Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 neck fusion 3weeks ago and in a hard cervical collar. 4 days ago started with pain in the middle of his shoulder blades while trying to sit up or stand. While lying on his back it is ok. Also feels like his shoulder needs to crack. Can move arms fine while lying down but can t while standing or sitting up ### REPLY: Hello, I have studied your case and I think that it can be due to muscle spasm in neck. Cervical cooler does not allow neck movement and that can also cause such pain. Sometimes there can be infection and that can also cause such pain. I would suggest you to take Moral or MySpace twice daily to take care of this. I hope his suture is already removed. If there is any wound problem or discharge then it suggests infection. In such cases you need to discuss with your doctor. I hope this answer will be useful 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: Hi, my mother is diabeti and has hpertension, she is taking tablets on a daily basis and she started coughing after she was diagonised with these chronic diseases and has ben coughing ery hard ever since. What type of cough syrups can help her please advise ### REPLY: Thanks for your question on . I can understand your concern. Chronic cough in diabetic patients is mostly due to lung infection (pneumonia or tuberculosis) and bronchitis. So better to take her to pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). Chest x-ray is needed to rule out lung infection. Put is must for the diagnosis of bronchitis. She may need antibiotics, inhaled bronchodilators and other supportive treatment. Don't start treatment without diagnosis. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. 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, So I had follow up mri for surgery consult. Not looking good. Its now showing mostly increases, and with disc protrusions at c4-5, c6-7 abutting the ventral cord. What does this mean? Also saying a lot of minimal effacing the ventral thecal sac on the levels. Guessing the surgery is the best bet in hope of getting some relief. ### REPLY: Hi, Thanks for writing in. The cervical spine is made up of 7 small bones aligned on top of each other. There are spongy discs between these small bones which give it a cushioning effect and help in forward backward and turning movements. The discs at two levels are protruding backwards and touching the covering of the spinal cord at C 4 - C 5 and C 6 - C 7 levels causing pinching of nerves. This is causing mild narrowing of the spinal canal also. This pressure needs to be released by doing surgery on the discs as recommended by your doctors. You must be having an advanced condition requiring surgical treatment. Many people get relief after surgery. 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: I have a lot of mucus in my throat..sticky and hard to breathe sometimes in the night..doc say my lungs are clear.. I heard wizzling sound when sleep, doc says its sinus problem.. I also went for xray..I have swollen glands. does this affect? Tks Catherine ### REPLY: Thanks for your question on . I can understand your situation and problem. Yes, swollen glands can cause breathing difficulty especially in night. In night, due to supine position, glands will narrow the upper airways, and thus you can have breathing problem and thick mucus. But in your case, we should rule out bronchitis also. Because bronchitis can cause wheezing, breathing difficulty and thick mucus production. So get done PFT (Pulmonary Function Test) to rule out bronchitis. If PFT is normal then no need to worry. Your symptoms are due to swollen glands only. You may need antibiotics, anti histamine and anti-inflammatory .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2years old boy has a small painless lump on his leg and hand, the one on the hand has flatten itself but the mark is still there.(kind of like a circle that looks like ringworm but it is not a ringworm) The lumps are small and my son looks health. We ve been to the GP, where refer to a skin specialist. The appointment is still very far. I am very worried ### REPLY: Hi. Thanks for your query. Noted the history of small painless lumps on the hand and foot of your child. The one on the hand is flattened. But the mark is still there, have been to GP who refers to Skin Specialist. I think these must be sebaceous cysts, although uncommon can occur. I would advise you the following:Get high resolution ultrasonography so that the exact nature of the lumps can be known. Since these are not the normal parts of the body insist on removal for the reasons of getting rid of the lumps as well as to get the histopathological diagnosis to make sure what these are. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 17 month old baby boy has been having loose motions for the last 4 days about 3-5 times. The stool smell like rotten egges and his buttox is red and sore from all the loose motion. I have checked for any signs of new teetChatDoctoring but there is no indication. He does not have a fever, nor a cold and has ot lost his appetite. Should I take him to the doctor? ### REPLY: Hello, It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better.  Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 take 50mg tramadol hcl pain pills for severe lower back pain. I take 2 pills 4 times a day for about 2 years. they are not working anymore. they did at one time. do they have stronger strengths available and/or something else that is stronger that I can talk to my doctor about. please help. John Krassnodemski ### REPLY: Thank you for the question. Two years is a long time to be on continuous medication, instead, I would suggest you get MRI of spine and supportive tests after consultation with a spine specialist to know the cause and go for radical treatment if some pathology is detected. Alternatiely try to seek a help from physical therapist for measureslike diathermy, massage, exercises. Avoid bending and lifting objects. There is an ayurvedic oil for massage of lower back by the name of Kate Bast which is applied for 30 minutes after warming it up. It gives a good symptomatic relief ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Goodnight I had intercourse last night, A hour later i was waken up by a bad stomach pain in my lower abdomen . I when to the bathroom to pass urine and it was pain full as it cam out. It has been about 6days since my boyfriend and i had sex so i dont know if this could have caused it. I still have to discomfort in the abdomen now and if i sit down to hard i feel it. Do you have any idea what it can be? ### REPLY: Hello! Thank you for the query. Such symptoms are most likely caused by urinary tract infection. Intercourse can trigger such infection. Frequent urinating, burning while urinating and lower abdominal pain sometimes radiating to the back are characteristic for these conditions. I suggest you to have urinalysis, blood work and abdominal ultrasound performed. Antibiotic seems necessary. You should also .  Hot baths should ease the pain. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I CAN HARDLY WALK AND MY LEFT LEG IS HEAVY. WHAT type of MRI SHOULD I HAVE? mY NEUROLOGIST ORDERED CERVICAL SPINE . IT HAS NOTHING TO DO WITH MY ARMS OR HANDS. IS THERE ANY INJECTION TO RELIEVE THE INFLAMMATION ,mY LEGS ARE KIND OF SWOLLEN. WHAT SHOULD I DO DOCTOR? ### REPLY: You can do cervical spine MRI with screening of whole spine.  If there is only lower limb involvement and symptoms of tingling lumbar spine MRI may be helpful, but anyway do whole spine screening with either MRI. Neurologist will have always looked at cervical spine first. But tell them you also want to get screening of whole spine also.  I also suggest vascular color Doppler of your leg to room out any vascular pathology(narrowing of arteries) like vascular claudication. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell off of an elevated (. 2 steps up) toilet, not kidding last Sunday night at 11:30. The toilet seat broke off and I hit every step . Landed very hard on my head. My head has three spots that hurt, my hip is black and blue and I have my first black eye (I am70 yrs old).head hurts. Should I see my doctor? I work and don t have time to waste, but I m worried cause my head hurts. ### REPLY: It's better to get medicines so that long term. Internal clotting doesn't take place. Without clinical assessment it's not advisable to comment. However, concussions and bruises will go with anti-inflammatory and analgesics, but main thing is to ensure no clotting takes place following head injury. In India, we advise patients to start taking Turmeric powder 1/2 to 1 tsp in warm milk or water immediately for few days. It's a wonderful first aid, anti-inflammatory and analgesic and bacteriostatic without the toxic effect of synthetic .  No side effects. Hope you understand and it helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a 54 year young lady and in 2002 I was diagnosed with invasive squamous cell carcinoma in my righr sinus cavity. After my face was layed open and tumor removed then went through 29 radiation treatments, and all has been great until a few weeks ago I have started having simular symptons and I waterpick sinus cavity now at least 3-4 times a week. Any suggestions? Thanks,Robbin ### REPLY: Hi, Thanks for writing in. Squamous cell cancer of the sinus cavity might become recurrent in some people. It is important that you follow up with your doctor and then get evaluated for possible recurrence. Medical literature says that squamous cell cancers have definite metastatic potential, and patients should be followed regularly after initial treatment. Overall, local recurrence rates after treatment of primary cancer ranged from about 3% to 23%, depending upon anatomic site. About 58% of local recurrences manifest within 1 year, 83% within 3 years, and 95% within 5 years. Please consult your doctor at the earliest and take treatment should there be any recurrence. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. i have pain on the right side of my head. it has been there for 8 months. at first i thought it was tmj. then i thought it was myofascial pain. i had dental work, too. deep inside i wonder if it s an infection. now it feels like the left side of my oral pharynx is swollen, but this is recent. sometimes the pain goes into the head or neck. 2 factors about me: i have a bone cyst at the back of my head which increases and decreases in size. also, i am one of those people who occcasionally gets food stuck in her eustachian tube. dentists and ddrs. find nothing. what doyou think? ### REPLY: Hi, Thank you for posting your query.First, I would like to reassure you that there is no need to worry about your symptoms, as they do not suggest any serious illness. Clinical examination, as well as ENT and dental surgeon have not found anything. This is good news. The bone cyst at the back of head would not lead to pain on the right side of head. The most likely cause of your headache could be migraine or muscle tension headache. Please consult a neurologist for confirmation of diagnosis and initiation of treatment. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dx colon CA met to liver Sep 2008, Colon resection Oct 2008, Folfiri Jan 2009-2012, Folfox 2012 6mo did not work, Cetuximab/Irinotecan Feb 2013- Jul 2013.  1st 3 mo of cetuximab/Irin was amazingly effective. Metastases and liver lesions under control with little or no activity on PET until 2nd 3mo of cetuximab. Now new multiple lesions in liver, paraortic and carinii nodes reflared, and new small lesions on pancreas, omentum fat and peritoneum.My current onc has no more alternatives for me except for a phase 1 trial for one specific genome that may be sensitive to tx. Trial is in Dallas.  Id like a second opinion to see if a more aggressive proven tx is available. 61yrs, no pain, otherwise good health and activity. Never mind, I already know the answer. A 2nd opinion from a reliable doc is always helpful to make the right decision. ### REPLY: Your case is a stage 4 ca colon, as u taken first line of chemotherapy with two types of regime. Now recurrence of liver lesions and metastasis indicates as the rituximab/ irinotectan what you are receiving is either not acting or already it's your advanced stage. As the oncologist suggest going for new treatment is one of the best option and only hope for the your disease. Hope u get well soon and also involving in trials help in research activity of malignancies ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I kicked a stationary object yesterday and the top of my foot has been hurting ever since..it hurts to walk without any shoes on but when I put a shoe on it feels a bit better.. There isn t a ton of swelling, although there is some and there is little bruising. It hurts to point my toes up and down in about the middle of my foot..any suggestions as to what I should do? ### REPLY: Hi, Apply cold pack over the injured part (as up to 48 hours cold pack is helpful in reducing pain and swelling). Use crêpe bandage over ankle, take relative rest (walk only if necessary). Sit with knees straight with a pillow under your ankle to knees to decrease swelling. You can also apply any pain relieving spray/gel. Wait for 2 to 3 days, your pain should subside by then. If you still experience pain, do visit an orthopedic as you may require medical assistance. Avoid climbing stairs and take rest. Hope you find the answer useful. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr. This is with regards to the pregnancy test. Me and my husband are trying for a baby. I have missed my periods in this month. My menstrual cycle is of 26 days. i had got my menses on 23rd, 19th, 15th in last 3 months. Hence i was expecting on 11th in this month. However i have missed it. To day i did a home pregnancy test by using velocit. It says 2pink lines means a positive result. I could see 1 dark line on C and 1 faint line on T. How do i confirm whether its a positive test or no. Just to inform you that, my menstrual cycle is regular and have never missed my periods before. Should I do the blood test or wait for another 3-4 days and do home test again? Please suggest. ### REPLY: Hello dear, I understand your concern. In my opinion I suggest you to repeat the test after a week. Usually the urine pregnancy test gives accurate results a week after missed period. The faint line is seen when the test is done too early or any abnormal pregnancy. So relax. Nothing to worry. Take healthy nutritional diet and prenatal. Mostly the faint line night be due early testing. Consider repeating it. 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 14 year old daughter has pelvic/abdominal pain for over a week . She weighs 115 lbs. She was in the ER last Wed and ruled out appendicitis. Liver enzymes were normal. I think she needs an US done. No vomiting or fever. pain on both sides, stabbing pain. intermittently.thanks ### REPLY: Hello! Thank you for the query. Abdominal pain is very nonspecific symptom. It may be present with all possible abdominal issues. Fever usually indicates an inflammation, however lack of it does not rule an inflammation. Lower abdominal pain on both sides can be caused by urinary tract infection as in such location bladder is present. If so, your daughter may have frequent urinating, burning while urinating, back pain. Other possible reasons of her pain are ovarian issues (like a cyst or inflammation), uterine issues. I suggest you to have some more tests. Urinalysis, abdominal ultrasound and gynecologist consult should be done. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 45 year old female. Generally healthy, but have suffered from bilateral reocurring kidney stones for several years. Slightly anemic. Was tired most of the weekend, woke up this morning with sore throat , runny nose, plugged up ears, sneezing and oddly - swollen gums specifically on around bottom four front teeth. Feeling progressively worse through the day. No sores in mouth and gums were fine last night. No fever. Had a flu shot a week ago. Had teeth cleaned about 4 weeks ago and had no issues with them. ### REPLY: Hello, a delayed reaction to the flu shot is a possibility although unlikely, but you are definitely having release of histamine with the sore throat, runny nose, plugged ears and angioedema (swelling) affecting the mouth. Delayed reaction to mouth washes at the dentist is more unlikely. A skin prick or specific IGE blood test would elucidate if you have any allergies particularly dust mite. Stopping smoking is a priority (if you do) for several reasons. Antihistamines such as cetirizine should suffice (taken one daily for 7 days). If you are on any blood pressure pills, do get these checked as ACE-i . Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have a question for my mom. she is 55 and has had several "attacks" over the last 3 years of migraines, shortness of breath, chest pain, and nausau. first few times they passed, the last time she went to ER and they rain a full panel: ekg, cardiac enzymesand CATscan etc....all normal. said if she had them again to come back......  she was fine for a few weeks now its happening again. the migraines are to the pt of 10/10 pain and dibilitating, severe nausea and chest pain. she was scheduled for a stress test (they dont think it will show anything but more to "check that box and cover their bases"), but it was rescheduled due to her having another "attack." .....thoughts? ### REPLY: Hi thanks for contacting ... Noted your mother having repeated migraine attack.... Here chest pain might be associated with migraine as stress can aggravate her condition.... Yes stress test can be done.... Your ECG was normal so no cardiac cause present.... Stress induce panic attack can lead migraine and chest pain.... So avoid stress.... Avoid precipitating factors for headache like.....-hypoglycemia-skipped meal-dehy . ..... For migraine sumatriptan can be helpful. 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 did a round off yesterday and when I put my arm down to start the round off, I landed on it weird. now whenever I straighten my fingers out, my forearm hurts. It hurts when I don t do that too. When it first happened, it felt a little numb and stung a little. What could be wrong with it? ### REPLY: Hi, I have studied your case with diligence Do ice application, and thrombhophobe ointment may help and give rest to forearm/ elbow. You can apply crêpe bandage for support. You may need X-ray of forearm/elbow to rule out any minor fracture. You can consult your doctor by taking appointment. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my doctors think i may have a kidney infection having my test today but after going to the toilet i noticed deep purple blood with hint of brown stringy discharge came out my period is also due in 2 days it has never been that colour should i be worried or what could it mean my white cells are up 14.9 and i did have obviously traces of blood in my urine. ### REPLY: HelloThanks for writing to  Probably you are suffering from urinary tract infection. You need proper clinical examination and investigations. Investigations include routine hologram, RBS,urine RE/ME and culture sensitivity and ultrasound of abdomen. Hematuria may be due to UTI. Hematuria can also be due to renal or urinary bladder calculus, tumour in kidney or urinary bladder etc. Your W.B.C is also increased, this indicates towards infective etiology need proper antibiotics, alkalizing syrups and paracetamol if fever. 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: After experiencing post menapausal bleeding, it was recommended that I have a hysteroscopy and uterine biopsy. However the doctor was unable to insert the scope past the cervix. He also tried to do a biopsy, but that came back as not enough tissue to determine if cancer is present. Is it a sign of cancer that he was not able to get into my uterus? ### REPLY: Thanks for your question on . In postmenopausal women due to hormonal imbalance, uterus, cervix and vagina tend to show atrophy and .  So due to this reason, doctor was not able to pass scope. But we can not deny possibility of malignancy at the same time. So detailed evaluation is needed. I advise you to get done CT scan of lower abdomen to rule out uterine cancer. Also get done multiple biopsies from cervix. This will give more yield than single biopsy. So discuss these things with your gynecologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, How long does it take for Cipralex to be fully eliminated from the body, once an individual stops taking it? I am concerned about possible effects the drug could cause when I decide to become pregnant in the next five years or so. Thank you! ### REPLY: Hello, Circle (Escitalopram) is a selective serotonin reuptake inhibitor commonly prescribed in the treatment of major depression, obsessive-compulsive disorder, generalized anxiety, and other conditions. The elimination half-life of Circle is about 27-33 hours and is consistent with once-daily administration, it may take up to four weeks to be fully eliminated from the body. Since you have decided to conceive in the next five years or so, Circle is not going to cause any harmful effects during your pregnancy. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I am 54 years old, 1.77metres tall and weigh 77kg. I have not really had any health problems except for light blood pressure (10mg Linisopril / day and use Symbicort inhaler - preventative - have not had serious asthma for 12 years). I have had pain on my RHS for about a month, just under the rib cage extending down to lower abdomen. Constant dull ache with occasional stabbing sensation. When I sit in a slight slouching position, the pain feels worse, as though there is a ball or something in there, or a pulled muscle. This morning, a bruise just appeared a hand s width from my navel (RHS). Should I see a doctor? Thanks Allan ### REPLY: Hello, Your symptoms can be related to many medical conditions. One of the possible cause can be a pulled muscle. Another possible cause can be gastritis which is an inflammation of the lining of the stomach. I suggest using Acetaminophen to relieve the symptoms three times a day. I also suggest using a Castro protector such as Omeprazole 20 mg daily. 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 Doctor.. Im having fever since 1mnth..when i hav tablets It reduces and after 3days of tablets course again i get fever.. 3weeks before culture test was doneand iIt was diagnosed as typhoid.. Doctor gave me ciprobid for 7 days..i thot im cured Bt after 3 days of completing tablets gt fever again ... Temperature was nt tat high as before Bt had slight fever.. I was advised to take same tablet for anthr 7days...Its 6th day today still i feel slight body heat at nit..should i do a test again? ### REPLY: HIT hanks for posting your query to .  Ok we have the diagnosis as Typhoid fever but the treatment given to you is not working and hence you require a different antibiotic for the cure.  In my practice I prescribe Tablet Definite+ ofloxacin for Typhoid, and it has shown a good response. I advise you consult your doctor again and ask for the prescription for the same. Hope you find this information useful. Any clarifications or Queries feel free to ask. Happy to help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ,I never had Asthma earlier , now I was diagnosed with Seasonal Asthma...Since two weeks, I am feeling breathlessness and cough..I am prescribed with Doxolin 400 ( twice daily) and Monticope ( once daily, before sleeping) and Brozedex syrup, thrice daily. I started one day ago and I am feeling dizziness and excessive yawning..should I talk to my doctor? ### REPLY: Hi, Here,your breathlessness and cough could be due to acute bronchitis for which you are taking domain, monticope and syrup brozedexx are good, but you may also need antibiotics (quinolones or accolades or cephalosporins or amoxicillin with clavulanic acid). Seasonal Asthma is itself an allergic disease due to cold or dust or pollen or grass etc. irrespective of the triggering factor. You can go for pulmonary function tests if not done. Treatment is mainly symptomatic which might require inhalation . To decrease the inflammation of bronchi and bronchioles, you might be given oral antihistamines with mast cell stabilizers(montelukast) and steroids (prednisolone) with nebulization and frequently steam inhalation. The best way to cure any allergy is a complete avoidance of allergen or triggering factor. Consult your pulmonologist for further advise. 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 doctor my brother is 10 year old and he is suffering from fever from last 8 days and today in diagonosis he is suffered from typhoid.  medicines are (XCEF 100DT  AND AZITHROMYCIN)IS IT OK AND WHAT PRECAUTIONS AND DIET SHOULD BE GIVEN TO HIM FOR A SPEEDY RECOVERY? ### REPLY: Hi welcome to the  I appreciate your concern for using this site to solve problems.... For typhoid continue prescribed medicine and complete the course of antibiotic.... Follow below helpful suggestions.... -take rest -fluid given more -small meal taken with frequent interval -fruit juice more -personal hygiene maintained with frequent handwashing -Avoid fried foods and fried non veg for few days -potato, boiled chicken etc. can be given If after two weeks no improvement than further work up will be decided Take care Hope your concern solved Consult physician for examination and further discussion about typhoid ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 check-up resulted in the prognosis.... Multiple prior studies,most recent 10/11/2013....Findings...A Linear density is seen in the the right mid-lung which was not previously apparent.The lungs are withoutout other abnormal density The heart and pulmonary vascularity are normal. ### REPLY: Thanks for your question on . In my opinion you should first consult pulmonologist and get done CT THORAX to rule out plate atelectasis. This is segmental partial collapse of lung mostly due to retained secretions in the lumen. So small segments can cause partial collapse and produce linear(plate) atelectasis.  And this can be seen as linear density on chest x-ray. So CT THORAX is must rule out this. Treatment for this is chest physiotherapy and antibiotics.  With proper treatment, it is reversible condition. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 34 year old male with DVT  on warfarin 5 mg since last 15  months. Have a dry cough since last 8 months which the ENT ruled out as allergies.Visit to a GP and a blood test later I found ,HB 10.5, iron deficiency anaemia.Pulse rate high 100 resting. Breathlessness after exertion especially stairs.bp 130/80. Echo normal no PE, NO VEGETATION.please advice next course of action for sinus tachycardia. ### REPLY: Hello, As you have mentioned you have DVT and you are on warfarin you have not mentioned your PT and INR Test. Whether PT and INR is being done to monitor dose of warfarin or not. Your sinus tachycardia may be due to anemia. What is the cause of anemia. Your other symptoms also may be due to anemia. Get your PT and INR done as if it is raised it may cause bleeding and anemia. Consult your GP and get your anemia corrected. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 22 yo female, no mouth pain, diagnosed w/ periodontal disease 2 days ago.  Appt set up for deep cleaning in 2 weeks, however, now in severe pain, swollen gums feel like they are on fire.....is this from the Dentist poking the tender gums, or infection?  Of course it the weekend and they are closed... ### REPLY: Hello:) Welcome to . You can take antibiotic Doxy-1 for a week course. This pain is not from the dentist poking, but it is due to the infection. You should not have milk along with this antibiotic and make sure you are not known allergic to this. You can also take a painkiller like Idol plus thrice daily for 3 days. Do warm salt water gargle thrice daily. DO NOT hesitate to brush even if your gum bleeds. Use a soft tooth brush. 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: Ive been having pain in the area around my tailbone for about 4 months now and its been getting progressively worse. I went to the doctor and she did an external exam and didnt feel any masses or cysts, so she sent me for an xray whicChatDoctore back negative for any fractures. The pain has been spreading upwards into my lower back and also into my right buttock, and it hurts to sit at certain angles and is excrutiating when I first stand up after sitting for long periods of time. Also, I fell down a set of stairs in November of last year and hurt my back and tailbone, but the pain subsided. Ive benn having recurring back pain ever since, but my tailbone only started hurting a few months ago. Any suggestions? ### REPLY: Hello, I have studied your case. Buttock pain can sacral in origin which is in midline of buttock at end of tail bone. Do you have pain on tail bone? Another possibility of spinal nerve compression. Due to compression of spinal nerve root there can be pain in your buttocks will advise you to do MRI spinor these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My name is Satina B. I am 26 years old and 30 weeks pregnant with our third child. I have recently discovered a quarter sized lump ball inside the right side of my neck. It is accompanied by an uncomfortable numb like feeling that is very constant especially when thought of. I am also having terrible sniffles, sneezing, runny nose, sore throat and irritability like fatigue. Im not sure what this could be but I do know it has gotten bigger since yesterday and more apparent. I feel apprehensive of the results due to my pregnancy and am hoping that there can be promising results to take care of this after the baby is born if life threatening. Hopefully it is something minor that is able to be resolved before the baby gets here. Only concern is that I usually go into labor fairly early, my first pregnancy he came at 37 weeks and my second pregnancy he came at 36 weeks. So hopefully within this time frame I can do something about it. ### REPLY: Hello, thanks for the query to . C. Here I want to make very clear that you need not fear about this swelling. You are a patient of asthmatic allergic bronchitis, that's why there are sneezing, runny nose, redness in the eyes. Actually all these problems are due to allergy. As far concerned about the swelling it is not serious, but you have to keep in mind that this swelling may be due to some infection (any type, we call this a lymphadenitis i.e. enlargement of lymph nodes in the neck. Please consult a physician and get a blood sample, ti will reveal the cause and after this, if you need arises you can take treatment in spite of pregnancy. Have a good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I took my nuvaring out and got my period as normal then me and my boyfriend had questionable unprotected intercourse a few days after ending that period but he knows he didn t finish inside me and thinks I m overreacting but I haven t gotten my period in over a month since last time I had it. My periods were slightly irregular before starting nuvaring. The past three weeks Iv had breast tenderness, slight cramps, tinniest bit of spotting, back pain, acne, and irritability basically pregnancy symptoms .. Is that normal coming off nuvaring? ### REPLY: Hi Hope this message finds u in good health. I have gone through your msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body, though there may be other reasons as reclothing to worry about, You should eventually get back to normal. Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsened back to me for any FOLLOW-UP QUERIES anytime. . .(MBBS, MS,MCH) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor i am satish age 25(male). i am suffering from cough from last four month. initially it happens in night more in the early morning(3 am to 5am). i had taken some antibiotic prescribrd by doctor. earlier it hapeens one or two in a week. till now i have been taken a lots of antibiotic now this time it diagnose as allergy and doctor(Dr. v.k goyal,delhi) firstly prescribed me medicine as ocad-d,montek-lc,nosivion,and duanose nosal spray for one week. not a single cougChatDoctore during this period after one week doctor prescribed me to take montek-lc not oftenly ,once nosal spray in night, but my problem increases as before what should i do. can i regularize previous one if yes then how long ? can allergy be cure? when cougChatDoctore then very badly i start to cough. that situation can t be handle. plz help and if possible then suggest me about any good doctor in delhi or gurgaon........satishkarankapoor@gmail.com ### REPLY: Welcome to  Allergic cough can also be caused by certain parasites. You need to get a blood test to rule out Ascariasis. You need to keep yourself protected from smoke, cold weather, dust, pollution, Use handkerchief in such situations and keep warm with warm clothes. Do steam inhalation for relief. Continue with the medication as they will prevent further attacks. There is no cure, but significant improvement will be there. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has been suffering with back pain for about two weeks that has been moving around, It t started under his left clavicle, then moved to the left lower back, then to the right lower back and back up under the right clavicle,. Next it moved to he left side of his neck which was swollen and tender to the touch and has now settled in his left shoulder. It is staying in the shoulder and almost constant pain that he rates at a 10 most of the time. The initial pain started when he was throwing drywall from a cart into a Dumpster. Hes been to ER twice and saw another doctor at MED Express. They all seem to think it is muscular.. The dr this morning at ER thought mayber it is the shoulder and it is a frozen shoulder We are at a loss as what to do, any thought or suggestionss ### REPLY: Hi I am . .  For my patients I may recommend avoiding heavy lifting and vigorous movements, painkiller like Advil tab when needed, hot massages with topical gels, muscle relaxants, physiotherapy and even yoga will be effective for such cases. For proper diagnosis I suggest X-rays and MRI to exclude the many options whether it is frozen shoulder, cervical disc herniation or even a muscular spasm, for the best management and treatment plan ask your physician for the main diagnosis of your husband back pain. Please click THANK YOU and consider a 5-star rating with some positive feedback if the information was helpful. Hope the above information helps you, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, I wake up sometimes with a little purple bruise on the inside of my upper arm smaller than a pencil eraser. It doesnt happen every day but always in the same area of both arms one at a time. What could it be? We have spiders and cockroaches around here. No bed bugs seen. The bruise goes away in about 4 days. Thanks, Ann ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should not worry about bugs. It is likely that it is from the purpura. Purpura occurs because of thrombocytopenia. The cause of which is not known. As platelets decreases this purple bruise occurs. There are many causes of purpura exact can only be known if completed general examination has performed which can only happens. I advise you should visit the hematologist to get your complete examination done. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,a few months back i was under treatment for typhoid fever and on the 6th day i had a bloody stool...doctors adviced me to go for a colonoscopy and the byopsy reprt said that its non specific colitis...i am 25 years old. Now i am fine, my stool is perfectly normal. Was it due to the typhoid fever that i developed bloody dyssentry for 1 and a half days. ### REPLY: Hi thanks for asking question. You have bloody stool in the past. It may be due to amoebic or shell dysentery. You have diagnosed non-specific colitis, and now you have no problem. So nothing to worry about it. This bloody stool may be because of typhoid ulcer bleed or dysentery. So just now you just do your stool examination for further confirmation. Avoid excess spicy food for few days. . So just now no worry. If symptoms appear again then we will decide about to whether start treatment or not. Thanks. I hope I have solved your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , I have sex with my wife with protection but during sex the condoms got broken . Would it lead to pregnancy . I also want to know she can have I-pill for the same but we are not sure if sperm ejeculates inside her vagina or not.Is having I-pill is dangerous for health or not. Please sir kindly answer these Questions. Thanks ### REPLY: Hi dear there are high chances for getting her pregnant as condom has torn.if you don't want child then u can give I pill but under consultation of gynecologist.if she misses her periods by 10 days do the urinary pregnancy test and ultrasound to confirm the pregnancy then it can be treated through medicine also.common side effects are bleeding, pain in abdomen, headache, nausea etc. it can be treated through painkillers such as acetaminophen.hope this will help you thanks and regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir my penis size is 5 inches and I suffer pain after masturbation.I used to masterbate daily from 14 th age,now I am 23 years old and also my penis grith is so small.Does the length and grith increase if I stop masturbating and any mention any natural ways to increase penis size? ### REPLY: Hellos you mentioned in the query, you are doing masturbation daily, since 14 years, this is not a bad habit, but excess of everything is bad and that too from 14 years, so quit this thing as early as possible. As far as about the size and about the girth at this age (after 23 years 0, you can't increase the size and girth with natural way. In sexual life only performance play important role not size and girth. So premature ejaculation is not good, if you have, take treatment, otherwise live a normal life. Don't trust over false misleading ads about the size of penis. 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: Brain scan shows loss od Myelin. Now I have what feels like little fingers or bubbles that started at hairline. Now they are working their way down to my eyebrows and below. What are these weird feelings. What are they doing to me. Feels like something crawling under skin. ### REPLY: Hello dear, I understand your concerns but the weird sensations you are feeling, have nothing to do with the clinical presentation of loss of myelin or declination. Loss of myelin can be due to several causes including small ischemic changes, primary declination like multiple sclerosis and even in a significant percentage of normal individuals. However, its importance is only when patient have symptoms like limb weakness, loss of sensations, incoordination,vision loss to name a few. Since you don't have these symptoms, its probably insignificant in your case. Your weird sensations are probably due to anxiety. You should see a neurologist so that he can examine you to reassure and even then, if symptoms continue psychiatrist may help. I hope it's fair advice. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 uncle hospitalised  due to vomiting of blood.after one day doctors said he is ok now.but after that bleeding occured and its not stopped and its happening intermittently,,and blood pressure is fluctuating(lowBp-96).. may i knw what is his current state?is there anything to worry?what can we do to help him out of this? ### REPLY: Hello, it depends on the cause of his bleeding. Re bleeding after initial improvement usually involves ulcers or esophageal varices. There are effective treatments for both conditions. A gastroenterologist treats them endoscopically. Hemorrhagic gastritis (another potential cause of upper gastrointestinal bleeding) usually stops even without treatment within a few hours and heals within 24 hours. If you do know which of the above conditions is the cause, I'll be able to give you more specific information. I hope I've helped! Kind Regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is suffering from cough.  She will be normal and once she starts to cough it continuesfor half an hour. I have consulted many  Doctors and they advice cough medicines and this is contined from past 1 year. I am looking for a permanent solution .  I require expert guidance regarding this .Please advice and do the needful. ### REPLY: Thanks for your question on . I can understand your concern. Your daughter is having chronic cough. So we should definitely rule out chronic lung infections (tuberculosis or fungal infection), asthma and bronchitis. So consult pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). Chest x-ray is needed to rule out lung infection. PFT is must for the diagnosis of asthma and bronchitis. She may need antibiotics, inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) depending on the reports.Don't worry, she will be alright. First diagnose and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My husband suffers from phimosis,we are trying to get pragnant and i have noticed that after intercourse there is ways some amount of semen trapped in his foreskin,will this affect my chances of concieving? Can i go for artificial insemenation at home? Is it safe? ### REPLY: Hi welcome to .I have gone through your question. As your husband suffers from fibrosis then I would advise that it should be treated surgically with operation. As fibrosis also causes urinary infection sometimes. But it doe snot affect chances of conceiving. No you can not do GUI intrauterine insemination at home, for that proper setup is necessary, otherwise chance of success rate decreased. Hope I answered your question. Would be happy to help you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor I had my first intercourse with condom and ejaculation was done out not in n deres a delay in my periods its been 2 days after my due date n till now I dint get I used to have normal and regular ones but now a delay is scaring me I  fear may be few droops might  have gone in without being noticed by us and so I feel what if I got pregbant..please,help me what could be that? ### REPLY: Hi and welcome to  forum. Condom usage for contraception is not a foolproof method, and the male partner should wear the condom prior to penetration. Yes it is possible for a few .  Since you have missed your periods, please get a urinary pregnancy test done with an early morning sample of urine to be sure. It is better to confirm/ rule out pregnancy rather than worrying. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I AM SATYA NARAYAN OF TRIPURA (NORTH EASTERN INDIA) DATE OF BIRTH IS 04 7 1960FOR  25  DAYS    I  AM  SUFFERING FROM CONTINEOUS CHEST(LEFT SIDE ONLY) PAIN CAN YOU PLEASE ADVISE ME ?e mail ID is:-  YYYY@YYYY Cell Phone:-(+91) 0000 ### REPLY: Hi welcome to the  Left side chest pain from around three weeks is not normal.... Your work up needed as follows .... -Auscultation -EKG -Blood pressure measurement -echocardiography -troponin estimation If EKG shows ischemic changes These investigation will be able to rule out any cardiac cause if present Is no cardiac cause present than muscular pain, abdominal cause leading referred pain etc. ruled out Take care According to cause further specific treatment given Consult pulmonologist or cardiologist nearby for examination and work up accordingly ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on the contreceptive implant for two years and had that removed in june, in august i then went on the injection and had one injection, then becasue i had to many side effects on it i went on the mini pill for a week, now mw and my partner have been trying for a baby since november and are finding it hard to get pregnant, we have unprotected sex 6 times a week sometimes more. does it mean i cant have children? ### REPLY: Hi, I understand your concern.  You have taken multiple contraceptives . Which need to be cleared well & ovulation established before you try for conception.  - Please get your husbands' semen analysis done / your ovulation day can be estimated by LH surge test.  - Start taking Tab folic acid, vitamin B12 & E . Both of you . Can take it since 3 months prior to conception.  - take LH surge test, when its +ve. Have unprotected sex for 5-6 days from the day of getting test + ve.  - pregnancy can be confirmed by UPT after 8 days delay in menses.  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: Four weeks ago, I went running--20 minutes later, it began hurting. It was enough to make me to keep the pressure off for a day, but I did all my normal activities with minimal dull pain. One week ago, my ankle swelled up pretty big. The next day I went to a walk in clinic, got an Xray, and the doctor said I was fine. He told me to wear a brace for a week. I have to walk back and forth to class every day (across campus, maybe a quarter to half a mile). The brace didn t give me any support--only made sure it wouldn t twist or turn on itself. The swelling hasn t gone down at all (it has been a week). Today it looks even worse, and standing on it has become unbearable. What should I do? ### REPLY: Hi, as you mentioned the swelling of an ankle, and your visit to doctor, x-ray, and brace. I see it more of an ankle ligament injury. That is the reason the pain is not coming down and also, you are having pain while standing more. Only an MRI can help us come closer to the issue. Ankle joint is the one first joint to bear the whole body weight so coming close to the diagnosis will be of choice with the help of an MRI. Also, rather doing all these, Try to pick bits of paper with your toes from the floor. It will help strengthen the muscles of feet. Also, understanding the biomechanics and pathomechanis of the foot is a wide area to explain, so care is important even in the smallest cases. X-ray can only show the bone, but the MRI will show the Soft tissues as well. I hope to see you, if you have any personal questions to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 slight problem around my penis area. For around 2 weeks now, I have been getting quite alot of pain around the base of the head of my penis. Before and during sex. Once my foreskin is pulled back where the skin rolls up I have been getting small cuts kind of like paper cuts but a little wider around the outside of my penis. These cuts are quite painful and sting quite alot. They heal after a week of no masturbation or sex. But the the skin becomes very very tight and once i try to pull back / or my foreskin comes back these cuts break through again ( like cracked lips) and the area becomes quite swelled and red for a few days ### REPLY: Hello, Pain arising from the penis is often a result of a sexually transmitted infection and can be associated with burning, itching, painful urination, discharge, or blood in the urine.  Trauma, persistent erection (Arianism), cancers, and Parodies disease (the development of scar tissue within the penis) are other causes. But do not be scared unless diagnosed. This could simply be an infection like Atlantis or prosthesis.  Therefore, I suggest consulting a skin specialist for physical examination, diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I had open heart surgery for removal of a left atrial myxoma on 11/25/13. Minimal invasive procedure ( incision under my right breast) discharged on 11/29. 11/30 had palpitations and irregular beats (PAC and some PVC ) - no atrial fib. Was put on Lopressor 25 mg daily (12.5mg in am and 12.5 mg in evening). I still feel SOB ( same as before the surgery). Cardiologist said cardiac wise Im fine - should stop the lopressor  and maybe see a pulmonologist. He said it is such a small dose that I dont have to wean off of it. 30 years ago I was put on Inderal for migraines(dont remember dose) and I had Sob and developed allergic bronchitis from the Inderal. Is it possible my continued sob could be from the low dose Lopressor and can I stop it abruptly since it is a low dose and I have only been on it for 2 months? ### REPLY: Hello Lopressor and federal are of same group drugs, through Lopressor is more cardiac specific. However, there are fair chances that if you did not tolerate federal you might not tolerate Lopressor too. The dose of federal you are on is very mild, however I would prefer that you take once a day 12.5 mg for a week and then stop to make sure that PAC s don't occur. Yes both federal and Lopressor can cause allergic bronchitis (asthma) like picture, and it should be avoided if that is the case. If at all PAC or any arrhythmia occurs calcium channel blocker like Vera mil / diltiazem would be ideal for you. Let me know if any clarification needed.  Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Morning Doc. I just would like to ask the result of KUB Ultrasound of my husband. Please struck because of stomach really missed him in the right please. Since we go to hospital he was taken to exit the urine and the results of his laboratory he had kidney stones. Please ultrasound right away and have him and placed him on the ultrasound. The Left Kidney is normal in size and parenchymal echogenicity. The top right is normal in size. No focal masses are seen. The corticomedullary junction is distinct. The renal sinuses are centrally oriented with no evidence of ectasia or lithiases. Ureters are not dilated. Urinary bladder is adequately distended with echo-free lumen. Wall is thin and smooth. Unremarkable sonogram of the kidneys Non-dilated ureters Minimal urinary retention ### REPLY: HelloYour ultrasound of PUB region is almost normal. There is minimal urinary retention, it is a non-significant finding. Other findings like both kidneys are normal and echo texture. There is no calculus or HY . Cortico-medullary differentiation in both kidneys also normal. This is a normal finding. There is no mass in either kidneys. Both ureters and urinary bladder are also normal. 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: I been having a cough for a little more than 4 1/2 weeks. .... before I couldn t talk without coughing mu lungs out now I feel my saliva thick, throats itchy before I start coughing, and I nearly choke when I m coughing. Sometimes my coughing leads to throwing up .... ### REPLY: Looking at your symptoms it seems to be a case of HERD gastrointestinal esophageal reflux diseaseStomach acid reflexes back to esophagus and throat which produces itchy throat and thick saliva and sometimes vomiting because of constant throat irritation it produces cough would advise in such a case to take tab pantoprazole 40 mg with antacids to reduce hyperaciditywarm saline gargles and steam inhalation to avoid cough Hope this helps you take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am suffering with right side jaw pain some difficulty in right ear ,neck pain ,shoulder pain ,back side of right ear and tenderness under jaws and I observer that small lump above the right tonsil.please suggest me some things  suffering from 6 months.went to dentist and ENT also they told me the I was suffering with TMJ. ### REPLY: Hello and welcome, Since you had pain around the right ear, there may be TMJ dislocation/pain/inflammation. I would advise you to visit an oral-maxillofacial surgeon and get clinical examination like palpation done at the region of condoles to rule out any disk displacement is associated. An OPG of the area will help to rule out any anomaly underlying. Take complete course of antibiotics and analgesics along with muscle relaxants. Avoid mouth opening too widely. If there is dislocation /fracture of jaws/condoles, then jaws has to be immobilized and splinting has to be done. Physiotherapic exercises has to be done. 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 there. My 12 year old son had severe dizziness and headache all Saturday and Sunday and slept a lot. That has subsided but now he has a rash and sore throat. He seems fine though otherwise. Energy, appetite etc.Could the rash be from a weekend fever? ### REPLY: HI, thanks for using  The rash is likely linked to the symptoms that he experienced over the weekend and is continuing to have (sore throat). The rash may be a viral exanthem which is a rash that occurs with a viral illness. It is common particularly in child . He can use symptomatic treatment only (treat particular symptoms present e.g. if itching- antihistamine, if painful- a painkiller) etc 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: how fast can i conceive after Lupride. I had laproscopy for endometrosis on Dec 6 2010. I was given three shots of Lupride in span of 21 days. Last shot was on Jan 9th 2011. I had got my periods last on Dec 18th 2010. It is mid March now and still i have not got periods. Now i plan to get pregnant . Is is safe to get pregnant now. if yes, then do i have to get periods in order to conceive. If yes what should i do in order to get my periods. if no then should we proceed with planning of pregnancy . or If it is not yet safe to get pregnant, how long do i have to wait for it. ### REPLY: Hi Welcome to  NO it is not safe to get pregnant now. Lupride has adverse effect on fetus and may lead to anomalies. Normal functions are restored only after 3 months of discontinuation of pride. As u took last dose on Jan 9th 2011.u should at least wait till April 9th 2011. By that time your menstrual and reproductive functions will be restored. Then u can plan for pregnancy without any risk to fetus. 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: what should be the next step with a 30 year old patient, c/o chronic dry cough, chest pain, SOB, strong family cardiac history, not an athelete, borderline cholestrol, bp normal, ekg showing sinus bradycardia with poor r wave progression and rate of 47??? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of heart block is more likely. It is conduction defect of heart which is causing low pulse rate and symptoms like cough, breathlessness etc. So better to consult cardiologist and get done stress test and Holder monitoring (24 hours continuous recording of ECG). If heart block is there then he needs pacemaker insertion. If these reports are normal then we should look for lung diseases like tuberculosis or bronchitis for his chronic symptoms. So get done chest x-ray and PFT (Pulmonary Function Test) to identify lung diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend has acute leukemia and had a cord transplant done over a year ago. She now has developed aspergillus pnomonia (excuse my spelling) and has just been admitted to the hospital and they are treating it with amphotericin. Is this going to have a good outcome or is she in serious serious trouble? Is this fungal pnomonia contagious? ### REPLY: Thanks for your question on . Aspergillus pneumonia is life-threatening condition. And that too in acute leukemia patient needs intensive care. Prognosis depends on response with the therapy. Amphoterecin B is the . So continue with amphoteric B. Get done repeat chest X-ray after 2-3 days, if improved than continue for total 21 days. If worsening than prognosis is poor. Shift to caspofungin and enidulafungin. They are higher antifungals. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 there, I have upper back pain between my shoulders. It feels like I ve been kicked and winded. I keep getting a pins and needle sensation (top left side). Also I experience pain between my shoulders when I breath in deeply. Additionally if I move suddenly I experience a sharp shooting pain. It s very uncomfortable... Any suggestions of what it might be and how I can improve it. Kind regards ### REPLY: Hello, thank you for the query Based on your symptoms of upper back pain and pins and needle sensation at L) supra scapular region which aggregates on deep breathing and sharp shooting pain, symptoms are consistent with cervical radiculopathy involving C5 root L) being more than right. You need detailed neurological evaluation for same and confirm the diagnosis by doing cervical imaging. Meet neurologist for same. Avoid lifting heavy objects and neck flexion exercise ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a bad fall 2 1/2 years ago have cervical spondylitis and herminated discs really painful shoulder and neck now found out ive got signs of small vessel ischaemic discease on the right side can this be caused by the trauma as mostly the damage is on the right side of my body I have also got multiple hip cysts on the right hip and ive as well got indention of the theca in my cervical level which hurts when I breath ### REPLY: Hello, Thanks for your query. After going through your query I came to know that you are suffering from cervical spondylitis and herniated discs. Now you are diagnosed with avascular necrosis(small vessel ischemic disease)of right hip. You want to know that can these all be due to trauma. In my view these are not related to trauma. Cervical spondylitis is a degenerative disease(aging), fall can be precipitating factor for herniated discs. Small vessel ischemic disease(avascular necrosis) is generally idiopathic(unknown cause). You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My name is Jon. You can consider me as a health freak since the start of this year. The reason being is that I just had an episode of high cholesterol, including stressful situations in office, therefore experiencing heart palpitation, nausea, sweaty hands and hard of breathing.Thank God, I had a change of mindset (coz i dont wanna die) and had to eat proper foods (mainly vegetables, fish, no dairy products,and lots of fruits) and exercise. After 3 months, things got back to normal, except the feeling of anxiety. I thought then its an blood ph imbalance, so i ate more fruits, but to no avail. Ive had my insides/abdomens checked (ultrasound),all are normal, had my liver and kidneys checked, results are normal,had my triglycerides and cholesterol checked, normal,except for LDL (.5 units lower than the lowest in range, i think its caused by lots of jogging). There was this time wherein i physically felt as if the anxiety just turned off without any reason at all, and it lasted for 2.5 weeks, then it turned on again. I hate this feeling. It feels like there s an impending doom, therefore causing me to have sleepless nights. I dont know what kind of doctor do i have to go to, hematologist? endoctrinologist? nutritionist? can you please guide me on this?Jon ### REPLY: Hello! Welcome and thank you for asking on ! I passed carefully through your question and would explain that your symptoms seem to be related to anxiety. Low cholesterol levels can contribute in sleep disturbances and in anxiety too. Coming to this point, I would recommend consulting with a specialist of this field (psychotherapist or psychiatrist), who can help you to deal with your anxiety professionally. Yoga and meditation can help too. I would also encourage you to continue on your healthy diet and your daily physical activity. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: At work today, I suddenly became very hot and dizzy, and then I started seeing a white light in my vision path. Like I had been staring at a light for too long, only I hadent been. I have a history of migranes, but this is frustrating. What could it be? ### REPLY: Hello ! Thank you for the question on ! I understand your concern. I think you should not worry about this problem. In my opinion it may be related to migraine, also called a visual aura. It is common in migraine and can also not be associated with headache. All the other associating symptoms seem to be part of a migraine aura. I would recommend you to have a neurological examination and a brain MRI, if the problem persists. Hope to have been helpful! 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: Congestion, nausea, fatigue. I ve been suffering with allergies for the last two years and continuously taking Zyrtec or Benadryl. I stopped all meds for the last 4 months but for about 6 weeks now I cannot breath through my nose. My nose is a little runny in the morning but no other symptoms. However, I started nasal irrigation the last two days, twice a day and now feel worse!!! I feel very tired with nausea and no relief from my congestion. ### REPLY: Hello mentioned that you were taking Zyrtec or Ben . Still you are feeling nausea, fatigue, running nose, difficulty in breathing. In my opinion all these symptoms are due to bronchoconstriction caused by some allergen. Bronchoconstriction causes breathlessness (difficulty in breathing), while allergy causes running nose, wheezing, fatigue (allergy produces fatigue) . When such patient visit my clinic with such type of symptoms I advise my patient to take montelukast+ albuterol tablet once or twice in day. Usually they don't require any medicine except this. Steam inhalation and hot coffee also provide relief. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell on a sidewalk three days ago and  landed on my face. The swelling on my upper lip has gone down but there is a huge sore on my inside upper lip and it seems to be torn by the impact of my upper teeth during the fall. I have been washing it with salty water several times a day but it is still present and when I  put a tissue on it and apply light pressure, a yellow "pus-like" smelly effusion comes out. Not much. But should I go to a dentist or doctor if if continues much beyong this weekend? One other thing, I am diabetic so the mouth  canker-like sore is of especial concern to me. ### REPLY: Hi ! Thank you for your query. Dear sir, You seem to have an infection that has been super added over the wound you got by falling over the upper lip. Since you are a diabetic the tendency of getting infections is increased and there is delayed wound healing. You should check with an endocrinologist for this immediately so that he can monitor your sugar levels which is essential for effective recovery and plus start with an appropriate antibiotic coverage to heal the wound. If you have any further queries feel free to ask. Wish 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: Ok so right now i just got up from a weid thing that has happened to me 2 or 3 times.. I was sleepy, (ihave narcolepsy and cataplexy) so i went to the counch to rest for a little. I tried sleeping but then i felt my heartbeat increase in speed and then i couldnt barely move. I started to feel my lips go numb and i tried moving them. I knocked out and just woke up. What can this be? i feel fine now but i got really scared... ### REPLY: Hello, This can be arrhythmia like PSV or atrial fibrillation, where your heart rate suddenly goes up and BP falls. You will need evaluation like ECG, thyroid test and holder monitoring. You should also get one hemoglobin levels done. So visit nearby cardiologist for this investigation. Also, to abort such episodes you should try to cough hard. 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: im 28 years old 180 ilbs woman, I had numbness in my face for a day and half I decieded to take my bp and it was 133 over 79 with 80 beats is this normal or could it be I have a serious issue i dont have insurance and Im trying to see if im over reacting ### REPLY: Hello, Thank you for your query. Your Systolic pressure (133)is a little high. Diastolic pressure and heart rate is normal. Numbness, however needs to be further investigated, even though it does not persist. Moving clots in the blood supply of the brain can cause transient symptoms. This is a precursor for stroke which is not treated on time can lead to nerve damage and paralysis. - do you have any family history of heart disease, high blood pressure, high cholesterol, diabetes, stroke? -do you have any other medical issues?or take any medications? -any other symptoms like giddiness, breathing difficulty, muscle weakness, headaches, palpitations, digestion troubles? -do you smoke or consume alcohol? I recommend :- a physician consult -assessment of risk factors and current status of heart, lung, vascular and kidney function. - blood tests (complete blood count, Thyroid panel, lipid profile, blood glucose panel, ) -carotid Doppler.  MRI angiography of brain if required -electrocardiogram and stress test. Please seek medical attention to catch any Impending stroke and treat early. I understand that without Insurance, costs can be difficult to cover. However, try to get a basic work up and assess risk. If you have any facial expressions' asymmetry, weakness of muscles or limbs, unexplained headaches, giddiness or breathing difficulty, or numbness again, fainting spells, go to the ER right away. Hope this helps. Please let me know if there is anything else I can help you with. Wish you good health ### END