Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 DoctorAs per health check up report attached, My sgpt and sgot are high. I am taking LiV 52 tablets since last 3 months on and off(1 tab , 3 times a week). Please let me know if all ok. I dont drink regularly but just once or twice per week have beer. Diet is low in carb and fat. Always do morning walk for 20 mins.RegardsVarun ### REPLY: Hi and welcome to . It would be easier if you've posted the exact liver enzymes findings. Its elevation is common found in many disorders must most usually is alcoholic, viral, autoimmune or toxic liver damage. The most common liver disorders are fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar and alcohol of course. If ultrasound didn't find anything and viral markers are negative then you have no reason to be concerned. You should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated .  Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. Liv 52 is helpful but only if associated with these measures I've mentionedWish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had the nuva ring for two days now and I have been constantly having to push it back up. I push it up as far as I can possibly get it. I even get in a bunch of different positions to make it go farther in, but it just keeps falling out! I was told I have a tilted uterus , can that be the reason it keeps falling out? And if not, please tell me a way I can keep it in. ### REPLY: Hi, I understand your concern and your problem. This may happen in the following scenarios. 1. The Nova ring is broken; sometimes the joint of the ring is broken, so it may not regain back its desired shape once inside the vagina and slips out. In this case try a new ring.2. The vagina is lax and roomy. Sometimes vaginal laxity may interfere with holding the ring in place, this is very rare and unless the vagina is too lax, it does not slip.3. Ring not pushed far enough; sometimes women do not push it far enough inside so that it remains at the vaginal opening and slips out. The first and third are common likely causes. Check to see if any of this is happening to you. If the ring is broken use a new one and use some other method like condom for next 7 days. If you are scared to push it in, I want to reassure you that don't be afraid. This ring is safe and will not go anywhere other than the vagina. It does not cause any trauma, so it is safe. Just push it way inside, so it will not slip. The best position to do this is lying down and slowly pushing it inside towards your buttocks that is backwards. A tilted uterus will not affect the position of the ring and neither will it have any effect on its insertion. Another word of caution is that if the ring has been lying outside for more than 3 hours, use another method like condom for the next seven days after correctly inserting the ring. Hope I was able to help you, Thank you for using  and have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: PLZ SEND YOUR PHONE NUMBER I HAVE QUERY ABOUT MY CHILD. I LIVE IN HOSHIARPUR PUNJAB. BY BIRTH MY CHILD LEFT HAND IS 60%. I HAVE TO KNOW THAT WHAT WILL DO TO SECURE HIS FUTURE AND PLZ DO SOMETHING ABOUT MY CHILD. PLZ SEND YOUR NUMBER IMMEDIATELY THEN I TALK TO CLEARLY ABOUT THIS MY EMAIL ID IS YYYY@YYYY ### REPLY: Hello, Your child has an anomaly of the hand. Sometimes this is associated with other defects. I recommend that your child be evaluated by a doctor who specializes in genetics (heredity) who will perform a complete physical examination. Look for a genetics doctor who is part of department of pediatrics at hospital connected with a medical school. Should this doctor feel your child needs additional study, then your child can be referred to a pediatric orthopedist (bones). Ideally, the genetics doctor and the orthopedist will discuss their plans for your child together. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently got very sick.  At first I felt like I had a bladder infection, because it was uncomfortable to urinate.  An hour later, I noticed blood clots in my urine and the discomfort continue to worsen. Within 2 hours my urine went from being normal color to solid red and I was in excruciating pain during urination.  The doctor put me on antibiotics and sent the sample for a culture/sensitivity test.  It tested positive for ecoli.  I am wondering if even though I am feeling much better, do I need to seek follow up care to ensure there isnt damage to my kidney, etc. ### REPLY: Hello, It is always good to follow up, and I don't think you will much to worry after the visit. It is just a reassuring visit as your infection has already been resolved, and well treated in time. Yes, E. coli is one of the main culprits of urinary tract infections. It causes bleeding in urine too, along with other symptoms of infection like pain and urgency to urinate. 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: Hello Doctor,Last more then 10 years , i am taking BP medicine Amlopin AT ( USV Ltd) and also i  am taking thayroid medicine       , now last two to three year , my wait is incress and also feeling Fatigue and also seen some time Swelling on my legs so please suggest .. Ketan ### REPLY: Hello, Thanks for writing to , I am . Your symptoms of weight gain, fatigue and leg swelling are consistent with thyroid problem, this is usually caused by low levels of thyroid hormones in the body, called hypothyroidism. I would advise you to visit your doctor regarding this problem he might ask you to get some tests like free T3, T4 and TSH levels these tests tell us the function of thyroid gland and levels of thyroid hormones in your body of these are deranged the doctor will get your thyroid medication adjusted and with time you will start feeling better as soon as your thyroid levels get back to normal. If thyroid levels are fine then heart can be looked at by simple echocardiography, heart function can easily be determined and then medication can be started. I hope this answered your question, If you have more queries I am happy to answer you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 10 year old said he felt dizzy, very hot and had flashing lights in front of his eyes at gym class today. He went to the bathroom and splashed cool water on his face and felt better. He seems very tired now and a little warm. Could he just been overheated? He is rarely sick. and only had an ear infection when he was one and pinkeye when he was two/three yrs. old. ### REPLY: Hi. I understand your sons' problem. I would like to know initially if there is any family history of migraine headache, epilepsy. Does your son take a stomach filling breakfast in the morning? Does he have wheezing problem? Does he complain of any chest discomfort or breathlessness or palpitations anytime? If none of these are there, I think you need not panic regarding one episode. Just make him have a sound sleep at night and good breakfast. If the episode recurs, I would advise you to consult your Pediatrician and evaluate his symptoms. I would be glad to clarify any further doubts.  . S. Sri Vichy Chennai ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 , Whenever i have really bad diarrhea& go to use the bathroom my chest starts to get tight i cant catch my breath , my throat ,eyes & nose itch really bad & it feels like i have a ball in my throat & then my gets stuffy, my face gets really red and irritated . on top of that i have really bad asthma & it feels as if im having an attack , i even weeze sometime.  i dont know whats going on :( Please help thanks ### REPLY: Hi thanks for contacting ... Noted you are having asthma that is allergic condition..... So here your presentation is congestive symptoms by allergy or viral infection... Mostly you are having viral infection and that secondary lead congestive symptoms ... In such condition diarrhea also can occur.... So first avoid stress ...Don't worry. Consult physician or pulmonologist for auscultation... If rhonchi heard and dyspnea is also complained then bronchodilator given...Meanwhile, for congestion relief give Ben .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hurt the top of my foot in dance the other day but I don t know what I did. There is no bruising in no swelling but extreme pain when trying to walk or put weight on it. My parents don t think there s anything wrong with it so they won t take me to the doctor. No there is something wrong with it because it shouldn t hurt this bad to stand. ### REPLY: Been there. The structures that are there are joints and tendons. While there can be stress fractures in the foot, irritations of the local structures is near 100% of those who dance regularly. Ice at first for the first 12 hrs applied as an ice pack without direct touching of ice onto the skin where it could cause frostbite. Then, aspirin like .  Resting the area is quite difficult to do. Then after the pain is mostly gone, physical therapy on range of motion, stretches, building up muscles, and how to hold positions correctly will be an important and quite difficult set of routines to come up with and to do. Basically, consult other dancers to find the best specialists in your area (sports medicine, physical therapy, maybe podiatry). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister 35 years old,suffering from chronic epilepsy for the past 15 years,behaves as though she bipolar, Aggressive,feels very great about herself, doesnt accept that she creates hell in the house.Shes on Encorate Chrono 500mg and levipil 500.She was given arpizol 10 some time ago,but she doesnt want to continue as she feels shes very normal.How do I treat her? ### REPLY: Hi, Thanks for using . She has bipolar mood disorder along with epilepsy. You should consult your psychiatrist for detailed evaluation and management. Doctor may advise having some fresh investigations like CAT scan. She might be benefited by increasing the dose of sodium valproate (enc orate). Usual dose is 20-40 mg/day, but you must consult your doctor before increasing the dose. In some cases, Lithium may be required. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was told by my PCP that the large lump on the upper right side of my stomache is an intestinal Herna, The Dr. told me to wait until Iam done w my major Dental surgery. then we will look at it closely. WELL IV BEEN LEAKING A POOP FLUID AND POOPING IN MY PANTS (WEARING A DIAPER) 24/7 IS THIS A SYMTOM THAT I SHOULD EXPECT? WHAT SHOULD I DO? IAM ALSO A DIABETIC INSULIN DEPENDANT. SUFFER FROM PANCREAS DOES NOT PRODUCE ANY INSULIN ### REPLY: Hi ! Good morning. I am  answering your query. Out of your symptoms, the leaking of poop fluid might not be related to your intestinal hernia. This could be due to an uncontrolled diabetes, and so I would advise you to get your blood sugar tested before undergoing any kind of dental or any invasive treatment. The answer to which surgery to be done first depends on a clinical assessment of your treating doctor for the urgency of the condition and has to be judged by him carefully. Once the sugar is well controlled, and you are made fit by the physician, any of the surgery could be undertaken depending on the priority. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i stopped taking my birth control pill normin-1 because ive been on it for 5 years and want to give my body a break and i no its a strong one so hoping to try shift some weight that ive gained over the 5 years. i didnt get my period only 1 day of light brown discharge when i peed for one day it was due 2 weeks ago and ive had intercourse twice in this time. then this morning i was in the shower and noticed a light brown jelly like clump. i then went to the toilet and had another clear one. am i pregnant ?? or miscarried ?? ### REPLY: Hi, Thank you for posting your question here, I will try to answer it to the best of my abilities. A brown discharge on its own is not something to worry about, it usually means that during your last period all the blood didn't come out and its coming out now, that is why it is brown color and not bright red. So if you aren't feeling any other kind of discomfort, don't worry about it. If you are still worried, you can take a home pregnancy test. I hope this answered your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir i am prashant Age- 18 yrs I am suffering from typhoid and jaundice from two weeks .my doctor given me medicine .when I am going to my coaching class then I feel very weak ..suggests me some way to become free from it..Also I am suffering from bronchitis also suggest me to be free from it... ### REPLY: HIT hanks for posting your query to  Weakness following Typhoid fever and jaundice is common and lasts for 2-3 weeks. I advise you to take more of fruits and fruit juices. Avoid oily food and non veg food as it will cause problem in digestion.  You can also take a multivitamin syrup like Zirconia for 2 weeks. This will boost up your energy.  For your Bronchitis you need to avoid dust, smoke and cold air.  .  If it still persists then ask your doctor for a prescription of Leveling Inhaler and use it. Hope this information was useful to you. Any 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: Salam O Alecum Doctor, My name is Qasim, Dear Sir actually i was suffered in bad things during my old days my age is 29 and now i am going marriage but there is no timing is remaining, even when i think about this topic or i touch to my penis i ejaculate very fast less than 1 minute........... i want to marriage now but iam afraid that in even atfer touching i will ejaculate. please suggest me the soltion . i am from Pakistan. only 6 months remaining ### REPLY: HelloThanks for query. What you assume is not a Premature Ejaculation but is early ejaculation due to excessive sexual stimulation. Premature ejaculation is term defined as ejaculation that occurs within one minute after penetration of vagina while having sex with female partner. The ejaculation the get immediately on touching your genitals is due to arousal and sexual stimulation is due to anxiety. You need to consult qualified Psychiatrist for counselling and further treatment. Do not worry this will get resolved with appropriate treatment by a qualified Psychiatrist. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Thank you, this is fantastic, I am impressed for such service. My concern is during night my feet(soles) and palm of my heands get very hot and have a funn sensation in them. It wakes nme up in the night and fell like but dont have swelling in my feet. Am quite worried about this. Thank you Tazim ### REPLY: Hello, As having a burning sensation in the feet and arms can be due to disturbed physiology. Having a uric acid test done will be good. Post which is the test turns out positive then medicine for the same will be advised. If the test is negative then try doing static neck exercises, upper limb strengthening exercises, core stability, and hip muscle strengthening exercises. This should relieve pain. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...My heart feels like its being squeezed and my arm goes numb on the left side - Ask a Doctor queries My heart feels like its being squeezed and my arm goes numb on the left side - Ask a Doctor queries ### REPLY: Brief Answer :Coronary Artery DeseaseDetailed Answer:Hello and thank you for question. I read very carefully your concerns. The sensation of heart squeezing followed by numbness of the left arm, in mos cases is caused by a problem of the heart vessels called coronary arteries. Usually the problem consists of their blockage due to atherosclerosis plaques that block. The blood flow inside the artery. In these cases the muscle of the heart it is not supplied with blood and oxygen, wich causes the death the cells of that part of the muscle. If that blockage of the artery persist for a long time, there are great chances of irreversible cell damages. In this situation it is better to ask some more specific question like: for how long do you feel this symptoms? How did they start? What you were doing when the symptoms started? Do you have difficulty in breathing? Do you suffer from any chronic condition, like diabetes etc.? First thing I would recommend doing an ECG (electrocardiogram) and a heart Ethnography. Also, to do some lab test like cardiac enzymes and a lipid panel. Please feel free to ask any other further question. 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 chest sternum is raised in the center.. It does not cause any discomfort to me.. I am 17 years old and this chest problem has been there since i was a child.. Please tell me if i am fit to join the indian army after this problem... and any alternatives of surgery in this case... ### REPLY: Your condition is called rectus caricature. Usually it is seen since childhood. Though you are asymptomatic there is some evidence that rectus caricature may prevent complete expiration of air from the lungs and also may have a decrease in stamina, even if you do not recognize it. Pulmonary function testing may be useful to determine the impact of the deformity on the performance of the heart and lungs. Consult a pulmonologist for the same. Even the army people will ask for the same. Ideally correction surgeries are done in childhood. Hope your questions were answered. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 taken primolut N to start my menses periods, but I don t know that I was pregnant of near about 25 days. And right now sonography result says that right now I have 9 weeks baby in my organ. Please tell me primolut N tablets will effect on my baby or can I abort baby . Suggest me ### REPLY: Hi, Primulot is a progesterone hormonal agent with very weak an . And since you have taken it around 25th day of pregnancy, it will not affect the fetus. The organs develop after 6 weeks of pregnancy and very rarely these hormones can cause male type features in female babies. But since you have not taken them in that period it is unnecessary for you to be worried or abort. Please continue this pregnancy without worries. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband who is a veteran , has had a veteran Pulmonologist , (after giving him tests), determine his breathing difficulty (after left shoulder repair ) was due to an injury to the phrenic nerve during the surgery . His tests have shown that his left lung is paralyzed. What can be done? They say this can not be fixed. Help!. The quality of our lives has been dramatically reduced . FOREVER? ### REPLY: Thanks for your question on . I can understand your situation and problem. Sorry to say, but Phoenix nerve once damaged can not repair. Phoenix nerve supplies diaphragm. It is one of the strongest muscle for respiration. At the same time it is not the only muscle for respiration. You can make other respiratory muscles (other than diaphragm) stronger by 1. Deep breathing exercise2. Chest physiotherapy3. Incentive spirometry. So by above things you can overcome diaphragm function by other respiratory muscles. These all will improve your lung functions and quality of life. You can record improvement in lung functions by regular PFT (pulmonary function test). So consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m under a lot of stress at work while there the last few days I m expericing mild pain in the middle of my chest . I am prescribed Ativan and when I take one the pain subsides but when it wears off the pain is back can it just be stress related ### REPLY: Hello! Welcome on ! Your symptoms seem to be related to anxiety. Coming to this point, I would recommend consulting with a specialist of the field (psychotherapist or psychiatrist) to help you manage anxiety. An antidepressant would be better than Asian as long term therapy for the management of anxiety. I would also recommend trying Omeprazole. If it helps, it would be indicative of gastroesophageal reflux or gastritis underlying your symptoms. In such case a fibrogastroscopy would be necessary. Hope to have been 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: sir my mom is heart pasint.she her angioplasty  in mey 2011. afer angioplasty  his health is well but 2 month leter his problam in heart beating bcoz she got a shock in his sister death. i have been check up in doctor s. mohenty DM . he got the medenine but . but heart medenine got a side effect. she have been problam Breathing. so what i do sir ### REPLY: Howell come to ChatDoctorI really appreciate your concern, if this is cardiac condition and angioplasty being done then patient has to take the medicine, cardiac medicine may not have any serious side effects it has got the negligible side effect that can be tolerated without any trouble, what ever the symptoms your mother having that could be due to some stress, depression, so no need to worry about this, hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am Sarita from Mumbai, In the month of March 2011 I had a tb node in my chest & got operated. I was continuing my medications for 2 months & left . I started it again & it almost 6 months completed till now. Now I am feeling a slight pain in my right & left lower abdomen . would this be a mittelschmerz or stomach tb. Kindly advise. ### REPLY: Hi Indirakonar, As you told that you have been operated for the TB node in the chest and after taking medication for 2 months you left it and again completed the course for 6 months. From this I understand that this is TB of lymph nodes and not the lung, and you have to surgically remove the node also. It is common that TB medication for TB of other part of the body apart from the lung is for long duration and should be stopped only after consultation with your doctor only. Now the pain in the abdomen can be because of recurrence of this or because of some other thing. I would suggest you to consult your doctor to make the confirmation and have the investigations done and keep monitoring yourself. Thanks and take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dr. kindly tell me that I have pain in my lowerside of kidney but as result of ultrasound abdomen whole it appears that liver is noirmal in size measuring 16.2cm with regular margin fatty echoi pattern of parenchma of liver gallbladder is normal in size and shape with normal wall thickness clear fuid is seen in the lumen noi evidenc eoif calsuli mass in the gallbladder I think result is noirmal what you suggust dr.sb ### REPLY: Hello and welcome to Ask A Doctor Service. I reviewed your query and here is my answer. Your ultrasound report is normal except for liver size, the normal liver size is from 11-13 cm or some take 14 cm as normal but yours is 16 cm, also it is fatty which means you may have fatty liver which occurs in obese people or people who take high fat diet mostly. However, you need to talk to your doc about increase liver size but if you have no other problem then taking control of your diet may bring it to the normal. Take low fat diet and have a good exercise daily. Hope I answered your query, feel free to ask if you need further assistance.  Thanks. Regards. . G.P ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hand, foot and mouth disease since November 20, 2016. I have been to my Kaiser Physician on three occasions. He has had me on a steroid cream, which I use two weeks and then stop one week, and repeat. I cannot seem to get rid of this virus. I have also been using lavender salt baths each morning for 20 minutes. Please help! Sincerely, Susie ### REPLY: Hi, Welcome to ! I understand your concern. Actually there's no specific treatment for hand-foot-and-mouth disease. Signs and symptoms of hand-foot-and-mouth disease usually clear up in seven to 10 days. A topical oral anesthetic may help relieve the pain of mouth sores. Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) may help relieve general discomfort. Some advices that I can give are:-Suck on ice pops or ice chips.- . -Rinse your mouth with warm water after meals.-Avoid salty or spicy foods.-Avoid acidic foods and beverages, such as citrus fruits, fruit  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have been diagnosed with Goblet Cell Carcinoid and Low-grade mutinous neoplasm. Both in my appendix. This during surgery. Since I have had a right side colectomy and many scans and blood work. All came back clean and no other signs of any cancer. The question is how is it determined if chemo is working? If it is through my blood and it shows no sign of cancer, why go through chemo and if it shows clean after treatment how do I know it was effective or more importantly warranted. Thanks Chris ### REPLY: Recommendations for chemotherapy after all macroscopic (overt tumor that is visible to eye by imaging or clinical exam) tumor has been removed, is based on the natural history of the tumor which has been studied in clinical trials. If these tumors are not given chemotherapy in post surgery setting the microscopic cells which may be present at the site of tumor bed or in circulation will form a tumor sides resulting in relapse or metastasis. So you may never know how useful the chemotherapy is until it is not given. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with cholecystitus and was told that surgery was the only option.  I have a cluster of gallstones, one being measured at 13mm.  I am home after a night in the hospital and awaiting a surgery date.  I am experiencing bloating but at the moment no pain.  i am 36 years old and am not obese.  I would like to put off surgey until after the holidays and would like to know if theres a way to avoid doing so. ### REPLY: Dear Friend. Welcome to . I am . I understand your concern. Asymptomatic Cholelithiasis doesn't require surgery. Indications for surgery are:1. Symptomatic cholelithiasis2. Stone obstructing Common Bile duct3. Attacks of Acute Pancreatitis4. Obstructive jaundice5. Any evidence or suspicion of malignancy. In your situation, if we see, you have symptoms as well as cholecystitis. So, getting gall bladder removed is indicated in your case. For symptomatic relief, you can observe following:1. To take a combination of Pantoprazole and Risperidone.2. To take fat free diet. This is my personal opinion for you based on available details. If you have any further query please ask me. Stay HealthyChatDoctor, MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Female aged 55-infected with Hepc during a surgery 1986 - checking constantly LFT -now slowly i get little pain near liver - iam taking vitamins & milk thistle for last 6 years- do i have any oral medicine to  control C virus? scared about interferon treatment- pls advise ### REPLY: Thank you for posting your query. HepC diagnosis. You need NOT worry. HepC can be cured completely now. "Oral . You may advice a special diet (fat free), abstinence from alcohol and smoking. You may visit hepatologist and take your blood reports as soon as possible. If any further questions, feel free to ask. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health. Regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a fall in January . Tore my ACL and meniscus and sprained my LCL. I have a bone spur. MRI showed bursitis and osteoarthritis. I had no pain in my knee or difficulty walking prior to fall. I am 67 years old. I also have a complete rupture of the rotator cuff, from the fall. I have pain in my arm and knee. A muscle in my thigh has been numb since the fall. The numb area is about 3 inches wide and 6 inches long. The top of my knee cap is also numb. Last night I found a lump the size of a pea in my knee. It moves around. What could this be? ### REPLY: Hi, thank you for providing the brief history of you. As you are 67, there is a possibility of degenerative changes in the knee joint leading to wear and tear of the soft tissues and bone. Also, due to ACL injury, meniscus injury, and LCL injury you may face pain and difficulty in walking. Also, due to fall there might be pinching of lumbar nerve leading to sensory deficits in the lower limbs. Rotator cuff injury also needs an attention. As per you symptoms and other things I will advise you to undergo physical therapy and by this the pain can be reduced and so the inflammation. Post this rehabilitation of the knee and shoulder is advised followed by the Strengthening of the spinal Muscles. Most cases in my clinical practice responds well to physical therapy. As an important note, that ACL and menisci injury are graded according to the physiological discontinuity and the treatment is planned accordingly. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I stood on two nails in one day on the same foot about a week ago and one of them is fine but the other is still very saw and the pain is about two inches around the hole, and the foot that hurts is hotter than may other foot. It s not agony just very annoying as I m a roofer and stood on it all day every day, thought there might be a chance of infection as it probably gets direct work ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that there is probability of infection. As it has pierced in the foot there is probability of anaerobic infections. I advise you should take metronidazole for these infections. Also take the tetanus toxic vaccine injection. This will prevent you from getting tetanus. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Am 27yrr old a student,for the past 3wks of so i developed some sort of do i say vomiting blood or.fresh non clotted,no hx of trauma,i never take alcohol.but i have experinced  some sorts of night sweats for the 2wks.i suspected pulmonary tubeculosis but my worry is the amount of blood i produce.My ESR is 49mm/hr.what could be the diffrentials ### REPLY: Hi thanks for contacting  ...ESR is non-specific measures ... It can be elevated in many inflammatory and infective condition as well in tumors. Your physical examination is necessary first... First it could be from tuberculosis e bronchitis or other respiratory pathology. Chest x-ray can be done... If suspected TB, sputum examination done for it.... For it AKT given. And for bronchitis antibiotic given. Vomitted blood could be from liver pathology. So palpate liver and investigate with liver enzymes study and PT plus serum protein. If present then varietal bleeding also can be there. Gastritis sever or bleeding peptic ulcer also can lead bleeding. For above two condition endoscopy needed. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 23  year old female.  Today I woke up and when I breathe in deeply I feel tightening on my chest , close to my collar bone.  My throat is also bothering me along with my left ear.  Im not sure if the chest pain is because I am developing a cold or it has to deal with my heart. ### REPLY: Howell come to ChatDoctorI really appreciate your concern, tightening here in your case could be due to muscular spasm, and it may not be due to any cardiac disease, in this young age and in female chest pain due to heart disease is not likely unless have some congenital disease, what the symptoms you mentioned it here could be muscular spasm and would be temporary if ever happening due to deep breathing spell and hope this information may help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had MRCP scan and got gallstones. But also found mildly dilated intraheptic biliary ducts in segment 8 and 4a returning into normal calibre of the right hepatic duct and some hypertrophy of left lobe of liver. What does this mean? I have pain in right area under the ribs and back / shoulder pain. But also gas / lower abdomen pain and floating stools. What could be the cause? ### REPLY: Hi and welcome to . It can be caused by gallbladder or liver issue and this is the most common cause of such pain. Dilated intrahepatic ducts are seen most commonly in biliary tree obstruction due to stones but also any kind of liver fibrosis or hepatitis can cause it as well. Rarely tumors are diagnosed after such MRI findings. So you should do cholecystectomy if pain persist and have frequent hepatologist follow up. Thanks for the query. Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i have tingles in my cheeks and hands, tingles and numbness in my back between shoulder blades that come and go, but i have constant tingling in my lower leg as soon as i stand with burning in my outer calf, when i walk a short distance, i starting to get very worried as this is causing me extreme pain. Ive been referred to an neurologist but app isnt for months, should i be worried? What do you think could be causing it? Please help :( ### REPLY: Hello, I have studied your case. First possibility could be lumbar canal stenosis leading to burning sensation and pain in your leg and inter scapular area. Due to compression of this nerve root there can be leg pain associated with it. I 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: i am 52 year i am suffering ashamatic elleargy from last many year i am doctor give citrazine monteculast and metyl prednisolone in this time regularly i have to take inhalar doctor say  you had bronco ashthama i can not regularly sleep in night i had also digestion problem due to stress as i take food my abdomine full with gas i so i got ashama  please give me the medicine so i can come out ### REPLY: Hello. Thank you for contacting . The course of treatment you are currently following for your problem of asthma is correct, and I would advise you to follow your doctors' advice for that. As for your bloating problem....it appears that you have Acid Peptic Disease. TREATMENT:cap omeprazole 20 mg at morning for two week stab. Domperidone 10 mg thrice daily half an hour before meal for three weeks.PRECAUTIONS:Avoid spicy and oily food. Decrease the consumption of alcohol, cigarettes and carbonated . Don't use  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes, recently I have had pains on my side and back. I am 54 years old, have high blood presure under control and diagnosed with chronic Kidney disease. Recently from time to time I have had almost all liquid diahreah, especially when stressed. What should I do?I will see my Doctor on this...thanks anyway. ### REPLY: Hello and welcome to . Your concern is understandable.  As a Urologist, let me advise you, that with CKD(Chronic Kidney Disease), you're prone to electrolyte (salt and potassium), changes with diarrhea. The kidney function tests, like blood creatinine, and urea with electrolytes need to be checked, and corrected according to changes seen. An Ultrasound scan of the abdomen may be advised, if needed. You may need admission after an examination. You should be careful to avoid potassium rich diets, like fresh fruits, coconut water, and adding table salt. Take fluid intake slightly more than urine output. You may contact me by name, with reports, for expert opinion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 57 years had triple vessel graft 2 years ago and on full medical treatment . I still have chest pain at rest and when taking deep breath plus feeling of sob which last one to two hours when i walk there is burning sensatin after 10 min which diappear after 4to5 min rest what should I do now thanks ### REPLY: Thanks for your question on . I can understand your situation and problem. Since you had cardiac surgery in the past, we should first rule out cardiac cause for your symptoms. Your symptoms like intermittent chest pain, shortness of breath etc. are commonly seen in heart diseases. So first get done ECG, 2d echo and if needed coronary Angiography to rule out heart diseases. If all these are normal than get done chest x-ray and PFT (Pulmonary Function Test) to rule out bronchitis. As bronchitis can also cause similar symptoms. So you should consult doctor and discuss all these. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 15 yr old boy and have a small bump on my testicle and went to a doctor and he sent me to an ultra sound, so i did today, but the results will not be back until a week and i wanna know what it might be.  He also said he has never felt anything like it before and he is a urologist for a while now.  Is this a good or bad thing? ### REPLY: Good Day, and thank you for being with  ! For masses inside the scrotum it is important to get a scrotal ultrasound to check if the mass is inside the testicle or outside the testis. There are numerous structures in the periphery of the testis like the epididymis etc. that can have cysts. Cysts structures are benign and not a cause for worry while intro testicular masses are almost always malignant and needs Surgical removal. I would wait for the ultrasound to see what you have. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ .  Best wishes.  Manuel C. See IV, M.D. DBU FPGA ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Husband is a Prostate Cancer Patient.  Early Stage and will begin radiationTherapy in about a week. All of a sudden he started having pain in his ear, and some Bleeding. Could it be related to the cancer? and should this be checked out before Radiation begin? Thank You. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your husband has ear pain and bleeding, but mostly it has no relation with prostate cancer.  He may have some infection in ear like Otis media or Otis external. He should go for examination once. Then he should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 9 days ago I missed one pill out of my birth control pack (orthotrycyclen), I didn t realize until the next day, so I just continued taking the pack again as I normally have been at the same time every day. I have had bleeding that is just as heavy as my period, and even a bit of clotting, in the 9 days since I missed my pill. What could be causing this and what should my next step be? ### REPLY: Hallow Dear, If you miss up to 3 pills in a cycle, it is allowable. However, it is advised that after missing a pill in the night, take it in the morning or whenever you remember it. You have taken a good step to continue your pills regularly after missing one pill. Do not worry, it will not lead to the pregnancy. Hence forward, continue to take the pills as regularly as you were taking previously. This cycle, though the bleeding is somewhat heavy, starts a fresh pack from day 2 of the cycle. I hope this 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: My father has beginning stages of Parkinsons and when he took the meds he began having suicidal thoughts and thoughts of harming others so he stopped. Can you please suggest some natural herbal supplements that would help in in any way possible. He also has diabetes and neuropthy. ### REPLY: Hi, First, your father can eat one tablespoonful of flax seed oil with his meal, or he could eat grilled fish three time per week. He could also take iron supplement tablet twice per week after meals, for example after lunch on Monday and Friday. Moreover, vitamin B complex once per day after meals, Folic acid 500 micrograms once per day before meal, Coenzyme Q 10 three hours after meals once per day and Benfotiamine 40 twice per day after meals every day can help him. But, these natural methods cannot replace the medical treatment. Your father should take antidepressant, but you should ask your doctor about the suitable .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up one morning with I thought a spider bite on my right leg on the shin an it had gotten bigger in two days and was hurting the bone in my leg I popped it really good threw some peroxide on it and it started to feel better now it s a dark scab with a pus bag around it and I have what looks like pimples but at the same time not starting to form on my leg I m a little concerned ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that such reaction can be possible after spider bite which got infected. I advise to take definite tablet as antibiotic, Diclofenac as analgesic, and pantoprazole as anti acidity agent take it for a week. Also take good care of local wound with cleanliness and . I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 17 year old son that has never had any back injuries except in 2003 he had guillian barre syndrom. Here recently I have been noticing reports that he has small subligamentous disc herniation L4/S1, small disc herination L5, radicualopathy and diffuse disc buldge L4/5. What exactly does this mean and for his age? ### REPLY: Hello! Welcome to Ask a Doctor service! Regarding your concern, I would explain that these changes could be related to weight lifting or vitamin D deficiency. Is he obese or overweight? This could explain these MRI findings. I would also recommend checking vitamin D plasma levels and performing a lot of physical exercise, in order to help reinforce his back muscles. Hope to have been helpful! Wishing all the best,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have sence august of 2012 are having systoms of metallic taste in month and groin pain,i had removed in 2009 maligment melanoma or skin cancer .pain in groin is present after riding my bike lifting weights and eating food,went to dentist in Dec 2012 every thing is fine thier.Is this Cancer again in a more serious maner i am 45 yrs old and they also took out in the same spot the skin cancer in dec2012 the borders were starting to show signs of cancer again from the freckler that apeared in that spot. ### REPLY: Hi, malignant melanoma has to be staged before commenting on prognosis. Surgery is the mainstay of treatment. IF it is local disease it canes be removed with surgery but in case it has loco regional spread to lymph node chance of cure decreases. Unfortunately adjuvant treatment does not help very much. They are very poor responder to chemo radiotherapy. Biologics have some role. Consult you oncologist regarding staging and treatment options for your case. 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 getting severe head ache from last 6 months at the temple regions of eye starting edge of eyebrow corner........consulted many doctors........one said its synositis other said its migrine other said its both u have......took tablets and treatment for all ....still suffering from head ache......dont know when and how it starts searching the reason and problem ......could you please help me to find why? ### REPLY: Hello Thank you for trusting  Dear many causes for headache If you're suffering from repeated cold nasal congestion it may be due to sinus headache, need CT paranasal sinus to confirm diagnosis. If your getting band like feeling around the head aggravated after stress full conditions it may be due to tension headache, need relaxation yoga etc. Unilateral, periodic each episode lost 2-3days with severe headache with blurring if visioned, aura it may due to migrant. Other causes like cluster headache and temporal arthritis. Please consult your euro physician he will examine and treat you 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: Hi there, I just wondered if you could help. For the last few days whenever I walk or do physical exercise I get really quite severe pain at the top of my chest, central but radiating slightly to the left. I do not get any pain when at rest. What is the best way to treat this? ### REPLY: Hello there! The pain in the chest coming on with exertion and being relieved on rest is typical of angina. You haven't mentioned your age and any other co-existing illnesses.However, to begin with you should get your blood pressure (BP) measured several times to rule out high BP and also get an ECG done. A Lipid Profile and Blood Sugar levels too would be helpful in sorting out your condition. Please do not ignore this exertional pain. Hope this helped. All the best! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 58 year old Black Woman and Im having a hard time breathing, I ve never had asthma or any other pulmonary disorder. I am currently off my diabetic medication because I don t like the side effects, however, I have not experienced any trouble breathing until recently. I can stand to lose 75 pounds or so and I am 5 7 inches tall. Can you give me a clue? ### REPLY: Thanks for your question on . Since you are diabetic and not taking treatment, your diabetes must be out of control and very high. And uncontrolled diabetes is a risk factor for heart disease like hypertension, angina, heart failure, coronary artery disease etc. Other risk factors along with diabetes are1. Old age (age more than 55)2. Post menopausal status. So get done ECG and 2D Echo to rule out cardiac cause. Uncontrolled diabetes can also affect lungs. So get done chest x-ray and PFT (PULMONARY FUNCTION TEST) to rule out pulmonary causes. So consult doctor and discuss all these and get control over diabetes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 what can cause belching , feeling of uneasyness in the chest and dizziness, i was given pylokit for 7 days after having fro 3 days i started to have this feeling, dizziness is there throughout the day with somitimes increased heart rate and uneasyness feeling ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of HERD (gastroesophageal reflux disease) is more. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of belching, chest pain, nausea etc. Only .  You should also follow these lifestyle modifications. 1. Avoid stress and tension. 2. Avoid hot and spicy food, avoid junk food. 3. Avoid large meals, instead take frequent small meals. 4. Go for walking after meals. 5. Quit smoking and Alcohol if you have these habits. 6. Keep 2-3 pillows under head in bed to prevent reflux. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I noticed one day in the shower that both of my knees were swollen, they feel fatty and not hard, my left knee is more swollen than the right. They look like elephantiasis. They are swollen above th knee cap, with indentations at the knee cap. I also recently noticed that my tongue is white. I started taking rephresh pro-b and wonder if I had a bad reaction to it. I stopped taking them. I have no pain. I have other symptoms that come and go, but are more irritating than painful. ### REPLY: Dear patient What is your age ?  If you are past middle age possibility can be 1. Supra patellar effusion due to osteoarthritis 2. Synovitis related to inflammatory arthritis. This needs to be investigated with X-ray of both knees anteroposterior (standing) and lateral views to assess osteoarthritis 2. Ultrasound of both knees to assess collection.  Please visit radiology center nearby you and get it done. You need to consult expert orthopedic surgeon with report.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have tingling and numbness in first 3 toes of left foot. Numbness is on bottom of foot the toes have both numbness and tingling. When foot is at rest the second toe sort of drops down. Saw a neurologist had MRI and blood work. All they could find was That my B12 was low. I take a B12 pill but have not noticed a difference. This was been an issues for a few years now. What should I do next? ### REPLY: healthier should be checkup with a neurophysiologist and mapping of muscle power in foot should be done along with neurophysiologist studies for any conduction defect in nerves, secondly, Blood and urine sugar levels must be checked for ruling out diabetes. Alsoa physician should rule out Hansen's disease, although, uncommon now, but may be present in endemic areas. After all this check up, the neurologist will decide for course of father action, if B12 is normal now 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: About a year and a half ago I had my IUD changed, it did not feel right when she replaced it. I called a couple times and she said that it was all normal side effects. Ever since I have had stomach cramps, feels like gas but way worse and back pain going into my sides. These were random up until about 4 months ago and now they are more then not. I get really bad headaches and my periods happen a couple months then I dont have them for a couple months. I have had random itchy spells. They have done blood and urine tests and have not found anything. They say it is not my kidneys, gallbladder, appendix. Could this be side affects of the IUD? ### 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: Hi, Im second pregnant after a kidney transplant in 2001, my mom donored me a kidney and im blessed to have a great health since then. my creatine 1.2-2.0 .. the thing im worry about is.. my firsy child was born 3 months premature with a heart failure and had to have a heart chest surgery after his birth, he is doing well now but im worry abotu my second child and my kidney,, my med. are:: sandimun neoral and azathioprin,, now, he re in USA they said azathiprin is bad for a baby so i have to stop takin it,, in Germany where im origin from they have a different ideas about that and i had to take azathiprin with my first pregnancy back then, wanna know what is right .. thanks ### REPLY: HiT hanks for your query. Unfortunately there is no consensus about the use of azathioprine in pregnancy. It is generally considered as the safer immunosuppressants but has been known to cause problems. So we really have to decide between the risks to the kidney versus risks to the baby. I personally would continue it. However, the ultimate decision is between you and your obstetrician and nephrologist. Hope this helps Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a PSA of 184. Appointments booked for next week biopsy and bone scan, Seriously looking at alternative treatments as the doctors have already decided my fate and type of treatment they will be using, I feel like Im being rushed through the hospital system and feel I could be happier receiving natural medicines to treat the Prostate Cancer. Please advise if you think I should or should not explore my options!! ### REPLY: Hi, Thanks for writing in. Having a PSA 184 is a concern. It is best to get your biopsy and bone scan done at the earliest and doing them next week is a good option. Please get these tests done and following this your cancer staging will be known. Prostate cancer survival is good if detected in the early stages and your doctors intend to help you out with it at the earliest. There is no need to look for other options and I guess you are getting the recommended attention and treatment choices. Cancer is a condition where delaying treatment even by few months can change the course of disease and make it difficult to treat. You can explore and take natural treatment if any after discussion with your doctor. However, the primary treatment should be the one decided by the doctors at the cancer hospital. Please get evaluated in detail and start treatment. 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. So I keep going number 2 several times lately. Sometimes I go and sometimes I just have gas. I also feel very shaky and in easy.. Sweaty palms. I do worry a lot as have made myself sick in the past from it. I have been very stressed lately.. I m not sure if I m having anxiety attacks which make me sick or I m just sick. ### REPLY: Hi, Welcome to  forum.  It appears that you might be having the irritable bowel syn .  Or there may be amoebic colitis.  I advise you to consult a physician for diagnosis and treatment. You may need to have colonoscopy for diagnosis.  Avoid taking more of spices, junk foods, and oily foods.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods for healthy epithelium of the gut.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir this is for my.uncle. the result i got after his test :- specimen: is floor of mouth clinical diagnosis shows:- ulcer left side of frenum in the floor mouth. macroscopic examination shows one small brownish white soft tissue .all embeded..microscopic examination shows: given hyperparakeratinised stratified squamous epithelium with dyplasic features.. Impression is:- suggestive of squamous cell carcinoma-well differentiated(grade 1) (sir what does it mean..i didnt understand what this result tell??? sir plz can u make me understand in normal language. ### REPLY: It simply means that your uncle is suffering from cancer of the part of the mouth below the tongue (called the floor of mouth). Squamous cell carcinoma is the most common cancer to occur in the mouth. You should immediately consult a cancer surgeon and start treatment. If it has not spread to other parts of the body then the treatment would be first surgery which may or may not be followed by radiotherapy. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 18 year-old and i might have Anemia ..I am having breathing problems like racing heartbeat shortness of breath like I ve run a mile. Recently I almost had a panic attack twice I felt like I couldn t breath and began gasping for air my chest felt heavy pain in left arm and like I couldn t inhale oxygen and my tubes were closing..... my parents say its fear and I have no problems .I would like a solution to my problem that do I have breathing problems or is it fear? ???? ### REPLY: Thanks for your question on . I can understand your concern. We should definitely rule out heart (valvular diseases) and lung (asthma) related diseases first. So consult doctor and get done ECG, chest x-ray, 2d echo and PFT (Pulmonary Function Test). ECG and 2d echo are must rule out valvular heart diseases. Chest x-ray and PFT are needed for asthma. If all these reports are normal then your symptoms are mostly due to anxiety and panic disorder. So consult psychiatrist for this. But first rule out heart and lung related diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last December 2013, I  had miner stroke .  Also I have a back neck problem.I wasnt sure what is cause, this few month I cant think too much,   IF I THINK A LOT,Sometimes  my  BACK OFHEAD,  FEEL LIKE SOMRTHING COVER  WHICH IS I DONT LIKE THIS FEELING, AND SOMETIMES MY BODY FEEL LIKE PUSH ME OUT... CAN YOU TELL ME WHAT IS THIS SIMPTON.....? ### REPLY: Hi. Thanks for the query. May I know your age, whether you suffer from diabetes, hypertension, thyroid function abnormalities etc. & if any of these is YES; what medications & in what doses you are taking for the same. Based on your history of recent stroke (extent unconfirmed); you may be suffering from anxiety or depressive episodes or an admixture of both! Psychiatric problems like depression, anxiety are known to occur after stroke & depend upon extent & involvement of area of brain affected by stroke. Hence, kindly get in touch your Neurologist & request for an assessment by a Psychiatrist for confirmation of diagnosis. Once ascertained, an antidepressant like sertraline, Escitalopram, timeline with lifestyle modifications & counselling (if required) shall help you through. Good Luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My son is 2.10 years old . He understands everything we say and he also follows orders,but he does not talk and communicate much. he loves to listen music and recognizes movie songs. A child of his age starts framing sentences...Is this something to worry about ? ### REPLY: Hi, I had gone through your question and understand your concerns. You should be worried but not too much, because boys usually begin to speak after 2 years. You may easily stimulate him to speak. Furthermore, you can propose him candy or toy when he will tell hello to aunt or uncle. Furthermore, you should develop social skills, because your baby can be introvert. If a person comes to me with speech problems, I would empirically treat and prescribe him B-complex with lysine 5 ml once a day for 1 month unless allergic to it. For improvement memory and speech I advise Nootropic for 1 month. At the same time I write him tests(levels of Vitamin B12, B6,folic acid) to confirm the diagnosis. I prefer to monitor this patient as this is very important. Start on these changes and get back to me in 2 to 3 months. Wish your baby good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I went to my primary physician last week due to lower abdominal pain , and discomfort in my kidney, he tested my urine and said there was no infection, then asked if I was menstruating, at the moment I wasnt and I thought I wasnt going to because I had my period in the beginning of this month... He said I may have kidney stones, I have not gone for an abdominal scan but the pain is not pain exactly its more like discomfort and it does not burn when I urinate... I have been discharging and spotting all month... My doctor prescribed ciprofloxacin just in case it was an infection... I got my period the next,day... I have been taking the medication for 7 of 10 days now I have been in a lot of pain and my flow is really heavy on my 7th day of menstruating... Can the pills cause this or is there a deeper underlying problem... I have no medical insurance at this time and cannot afford testing and specialist visits please help me ### REPLY: Hello and welcome to . As a Urologist, I can understand your concern. According to your symptoms, you needn't take ciprofloxacin anymore. . You should have an ultrasound scandium, to know the cause for your pain. You should check blood routine, RBS,creatinine, platelets,and urine routine. This is needed to give you specific curative treatment. If you've any doubt, you can send your reports to me, as a direct question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lost quite a lot of hair over the years, I think due to several things, one of them being a massive haemorrage after an op and the other being I lost my husband. Is there anything you could recommend to make my hair get a lot thicker, there is considerable loss on the top and back. ### REPLY: Hi, Hairball can occur due to a number of causes like fungal infection, nutritional deficiency, stress, long-standing illness, side effects of medicines. If there is excessive hemorrhage then it can be due to low hemoglobin levels, so it can be a cause of hair loss. Stress can also be a cause. You should consult a Trichologist and get evaluated, and he can advise you investigations like hormonal assay, blood tests, pictogram, to rule out the exact cause of the problem and treat you accordingly. You can be advised to apply 2% Minoxidil lotion over the scalp. Furthermore, you can be advised to take multivitamin supplements. Furthermore, you should massage the scalp with warm coconut oil. Furthermore, you should take a nutritious diet and .  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: yesterday i suddenly vomited with blood in it after getting a tight feeling in my chest. the feeling continued and i was extremely short for breath. i went to a&e but they couldnt find anything wrong with me. the sick feeling is still here and my chest still feels restricted. what should i do/what could this be? ### REPLY: Thanks for your question on . I can understand your concern. Tightness in chest and blood vomiting are seen with gastric ulcer and gastritis. So you should definitely consult gastroenterologist and get done upper GI (gastrointestinal) copy. You may need combination of pantoprazole and levosulperide twice daily before food for 1 month. Avoid stress and tension, be relaxed and calm. Avoid hot and spicy food. Avoid junk food.Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im 26 yrs my lmp was on 14 th may 2011.. i was given clomiphene 100 mg for 5 days from day4 tvs showed dominant follicle 19 mm on day 12 had inj. ChatDoctor 5000 units on the same day.. tvs showed fu seen (R) collapsed structure seen s/o corpus luteum day of ovulation day13/14 emt: 7mm ... i took ..meprate 10mg on day 17 and 18... took progesterone 400 mg from may 30/day 17 to june 10/ day 28 as suppository ... preg card was positive on day 29/june 11.. Serum beta ChatDoctor on june 11 was 133.20 mIU, took inj.progesterone 100 mg ...on day 31/ june 13 serum beta ChatDoctor was 400.10 mIU later had inj.HUCOG 5000 on the same day..now im advised to take tab.susten 300 mg twice a day ... im having spotting from yesterday june 14 and today june 15 im really worried pls what shall i do now ### REPLY: Welcome to  Good Earthier could be two possible options in your case. Either trouble in the pregnancy or implantation bleeding which is usually a good sign. Implantation bleeding is typically defined as bleeding that occurs 10 to 14 days after conception, when the fertilized egg attaches to the lining of the uterus. Although the phenomenon of implantation bleeding hasn't been scientifically proven to exist, bleeding at this point in pregnancy is relatively common and perfectly normal. Implantation bleeding is thought to result from blood leaking from the implanted egg into the uterine cavity. It occurs earlier than a menstrual period. Implantation bleeding may last for one to two days with a flow similar to a menstrual period. Implantation bleeding that's heavier than a normal period is rare. You need to get an ultrasound to confirm if the egg has implanted to the uterus. This is the only way you can allay your dears at this time. Speak to your Obstetrician regarding this and take his/her 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: Hello, Thank you for taking the time to even begin to read this, it is much appreciated. About 1/2 a year (quite possibly a full year) I was strongman conditioning with my step-dad (which included me lifting a bunch of things that I could barely lift right. So I was finally getting into shape (since even with conditioning I am still overweight , was striving to become fit.) So, stupidly, I lifted something that was about 450 pounds total (225 in each hand on a farmers lift for a competition we were gearing up to do.) Instantly felt something wrong, so as weeks progressed my back became terrible in condition. Went to the doctor and she sent me to physical therapy . After a few sessions of physical therapy I got the exercises I was meant to do there, and to save money just decided to do them at home. (they didn t require any special equipment despite all my complaining of my back.) So ever since then it has been kind of dormant, sometimes hurting other times not. Fast forward to recent times, I started a job. Basically being on my feet for the entire period of time, doing different jobs with different back stresses. That stuff doesn t bother me in the moment, it just waits until I get home. Once I get rested in my bed, I tend to forget / have to do something and get up. It has gotten to the point where I cannot stand, or if I can stand i have to have something to hold onto the entire way. It feels like my legs are going to just give out with excruciating lower back pain (worse than the initial injury and physical therapy weeks). I would just really like to know what I am dealing with, potentially. I should be able to stand up as much as the job requires me to, there are plenty of young people (overweight and not) doing the exact same thing as me and not complaining. I would like to know how serious this could be. Please, if any light can be shed on this it is much appreciated. Also if you need me to clarify anything please say so, its about 4:00 AM and I just got off work so I don t expect some of this to make sense. Thanks, Robert ### REPLY: Dear patient, Have you your X-ray report, CT scan report? If yes it should be mentioned here. Ok it seems that you are facing with data award according to Ayurveda. The application of ball tail am/hairball tail am is helpful.Also, the bast treatment is essential. The diet should be easy to digest. . The theistic Linda Swede is also helpful. Yograj juggle/Kishore juggle is the best at this situation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lightheadedness and a balance problem - my head feels like a hangover and when I walk I feel like I am walking lop sided but actually walking in a straight line. I have had all sorts of tests and nothing shows - right now I am on a high dosage of vitamin D2 and a light dose of B6 - I am at my wits end - keep going to drs to no avail. Any thoughts please! Thanks, Jane! I didn t realize there would be a charge, my funds are limited, so I ll pass ### REPLY: Dear Jane, The queries asked in this forum are answered free of cost. Please feel free to ask your questions. The symptoms as mentioned in your post can be attributed to pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthine or Benign Paroxysmal Positional Vertigo. Symptomatic relief can be obtained with intake of Vestibular sedatives like Betahistine or Linearizing preparations (to be taken only under the guidance of a Physician). If it still persists, then you need to consult your Physician/ ENT Specialist & get a complete clinical examination done. Investigations like estimation of blood pressure, blood sugar levels, serum electrolytes & vestibular function tests will be required to rule out any pathological cause for the symptoms. There is no need to worry, you will be fine. Till then, maintain adequate HY . And also take precautions of getting up from bed slowly & avoid sudden head movements. Wishing you a Good Health. Take care. ### END