPLY: Hi, thanks for the brief history and the opinion of the surgeon. As you mentioned you get pain by standing for long or walking long that means something is wrong in the upper part of the body not to hold up the additional pressure onto the particular bone. Why don't you try doing physical therapy for some days and see how it helps with exercise. Looking forward by taking Arabic stimulation underwater is an optional way of activating the muscle of the feel and even provide a little of strength. Post that try to discuss with your physical therapist as how about stretching the core muscles along with hip and knee muscles. All doing it in non weight-bearing and free exercises. Like open kinematic exercises. I think that this might help to an extent for reducing the pressure onto the particular bone. And of course the Use of faradism underwater will also add on some help. I had a similar patient in the past, and he got helped to 100%, and today he can walk, run, climb stairs and everything and no signs of pain and aches. Body is a unit. And if the whole unit is made stronger at one go then the aches and pains will surely come down. I wish you a speedy recovery with the grace of god ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife has been diagnosed with congenital hole in the heart at this old age of 65 years.  When 2D-Echo has been conducted in two different corporate hospitals with an interval of 1 year 8 months has recorded as 1.1 cm and 1.3 cm respectively.  Angiogram revealed no coronary blocks. Whether she can pull on for some more years without opting for closing device?  If it is not closed what would be future complications?She is high B.P. (only marginal) for which she is taking medicine. Only problem is she cant walk at a brisk pace.Thanks for the advice. ### REPLY: Thanks for posting your query here. There are different kinds of holes in heart. But at this age, the most common hole is ASD which is a hole between the upper chambers of the heart. Now coming to the treatment, I would advise you to immediately see a cardiologist and get a detailed echo to see if it is still closeable! But if there is any doubt, then she might need a right heart catheterization to see the closeable. Because by this age many of the ASD would have caused irreversible damage to the lung vessels and if the hole is closed without proper evaluation for this lung vessel damage then closure of the ASD can do more harm than good. And if it has not caused that damage, then it must be closed either percutaneous with a device or by open-heart surgery, otherwise it would permanently damage the lung vessels. I hope this information would be of help to you. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello Doctor. I am 17 weeks pregnant and from about 3 months ago i have noticed sore lumps under both my armpits, there are a number of them under the left armpit but two under the right armpit. My gynae touched them ann i screamed and she suggested that i go to a surgeon. I have not yet made the appointment as i am busy but when i touch them now they are less painful. Should i still see the surgeon? ### REPLY: Hi, Dear Good Evening, and thanks for the query to . I studied your query and understood your health concerns. In my opinion the multiple armpit painful lumps are due to the boil -infected hair follicle. To avoid any further septic complications from it -I would advise you to consult an ER Surgeon ASAP. And hence they need to be attended medically. Hope this would help in planning treatment with you Doctor. Hope this would resolve your query. Welcome for any further query in this regard. Plz write a Good Review-without fail, as it would help other patients coming to . With Regards. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I tore my frenulum during sex yesterday. I went to a urologist and he told me to just wait and let it heal with application of a cream. But I noticed that there is a small scar from were the frenulum was, and the penis head looks a bit bruised. It also hurts sometimes when I have to pee and there is a painful stinging sensation when I try to touch it or wash it with water. Should I be concerned and go see my urologist again? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have sustained injury to your frenulum during sex and have wound on the under surface of glans penis. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory . Along with topical antibiotic ointment like Newsprint twice daily. Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely. Please do not worry it will heal up within a week. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 currently have a pituitary tumor and was recently told I have a kidney stone that may not move. Also have irregular menstral cycles and was told I have a complex cyst. I guess my question is do you think it could be cushings? I have had extreme back pain for 2 weeks. ### REPLY: I read your query and I understand your concern. A pituitary tumor could be related to many hormonal imbalance types, or not influence hormone levels at all, depends on the type of cells proliferating. So Cushing syn .  Irregular menstrual cycle could be one of the signs of Cushing, but could be present in other hormonal changes as well. In Cushing there are many other possible signs like weight gain, skin changes, hirsutism, hypertension, diabetes mellitus, mood changes, muscle weakness etc., the signs are so many really. Osteoporosis can also be present to predispose to back pain. The diagnosis is usually established apart from clinical signs also by testing for hormonal levels, if you've been diagnosed with a pituitary tumor usually those are standard tests. I hope to have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: on the 4th of july i was stung by a bee  above my left knee,in which the stinger was left in, I scraped the stinger out but not sure I got it all.  I  had itching, swelling, and the area was very hot to the touch off and on for the next week.....there is still a purplish color mark about the size of a baseball that is dark and then fades out in color in the area.  Today I noticed a swollen gland in my neck just about my collar bone also on the left side of my body it is a little tender to the touch.  do you think this could be related to the sting? ### REPLY: Hello, Welcome to , When bees sting a person they will inject venom through their stinger into the skin of the victim. People stung by bees will have an allergic reaction to the sting and in severe cases it will cause anaphylaxis. For any Bee sting, following measures should be followed1. If the stinger is present remove it immediately. 2. Apply ice or cold packs to the area to reduce the bodies inflammatory reaction.3. Wash the area with soap and water4. Take antihistamine such as Ben . 5. Pain relievers such as ibuprofen or acetaminophen can also provide relief of symptom. Aforementioned measures should follow whenever there is a bee sting. 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: Doctor my husband was found having Abdominal TB . There problem is that he said the Doctor had told him not to have sex with your partner until he tell him to have. is it true or maybe he have another infection which he doesnt want to be open? . Is abdominal TB dangerous if we have sex can it affect me also ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. Abdominal tuberculosis never spread by sexual contact. It can only spread if the partner is having tuberculosis at the penis that is also cutaneous tuberculosis. It may be some else infection other than TB so that doctors has refused to ask for sex. Even if it is a penile TB you can perform sex with condom. Condom can protect TB to spread to you. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Two days ago I had a sharp pain below my left breast and today I have a pain in my left shoulder blade. The pain below my left breast was like a knife stabbing me but only last a few minutes and haven t had it since. The pain in my shoulder blade has bee there for about two hours. ### REPLY: Hello, Welcome to the magical world of health care, I went through your query, and in my opinion you will need to see a general surgeon for cause of pain in your chest or abdomen hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. I hope a 5-star rating if you feel guided in your treatment, 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 have a pain & it seems like it s right under my breast. in the center above my abdomen & it hurts every time I bend over or take deep breathes ... I m kinda freaking out because I did have unprotected sex a week ago like two days after my period ended and I was wondering could that have anything to do with it ? ### REPLY: Thanks for your version on . In my opinion you are having HERD (gastroesophageal reflux disease) mostly. And no need to worry about pregnancy due to unprotected sex because your timing of sex is in non-fertile period (just after menstrual bleeding). But get done urinary pregnancy test to rule out pregnancy. Better to avoid such unprotected sex. Use condom. And your current symptoms like central chest pain above abdomen is mostly due to HERD. It is because of laxity of gastroesophageal sphincter. Due to this the acid of the stomach tends to come up in the esophagus and cause the symptoms like burning central chest pain. So avoid hot and spicy food, avoid stress and anxiety. Start proton pump inhibitor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I got ankle sprained 3 days ago, got X-ray, it is not a fracture but high ankle sprain. I could walk little with limp. Swelling is there on ankle but OK. and I could bear the pain while little walk. Question is- why I am having a swelling on front foot after ankle, I had elevated the leg while sleeping and this swelling is there from 2nd day of injury. There is no pain in the swollen area. doc have given following tabs- celin-100,nucoxia,pantocid and started taking these from 3rd day of injury. ### REPLY: Hello, What I can infer from your history is that you have an ankle sprain; that is simply you have got a ligament injury which will take about 3 weeks to heal completely. As advised by your doctor, continue the medications. I would also suggest you to use a crêpe bandage to give mild compression at the ankle joint; this you can use throughout the day and not at night.  I would also suggest you not to take part in any sports and avoid twisting your ankle for 3 weeks. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, so two days ago i went to my doctor because i had a yeast infection and she gave me a pill to help it go away.but ever since i took that pill alot of yeast has been coming out so im not sure if that is supposed to happen or the pill just isnt working? ### REPLY: Hi there, and thank you for your question. I can appreciate your concern in this matter and I'll try to help you where I can. Treatment for yeast infections (caused mainly by Candida albicans which is a fungus) varies in form of medication, route of administration, dosages and manners of application. The routes involved include either being taken orally or inserted vaginally and the dose regimens can be daily or in the evening. The medication can be found in a pill, pessary or ointment form and the duration of treatment can last 1, 3, 7 or even 10 days. Therefore, there can be quite a bit of failed treatment protocols as well as a lot of confusion that can occur. The medication that I have previously prescribed for my patients that works very well is a single dose of ketoconazole 600 mg pessary that is inserted in the vagina and the infection usually clears up after the third day. You can speak to your pharmacist about supplying this specific medication for you and see how you respond. If this also fails then I would suggest seeing your doctor to exclude other issues such as a secondary or superimposed infection with this current one. I hope this helps though and 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: Is a hemoglobin of 8.8 considered low? Previously I had 2 infusions when my hemoglobin dropped to 6.5. It had climbed back to 15.3 now I m told it is normal even though I have been tired and experiencing shortness of breath and have been craving and eating ice like crazy. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have very low hemoglobin.  Your symptoms of tiredness and breathlessness ate due to anemia.  You should take treatment for that. You should search the cause first. Furthermore, you should go for peripherals smear examination and ultrasound abdomen.  This will give some idea about cause of your anemia.  Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I and my wife have staphylococcus infection for along time now, which has caused weak erection for me and lost of sexual appetite and pain please advise.age 36height 1.75mweight 82the last treatment i had was streptococcus found in the urine specimen ### REPLY: Hi I did review your concernStaphylococcal infection generally does not cause infertility and weak erection. It has different manifestations like fur uncle, carbuncle, cellulitis, pneumonia, food poisoning and few others. The antibiotics that work for staph are oxacillin, dicloxacillin, methicillin, vancomycin, ninefold, but they need to be taken only under doctors advice. I hope this helps. Let me know if you have any more questions or concerns. Wish you a very healthy life ahead. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 husban is 61 yrs of age and he has only have a heart from 2 heart attacks,and hardening of the arteries,he been having episodes of shortness of breath,almost passing out,and rapid heartbeat and now blurred vision,to no avail hes had a stress induced test/w/no results of a blackage and hes going to a pulmunary dr.,now and theyre gonna do a breathing test on him,they also put him on sprivia which didnt do any good,what is it? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion you should get done coronary Angiography to rule out blockage in coronary arteries. You are at high risk of heart diseases because of stiff arteries and previous two heart attacks. Sometimes stress test can be false negative. So only on the basis of stress test, coronary artery blockage can not be ruled out. So better to get done more diagnostic test (Angiography) to rule out heart diseases. Angiography also have benefit of treatment. If blockage is there then stenting can be done in the same sitting. So get done coronary Angiography. 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: For a couple days now Ive had a lot if gurgling in my abdomen area on the left side. The first day had some Sharp pain but that subsided. Today is day three I have loose stools for last thee days as well.  The last two times I went to.the bathroom it was just bright red blood no stool. No weakness or dizziness but my feet are ice cold and pale.  Im 42 and female. I do not have insurance and am not working so its extremely difficult for me to.get checked out. Please advise.  I know Im not drinking enough.water. ### REPLY: Hi ! From your history, it seems that you have diverticulosis of the colon which caused you sharp pain due to getting inflamed and the lot of gurgling in your abdomen could be due to the irritation caused by the infection. The frank red bloody stool also goes in favor of it. Even if there is no weakness or dizziness, the ice-cold pale feet are evidence for a good amount of blood loss from the body. Immaterial of the status of insurance, I would advise you to go to a gastroenterologist for a preliminary colonoscopy which can exclude many other conditions with rectal bleeding like the one you have which may need immediate attention. Wishing you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, 5months old couple, my husband having a problem of azoospermia. His medical history: Undescended testis operated at the age of 26yrs. Left testis is at the root of the scrotum, right testis is at the ingunial canal. Is it possible for him to produce a fertile sperm naturally to beacome a father? His FSH-81. ### REPLY: Howell come to ChatDoctorI really appreciate your concern, if this is the surgical history of descended testes then chances of producing sperm depends upon the presence of cell that produces the sperm and for this better to get done the biopsy and semen analysis, some time sperm can be taken directly from the cell (Semnifirous tubules) if ever presence there, for reproductive purpose, hope this information helps, take care and have a nice 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 do not have a prescription for the pain medication that I have been taking for 12 years. I have Scholiosis and my doctor has lowered my dose of methadone. I don t understand him, or he forgot I have this uncurable disease. can I order from you with no script? ### REPLY: Hi, I have gone through your question. I am a practicing anesthesiologist and pain consultant. I can understand your concern and the pain you must be experiencing. As you are taking these medicines since long time your doctor must have reduced the dose, because these .  It doesn't mean he has forgotten about your problem. Methadone is an opioid analgesic (painkiller). It can be available without any prescription from doctor. You have the option of other painkillers like paracetamol and tramadol for relief, which are safer and available off label.Don't worry, I am always there to help 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: Hey Doctor,I Just wanted to ask about the home remedies for removal of moles and if it does really work??..and if so which one is the best..ive heard of Honey, apple acider vinegar,Toothpaste..and so,, and also wanted to know its Safe or Not..Thank You So Much :)) ### REPLY: Hello, I read carefully your question. The treatment would depend on the type of mole- if it's a mole caused by pressure/friction, or it there is more than one, most probably from a virus. In the second case, you may burn the moles by applying locally chemical topical agents, burning to the doctor with different methods, or if they are really spread trying even oral therapy. I would not recommend applying home remedies that might not only not work, but also cause damage to the skin around the mole, which might leave a permanent scar. Hope this helps, Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am female age 53  and for a few years suffered with fatigue, getting worse. I work full time and find it difficult to concentrate. I regularly go to bed about 6pm and get up at 7am to 8am still feeling exhausted. I have blood pressure tablets and beta blockers, I now take vit D supplements advised by my Doctor who a;lso said I was depressed!!!!I started to take 2 types of anti depressants but they really made me feel too sick and nauseous. I have stopped taking.I am not feeling low or unhappy but just so tired all the time. I have just returned fro  2 weeks holiday where I was fine, but now struggling to get out of bed, please help. ### REPLY: Hi, Thanks for using . I have gone through your available history. Tiredness and lack of concentration might be due to - Thyroid dysfunction- Vitamin B12 or vitamin D deficiency-Depression- Menopausal syn . You should rule out thyroid dysfunction and vitamin Deficiency by doing blood investigations. You may get prescription by your doctor. Treatment would be directed as per cause. Sometimes excessive sleep may also make you fatigue. In that case you may need to reduce sleeping hours. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in the right upper back and sometimes a stabbing pain under the right breast. The pain is worst by laying down on right side or sitting and putting pressure on it. It,s  been going on for a few years on and off. Sometimes the way I move the pain gets worst. ### REPLY: This sounds musculoskeletal in nature. I would use topical ice, but if it has been going on for years, then you should seek a referral for physical therapy as well as massage therapy. This could also be accompanied by local muscle trigger point injections. And if those don't work, then a trial of acupuncture would be beneficial. And once you do see your doctor, a chest x-ray would be warranted just to rule out any rib or lung abnormalities. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 found a lump in my scrotum. It is not on the testicle, it feels like it is on the vas deferens. It is only on the right side and about the size of a large raisin. The left side has a very small lump, much smaller than a raisin. I had a vasectomy last December. Are these lumps likely from the vasectomy? ### REPLY: Good Day, and thank you for being with  ! Yes the lumps that you are feeling in your scrotum are due to the vasectomy that you underwent. These lumps could be suture granulomas that fibrosis during your normal healing process. You can just observe these lumps An .  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ ### END