Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 discovered a large lump (rather visable) behind my ear and where my hair begins, it has been there for 2 weeks (that is when i felt it).  now there is one above it and a small one below.  I went to my gp, he did blood tests, he says all is clear, no infections, no cancers etc.  he has now put me on penasilin medicine for 2 weeks.  He says if theis medicine does not work, we will do a biopsy.  I have had abnormal cells before, and have had to do a hystorectomy when i was 26.   My grandfather died of colon cancer, my aunt died of breast cancer, my mother had cervical cancer and my other gran had cancer all over her body.  I am now 32, about 5.2.  My question is that if these lumps do not go away, and the blood tests were clear, is it possible to still have cancer? ### REPLY: Hi, Thanks for writing in. Cancer is a diagnosis that can appear in many ways, however if you are having swelling that appeared within days then it is most likely that you have an infection. Cancer will not appear quickly and takes time. Another point which is important concern if you had pain in the lumps. Any pain is usually an infection and cancers are usually not painful in the beginning. It is most likely to be lymph node enlargement at the back of the ear. This is because there are retroauricular lymph nodes in that location, and they can get enlarged due to infection. If possible, please get an ultrasound scan of the area to know exactly the findings and cause of lumps and continue taking medicine given by your doctor for a week. It will most likely treat your lumps. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor my mom is 55 yrs old in Jan 2011 these year she faced breathing problem and she was hospitalised. Doctor said her heart pumping is low 20-25% . She is treated now with the medicines Cardivas 3.125, Lasilactone 50 , Cardace H 2.5, Dexorange syrup. Her haemoglobin was 7.5 . Doctor she is coughing too much mostly she is coughing in every 10 minutes and it lasts for 1to2 minutes. The sound of coughing is too severe. Doctor please tell me what has to be done to get rid of her severe cough and how to improve her heart pumping and also make her heart healthy and strong and also inform what she has to eat ? ### REPLY: Hello, First thing is to find out the cause of this weak heart function. We need to rule out the blockages, so I guess that was rule out.  In her medicine, she should get lasilactone dose increased. Cough is there due to excessive fluid in lungs, so there should be fluid restriction including milk, water, tea, juices etc. to less than 1 liter per day.  She should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello i am a 22 year old female i have a really bad cough that wont seem to go away, i have been coughing up mucus that seems to be white at times then watery and clear the next at times i will cough to the point i throw up, i have lost sleep due to cough spells as well i had this issue about two years ago and had xrays done on my lungs and the doctors said everything seemed to be clear, but lately i find it hard to breathe if i try to get a good draw of air i end up coughing or wheezing. ### REPLY: Hi. I can understand your concern.  Chronic cough is commonly seen in bronchitis and lung infection. Since your chest x-ray is normal, no need to worry about lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I m a 26 year old male in good health. I ve been active for the majority of my life and have lead a relatively healthy life style (minus drinking on the weekends) for most of my life. About a year ago, I was sitting on the couch when all of the sudden I felt my heart skip a beat and I was dizzy for a second. Ever since then I get the same feeling at least once a day, sometime more. I ve also noticed that my pulse will feel stronger at times and I can see it in the center of my throat. I do have a history of anxiety and panic attacks, so I m assuming this is the reason. My biggest concern is that I ve never had these symptoms before. Now I m fixated on it and it seems to happen more and more, especially when I do physical activities and get my heart rate going. I m constantly worried about it. don t have a history of heart disease in my family. Im going to see a GP next week, but I wanted a 2nd opinion. Is this something that I should be worried about? ### REPLY: Hello, I would like to tell you that predominantly your symptoms are because of anxiety only but to exclude any heart abnormality and to rule out any heart arrhythmia kindly get a basic cardiac evaluation done which includes ECG, echocardiography and Holder (ambulatory ECG) and consult a physician with reports for further management. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has a liver disease, we are trying to find natural ways to help him with his difficulty in getting enough air. His air is short, sometimes he can t complete a sentence. This just started yesterday. Before that he had body aches (now gone) and a headache (now gone) what can we do to help him to cough more and so clear his lungs..... ### REPLY: Hi thanks for asking question. Get examined patient by doctor. If on auscultation rhonchi heard then it is bronchospasm by obstructive condition like asthma or bronchitis.x-ray and pulmonary function test useful for it. If along with headache fever also present then chest x-ray done for rule out any consolidation in lung. Noted you have mentioned liver disease ... But which dz?? Fatty liver or cirrhosis or any other?? I am asking this because in cirrhosis functional pulmonary problem occur as result of portal hypertension and development of hepatopulmonary syn . I hope your concern solved. 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: H I doc, i dont know how but since 1 year I m experiencing loss of memory , i can t remember what I did whole day, don t remember my priorities, infact I don t like to go on work, don t like to respond daily matters, always feel scared, this situation has made my life really miserable, I wish to have a real freshness of mind but can never achieve it for last 1year atleast, I feel this might b cause of over sex that loosen up some important energies of mine but u can advise better? I m also little over weight and have indigestion and gas problem, i eat t less but expanding irrationally, also have knee pain and this pain alerts enhances whenever I do sex, pls advise your help, thanks, acber ### REPLY: Hello and welcome to . Thanks for your query.  I understand that you are going through a difficult time. Your symptoms of memory and concentration difficulties, lack of interest, feeling dull, decreased energy, etc. could be indicative of depression. They don't appear to be unrelated to your having more sex. I would advise you to consult a psychiatrist for a detailed psychological assessment and further treatment. There are effective treatment options for this, in the form of medication or counselling / psychotherapy which will help you overcome your problems. You can deal with your gastric problems by having your meals on time and avoiding spicy or oily foods, carbonated or caffeinated .  You can take an over the counter antacid for quick relief. If the symptoms don't subside with these simple measures, then you may need to see a doctor for further treatment.  Regular physical exercise and diet control in order to reduce weight will help both your physical and psychological problems. Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Mother is 74-years-old and said she has dark black spots with lumps underneath her skin. She was not sure of the spelling but, she tried to spell something close to what I just found.  Just looking for answer, I found Lipoma. Want to know how to cure it? ### REPLY: Hi, Good afternoon from India. T-Thanks for your query to My-ChatDoctor Clinic.-I studied your query in depth. I understood your concerns.-My opinion -Your mother is having -mostly-Mole ?dermatofibroma ? Lipoma?-Consult your family doctor and confirm that is lipoma-as felt by you.-Cure -is by-Surgical Excision Biopsy by ER Surgeon.-Hope this would help you to recover from worry-some query. Wish you a Fast Recover. Wellcome to  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: I am working in bangalore from last 2 years.I have some problem like breath smell some bad smell is coming.because of that i am in tensed.i contact the teeth doctor he told everything fine.i am facing this problem from last 1 years.what should i do?sometime i feel like some major problem is this.i have been contact 2-3 doctor every one told its o.no problem.but why that smell is coming then..its coming continuosly.please give me ans for that ya call me..0000 ### REPLY: Hello, Bad breath causes multiple, first the dental or oral causes it could be due to bad oral hygiene also avoiding of tongue cleaning. Get your teeth professionally cleaned and start maintaining your oral hygiene by doing four things daily at night and in the morning.1. Proper brushing.2. Using interdental aids for cleaning in between your teeth areas (Dental floss and proxy brushes (single bristle brush)).3. Tongue cleaning with a tongue cleaner. 4. Using mouth wash (Initially for two weeks go for Chlorohexidine later you can change to milder one like Listerine)Visit your dentist regularly for checkup and professional cleaning. If it still persists, then it could be related to gastric problems. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have pain in the right side of my abdomen from the lower two ribs to just above my hip, its tender to touch an to me feels swollen an firm to touch....i also felt nausias for the last 3-4 days but the pain has only really started in the last 24 hrs....i have had tenderness in my lower ribs for maybe 8 yrs ive had it checked yrs ago but nothing showed up...now the area has increased an i have constant pain, without it being touched, as it would only hurt before if it was pushed or proded...im 37, female, 3 children, not pregnant ### REPLY: HI, I think you deserve a medical consultation with your family physician. It could simply be an intestinal transitory dysfunction. However, gall bladder stones, liver disease or even other forms of appendicitis could still present in rare cases as such. Lower right lobe pneumonia is also a differential diagnosis. However, a physician clinical evaluation, an abdominopelvic ultrasound and a chest X-ray could EB be very useful. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am Kate. My age is 33 years. I have PCOS and usually need to have a withdrawal bleed. Last cycle i went in for fertility treatment and was treated with 100 mg clomid for 5 days + 150 mg Gonal F for 3 days + 225 mg Gonal F for 4 days and on Day 15 was given a trigger shot. But i did not conceive. I also had mild OHSS. THis cycle i visited another doctor on Day 15 of my cycle. He gave me 60 ml of some injectable to release the egg from a follicle 18 mm in size. he said it is not ChatDoctor . what can it be? Also in the scan he said one follicle is leftover from last time and one is new. Is it possible for him to know this if he hasnt seen the previous scans? He has also asked me to take duphaston 2 tabs from Day 18 to 28. Many thanks - Kate. PS: My height is 5 feet 3 inches and weight is 68 kgs. ### REPLY: Hello, I have gone through your query and understood the concern. The fact that you always need to be induced to get a period makes me think that you are probably not ovulating naturally. A proper clinical evaluation is needed before initiating medication, more so, as you developed ovarian hyperstimulation with induction. Also, it is important to stay with one doctor whom you find comfortable. Else, your treatment gets haphazard. Metformin is often used before trying induction to see if natural ovulation is possible thus avoiding unnecessary HSS. You are overweight and need to maintain a healthy lifestyle. Taking progesterone in the latter half of the cycle in micronized form is safe. A maximum of six cycles with proper monitoring is given for induction of ovulation. Gonadotropin or  is the medication given to facilitate ovulation. Follicles in different stages of maturity can be seen but cannot be differentiated if they are from a previous cycle. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 70 yr old lady with type 2 diabetes on insulin I have recently been diagnosed with a Fatty Liver. I also have an ileostomy done 40+years ago I am restricted on diet from the ileostomy to low fibre, with low carbohydrate to help control the diabetes. What can I do to help with the fatty liver? ### REPLY: HelloFatty liver is a reversible condition. It is often seen in diabetic patient due to metabolic disorder. It is due to deposition of fat within the liver cells. Fatty liver may also be due to many other reasons like obesity, sedentary lifestyle, altered lipid profile, hepatitis etc. You need few more investigations like routine hologram, lipid profile, liver function test. It is good that you are following dietary restrictions. You may need to take few medicines after proper evaluation. You should also increase your physical activity and go for brisk walk. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had kidney stone surgery on 12-12 and on 12-18 they removed the stent ..I know have a fever and I m not going to the bathroom hardly as much as I was when I had stent..I don t know if I have a common cold or problems with the stent being removed...my family doc put me on antibiotic do u think I should go to er and get checked or give it another day ### REPLY: HI, sure you need to see your family physician. Fever could be a sign of infection. The anti-biotic given you are prophylactic, if you still develop fever, its worthwhile doing a culture and antibiotic sensitivity tests to ensure what we're treating really works. The fever could also be due to something else, worth checking with your family doc. It is common to have changes in urination frequencies with removal of the stent. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump over my left rib cage and it hurts to the touch. It hurts when i stretch my arms over mu head or when i try to reach for something or put my blouse on. Also, recently it appears that my vein pops out directly over the lump. The lump has been there for almost 3 weeks. The protruding vein for 2 weeks. ### REPLY: Hello and welcome to , A lump over the chest region (left rib cage) could be a soft tissue swelling or a bony swelling. Pain in the lump on movement suggests that the lump is associated with the musculoskeletal system. I would suggest you to get an x-ray chest to know the site and origin of the lump. After knowing the site and origin, the nature of the lesion needs to be known- whether inflammatory or neoplastic. To know the nature of the lump, an aspiration cytology of the lesions needs to be done. In aspiration cytology, cells are aspirated, stained and examined. Depending on the nature of the lesion, treatment can be planned. Consult your primary healthcare provider for further work up. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am a 20 year old man who masturbates about once a day (sometimes twice). I have read that masturbation can cause memory loss (short term) and absentmindedness, both of which I have started to suffer from starting about 6 months ago. Is this a side effect of over masturbation . If not, what can I do to help these ailments? Also, is over masturbation bad for you? ### REPLY: Hello,No, masturbation is a normal phenomenon it will not cause memory loss or absentmindedness. It is a wrong notion that masturbation causes all these symptoms, but it is not wright. Masturbation is good for health and doing that will help to keep good sexual activity. Take out from your mind that masturbation can cause ill health and causes loss of memory, in fact it will help you to keep focused. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother in law was suffering from stomach pain frm two weeks.. we did the check ups.. doctors told its gas trouble.. later we checked..thn we got to knw jaundice s there.. nw whn we took to hospital 2 days bk till today mrng they told its curable with medicine.. but now they r telling there s a growth in lever .. surgery has to be done,, but no hopes it will be successful ### REPLY: Hello, dhanyaplakkat, Thank you for contacting . Your mother-in-law has jaundice and the doctors say that she has alive tumor. There can be several types of growths or tumors of the liver. There are cysts, benign tumors and also cancerous tumors. If she has a cystic growth which is more than 5 cm. in size, they have to do surgery. Results are very good and she can recover completely. If she has growths called Adenoids, which are usually benign, if they are big, then surgery is necessary to remove it. Liver has tremendous regenerating power and a person can have half the liver removed and still lead a normal life. Cancer of the liver is more serious and it would have to be confirmed by special tests and biopsy. There are several options depending on how advanced the cancer is. Cysts and Adenoids generally do not cause jaundice unless they are near the channel or duct that carries the bile thus blocking. I cannot comment without knowing the specifics either CT-Scanor MRI, ultrasound etc. We also need to know all her blood tests to find out the liver functions. I hope she will be under care of a competent surgeon who has performed liver surgeries in the past with good results. You may have to enquirearound to find out. I really wish her the very 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 I ve had the outer side of my left thigh numb for the past 2 years. Once I started feeling it never went away. It tingles from my hip to a little bit over my knee. I ve put ice packs and it s like nothing is there. I press on my thigh and I feel like something squishy moving around. Thank you if anyone could help out with any info. ### REPLY: Hello, I have studied your case. Most probably it is due to either a nerve compression at groin or in the spine. It is called neuralgia prosthetic. You need to see a neurologist to confirm the diagnosis and treat accordingly. I would recommend you to take tablet Pregabalin and methylcobal daily at nighttime. Make sure that your blood sugar is under control. Steroid injection can be given if pain is also there. I hope these steps will be helpful for you. Let me know if there is any other followup questions. 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: Dear Sir,My age is 58 years and only 30 % of my heart works. I came to know this on January 7,2011 when I got a silent heart attack. I checked today and the same 30 % works with BP at 110/80. What extra care should I keep so that I can live a normal life for few more years. What diet should I take.The only problem is I get a rare cough in morning times but its Thanks,JVS ### REPLY: Hello, First cause for this should be treated like angiography followed by Stenting or bypass. Secondly, regular medicine and follow up, which you must be doing.  You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, and avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Thirdly the patient if less than 30 are advised for ICD or CRT device which is life-saving in multiple patients, so you should discuss these issues with your cardiologist. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,this is Pauline,i am 23 now and i have been married for about 1year. My husband and I were trying to have a baby,but we failed because I have hormonal imbalance. I want to have baby this year. What shall we do? please advice me what to do. Thanks and more power. God bless ### REPLY: Hi, I think you can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days after injection.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months.  Just do a thyroid profile and prolactin levels for yourself and a semen analysis of your husband.  You can also do a tubal patency test.  Discuss with your doctor regarding this.  If it is normal, you can go for GUI also. Hope I have answered your question. 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, Ive been having alot of problems with my chest.. for example when I wake up in the morning and sit up the whole left side of my chest is incredibly heavy and hurts alot. I get sharp pains at the same time. I get heart palpitations nearly everyday and my heart seems to thump agaisnt my chest alot of the time. If i put my shoulders back i feel pressure on the left side of my chest. Im not entirely sure but my heart seems to go from beating quickly then slow down alot of the time. Im always fatigued, weak etc. I get sudden dull aches in my pressure points in my wrist/hands/feet that come out of nowhere and leaves me with no energy afterwards. ### REPLY: Hi thanks for your question. Let me know you do you have hypertension or positive cardiac history ?? First to rule out heart problems do ECG of chest there might be fibrillation present that can lead it. The palpitation could also be physiological. In increased metabolic activity palpitation can occurred like fever, hyperthyroid etc. After ruling out cardiac problem move toward musculoskeletal pain. Note you have pain esp after getting up. So it might be by improper sleep posture. Sleep in supine position rather than lateral. By heavy exercise or heavy weight lifting muscular strain can occur. Simple analgesic taken. If ribs are tender to touch then Costco . Try to avoid stress. I hope these suggestions will help you a lot. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 24 year old female I work out quite regularly and for the past 2 months I have had this chest cold. I went and bought a new sabutomal puffer today and since started taking that I have been projectile vomiting every time I take my inhailer. It is my only way I can breath at the moment but I can t take it due to me vomiting. Should I be going in to the emergency. I also have asthma and I had a hole in my heart repaired as well as a valve closed. Is there some sort for concern here. ### REPLY: Hi, Thank You for giving us the privilege to answer you here on , Your breathlessness needs to be evaluated whether it is related to cardiac etiology or is it your asthma flaring up. You have just now got yourself a new Albuterol Inhaler. One common problem is improper technique of use. If it is an MDI (pressurized Metered Dose Inhaler) it's best to use a Spacer (A device that helps in delivering the medication to the smaller airways while minimizing deposition in throat). If you are Asthmatic, you must be on ICS/LAB Inhalers (Inhaled Corticosteroids/ Long Acting Beta Agonists). If not you need to have an Action Plan devised to keep your asthma under control. Investigations: Chest X-ray Blood Counts SpirometryVomiting part can be got over by proper inhaler technique and T. Ondansetron 4 mg thrice a day shall help in tiding over till you get evaluated. Hoping I have helped you with your query, 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 had a c section 3 months ago. Healthy baby. The incision was closed with staples on the inside that dissolve.  Some of the staples worked themselves out.  This was painful. There are still almost all of the staples still in. They are still whole and very painful.  The outside is completely grown together ( not pretty). The staples are trying to push out.  The do not appear to be dissolving.  I have a constant burning pain in my abdomen.  I am also no heavier but much puffier than after her birth. I wear supportive garments and still have trouble getting up. This is my second setction and third delivery.  This is the hardest recovery. My temperature has maintained at 96 degrees. I had a discharge from from my belly button a few weeks ago and that went away. I sweat often, feel fatigued and occasionally get very physically overwhelmed. The newest symptom is pain around my ribs on my right side. ### REPLY: Hello and welcome to , The staples used to suture the wound (surgical wound in your case) are metallic in nature. They do no dissolve and have to be removed few days after adhesion of the wound edges. Pain is usually present postoperatively.painkillers are prescribed in the post-operative period. However, if the pain is constant not relied by common painkillers, there can be a possibility wound infection or wound dehiscence. Wound dehiscence is a condition in which the deeper layers of the wound give way. It is associated with oozing out of blood and serous yellow colored fluid. Burning pain in the abdomen can be due to nerve injury during surgical procedure. Heaviness and puffiness that you are experiencing is due to baby weft that you have gained during pregnancy. Consult your doctor for clinical examination of the wound to look for features of wound infection and/or wound dehiscence. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: am a woman age nearly 53 my uppar back seems to b on fire feels hot prickly severe itching am soo uncomfortable my hygiene is v good mostly wear cotton take an anti allergy but hasn t helped...sometimes I feel the same on the breasts...v uncomfortable,my back is hurting coz of the constant itching its been terrible since a mth ..please advice ### REPLY: Allergy a develop at any time at any age with anything you need to investigate cause soaps shampoo oils medicines creams ointment and other body application material scan be culprit for allergies it can be food cloth or pollen if you consult allergy doctor he can tell you cause after getting allergy test sand you can treat accordingly avoid foods and for pollen immunotherapy control by using anti-allergic tabs and ointments ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am unable to breat properly...specially at night..it feels like something is chocking my throat..I even visited emergency...but they advice to gargle...and gave me some antobiotic...but its not helping me completely...in day time its ok but in night its worse,what should I do ### REPLY: Hi welcome to ... Here your posterior pharynx examination needs to be done ...along with auscultation ... If auscultation reveal rhonchi or crew than digital chest x-ray and spirometry done for further evaluation.... According to cause treatment given.... If chocking is from inflammatory sweller than anti-inflammatory . ... Avoid excess spicy and excess fried food ... Take care Advise : consult pulmonologist for examination ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 not ovulating till the 5th of october my last period was on the 24th sept I had unprotected sex with my husband last night. Is it alright or should I take the morning after pill. I have some marvelon that I havent taken before should I take one of those? ### REPLY: Hello, I have gone through your query and understood the concern. If you add the intercourse during the safe period, you do not need any emergency contraception. However, if you are around the fertile or ovulation period, you need to take emergency contraception if you do not wish a pregnancy. Marvel on cannot help in a single dose; you have to go for a proper emergency pill. You can also opt for the insertion of an IUD if you need prolonged contraception. With the use of emergency contraceptive pill, there can be some menstrual disturbance and delayed period. If you become overdue by ten days, you have to see a specialist for further help. Hope I have answered your query. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when i was in my twenties i had to stop wearing jeans because it caused a pain just off to the right by two inches of my belly button when i bent forward spoke to a couple of doctors at that time about it got shrugged off so I just didnt worry about it any more and wore elastic waist band pants instead.  Recently I awoke from sleep with a sort of stinging pain shooting down my whole right side of my stomach.  I started to push around on my tummy and found a lump in that area fairly deep beneath the fat. it was about a 50 cent piece size...when I went to check for it a couple of days later it was difficult to find but this morning when I awoke it was the same pain and I checked again standing up is the best was to find it..it was there again..  dosnt hurt to push on initialy but it does afterwardswhat could it be....Our doctors here are fairly inconsistant and do not have much faith in them they misdiognose so often, I dont trust them ### REPLY: Hi ! It could be a hernia which gets reduced at times and comes back again due t increased intro abdominal pressure. However, it is not possible to diagnose it without examining you clinically and going for other investigations as need be. Therefore, I would suggest you to show it to a general surgeon of your area, who can examine you, get an ultrasound abdomen if need be, and then go for further needful. 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: Why does it feel like someone is pressing my rib cage in when I blow my nose?  It feels like someone is squeezing my left lower lung.Ive had a slight temp. But its gone.  Blowing green and coughing up green. Yesterday an occasional streak of brown in what I was coughing up, but not blowing out. ### REPLY: Hi thanks for asking question. Here are few possibility.1. First you have slight fever with cough expectoration. So here pneumonia like infection has to be ruled out. Chest x-ray useful for it to see for consolidation. Sputum culture also done because green sputum might be because of pseudocodes. Or brown may be because of klebsiella. According to culture report treatment should modify.2. Second you might have simple viral infection and pain may be simple muscular as might be because excess coughing or heavyweight lift or bed sleep posture. I hope my suggestion will help you. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,i have got pain on my galbladder for 2 years, pain is really hard now. i went to doctor a lots of time and they made me ultrasound,endoscopy,MRI,a lots of blood test but everything is normal. is it possible to seem nothing if i have got problem in my galbladder.im sorry for my english. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  Gall bladder pain may be due to gall atones or chronic or acute cholecystitis or rarely other gall bladder disease. However, all conditions can be easily diagnosed by ultrasound study and MRI. So if you're all ultrasound and MRI reports are normal then there is high chance that you may have some other pathology like muscular pain or other pathology not detected by imaging study. You should go for examination. Search the cause of your pain and take treatment accordingly.  It's less likely that you have any gall bladder disease. 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: can severe pain and mild swelling with warmth central located in the most tender spot, be torn rotator cuff. and exhibit serious pain 8 months after a serious fall which resulted in a broken shoulder on opposite side. I have unexplained pain 10+ scale. Regular xray yesterday showed no fractures, no arthritis. Can you get a rotator cuff tear and have no symptoms and then with out additional injury or unusually use begin exhibiting pain as severe as the broken extremity from last Halloween ### REPLY: healthier is difference in rotator cuff tear and supraspinatus tendinitis, whereas in former the movement of shoulder is impaired especially abduction and rotation while lifting arm sideways, in tendinitis there is pain and movements may be painful and not restricted as such, an MRI may distinguish the two. So consult a shoulder surgeon or orthopedic surgeon. In your case, it may be tendinitis. Take Advil thrice a day after meals for 7 days and do hot fomentation, rest arm in a broad arm sling for 10 days., it may help but if not go to orthopedic doctor for investigation. Also apply anti-inflammatory gel like voltarenthanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 football player that had odd symptoms 35 minutes after High school football game this past Friday night. He was unable to move right hand and had no feeling in hand or finger movement and appeared to have lost of circulation from tricep down to hand, Arm appeared to also be retaining fluid. No present pain or pain during the game. Numbness radiated up arm into shoulder, Athlete went to emergency room. CTscan of neck performed and cervical xrays done. Results looked clean. He was given muscle relaxers and told he had a myo facial cervical sprain. Today on monday he came to my office before school. circulation looked worse in hand and arm, still whole hand numb except thumb. He was unable to move hand or fingers, He still appeared to be retaining fluid in arm. Hand and lateral side of arm was cold to touch and circulation poor. He again went to hospital as recommended . He had a cervical MRI and xray of forearm. All results showed no injury. He was referred to neuro doctor for nerve conductivity test but was unable to be scheduled as no one answered phone today. Any suggestions ### REPLY: Hi, These are clear signs and symptoms of brachial plexus injury, brachial plexus is the plexus of nerves and their roots that emanates from shoulder and goes into the arm. He needs an MRI of brachial plexus 5-7 days after the day of injury as in the initial period there is so much swelling that it is not possible to see brachial plexus clearly. She needs to consult a neurosurgeon or a plastic surgeon who can repair the plexus. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband is 6 weeks in to a 7 week treatment for prostate cancer.  He has just passed water, which he said was painful, but after this a patch of blood about 2" diameter appeared on his trousers.  He is very worried about this. There is no bleeding now. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  He has history of prostate cancer.  He should go for PSA level, ultrasound abdomen and urine examination.  It may be due to his prostate problem or urinary tract infection.  Go for investigation and 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: Dear Doctor, TTC for 2 years with pcos , this cycle my dr prescribed HMG shots from day4 to day9, then trigger ChatDoctor shot on day 12, i ovulated day15, then he put me on cycloprogenova 2 white pills daily and told me to take it for 2 weeks bec my endo was 9mm. am on day 18 now, but am worried bec cycloprogenova is category x, and when i stop it would my hormones become low and if there s pregnancy i would have miscarriage? Thank you ### REPLY: Hi, As your endometrium should be enhanced for proper implantation should you conceive in this cycle, you would need the medication. Yet, estrogens are contraindicated when pregnancy is contemplated. Effect of hormones on the embryo has been seen after 45 days, so your doctor may have prescribed this now. Once implantation has occurred, you may not need the medication and supportive treatment is ensued, to prevent a miscarriage.  Please discuss with your doctor if you do not wish to continue the .  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 broke 2 bones in my wrist and dislocated my hand from my wrist i have a plate and screws and my wrist is always hot and it hurt my surgeon first said i should be in the pain i am in but then tells me to come back in a month if it still hurts. i hurts everyday and everytime i use it or move it. i did the theaphy. it has only been since february. the pain and hotness concern me he gives me no pain medication and there is no relief it keeps me up at night ### REPLY: Dear patient What is the duration post your surgery and is there fever ? Common causes for pain after implants in wrist and hand are 1. Infection of implants 2. Screw back out 3. Implants are broken 4. Rarely if screws are going into joint and leading to early arthritis.  Since it is hot and causing pain possibility of infection should be considered.  I would advise X-ray of involved wrist and hand anteroposterior and oblique views.  It can help in diagnosis and ruling out other conditions. If there is lysis around screws and screw back out it suggests infection.  If implants are broken it suggests non-union of fracture.  Please take visit to expert orthopedic surgeon with X-ray report. 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: I was at a 5K walk this morning and had a sharp pain in the left side of my chest followed by a metallic taste on the left side of my teeth and mouth.  The chest pain went away within 30 seconds and the taste dissipated over a few hours.  I am a 40 year-old, 59, weigh 125-130 lbs. woman. ### REPLY: Thanks for your question on . I can understand your situation and problem. You are having left sided chest pain on exertion. This is characteristic of cardiac diseases. So better to first get done ECG and 2d echo. If both are normal than no need to worry about heart diseases. Muscular spasm due to exercise can also cause similar symptoms. So avoid stress and tension. Avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Start painkiller and muscle relaxant .  Apply warm water pad on affected areas. Don't worry, you will be alright. But first rule out cardiac cause. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: a friend of mine has been complaining he cant stop jacking himself he does it twice a week and his habitual after trying to explain him that he might suffer ed and also urged to get married ASAP he still doesnt understand pls help he is in mid twenty by age ### REPLY: HelloThanks for query. Your friend is indulged in masturbation twice a week. Masturbation is a normal act of a human being to get sexual satisfaction without a physical intimacy with a female partner, and it is natural for every individual to get into it at the age of adolescence.First there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body.However, one should observe that he does not get addicted to it. One can restrict it to twice a week without any harm. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, me and my husband are wanting to get pregnant. I recently stopped taking my birth control medicine. I have no idea how long it is going to take for me to get pregnant. I am also unhappy with my weight at the moment. I was wondering if I start to lose weight while we are trying to get pregnant could this hurt my possible pregnancy in any way? ### REPLY: Hi, Weight loss before getting pregnant is advisable, as ideal body weight before pregnancy, leads to an uncomplicated pregnancy and delivery. Overweight and obese women are known to have more complications. So, it would be advisable for you to get to your ideal body weight, by diet and exercise. You could get in touch with a dietitian for a good diet plan. Also, you should try for a baby for a years time, if unsuccessful contact a fertility specialist. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my 3 year old daughter s breathing seems rather quick -- 60 breathes per minute. She is sick right now (complains of a tummy ache and is on antibiotics for MRSA staph). She had RSV one year ago, and it seems that since then, whenever she gets sick, she breathes rapidly. Should this be a concern? ### REPLY: Hi, welcome to . Can understand your concerns. - Rapid breathing rate of around 60 per minute is very high at 3 year of age. It suggests that child has pneumonia, and she is not responding to antibiotics which you are already giving for MRSA staph infection.- Child needs to be hospitalized and blood culture and CRP levels should be repeated. - Further treatment will depend on above reports. I hope this will help you. Wishing your child 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: hello. I am experiencing fluttering feeling in the middle of my chest. I awoke this morning in a rapid manner-getting up quickly and walking fast, like I was trying to run away from it. I have been told I have a small nodule on my heart. as the day progressed, im still feeling like the feeling is there but not as strong as this morning. thank you. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. Fluttering feeling in the chest is mostly due to palpitations (rapid heart rate). Since you had nodule in heart, arrhythmia can be the possibility. So better to consult cardiologist and get done1. Ecg2. 2d echo3. Holder monitoring (24 hour continuous recording of ECG) to diagnose arrhythmia. If all abnormal then no need to worry much for cardiac cause. Anxiety can also cause similar symptoms. So avoid stress and tension. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 4 and he fell and hit his cheek bone hard on a wooden table. It caused a bad bruise and a black eye. Its been three weeks and the black eye and bruising have gone away but there is a hard lump under his skin at the impact location. Is this anything to worry about? He also sais its sore to the touch. ### REPLY: Hi. Can understand your concern. As per your complaint due to trauma and injury caused to your son due to falling has caused trauma to the soft tissues leading to inflammation and formation of inflammatory exudate as well as trauma can lead to rupture of blood vessels leading to spillage of blood into the surrounding soft tissues leading to HEMATOMA formation and bruising. The soft tissues also shown signs of inflammation and there can be proliferation of fibrous tissues as well as accumulation of inflammatory cells in that area which can encapsulate the hematoma and there appears to be a hard lump. The black eye is also due to blood accumulation due to rupture of blood vessels. As the blood accumulated gets disintegrated the bruising gets subsided. But the lump formed due to inflammation and hematoma formation takes a longer time to subside, and you need not worry about it as it will gradually subside. I would suggest you to consult a physician and get evaluated for any underlying bony fractures and if it is present reduction of the fracture segments and fixation is required. In case if there is only soft tissue injury you can do alternate warm (not hot)and cold packs over the swelling. Application of thrombophob gel contain heparin sodium will help in faster dissolution of hematoma. In case of pain Tylenol or eugenic kid can be given. Hope your query is solved. If you find the answer helpful please write a positive review and click on find this answer helpful as a token of appreciation. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Six months ago I had a routine colonoscopy at age 49. The Doctor said I had an ulcer in the ilium. Biopsy was negative. This week I had a followup colonoscopy and the Doctor said more ulcers had appeared (awaiting biopsy results). What are likely causes, what is the risk of cancer? ### REPLY: Hi, dear I have gone through your question. I can understand your concern. There are many causes of multiple ulcers.  It may be due to Crohn's disease, ulcerative colitis, typhoid, tuberculosis, amoebic colitis or colorectal cancer.  Biopsy gives you exact diagnosis.  It is negative for cancer, so you should search for other cause and 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 cant breathe. Im only 15 years old and I get this a lot but not this bad. I have tried Vicks and Asthma inhaler but its not working. I read that itd be easier if I was sitting up, but thats not helping either. I have to take short gasps of air when I try to breathe. Please help me out. Thanks - Sarah Hetherington( YYYY@YYYY ) ### REPLY: HI, thanks for using  You need to speak to your parents or guardians about this concern. Difficulty breathing may be related to varied causes such as: (1)problems with the lungs such as asthma. Since you are a known asthmatic and having trouble breathing, an acute asthmatic attack should be considered first. You need to speak to someone and get assessed quickly(2)nasal obstruction due to infection, allergic rhinitis, mass in the nose, abnormal structure of the nose(3)any obstruction or abnormality along the upper airway-pharynx, larynx, trachea(4)heart disease(5)anxiety-this is only considered if the other conditions are ruled out hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is Rose,I had a hip replacement in 2003 was diagnosed  with MRSA.  Went home on IV vancomycine.  After that I was put on bactrim ds,. I live in florida am not happy with the doctors out here. I have discoloration of legs.  Could this be the MRSA starting up again? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, leg discoloration is not the sign of MRSA starting. MRSA is the methicillin resistant staphylococcus aureus. So the infection caused by the staphylococcus aureus will be same as that of MRSA.MRSA additionally has high resistant pattern to the routinely prescribed medication. But there are chance of the MRSA in future is on you. In my advice you should test yourself for the MRSA swab test from the nasal septum, umbilicus and groin. If the report state that you are carrier of the MRSA than you should take the mupirocin ointment therapy. This will clear up the MRSA from your system. And you are free from the symptoms even in the future. Along with this good hygiene keeping can help clear the infection away from the body in the future. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a very sick 4 yr old today doctor prescribed augmenten in pill form cant remember if he said has to be taken with food or just to crush it and hide it she is not hungry at all can my wife crush it and put it in chocolate milk her tummy is empty. wow you want money and my baby is very sick go fuck yourself what if this was your baby ### REPLY: Thank you for using  .no inappropriate to give a kid augmenting tablet/pill. There's a liquid/solution form of augmenting which you can give your kid. Dosage is based on the kids weight and its given usually every 12 hours for 7 days (depending on the impression of the doctor). Also, giving it with meals is better so as not to produce an upset stomach. Sincerely, Mark Rosario MD general pediatric/pediatric pulmonology ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently in the past few weeks been getting really bad stomach pains after I eat anything, I can be really hungry and eat the smallest amount and still get a pain in the stomach and need to go to the toliet, I have also had some blood in my stool . I had a carcinoid Tumor in my appendix nearly two years ago and was wondering if it has come back or is there something else it could be ### REPLY: Hi welcome to  forum.  As you describe you had bad stomach pain after eating anything, and an urge to go to stools, and there is blood in stools. There is a history of carcinoid tumor, of illogical junction.  It appears to be irritable bowel syn .  If there is no response, you have to consult a gastroenterologist for screening about the relapse of the cancer.  First you consult a physician for treatment of common causes.  I advise you to follow some diet recommendations as avoid taking more of spices, junk foods, and oily foods, to minimize the irritation to the gut.  Wishing for a quick recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, Well my mom is having chest pains when she breathes deeply in and out and she has sharp pains when she is moving in lower back area she already went to the hospital and they said they do not know so is there anything she could have. She had x-ray done, sonogram, and mri. WHy is she still having these pains while taking zofran 4mg, Zantac, and vicodin? ### REPLY: Hi, Dear,Thanks for your query to . Dear I read facts of your query and reviewed it in context to your query health issues. I understood your health concerns and feel Concerned about them. Based on the facts of your query reply is-Your Mother could be suffering from Hepatitis. As your doctors could not come to diagnosis after-USG/X-ray / MRI and gave some medicines, suggesting Acidity with inspiratory pain-thinking it to be Gastritis. I would suggest LFT tests and USG of the Liver and Kidney, to rule out -Hepatitis / Cholecystitis. Other causes like Pleurisy / Acute Colitis / Acute Gastritis/duodenitis need to be ruled out.EGD(esophagi- gastro-duodenoscopy) could be needed to confirm the cause of the chest pain while breathing. Treatment-Suggested-This would depend on the cause found. This could be done if Physician is consulted on this matter. Just don't worry till you verify with your attending doctors. Need to Check with Physician /Surgeon doctor if things don't recover.-Other causes need to be verified with your family GP doctor, as the facts may be different what you submitted.-For this Second opinion from PCP-or GP doctor and if need be with Physician / Surgeon specialist-is needed who would do proper investigation after proper physical assessment to resolve your health issues.-for early recovery-please follow above dos which would resolve your issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard. Good Day!!  . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello! Im 38 and have a hard lump that does not hurt when its touched. it is lower neck area. Its been there for awhile and at first I thought it was part of my spine. I also have been experiencing stiff back and neck problems. But nothing serious, just seems stiff when I stand up after sitting, etc. ### REPLY: Hi. Good day. You have not mentioned whether the hard lump is in anterior neck or posterior neck And whether it is in soft tissues or related to bones. A hard lump needs medical attention and a clinical examination is required. An ultrasound scan of neck if the lump is in anterior neck or related to soft tissues OR a radiograph if it is related to bones will help. If the doctor feels necessary a FNAC will distinguish benign from malignant lump. Please discuss it with your doctor. If you have any further questions I will be happy to answer. Thank you for choosing . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here... I am a 40 year old woman with high blood pressure.  I am not overweight and my height/weight is proportionate.  I am currently taking 8 mg ofPerindopril daily.  My pressure is sometimes as high as 150 over 110.  Any suggestions.  Thanks, Patt. ### REPLY: Hello, You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week.  If BP is persistently more than 140/90 MMH, then medicines need to be changed. Occasional readings above 140/90 is acceptable. If the majority of readings are above 140 then better to shift on other medicine like telmisartan Amlodipine combination 40/5 mg once a day.  Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any.  Hope this helps you and get back if you have any doubts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 have a question regarding occasional skull pain with sharp shooting pains that make me stop doing what I am doing, then it goes away as fast as it comes up. today I have had five while in the grocery store and continue to have them now that I am home. ### REPLY: There are different kinds of stabbing headaches, but the first I can think of corresponding to your description is cluster headache (HA), which is a primary HA which is rare, and happens more often in adult male smokers. Cluster HA is commonly one-sided. The HA happens in clusters every day for a number of days or even weeks. It disappears for months then, but can happen again. To abort a HA you can use oxygen 100% by mask, or trip tans (like sumatriptan) subcutaneous or ketamines intravenous. The prophylactic treatment consists of calciblockers (verapamil) more often and corticosteroids. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Respected Sir i am 28 years old guy, unmarried, my problem is that i have noticed that foreskin of my penis has turned almost white and i am suffering from notrocural emmissions at nighat after every 3 days since last 10 years kindly suggest me way out ### REPLY: HelloThanks for query. The color of your foreskin has changed to white. This is termed as Atlantis Erotica Obliterate (B.X.O)This is chronic, progressive, sclerosis inflammatory dermatitis of unclear etiology. And may lead to Mitosis (Lightning of Foreskin). Please consult qualified Urologist or General surgeon for clinical examination and to confirm the diagnosis. You need to get circumcised under local anesthesia. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 31 female, height 5 ft 2 inch , weight 71 kgs, recently I have started feeling very mild chest pain that occurs 3 to 4 times per day which lasts for few seconds. If I run or jump for around 10 mins, I feel tired and have a bit of problem in breathing. Then I have to take rest for few minutes. Do I have a severe heart problem? ### REPLY: Hi thanks for contacting ... You are feeling dyspneic on slight exertion. So cardiac cause has to be ruled out .... Investigate yourself by physician or pulmonologist for .....-physical examination -auscultation -blood pressure measurement -Tread mill test -echo -CBC If no cardiac cause present and auscultation reveal CREPS or any abnormality chest x-ray and spirometry done for rule out respiratory causes.... According to cause treatment given ... 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 WAS DIAGNOSED WITH RESTLESS LEG SYNDROME ABAUT 10 YRS BACK, IM 45 , AND ABAUT 5 YRS AGO I WAS RX,ED TRAMADOL 50 FOR PAIN AND FOR RLS, BUT THE DOSE KEPT INCREASING, UNTIL I WAS UP TO 600 MG EVERY 4 HRS, I HAVE BEEN RX,ED SUBUTEX TO STOP TAKING TRAMADOL AND I STOPPED TAKING TRAMADOL COMPLETLY 1 1/2 MOS AGO, AND 6 DAYS AGO I RAN OUT OF SUBUTEX, NOW I HAVENT BEEN ABLE TO SLEEP KICKING, ANXIETY, I FEEL SOOO WEAK, TIRED, CAN,T EAT, ANXIOUS, AND JUST BLAH, WHAT DO I DO, ASK FOR MORE SUBUTEX, OR START TRAMADOL AGAIN, OR GET A DRIRENT MED FOR THE RESTLESS LEG SYNDROME, HELP PLEASE, IM NOT GOING TO LAST TO LONG AT THIS RATE. THANK YOU, IM A 45 YR OLD HEALTHY OTHERWISE WOMAN. ### REPLY: Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As you are having restless leg syn .  Also, the symptoms are totally sensory disturbance in the nerve root at the lumbar spinal region and then the course of the nerve. As along with medication there is a need of some physical exercise to stabilize the lumbar spine and make it strong to avoid any nerve root compression. Also, performing Breathing exercises and meditation will help improve the metabolism of the cells. In my clinical practice I recommend my patients physical therapy, breathing exercises and meditation and the majority of them are able to control their symptoms. RegardsJay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 8 year old grandson seems to wet his pants slightly right when he gets up in the morning. His bed is never wet so I know he is not wetting it at night or in bed. He is not circumcised if that matters. He has a strong urine. He has done this since totally potty trained at age 5. ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. The 8-year young person could be wetting his pants when he gets up in the morning just because there is too much urine in store. Naturally, child .  This could be overcome by a simple step. Wake the child up at around midnight for urination. Also counsel the child about the behavior he is having. The problem should be settled in a day. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, i am 29 y old,i was recently diagonsed with h. pylori via blood invstigation and the result is positive ,i was treated with triple therpay for one week only after one week doctor give me lorsec PPI the last week  I finished them now the pain feels like it is coming back - does that mean i still have the infection? when should i re-check the H.pylori test? shoul i wait for time if the pain will go or i should take another triple therpay dose. ### REPLY: WELCOME TO , The available regimen for h.pylori eradication are1) omeprazole, amoxicillin, and azithromycin for 10 days;2) bismuth salicylate, metronidazole, and tetracycline for 14 days; and3) lansoprazole, amoxicillin, and azithromycin which has been approved for either 10 days or 14 days of treatment. NOW FAILURE RATE ARE SIMILAR FOR EACH REGIMEN AND DEPENDS ON AN INDIVIDUAL.BUT I WOULD SUGGEST YOU TO DO UREA BREATH TEST AFTER 4-12WEEKS FOR ERADICATION AND REPEAT ANOTHER REGIMEN IF H. PYLORI ARE STILL PRESENT I PERSONALLY BELIEVE 2ND AND 1ST REGIMEN ARE BETTER BUT WAIT TO SEE YOUR RESULTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 trying to stop snorting pain pills. i snort hydrocodone and some times percocets. i usually average around 4-5 5mg vicodin a day and i have been snorting for a while now and before i would try to stop and i always would constantly sneeze so i would do snort again to make it stop. well with-in the last month i have noticed if i go longer than 4 hours with out anything up my nose my face hurts to touch and i have pain in my jaw so bad. i had all of my teeth extracted about 2 years ago so i have dentures and my pain gets so bad i have to take them out cuz it seems to irritate it more. i am ready to stop NOW!!!! please is there anything over the counter that will ease the pain so i can stop. i have tries to ween my self off but the pain just comes back sooner. i have tried saline , bacitracin, triple antibiotic cream, carmex,medicated camphor & phenol blend cold sore treatment and even baby orajel! please tell me there is something over the counter i can buy that will ease the pain so i can stop like right now? ### REPLY: Hi welcome to  forum.  Thanks for writing to . Forum.  You are suffering witChatDoctormon cold, snoring, and pains around the nose. All these collectively called sinusitis, it is secondary to the common cold may be allergic, viral, or eosinophilic related, or may be due to deviated nasal septum.  With over the counter medicines you won't get the complete relief, without a proper diagnosis.  I advise you to consult an E.N.T. Surgeon, for diagnosis and treatment. You may need to have M.R.I. besides other routine tests for confirmation. Except D.N.S. others can be treated with medicines, and D.N.S. requires operation.  Wishing you a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son had a large patch of ringworm on back of his scalp. Lost his hair, took a whole bottle of oral meds to clear it. Seemed to be doing ok. Hair grew back. Now, same area, there s a patch of hard bumps. Some red, some pussi. Could it have not cleared up completely? ### REPLY: Hello, Welcome to , I understand your concern regarding your skin problem and I hope I am able to help you in the same. Your child seems to have developed Tina wapitis which is a fungal infection of the hair which occurs mostly in young child . The most important part of its treatment is the intake of oral antifungals which your child will start taking in few days. For the associated pain, you can give a simple painkiller like paracetamol in the right dose which is determined by her weight. Maintain proper hygiene of the surrounding hair also. Avoid use of hair oil. Wash the hair properly. This problem might take at least three to six weeks to completely heal. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is turning 16 soon.She had a very severe bout of insomnia 3 years ago, lasting approximately 3 months. During this time she missed school, became extremely anxious, and suffered intense vertigo. A sleep study showed abnormal brain-waves during what limited sleep she got (every few minutes right after falling asleep her brain would turn back on and awaken her. She is now having difficulty sleeping again. Each night she gets to sleep later and later. This fuels her anxiety and it is like a never-ending pattern: she stresses about not being able to sleep, then she CAN T sleep and she stresses more! For the past few nights she has had full-blown anxiety attacks in the evening: rapid breathing, feeling as though she is going to die, and crying uncontrollably for up to 2 hours! Her anxiety is definitely related to her insomnia, and vice-versa. Any suggestions so that she can get some regular sleep and hopefully slow down these crying bouts? ### REPLY: Degree understand your concerns went through your details. I can understand. Her anxiety is purely due to her insomnia and vice versa. During those three months and even now, she must be taking pills for sleeping and possibly those pills are not working because of her brain wave pattern. Doctors must have analyzed her brain too to determine any other possibilities. I suppose there no other possibilities or brain or neurological causes. In that case, she should be given counseling to educate herself about insomnia and related anxiety. If you become anxious and stressed, it is natural you don't get sleep. Sleep depends on physical activities, exercise, mental physical fatigue, stress and anxiety. In my opinion she should get enough exercises, and meditation to relieve mental stress and physical rejuvenation. She should be educated about this and counseling given. Please approach a psychologist as soon as possible. If you are interested, I may take up this case online. Take care. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i m 22 ,me nd my partner hd protected sex fr 2 days continously on 13 nd 14th sept....i guess 9 tyms ..aug 23rd i hd ma period....i usually hve 26 or 27 days cycle....nw its already sept 23....i didnt get ma period...any chances of pergnancy...? Pls help ### REPLY: Hello dairy understand your concerned you are sure about the protected sex then pregnancy is not possible. In protected sex, sperm can not enter in to the vagina, so no fertilization will occur. To become pregnant, unprotected penetrative sexual intercourse in the unsafe period of cycle is required. Pregnancy depends on also which method of contraception you have used. Each contraception has some failure rate. So I would suggest to wait for the period to come. If period will not come in next 7-8 days then go for urine pregnancy test to confirm the pregnancy. Period can be delayed by hormonal imbalance, change in lifestyle and dietary habit.Meanwhile, avoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 age 19 has a lump under her armpit. She was put on anitbiotice for a week and nothing happened to the lump. Now they are saying she needs an ultrasound. Where do I go to get this done? What could this be? She said in the last month it has started to get sore. ### REPLY: Hi, Dear,Good afternoon. Thanks for the query to my  online-clinic. I studied your query in-depth. I can understand your concerns.-In my opinion this sore lump, is -armpit-Boil/ fur uncle with cystic contents-pus.-Advise-I would advise you to Consult a-ER surgeon and there is no need of Ultra Sound. Er Surgeon-who would treat it rightly by I & D-proper Incision and . -Alert-A review with ER-Surgeon for the steps to be taken with his advice is a must and urgently advisable in your case.-Hope this would resolve your worry-some query. Wellcome again to . Have a good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in my right upper back in between my neck and shoulder. moving my head results in sharp stabbing pain but without movement it aches. I have taken tramadol and a mild muscle relaxer but it has not helped. Should I seek medical care or wait it out? Thank you. ### REPLY: Hi there, thanks for your question at . I would suggest you to give rest to your back, use Ice application and continue the pain medicines. It usually takes 3 to 4 days for these to work. If at the end of a week, if pain is increases or is still the same, or you have new pattern of pain or your daily routine is severely affected you should meet your physician. Hope this helps. All the best. Regards.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI doctor, my son is months old and he developed brown tongue when he was one month old. It got cleared Amoxicillin but now is back again.He was 6 weeks early 4 pounds and 12 oz but now he is over 17 pounds and he looks pretty happy and normal baby. I am afraid that he might have some kind of metabolic disorder ? ### REPLY: Hello, I can understand your concern. As your son is otherwise healthy and not showing any signs of disease or discomfort, it does not seem that he is suffering from any pathology regarding the tongue. Do you clean his tongue with a thin, cotton cloth while bathing? It is necessary to clean the tongue of newborns or small kids in order to keep it free of debris and bacteria along with coating on the tongue. In addition, some food item that you might be giving him can cause the tongue to turn brown. I do not advise giving a course of antibiotic again unless it, I am not removed by proper cleaning. If he had infection, he might be presenting with fever, malaise etc. that may have needed antibiotics to clear the infection. If cleaning and changing diet does not help, you should see a periodontist (dentist who specializes in treating oral cavity problems of kids) to ascertain the cause of the problem and staring treatment. I hope this information helps. Thank you for choosing . Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has a warm sensation when peeing and now says that his penis feels hot. Went to urgent care that said the sugar in his urine was high especially since he had eaten 4 hours earlier. Confident no STD, but not given any ideas. I know he is in significant discomfort. ### REPLY: Hi, Discomfort and warm sensation in the penis may suggestive of urinary tract infection and the possibility of mild ulcers in the tip of the penis.  Since sugar in urine may indicate diabetes. Kindly work it out for diabetes. In a diabetic patient, urinary tract infection and penile ulceration and pain are the commonest symptoms. Hope I have answered your query. Let me know if I can assist you further. ### END