Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Heya Im natasha, iv been on the depo conreception injection 2months now and two weeks ago I got a sharp pain under my belly button then started bleeding but it was more like spotting and it was browish pink blood then went red then stopped, then a week after that I got the same pains on the night and the day after sex I started spotting the same blood pattern again. Iv been on the depo and other contreception befroe and never experienced this, do you know what the problem is or some advice on what to do or what might be causing it? ### REPLY: Hi, Thanks for the query. Depo can cause side effects like pain abdomen, breakthrough bleeding etc. So possibly the bleeding could the side effect of the demo. If the same thing gets repeated, you once consult gynecologist get examined to rule out the possibilities like pelvic inflammatory disease. Then you can go for symptomatic treatment in future if needed. For more details you can ask me through: http://www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having chest pain in the middle of my chest. When I lie down it hurts more than when I sit up. I also checked my pulse and I normally run pretty low like between 45-55, but it was 63 when I checked. Do you think maybe its gas or something more serious? ### REPLY: Thanks for your question on . I can understand your concern. Central chest pain more on lying down is commonly seen in HERD (gastroesophageal reflux disease). But better to first get done ECG to rule out heart diseases. If ECG is normal then no need to worry about serious illness. Possibility of HERD is more. HERD is due laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of central chest pain, gaseous distention etc. So take antacid tablet like pantoprazole. Avoid large meals, instead take frequent small meals. Avoid stress and tension. 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: My son has just been for a whole arm cover up. Started at ;11 and by 3.00pm he had a seizure and was in an ambulance. He is not epileptic and has never had a seizure before. He has discharged himself from hospital and 4 hrs later is being vielently sick?? ### REPLY: Hello, First, your son should do some investigations such as MRI T2 weighted Brain, EEG, ECG, CBC, Liver, and Kidney function tests, blood analysis for toxic or illegal .  Then he should be put under complete medical supervision in a hospital for 24 hours. The results of these investigations can give you the correct diagnosis for his case. 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: I have a dark circle around the outer edge of my eyes. The right one is worse than the left. I have had this going on since May, and it betters and worsens at times. It is hard for me to read, but it isnt blurry, it just strains my eyes. I have been to numerous doctors, none of which have any idea what this could be. The black circle is not completely solid, but close to it. I researched and found a disease called Retinitis Pigmentosa, which in turn led me to read about Multiple Scleroses. As I read about MS, I came to realize that I do have other symptoms of MS, such as shaking of my hands, weakness in arms and legs, slow reaction time. Do you have any suggestions as to what this might be? Could my age of 14 years old have anything to do with this? ### REPLY: Hello, Welcome to . Common causes of dark circles around eye are stress, overwork, vitamin deficiency, poor sleep and deny .  It is very less likely due to MS in your case. MS diagnosis is not very simple to make. It will need examination from neurologist and imaging studies like MRI brain to confirm it. Your other symptoms (shaking of hands, weakness in arms and legs, slow reaction time) can also occur due to stress/anxiety and vitamins deficiency. So evaluation by general physician and psychiatrist will help you. Wish you good health and all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr, My baby got infected with bronchitis at age of 9. he was dehydrated and was hospitalized, Dr started antiboitic along with nebulization with medicine ventolin, clenil and aterment/atem . may be got better in a week and after 2 to 3 week nebulization process he was 100% well but as he is turn 11 he got infected again with, dr said its same sort of illness with some effect of pneumonia ( may be bronchiolitis ) this time, may be stopped taking milk , it was very difficult for us to handle, as we were worried of dehydration. then we use Salinase drop and he started taking diet. What i wanted to know, is it normal to get infected with such issues like we do with flu , cough etc? or getting infected again and again is an issue ? its not easy to find baby breathing very difficulty so i am very worried, please advice, what we can do avoid such thing later, do formula milk cause this. also dr this time started piriton syrup. THanks ### REPLY: It appears that your baby is 11 months old and not 11 years old. If this is correct, attacks of bronchiolitis are due to virus known as RSV and this can happen recurrently and even lead to childhood asthma. You should follow your doctors advice and use nebulization as often as needed to stop his breathing problems. No one really knows whether food or milk can contribute to the problem as the major cause is the RSV virus and not milk. Do not change his milk unless you have had your son tested for milk protein allergy.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Doc,I wanted to postpone my period due to my wedding...my date last month was on 2nd and i generally get periods 1/2 days before..so the gyane had put me on Primolut Nor 10mg...and she prescribed 2tab for 3 days and then 1 tab for 7 days...and she said after you stop taking it you will have your period within a week....and she also suggested that 3 days after my period starts i shouldtake a contraceptive Pill ( Yasmine) for 21 days...but how ever i was not sure if i should be on medcines for so long so she said taking this contraceptive pill is your call...However can you tell me if i should take this contraceptive pill?..also its been a day since it started taking Primolut Nor 10mg...everything seems fine but i have read online that there could be slight bleeding initially....is that true and is the bleeding after i stop taking this medicine irregulat & heavy with prolonged days?? im worried cz i have always had regular periods with heavy bleeding on 2 days out of 5 days.Please help ### REPLY: Hi, I think if you want to delay your periods, you can continue primal N. There is no need to take contraceptive pill if you don't want contraception now. You may get some heavy bleeding for 2 to 3 days.  If it persists or is very heavy, you can take some medicines like Tranexamic acid to stop the bleeding.  You can discuss with your doctor regarding this.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was bitten by my new pet hedgehog a day ago. do i need anti rabies or anti tetanu? i had an anti tetanu and tetanus toxoid last month when i was punctured by a nail. but i havent received any anti rabies yet. so basicaly do i need any medications? ### REPLY: Hello, Welcome to , As you are bitten by your pet hedgehog, which is known to transmit rabies if it carries the rabies virus in it. The disease rabies is 100% fatal, but it is 100% preventable by proper treatment. For your bite and the symptoms I would suggest you to follow1. Wash the wound thoroughly with soap and water for at least 15 mins2. Antirabies vaccine on days 0,3,7,14 and 28, which should be administered intramuscular to the deltoid muscle3. Antirabies serum, should be administered in and around the biting wound.4. In Tetanus, should be given intramuscular. These medications will help you to protect you against the disease rabies. 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: We need your advise about a male patient, 67 years. He was found with carcinoma of the colon 9 months ago.He got 6 sessions of chemiotherapy,but now the ultrasound shows 2 small masses on the liver . Please let us know what you thing and if possible to get a treatment in india? ### REPLY: Hi, I am so sorry to hear about the diagnosis. Provided the liver looked normal on previous scans, the new masses in the liver would suggest spread of the cancer to the liver. The future course of action will depend on a) whether there is any return of cancer in the colon itself (local recurrence) b) whether the cancer in the liver is amenable for surgical removal and c) whether the cancer has spread to any other parts of the body. There are various centers in India with excellent surgical teams which can potentially treat this patient. Please do not hesitate to contact me for any further details needed. Hope the patient gets well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recurring UTIs and recently was bed-ridden with extreme dizziness and vomiting for a day and a half.  It wore off and I assumed it was a flu virus but now I have realized this could be symptoms of a UTI.  I still feel tired and bit feverish although no real pain urinating, possibly slight odour but it has happened so often Im not sure now.  I was on a low dose antibiotic for 3 months which I finished a few weeks ago.  Should I see a doctor or be worried about an upper UTI and kidney damage? ### REPLY: Hello and welcome to . Well your concern is understandable. As a Urologist, let me assure you not to worry. But, you must see your doctor for an examination. Your urine routine and culture test, blood sugar, blood routine and kidney function test, and an ultrasound scan of abdomen must be done. According to the reports, the doctor will be able to advise the proper treatment. Wish you a speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my periods are irregular 25-30 day cycle. my last period was 22-27 april 2012. i had intercourse 24th may and my period has not arrived yet, i took a pregnacy test yesterday whicChatDoctore up negative, its now 30 days and counting, i get very light cramps but my period still has not arrived. could i be pregnant? ### REPLY: Hello dairy understand your concernThere is no chance of the pregnancy as you did sex at the 24th may. Your previous period was at 22nd-27th date. You did sex in the complete safe period of the cycle. During this time, there is no ovulation so no chance of the fertilization. Your light cramp could be due to premenstrual symptoms, hormonal imbalance. I would suggest to wait for the period for next 7 days. If period will not come then it can be induced by the progesterone pill in absence of the pregnancy.Meanwhile, avoid stress, take healthy diet, . Hope this may help noncontact  for further health query 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: I am 29 years old and I have 2 children ages 12 and 9 years old.I found a small knot in my lower abdomen that is about the same size as a marble.It doesnt hurt really but if I apply pressure to it I have a real funny feeling go through the bottom of my stomach.What could it be? ### REPLY: Hi, Dear,Good Afternoon, and Thanks for the query to . I studied your query in details and understood your concerns.@My impression of your Lower abdominal lump-is as follows--its mostly ?Spiegelman hernia ? Boil-early stage. Spigelian weakness gives herniation in the para-umbilical region in lower abdomen. I would advise -a-Consult ER Surgeon who would check and fix its diagnosis. This would resolve your lump issue in leg. I would suggest consulting ER surgeon and test blood forces / PPS -levels. This would help you to plan treatment with your doctor.@Hope this would resolve your worrisome query. Welcome for any further query in this regard, and would love to help you to resolve this problem till it is solved to your satisfaction.@ One Small Request to you to Write strong recommendations promoting my services for the benefit of my new and old patients at  clinic. Wishing you fast recovery.!! Have a Good Day. With Regards, . N. Super-specialist in NCCD-Non-Curable Chronic Disorders and Rejuvenation therapies in tissue and organ failures. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 serious rush hives and its very itchy I hade it for 19 years for the last 7 years it almost fade away I took twice a week 10 mg doxifen and I hade no problem 2 weeks ago I hade to take antibiotic and it trigger my allergy to a level that even any medication I take its not helping me can I get advice help I am desperate ### REPLY: Hi I do care for your concern. The .  Some antibiotics cause rashes and itching as its side effect. Taking a course of steroids like DEXA or preen will help to resolve the symptom as of now. However, I would advise consulting your skin specialist and know about different treatment options available, most of the time desensitization procedure will help you on long run. Hope I have answered your question, if you have more feel free to ask. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! My four month old baby is suffering from loose motion since past seven one month. He passes loose stools almost after every feed.she has caugh also ,.wt i do nw .. her weight is 6.5kg ..no lose from one month My doc asks me to wait and watch but am worried now. Can you please please help? ### REPLY: Hi... Thank you for consulting in . What your kid is having is not a diarrhea and is only a gastronomic reflux. It is quite common for babies of this age group to pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated. When the baby takes milk, the stomach expands - then when it is contracting it sets off a wave form which moves down the intestines and when that wave reaches the lower down rectum, a small quantity of the stool is evacuated out. This is the basis for gastronomic reflex. Do not worry. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid 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 periodically have lower back pain with spasms on my left side which I have been experiencing on and off now for at least 10 years. I am 53 years old, female and was in very good health until I first experienced a painful spasm while gardening. My back went into lock & I couldn t move for a couple of minutes. When I now have back pain it is quite severe and I m walking as if crippled as it is impossible to walk properly. In the last year, this has happened me about 4 - 5 times and lasts about a week to 3 weeks. Although the pain doesn t affect my legs, it is going down into the hip. Is it possible that I may eventually need a hip replacement if the pain becomes more frequent and severe. ### REPLY: Hello, I have studied your case. Due to compression of this nerve root there can be pain in your back. 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. Hip replacement can be advised after clinical examination. 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 schizophrenic taking phychaitrist treatment and currently in good health. if I want to get rid of medicines or cure myself, what would you suggest? what about dialysis? I just came to know its very painful process and if i do it, how many times I will have to to cure myself. what is the sucesss rate of dialysis for schizophrenia? ### REPLY: Hi Rakesh, Thank you for posting your query. Schizophrenia is a chronic illness, requiring medications for a long period of time. Good thing is that the medicines used for treating schizophrenia are very safe and do not lead to any serious side effects. So, if you are doing well and are not having any side effects, I would suggest you continue using the .  Dialysis is not recommended for treating schizophrenia. I hope it answers your query. 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: choleterol is 188, triglycerides 164, hdl 31, Ldl 124, chol/hdl ratio 6.06, non-hdl 157 findings suggestive of no mypcardial injury. i am hypothyroid, 42 yr old nonsmoker,nondrinker,female, 5ft 11in, 260 lbs. been overweight since i was born. how do i fix the numbers and avoid an early heart attack? ### REPLY: Style modification should be tried for next 3 months exercise daily for 45 minutes a day brisk walk daily at a speed not less than 5.1 km /hr daily for 15 minute seat low salt food add fibers to you diet reduce your weighting take ghee or butter use Suffolk or olive oil instead. Take low fat food avoid dairy produ1. Reduce body wt 3. No tobacco 4. Diet - no ghee/ butter, have mix of vegetable oils - mustard, til, ground nut, olive oil, have more green vegetables and fruits, have whole grain Alta, now fried. Fast. Spicy / processed/ junk food. Less sugar, potato, rice 5. 30 MTS brisk walk daily 6. Deep breathing exercise for 10 MTS daily 7. Meditation daily for 10 MTS. 6-8 hrs of sleep at night 8. Expose your body to sun for 15-20 MTS daily after some oil massage to get it d. 9. Take more water ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey, I fell and got a mensicus tear in my left knee. Since then im on crutches because of a ligament aswell.since that day I lost feeling in my left hands small finger and half of my ring finger and that part of the palm aswell. The feeling has changed to pins and needles to the point of pain, the doctor took a xray of my neck and said one of the vertabraes have a little swelling around it but it should go away quick and cant be that bad. It has been a while now and I am 17 so cant just go to another doctor and our medical aid is depleted. I have to drink zytomyl which is a antidepressent of 20 mg daily ,4 * 30mg ritalin(generic methylphentidate), purbac,topiramate which is like epilum used to control intense migrain I hardly have ever since. Any advice please just as prove maybe even for my mom, it went from funny to realy cant handle. Thank you ### REPLY: Hello, I have studied your case. Due to compression of cervical nerve root there is pain in neck and upper back. I will advise you to MRI cervical spine for better diagnosis. For 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. MRI knee will help in knee meniscus injury severity.arthroscopy repair will help you. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. We have a baby Girl and she is 6 months old and she is our first. We have been weaning for about 2 months, and every thing is going great, but we have tried to up the consistency of the food and she has started to gag, and be very sick. We are very concerned, and would love some help. ### REPLY: Hi, Try decreasing the consistency and then gradually building up. Also, add new items to her diet (semi-solid) at an interval of 7-10 days (so that we can see whether she tolerates that particular item or not). Then we can avoid monotony, which most of the babies won't like. She is only 6 months and hence will be getting adequate breast milk also-so need not worry much about the quantity that she take-just give 3- 4 feeds a day, only up to her satisfaction. Forcing beyond this will cause gagging and vomiting. 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: Morning bp has been high. Rapid hr and weak/shakey. Head ache and ears hurt.  My dr sent me to have ct and ekg. Was told ct showed brain and sinus clear and ekg normal. Was told to go home and take it easy as well as monitor bp. Bp down today but still weak and tired. Any thought. Also take synthroid and anti depressant. A week ago had sinus infection and fluid on ears. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have high blood pressure.  Your ct scan and EKG is normal so no need to worry. Just be relaxed.  Weaknesses and fatigue is common after change in blood pressure. Fluctuating blood pressure leads to these changes. Don't worry. You will be ok once your bl blood pressure become stable. 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: My mother (age 79) has been treated for multiple myeloma since January when she was diagnosed with multiple fractures.  After a chemo holiday, then after two weeks of returning to Revlimid, her numbers are way off IGA=2200, IGG =314, IGM=16.  Does this mean she has a limited life expectancy? ### REPLY: Hello dear, thanks for your question on . I can understand your mothers situation and problem. Multiple myeloma is very notorious in behavior.  It is very aggressive tumor. And in old age, it is not having good prognosis. She is also having very high levels of IGA and Egg. So her prognosis is not good. Life expectancy is less than 17-18 months. And five year survival rate is less than 20-25%. So better to discuss end of life issues with her. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 1/2 yr old as always had a big belly. At her 2 year check up the pediatrician questioned why it so big (like we would know), but she never seemed to concerned. My 2 yr old lately has been complaining of her tummy hurting and last night it felt really hard. Usually simple things help, like giving her a snack or something then she will say it doesn t hurt. Could it be more serious or just growth and changes in eating habits? ### REPLY: A few things needed to be answered first what is the babies weight ? Does this distention come and go, or it is the same all the time ? Do you notice any itching, discoloration of the skin or skin rash on the legs ? Is she developmentally well ? What is her nutritional status ? A complete physical exam by the doctor will exclude organomegaly (big liver or big spleen) .if the distention comes and goes, flat abdomen in the morning and big one in the evening this means that is some sort of digestion, most commonly from carboy .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 started having brain seizures and believe there is a link with going through the menopause.  Is this an established connection?  I was a severe asthmatic as a child and am still on medication.  Could dehydration in the recent hot weather also have been a factor in my major seizure on Sunday afternoon?  (they always occur while I am asleep).  Jennie ### REPLY: Hi, Thank you for posting your query. Generally, there is no direct link between asthma, menopause or hot weather and seizures. Fatigue or exhaustion however, may precipitate seizure in a person prone to get seizures. Please get evaluated by a neurologist (who may order an MRI brain and EEG) to find out the cause of seizures. Please get back if you require any additional information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I have areas that look like ringworms on my virgina lip, just on top of my bytts, under my breast, my wrist my legs and neck. What can it be? Really iches bad!!! Some looks like ringworms and others just straight lines that are bumpy and itch really bad. Thanx. ### REPLY: Hello, Welcome to , As you are having symptoms of fungal infection for which your doctor has prescribed topical antifungal cream and oral antifungal .  The fungal infection is more common in this area and the fungus can sustain for longer duration of time as this area is moist and favors the growth of fungus. These medications can will help to control the fungal infection, and it should be taken for longer duration of time. You require physical examination to confirm the presence of fungal infection. The antifungal oral medication should be taken once a week for at least 10-12 weeks to treat the condition. The personal hygiene should have taken care this area should be kept  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son has advanced stage 4 colon cancer. They have removed a mass that was the size of a big grapefruit. in the mass there are strings (VERY UNUSUAL) lymp nodes are affected and they are saying aggressive cancer. Chemo has not been started yet. how long do you think he has.he is 39 years old , the doctors are saying he has had it for 5 years ### REPLY: Hi and welcome to . I am sorry about your son and this serious diagnosis. This is really unusual in his age, especailly that kind of aggressively. Usually those cancers are found in stage 2 and 3. Statistically the five-year survival rate for people diagnosed in this stage is about 8 percent but if he doesn't have verified metastasis yet and if he shows good reaction to chemo I think he really can hope for those 5 years. Not more, unfortunately.Wish you good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir i am a biy at the age of 22 age i feel possessive about my own thing.. even more than that it is continuing in my love case also , if my lover say that i speak with that boy means i feel disturbed, but she in in love with me and me too. plz give any solution for this , is this any problem any treatment is needed ah sir.... ### REPLY: Hi Dear thanks for your question, possessiveness in love at this age is a normal, but don't be possessive so much that it disturbs your day today life, take things lightly, your primary concern should be your studies, or your carrier, i mean what ever you're doing, as you will grow with time these things settle dawn of itself. Love at this stage is usually lusted. Concentrate more on your studies, keep yourself busy with work and after a few years you yourself will realize, was it love or, lust or wastage of time, remove the fair of loosing her /him, in journey of life you will find many better lovers than you think he or she is. Hope my answer will benefit you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i just had blood work,....was told my live enzymes were elevated,....the dr wants me to come back in a month,if they are still elevated,...he wants to do an ultrasound ,.....im a little nervous,....i take high blood pressure meds and ativan for anxiety and drink on occasion,...I was on vacation the week prior and drank more than usual,..can that be the reason they were elevated??? ### REPLY: Alcohol intake does cause you liver enzymes to be elevated, but there are other reasons too. Like viruses which attack the liver, some medications or simply being overweight can cause what is now known as NASH (non-alcoholic steatohepatitis). You must get the ultrasound done, also you need to avoid alcohol and have you meds reviewed by your doctor. Also get viral markers-hep B and C done. One time alcohol binge would cause a sudden raise of liver function tests, however a long time sustained intake can cause problems. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell onto a tiled floor a week ago today, my right knee is cut and bruised but a lump came up almost immediately. it is still there now at the top of my kneecap, my knee is sore and warm to the touch but I can walk without problem. Just feels stiff but I thought it was because of the grazes I sustained to it. Any ideas? ### REPLY: Hi ! Good evening. I am  answering your query. You might have got a hematoma of the knee (blood collection) due to the trauma. Walking without problem signifies that the joint ligaments and cartilages are possibly not injured. If there is no fresh ooze, the hematoma may gradually subside with absorption, but it would need proper rest and splint age of the joint. In case the problem increases which interferes with your walk, then you might have to see an orthopedic surgeon in your area, who might advise you for an x-ray/MRI of the injured knee joint. Till that you could start taking an anti-inflammatory .  Further management in that case would depend on the MRI report. 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: Hi,My baby is 3 months now and I have started feeding him Lactogen. He sometimes refuses to have it. I notice that he finds it difficult to pass motion the next day of feeding him Lactogen. He doesnt seem to have any other kind of reactions. Is this normal? Should I continue to feed him the same till he gets used to it? Please recommend as I will  be joining work in other weeks time and I dont want my baby to suffer due to this. Thank you ### REPLY: Hello an infant passing stool 7 times a day or once in 7 days is considered to be normal if not associated with vomiting, abdominal distension or vomiting. If he is feeding well, is active, passing urine normally I won't get overly worried. Check whether feed is being prepared in a normal proportion (30 ml water with one scoop of formula). I would suggest you to continue the feed and observe for any abnormal finding. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a cyst on the base of my penis shaft... the doctor said it was not threatening and to just leave it alone... i cant very well leave it alone when trying to have intercourse... there was no pain originally but now has started being sore to movement and to the touch cant tell if its getting bigger or about to rupture. should i get it removed? ### REPLY: HelloThanks for query. You have what is called as Sebaceous Cyst over base of the penis. The skin in genital area is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If needed it may need to get excised in Toto (Completely along with the sac) .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Every now and then I get an itchy rash-like patch at the base of the back of my neck.  I sometimes think its related to me having been rubbing my neck, but I cannot always correlate neck pain with the onset.  I dont have a fever, or any other symptoms that Im aware of.  I cant recall coming into contact with anything that might irritate it.  I do have a history of cervical discectomy and fusion (anterior) at C 5-6, 10 years ago, and sometimes get stinging and burning in the area, presumably from nerve pain.  As I mentioned it isnt painful, just itchy and sensitive if I scratch it. ### REPLY: Hi, It seems to be lichen simplex chronic us. It is a chronic type of eczema. I would recommend you to apply potent topical steroid like clobetasol propionate cream on the affected area twice daily and take antihistamines like tablet chlorpheniramine male ate 4 mg twice daily for 3 weeks. Steroidal preparations are prescription .  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I was diagnosed with a urine infection a couple of days ago and my Dr put me straight on antibiotics while we waited for the urine culture. It came back as an Ecoli infection ...... is this serious? I have been on the AB s for 2 days now and have just developed excruciating pain in my lower left abdomen. Could this be related. I also just remembered that a couple of months ago when having a ultra sound for Gall Stones they found a couple of stones in my left kidney. Could this be the cause?? Thanks ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. Your Urinary tract infection is most likely due to existing kidney stones. Antibiotics should be started after routine urine examination and culture and sensitivity should be sent and change antibiotic if necessary after culture report. If you wait for culture report to start antibiotics infection and pain will become worse than happened in your case. I also advise in such conditions with urine alkalinizes like sodium citrate or potassium citrate and urinary antispasmodics like favorite. I also recommend them to take barley water or cranberry juice which are also good urine alkalinizes. Hope this may help you. Let me know if you have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need to switch from cerazette to yasmin but I m a week into my cerazette pack. Do I have to wait until I finish this pack before I start the yasmin, or can I start it now (since I ve been bleeding the past couple of days, so I guess I m on my period?)? ### REPLY: Hi, Yes, you have to finish your cigarette pill completely first. If you wish to switch from cigarette to Yasmin, finish your entire pack of cigarette (including the placebo pills). Then, when you come to what would have been week one, day one of your old pill, start your new pill pack of Yasmin thereafter. If you do this, you are protected against pregnancy straightway and do not need to use a backup birth control method. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother has a history of mental illness and we suspect she is showing more and more signs of dementia.Is there a test her doctor can implement and if not, where do we go to get some form of diagnosis? She is failing to be ale to hold a logical discussion of any kind, displays catastrophic reactions to day to day comments and is repeating herself more and more.Daily tasks are becoming more obviously challenging like knowing which key opens the door of her unit. ### REPLY: HiT hank you for using HM. I understand your concern. Dear only confirmatory way to diagnose dementia is clinical evaluation.More detail we have to do MUSE means mini mental status examination. You can download it from net. Brain imaging can only give supportive idea to diagnose. But final decision and treatment depend upon clinical presentations. Proper and systemic clinical evaluation by psychiatrist or Neurologist can give better conclusion. If still you have a query then feel free to ask. Happy to help you. Do not forget to say than if you are helped. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hav tremendous pain in my lower back whch later stresses on the entire back , i hav been asked 2 do a MRI , whch i hav done . it says i have posterocentral protrusion of l4-5 disc indenting thecal sac . diffuse posterior bulge with small posterocentral protrusion of l5-s1 disc effacing epidural fat . no nerve root compression or impingement is seen . ths is wat the conclusion of the mri report says . i wanna know d meaning of the above .. ### REPLY: Hello. I have been through your question and understand your concern. The MRI result is normal with no correlation to your symptoms. The protrusions are definitely not the cause of your complaints. Basically the MRI was not of a great help, but it definitely ruled out some of the serious conditions that are progressive, like stenosis, disc herniation, tumors, or spinal anomalies. I suggest you to do a final dynamic X-ray, which is simple and rules out spondylolisthesis, which MRI does not help. Wish you the best 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: On the inside on my mouth on my lower jaw bone beneath me teeth , my jaw bone seems to be protruding out like there is a large lump. It does not hurt to press on it and I cannot move it. It also feel very hard and seems to be part of my jaw bone. It is similar in the other side but not nearly as large. I m afraid it might be a tumor growing within my bone ### REPLY: Hello, Welcome to . Large lump may be arose due to abscess formed either due to deep caries or due to periodontal infection. A detailed clinical as well as x-ray evaluation is necessary to diagnose the problem associated. I would suggest you to take augmenting tab. Along with analgesics. Pus within the lump has to be . Meanwhile, maintain oral hygiene well. If symptoms persists, biopsy of the lump will help to rule out the nature of tumor. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor am Mary Edwin aged 31 trying to conceive for the last 8months and have been diagnosed cyst. have visited gyno and they have suggested me with fertisure the implantation bleeding occurred, but now had my periods what should be cause. Besides my body temperature for over head over the last weeks could that be a reason. ### REPLY: Hello, Welcome to . Thanks for your query. I have gone through your query and understand your concern. First think we have to do is to differentiate whether you had implantation bleeding or normal spotting before menstruation. Have you done Hormone pregnancy test to confirm the pregnancy? Some women have the spotting just one week before the regular period. This may misinterpret as Implantation bleeding. This may be due to Intermenstrual bleeding also. Implantation bleeding typically occurs one week after the ovulation. It is not a usual bleeding like menstrual bleeding. It looks like increased spotting.Thus, my advice is check Hormone pregnancy test and confirm whether the implantation occurred or not. If the HPT is positive, then it may a failure of proper implantation. There are many causes for implantation failure.1.  Improper implantation2. Not well-developed endometrium3. Hormonal imbalance4. Immature egg, etc. Please do HPT and confirm. Then consult your treating doctor for further management. Hope this helps. Please reply for further queries. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: odd skin condition I have recently discovered a series of perfectly circled patches of dry skin. It started as a few small spots under my right breast and soon spread up into my cleavage. And now there are 6 visible spots. They are tiny, maybe a quarter inch at best. There are very very slightly raised, no itch, no burn...they dont bother me at except for the fact that they are there. Light in color almost not visible maybe 1 pigment darker than my usual caucasian flesh color. However when I shower they tend to darken momentarily. ### REPLY: Hello and welcome to  I would keep a possibility of Erythema. Erythema is a chronic superficial infection of the intertriginous areas of the skin. The incriminated organism is Corynebacterium minutissimum. Dark discoloration associated with erythema is usually limited to body folds that are naturally moist and occluded. Infection commonly is asymptomatic, but it can be pruritic. The typical appearance of erythema is well-demarcated, brown-red macular patches. The skin has a wrinkled appearance with fine scalesTreatment is with oral erythromycin Or topical erythromycin Or with topical clindamycin for 2 weeks 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 cconstantly dream about my jaws got locked and when I wake up, I m normal... Is this my fear or any condition ..I did felt pressure in my head and nostril few days back but m fyn now but I m still dreaming,.I hv been terribly affecTed by my mothers jawlock ### REPLY: Hello thanks for asking from  for your health related queries can understand your concern. Your mother had lock jaw, and then you have developed fear and this causes constant .  This is nothing but severe anxiety (anticipatory) and there is no need to fear. Slight pressure in nostrils and head is also probably due to this anxiety. Try to relax yourself and reassure yourself. Even if your mother had lock jaw this doesn't mean that you would have lock jaw. Relaxation exercises, yoga will help you to come out of this condition. If symptoms persist then visit a psychiatrist for treatment. Mild doses of antianxiety  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a mass in the left epigastric region 2 nights ago. It is non-tender, about 3 finger spaces below the ribcage, and solid to touch. I am overweight and have a number of lipomas, but this one feels different. I am not in a geographic location where immediate, reliable testing is a good option. Any suggestions what it might be? ### REPLY: Hello! Thank you for the query. It might be another lipoma, sebaceous cyst or other benign soft tissues lesion. Usually it does not need medical attention and can be left alone. It will be gradually getting bigger, and if it's a sebaceous cyst, can get infected and cause some pain. There is also a possibility that what you feel is a hernia. It is possible if you have had any surgery in this region. The best way to find out what it is, is an ultrasound. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Son is 1 year and 10 month old and since last five months he was and is often suffering from fever his blood report is following:- Haemoglobin 12, TLC 9400, Poly 31, Lympho 62, Eosino 02, Monocy 05, EsR (Wintrobe) 15, Widal Test S. Typhi o 1:160, Styphi H 1:80 ### REPLY: Hi....y what you quote I feel that our son might be having a recurrent viral illness, which is quite common in this season and age group. The blood test is showing lymphocytes of 62 which is again suggestive of viral illness. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration or recurrent or fever if the kid is active. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son hit his right side jaw when playing with his older sister. It is swollen and very tender to the touch. When touched it feels like a not. His mood is ok as long as you dont touch his jaw. He ate all supper with no problem, and can open his mouth, but not wide like a dentist would want. My question is, can this wait until tomorrow as he is sleeping now, or do I need to get him to the ER ASAP. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint it seems that pain and swelling over the jaw after being hit is not abnormal as it occurs due to sudden blow to the jaw leading to trauma to the soft tissues leading to swelling and pain. Secondly in case if he is unable to open the mouth wide and the mouth opening is reduced, then it has to be taken care of as it can be due to injury to the jaw joint leading to displacement and dislocation. You need to consult a Periodontist and get him evaluated and a Panoramic x-ray has to be done along with manual palpation to the exact rule out the symptoms and can be treated accordingly. You need not rush to go to emergency room immediately and can wait till morning and see a pediatric dentist. You can however give him Ibuprofen to relieve pain and inflammation and do cool compresses over the swelling. Hope this information helps. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i went to my doctor complain ing of back pain in lowetleft side around mywaist he wrote arthopathy 716,90  and 724 as my diagnosis  to my short term insurance .i was taken off work for 4 weeks i still feel the pain but i originally  thought i pulledamuscle now i have  BEEN REFERD TO A NUROLOGISt want to know why would this get claim denied ### REPLY: Hi I had gone through your query and understand your concerns. I would come up with two most possibilities to fit your condition.these include1.first possibility is, RENAL STONES;ultrasound scanning for PUB may confirm the diagnosis.2.second possibility is, DIVERTICULITIS;inflammation of balloon-like protuberance due to excess Gas pressure in intestines. Often caused by additives in food, or low blood sugar. X-ray with barium enema may confirm the diagnosis.  Diet to follow;-high fiber diet which produces large volume of feces requiring wider diameter of colon, and gas. -refined food lead to hard stool. Softer stools do not strain the gut. I hope this is helpful for you, thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have sever lower adominal pain/pelvic pain.  I was in the ER for it about two weeks ago.  They did a CT Scan and an ultrasound... I have the results, but I cant get my doctor to call me back to explain them.  It say very heterogeneous soft tissue mass posterior to the bladder, which measured about 5.5cm, and in long axis 5.2x5.8cm.  What does this mean? ### REPLY: Hello Heterogeneous soft tissue mass posterior to the bladder may be due to many reasons like pelvic pathology, bowel origin mass etc. It is important to know your age and sex. You condition need contrast CT scan of abdomen. CT is needed to assess origin, extent,invasion to surrounding structures. You may need further investigations lie tumor markers, FNAC depending upon CT scan findings. Proper treatment depend upon clinical findings and investigations reports. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my younger brother age about 28 years has a surgery 8 years ago for Hydrocephalus due to Tuberculosis meningitis. a shunt (flexible tube) was placed within the brain to allow CSF to flow around the blocked area. , The shunt tubing travels to another part of the body, such as the abdomen . Now his condition is good, some times he is feeling weakness, body pain. Is it possible to remove the shunt tubing ?? please advise me?? nescoorganisation@yahoomail.com ### REPLY: My younger brother age about 28 years has a surgery 8 years ago for HY .  A shunt (flexible tube) was placed within the brain to allow CSF to flow around the blocked area. , The shunt tubing travels to another part of the body, such as the abdomen. Now his condition is good, sometimes he is feeling weakness, body pain. Is it possible to remove the shunt tubing ?? Please advise me??nescooanisation@yahoomail.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 34 years old. I got married about 10 years ago. since last two years, i am trying to be father but I couldnt because of low motility, high viscosity and high sperm liquification time. my doctor told me the best way for u is IUI. i want to know, is there any treament by medicine to solve this problem? Best RegardsPouya ### REPLY: Hey thanks for your faith in the .I have gone through your question and understood your problem. Normal fertility is associated with sperm counts >48 million/mL, motility >63 %, exhibiting normal morphology >13 %. It is very difficult to say without read of exact report. However, normal sperm counts is important for fertility, so also motility. In my opinion either upload all detail reports of SEMEN analysis or consult an INFERTILITY specialist and get his opinion. Hope I have answered your query. If you like my answers and wish me to answer in the future, bring it to my attention ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is almost 10 years hes good in studies but one month back he was admitted with food infection.After recovery hes complaing again of he cant walk and agin feels like vomiting as hes school time have chaged from afteroon to morning from 7 am to 1 pm i am confused does he need couseling? ### REPLY: Welcome to the ChatDoctorI have gone through the question and understand your concern. If the symptoms occur only before school timing and improve at other times, its more likely due to anxiety he is facing for school. Counselling will be useful in that case. In case the symptoms are persistent at other times of day as well, then we need to think in organic cause of illness such as vitamin deficiencies, gastritis or worm infestations. You may deform him by Albendazole or nitazoxanide in that case and start him on Lansoprazole before breakfast for a few days in such case. Also, assure a healthy balanced diet with lots of fluids. Hopefully this will help. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my friends son has been having a small fever, alot of stomach pain and frequent headaches. he has been to the er but the tylenol they gave him is not working. he is not eating much either and his mouth has small blisters and his lips are chaped. what else can i do to help??? ### REPLY: Hello, I can understand your concern. It seems that the child is suffering from the stomach infection that is causing the headache, fever and stomach ache. Tylenol alone will not help to cure the infection. Based on the age and weight of the child, the child needs to be given antibiotics. In addition, the mouth blisters that the child is suffering from can be attributed to the stomach infection or presence of vitamin B complex deficiency. This should subside itself after the stomach infection is cured. You can also start vitamin B complex supplements such as B-Folcin once a day. Also, local Endocrine gel (McCoppin) can be applied to the mouth sores for faster healing and relief from pain. I would advise you to visit a pediatrician for the clinical examination regarding the stomach pain and for the prescription of antibiotics based on the age and weight of the child. I hope this information helps you. Thank you for choosing . I wish the child gets well soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My hsband has been having 3-5 heart palpitations a month for about the last year they last anywhere from 30 seconds to 5 min. Should we be conserned about this I know heart palpitations are normal but this seems like a lot to me. He used to drink a lot of energy drinks but quit drinking them about a year and a half ago. ### REPLY: Dear thanks for posting here. The likely cause of your husbands palpitations seem PSVT as you have not mentioned any associated symptoms like loss of consciousness during the palpitations (and I presume these symptoms are not there). PSVT is basically short-circuiting of the electrical system of the heart. This is a benign condition that can be easily treated but before that we have to be sure about the diagnosis. Now for diagnosis, we need an ECG done during palpitations but as the duration of your husbands palpitations is quite short, so I donor feel that it can be done. The other way is EPS (Electrophysiologist studies) which is an invasive method where in we introduce catheters inside heart and then try to induce the palpitations. When diagnosed, we can ablate the abnormal electrical pathways so that no short-circuiting occur again. All of this procedure is done with catheters that can be passed from one of your groin just like the angiography is done. BUT before all this, I would like him to get his thyroid function tests to rule out any thyroid abnormality and echocardiography done to be sure that his heart is structurally normal. Hope you get your answers and 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: Hi. My father is of 49 year age. He has hepatitus c positive since year 2004 with genotype 3. In 2005, he was treated with Pegasys with ribavirin for 6 months but unfortunately the treatment was not successfull. Again after break of 7 years his treatment was started 6 months before with Pegintron with Ribavirin. Doctor suggested that the treatment will last for a year. After 6 months, the virus is still present in the blood with the Real time PCR quantitative1600 IU/ml. At the start of treatment it was 922,812 IU/ml. My family is too much worried about him. Kindly guide....?Are results satisfactory? ### REPLY: Hi, Based on the treatment information all things look pretty good. (1) Let me give you some information about clinical trial for genotype-3 treatment, it shows that 24 week treatment only cures 65% of patients so in order to achieve or cover the complete 100% case it needs to have 40 weeks treatment, so in theory we will be able to cure 100% cases. But we are taking year worth of medicine will cure you of HEP-C WITH 130% result, hope it makes sense, if not try to read it again, More over in simple words you will be cured completely even before 12 months of medication but YOU ARE a reoccurrence case so taking medication for 12 months is a great option. (2) Now let talk about the PCR- IT REDUCED BY MANY FOLDS from 922,812 IU/ml to 1600 IU/ml. It's the best result one can have. So from that estimate the PCR Will be near zero in next 3 months, but please continue taking medication as physician has asked for, as this is a naught disease and can reoccur if not cured completely. (3) PLEASE let your family know that things are working fine even better than expected, so there is nothing to worry about and will be as normal as before after 6 months of treatment. Hope its helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have mass in right side of lung of 2.5-3.00cm.i have done FNAC  yesterday after ct scan of the chest but the reports have not come yet,my age is 75,my voice have become hoarse n choking,my neck is ok as the ct scan of the neck shows.what it could be? ### REPLY: Thanks for your question on . I can understand your concern. At your age of 75 years, 2.5 to 3 cm mass in right lung is more likely due to malignancy (cancer). Your hoarseness of voice is also due to recurrent laryngeal nerve involvement due to malignant mass in lung. So wait for FNAC (Fine needle aspiration cytology) report. This will be confirmatory for malignant mass. If it is malignant lung mass then we will have to determine staging because treats based on staging only. Early stage 1-2 will need surgical removal of mass. Stage 3-4 will need chemotherapy and radiotherapy. So collect FNAC report and consult oncologist for further 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: My uncle who is 63 had a seizure the other day for the first time ever. He was rushed to the hospital via ambulance, but remembers none of it. Upon ER tests including a cat scan, they diagnosed him with a UTI, and put him on Cipro, and was recommended he make an appointment with a neurologist for an MRI. I was wondering could the UTI have been a cause for the seizure? ### REPLY: Infectious diseases in people over the age of 60-65 are one of the most common causes for seizures or seizure like disorders which occur for the first time as well as changes in mental status in an otherwise healthy individual with no history or cause for problem.  I think that in this case the call is a good one with one single detail that could be problematic for your uncle.  The use of CIPROFLOXACIN.  Cipro as well as all the other antibiotics in this class of .  If the ER simply put him on the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Name: Saba Ashraf Date of birth: April 1981 Status: Marieid (3 children) Note: Asthma problem, use the foster spray normally when very serious attack of asthma take I take neoclav 625mg tablets when humidity is high, I have to face asthma problem After the second baby birth i am facing this problem ( second bay is 5 years old) Please advise me what is better for me, what i should now, I will be thankful to you Saba Ashraf E-mail: YYYY@YYYY ### REPLY: Hi, If you have been diagnosed with asthma and are getting repeated attacks the need to take a maintenance inhaler regularly on a daily basis and not as and when required. Also, please do not NeoChat tablets by yourself in any situation. It is advisable that you visit a Pulmonologist and get yourself fully evaluated and get a pulmonary function test done so that your treatment is optimized on inhalers and oral medications. Once your treatment is optimized as per you evaluation parameters then you won't have to tackle these frequent asthma attacks. 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: Hey Doc just wandering what I have I m very cold I have the chills even though it s like 30 degrees Celsius I m very lazy and very tired for the pass two days lack of appetiate have eaten anything everything taste horrible Doc can you please let me know what I have and how I can treat it thank you for your help. ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you to do complete blood count, test for malarial parasite, dengue, tidal test. I suspect you have the infection from one of the above suspected pathogen. Kindly check for above infection and take treatment accordingly. Once you got cured you are free from the chills and weakness. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, doctor, im 21 yr old girl, just recently got married, 8yrs before i went under ASD DEVICE CLOSURE, (HOLE IN THE HEART). i never get my menstruation regular. just twenty days i have got married, now im having pains in ma lower abdomen, as if im getting my menses, but im not getting it. the pain so severe and unbearable doctor. please be kind enough to advice me in this painful situation! ### REPLY: Hi ! Good afternoon. I am  answering your query. If I were your doctor, I would go for a complete blood count, an Bag and an HIV test as a routine, a serum  test and an ultrasound of the abdomen to rule out any pelvic pathology and an unsuspected pregnancy as well. Till then, I would prescribe you with a mild anti-spasmodic .  Further management would depend on the reports of investigations. 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. I wish 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 had elevated bilirubin at 11.25 which has now come down to 7.54 but my SGPT & SGOT levels have increased to 284 & 224 respectively. I was diagnosed with acute viral Hepatitis A and I am having constant fever for the past 1 month which has come down to 99 - 100 twice a dayh. Kindly advise. ### REPLY: Hello. Thanks for asking query on . As I understand from your narration that you have been diagnosed with acute hepatitis A (I assume diagnosis was based on IGM anti HAD levels and other viruses ruled out). Acute hepatitis A is a self limiting illness which requires only supportive measures. As I see your bilirubin level is coming down which is a good sign and indicates recovery phase. I think your GOT and SGPT levels may also be coming down (probably from 1000s or so). Usually complete recovery takes about 4 to 6 weeks. Alarm features of severe disease are - excessive sleepiness, worsening jaundice, bleeding manifestations and swelling of the abdomen, which are not the case with you. You require UCA 300 mg twice daily along with PPI, antiemetic and good nutritious diet. Hope for early recovery. Take care. Laxmiaknt DesaiGastroenterologist and Hepatologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has been sick with some sort of respiratory thing for over a week-she is very susceptible to pneumonia-so we always make her go in. She was on antibiotics, and after five days on them developed a very itchy rash and swelling around her mouth. Her hands and feet swelled. Her Nurse practitioner changed her antibiotic, and she has only worsened. She is in so much pain she can hardly move, and now her throat is really sore tonight. She is 51 years old and has stopped all her meds today as she thinks they are making her sicker-I do too. I was leaning toward strep and trying to convince her to go to emergency room tonight...Could It be that? ### REPLY: Hello! I can understand your concern. As you have rightly pointed out, your sister seems to have developed severe allergic reaction to the antibiotic she took. The most important treatment now is to stop the culprit .  She will also need a short course of Cetirizine or other antihistamine medication, and oral or injectable Dexamethasone, which is a steroid that treats the allergic reaction. You can get an allergy panel test done to find out what all  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a constant background pain in my lower abdomial area. I have tested for infections and it all have been negative. I am 43 and I am suffering from this pain for 3 years. I have done Laparoscopy , but nothing was wrong. I took two Mintec capsuls 3 times a day. It reduced the pain for a while but then pain has returned. I appreciate your help. Regards, Kerry. ### REPLY: Hello, magh7546,You mention that you have had this pain for three years. I am glad that infection has been ruled out. I suspect that you have had upper GI-X rays and also either a Barium Enema or a colonoscopy to rule out any problems such as gastritis, ulcer or colitis or diverticulosis. If these have been ruled out, you may have Irritable Bowel Syn .  If you have abdominal bloating, constipation associated with pain, this supports the diagnosis. When you mentioned Minted did give you some relief, peppermint oil has been helpful in reducing the spasms associated with IBS. Minor heartburn is one of the side effects of peppermint oil capsules. You need to be on a high fiber diet,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went for a free oral dental screening in my area yesterday. I have had an inflamed taste bud for 6 to 8 months. It almost goes away, then returns. It sometimes bleeds and when it bleeds it bleeds alot. At one time I had a chipped tooth that was pulled but the taste bud became inflamed because of the chipped tooth. I kept rubbing my tongue aganist the sharp edge. The dental technician I saw yesterday did a thorough exam, and she even shined a special light inside my mouth, it was very warm and I had to shut my eyes while she did the exam with this light. The dental technician said to rinse morning and evening with salty warm water, and it already feels better. But why will this inflamation on my taste bud not ever go completely away. It is horrible when it bleeds and scary. Is there anything else I should do? Thank you ### REPLY: Hi, Thanks for posting the query, Inflamed taste buds can be due to bacterial or viral infections, consumption of hot food, allergies to some foods, trauma from tongue biting or chipped tooth. I would suggest you to get the checkup done by the Dentist take an x-ray of the chipped tooth and go for the treatment. Apply Colonel oral ointment topically over the affected area. Start taking multivitamin tablets. Take complete balanced diet and .  Hope this helps out. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a rash on my chest and one in my upper thigh/groin area. The one on my chest is itchy, but the one in groin area is just painful (probably because its constantly rubbed walking) but Im pretty sure they appeared around same times about a week ago, and are not getting better. ### REPLY: Hi, You have lesions on chest and groin areas. They are itchy. The lesion in groin area is painful. This much history suggests that probably you are having fungal infections .Tina courts in groin little infected with bacteria and Tina corporal in chest. However, you consult dermatologist for firm diagnosis. Antifungal like ketoconazole for two weeks may be taken along with antihistamines like levocetirizine. Short course of antibiotics may be taken. Apply antifungal cream like clotrimazole cream. Avoid soap during bath. Use detail in water for bath. I may be alright. I hope you got my answer. 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 just recently noticed a lump on my right pelvic area, about 2 inches above the penis and 3 inches to the right. It feels like a small ball, I seem to have the same ball on my left side but it isnt as inflamed or stuck out as the left side. Another thing different is that when I push down on the right side lump it hurts, feels like a bruise. I didnt hit myself or anything. Something else that might be linked to the pain; About two-three weeks ago I had a smaller pea sized ball above my right testical that was hurting me. I felt around and squeezed on it a bit to try and get an idea on what it was or could be exactly. The pain went away an hasnt resumed since. I really need help, Im worried on what it might be. ### REPLY: Welcome to . 1. The history suggest that possible cause could be an inguinal hernia.2. In this case you need to get an ultrasound scan, that would help to assess the defect and contents of the lump and extension.3. Presence of any strangulation and blood supply will be assessed.4. The symptoms seem like strangulation is there, at the same time the scrotal scan will be done to evaluate the related causes.5. In this case treatment of choice will be operative to correct the defect. Good luck. Hope I have answered your query.Anything to ask do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had two small bumps appear on the inside of my mouth. One inside my top lip, and on on the lower lip, closer to my cheek. Also my mouth felt a little bit numb.This occurred immediately after I had lunch, which contained fish soup. Does this sound like an allergy? ### REPLY: Thanks for your query, I have gone through your query. The bumps inside the mouth could be secondary to burn caused by the soup or allergy to the contents of the soup, or it can be muscle or herpes virus infection. Consult your oral physician to rule out these conditions. You can observe for two-three days and see. If it breaks and forms ulcer then you can use topical anesthetics and analgesics that will clear the issue. If it doesn't disappear then consult your oral physician for 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: moderate to severe muscle spasms now including right eyelid. Have lower back issues but this is even when I try to stretch. All bloodwork came back normal. Also noticing I am dropping things too. Wondering if this is neurlogical or if my thyroid can be causing some problems. ### REPLY: Answer: Hello, I have studied your case. I will advise fasting blood glucose levels and thyroid function tests and acetyl cholinesterase levels reports with MRI whole spine follow up for review.it might be diabetes or hypothyroidism or myasthenia graves 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. 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 on synthroid.  75mg.  Had a hysterectomy in April for uterine cancer.  In the past couple of weeks, Ive started feeling very fatigued and lightheaded.  Also feeling very depressed/sad.  My TSH was 4.15 a year ago (I thought this was too high, but my dr said it was still in normal range).  I think now my TSH must be way too high.  Possibly the hysterectomy has also affected it?  I am going for blood work tomorrow and a physical the following week.  What do you think? ### REPLY: Hi and thanks for this query. I am sorry about what you are experiencing. TSH normal values vary slightly from one lab to the other. If your doctor said it was normal, then I believe him. The symptoms you have cited make the diagnosis of under treated hypothyroidism very likely. It is a good thing that you are going in for blood work up and a physical. Thyroid hormones supplementation dosages vary for one patient to another. Even the same patient may need the doses t be reviewed several times in the course of his/her treatment. A simple adjustment will correct the identified problem. Hysterectomy per se cannot be directly responsible. However, may be some other . I hope this answers your question. I wish you good health. Also, feel free to come back for more answers. ### END