Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: This is Dr.zobaida akhter, age 56, before 5 months it was diagnosis SGPT 165, SGOT 135, at present SGOT 50 and SGPT 80. I have hypothyroid . I am taking Ursocol 300. At the begining I had no symptom, but before three weeks i had a decentry from that my whole abdominal pain is going on, I have IBS also not so serious. I took medicine for both but not get relieved from pain. Is it for acidity, IBS, Mucus or for liver? or food habit. I took lots of leafy vegetables. Kindly give your opinion how to reduce pain and fatty liver?y weight is 68 kg , height 5 feet 1 inch ### REPLY: Welcome to health acre magic! Fater reading your question there are some major points: elevated GOT AND SGPT few months back, you are hypothyroid and have IBS, currently you are on protocol. Three weeks ask you had dysentery for which you took treatment but still you suffer from pain in abdomen. From my clinical eerie nice I can say that the pain appears to be due to dysentery you had as prior to it, you had no pain. Dysentery might have also aggravated your IBS, thereby increasing the discomfort. I think that taking another course of a good antibiotic which targets both aerobic and anaerobic bacteria, an antacid and anti-spasmodic would help you a lot. You should get an ultrasound abdomen done, along with blood counts and a complete LI .  Fatty live can also cause some pain in abdomen. What you can start now to help yourself is that-avoid fatty and spicy food altogether, - eat small and frequent meals-prefer semisolid diet over full heavy meals-get adequate HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffered from severe jaundice when I was 9 yrs old.. Due to that my liver got severely infected and became more tender & enlarged. Sometimes I have terrible abdominal pain due to which I cant even get up from my bed. Now whenever I eat something of outside, I feel that pain crawling up inside me. I want to know that is my liver getting terrible ? Will it harm me in near future ? Im just 17 right now..! ### REPLY: Hi, Welcome to , After going through your history, you suffered jaundice possibly viral hepatitis 8 years back usually such hepatitis are self limiting and liver becomes completely normal after full recovery. In only some cases of chronic hepatitis like B or C chronic liver failure develops, so please visit your Physician or Gastroenterologist to test for any abnormality and test for viral markers if necessary and ultrasonography to detect any abnormality in liver. Pain in abdomen may be due to stones in kidney or gallbladder or disease of intestine itself. Please go for medical checkup and if any cause is detected it can be treated there is nothing to worry. Wish you good luck. Take care. .  M.D. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My bottom left wisdom is impacted. Ive been dealing with it 4 years. Past 8 months its been progressively getting worse. Right now The gums are swollen, red, sensitive to the touch, some puss has come out from the gum over hang on top. My jaw, cheek, ear and throat are swollen as well. Red at sight and warm to the touch. Hurts to open and close my mouth feels tight when I do so. Also hurts to swallow now. Please please help me. What do I do???? I have no money or credit card if I go to the er I will owe. ### REPLY: Hello, You have definite symptoms of an infection that is spreading. You require prescription antibiotics such as amoxicillin to control the spread of the infection. Seek care with a dentist or visit an emergency room to control the spreading of a serious infection with possible severe systemic effects. Take some anti-inflammatory medication. Very effective medication includes the combination of two Tylenol and two Advil, taken at regular intervals. Rinse with warm salt water. Encourage any pus to .  Buildup of pus with cause increasing pain and may require surgical  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been getting grayish, spongy lumps stuck on back right side of my throat. I can feel the lump with the back of my tongue & when I swallow. I ve tried gargling, coughing, etc. to dislodge it, but that doesn t work. Then, it will dislodge & I cough it up. Smells awful. What is it? I thought maybe tonsil stones, but what I ve read doesn t sound like what I have. ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Treatment for Smelly lumps on back of your throat-In my opinion you seem to have infected subacute tonsils with infected mucous plugs on them, which pains on swallowing and get cleared out after coughing it out with a bad Smell.What's the color of the mucous plugs? Yellow/ green / muddy/brownish?Hence, stop worrying about it but do check it up from ER Ent-Surgeon. For Final Diagnosis and treatment needs clinical data from a Doctor. And Hence for further treatment I would advise you to Consult ER Ent-Surgeon, who would treat it accordingly. This advice is based on the facts from the history you give and needs further clinical check.Hence, I would advise you to check with ER Ent-Surgeon. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you. Hope this would relieve your problem. Welcome for any more query in this regard to . Write good resume and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 29 weeks pregnant and I have very intense lower back pain, low pelvic pain, spots in my vision that look like tiny fruit flies flying around, and after not having nausea since the first trimester I am very nauseous today. (there was protein in my urine my last urine test and my BP was in the normal range but slightly elevated to what it normally is for me) ### REPLY: Hello, Thanks for your query. Back pain in last trimester of pregnancy is not a pathological pain. I5 occurs due to change in center of gravity of body. As there is a fetus in abdominal cavity mother has to lean backward to maintain body posture. It alters normal spinal angle which is the main cause for pain. It will get resolved after delivery. You need bed rest till delivery. Avoid medications as much as possible. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: We are using this Valparin 200ml syrup for fitz complaint. My son is very speed in all his activities but some times he was fell in like unconsious. After long sleep he got up and normal with tired. Is this any indication of any side effect please help me. ### REPLY: Hello, Valarie is used to control your sons seizures. If he's still falling unconscious his fits are not controlled. He may sleep more with Valarie but becoming unconscious is not a side effect.  Please contact his doctor, he may need a change in the dose or an additional medicine. Do get back to me if you have further questions. 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: Walk 1-2 miles daily with dog. Immediately after stopping I feel sick. Lightheaded, a little sick to my stomach. Sometimes worse than others. Take 5mg of lisinopril once a day for BP. Try to eat well. Take 1200 iu of vitamin d daily and 1200 iu calcium daily. 51 years old 168 pounds. ### REPLY: Thanks for your question on . I can understand your concern. Light headdress in hypertensive patient can be due to sudden rise or fall in blood pressure. So better to consult your doctor and get done blood pressure monitoring and stress test (trade mill test) to see for any fluctuations in blood pressure. If your BP is falling then you should avoid lisinopril. But if your blood pressure is rising then you may need another antihypertensive .  Don't worry, you will be alright. Consult your doctor and discuss 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: Hi Doc. I want to consult health situation of my mother. For about two weeks she had vaginal bleeding. After a series of test, the doctor conducted a hysterectomy operation. Sample of tissue was biopsied, the result was: WELL DIFFERENTIATED ENDOMETRIAL ADENOCARCINOMA.Other findings: chornic cervicitis, corporal albicantha, bilateral ovaries, congestion, bilateral fallopian tubes. The oncologist advised that my mother sh.undergo chemotheraphy. Is it the best option? Please help me. ### REPLY: Thanks for your question on . I can understand your situation and problem. Endometrial carcinoma is highly chemotherapy sensitive. And surgical removal is treatment of choice for endometrial carcinoma. During surgery, handling of mass can cause local site spillage of tumor cells. So possibility of recurrence is high. This is the reason for post-operative chemotherapy. Chemotherapy will be effective against not only local site but also on systemic spread. It prevents local as well as distal spread. So chemotherapy is must after hysterectomy in case of endometrial carcinoma. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the past 9yrs my mother is suffering from multiple health problems. From delivery onwards she suffers from piles, but no bleeding occurs. Now she is 58. Exactly all the below discussed problems started after menopause. At bed she can t turn her head rightside, if accidentally turned it results in vertigo. Few times vertigo is accompanied with vomiting. Besides this she have joint pain. Now-a-days after looking to television or sunlight coloured spots or shadowed images appear. Sometimes burning sensation occurs in whole body & specially in face & soles of foot & hand. Please help me doctor. To whom should i consult her? ### REPLY: Hello, I passed carefully through your question and would explain that her situation seems to be complex: - Vertigo while turning the head could be related to chronic degeneration in the cervical spine or an inner ear disorder. For this reason, consulting with an ENT specialist is necessary.  - Joint pain could be related to vitamin D deficiency or arthritis. For this reason, vitamin D levels and inflammation tests should be done. - The colored spots and shadowed images could be related to a brain disorder.  For this reason, performing a brain MRI and EEG is necessary. I would also suggest checking thyroid hormone levels.  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 think I have psoriasis, more specifically, genital psoriasis. I have always had problems with my skin. Acne, rashes etc. A few months ago I had noticed a red patch on the cusp of my penis, it was pink and shiny and I began to worry like crazy. I havent had sex very often, and when I do Im protected. I do masturbate. I googled several pictures pictures and it does look and sound like genital psoriasis. I decided to wait because I was embarrassed and scared. Many months past by, sex free, and then recently after masturbation a new sore red patch appeared, it was pink and very tender. Im beginning to worry, very much that my life may be over as I know it. I would feel a little better with a few answers. I have some pictures if need be. ### REPLY: Hi, Welcome to . Genital psoriasis may be an isolated patch or multiple. Well circumscribed and localized and not diffuse. It is not difficult to cure and not very harmful. Usually not painful.Anyhow, a blood work up to rule out other STD/ HIV is recommended. As you had only protected exposures the possibility of STD is rare. Consult your Dermatologist and follow his guidelines.  . Morgan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello! My husband (40y/o) was lifting weights, bench pressing about 205, after dead lifts of about 325- he is an experienced power/heavy lifter so this isn t normal strain. As he was pressing up, he felt warmth in his lower back, right side that felt like liquid spreading. Then just constant pain. He is now having trouble walking and bending. Any thoughts? Thanks so much ! ### REPLY: Hi, welcome to our site. I am , MD. Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your querying view of the history, I am pretty sure that he has injured his back. The exact localization may not be possible without a clinical examination. Yet, the possibility of the spine or disc damage is highly followed by a possibility of a muscle tear. I would suggest testing an MRI of the affected area of the spine. You may need to meet a neurologist with the MRI. Depending on the extent of damage, surgery, medicines and physiotherapy are your options. I hope this helps you. Inform the reports mentioned above/if any other, so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. You can upload them on the site. You can upload them with the query, or if you have a problem, send them to attachments@ChatDoctor .com with Sub: ATTN Your Name. Once we receive the photos or diagnostic reports, my team will send reports / pictures to me. Please do understand that some details could be extracted from a detailed history and examination. Please click on Thanks/Helpful if found useful. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck. . MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 3 year old complaints that his bum hurts and cannot sit on it for long or walk for long i took him to the doctor and they just said it was part of potty training him and prescribed him movicol but then he got such a sore bottom a stopped using it. this has been going on for 4 weeks now ### REPLY: The pain is different for the two situations, sitting / pooing. If you think he is in pain the moment just before pooping then it's a probably an analysis fissure from constipation and warrants SYVICOL if you think the pain is always when he sits on it, then he probably has an injured coccyx, and this is confirmed by an x-ray. These injuries take a long time to heal because of its position. And warrants avoiding constipation as well because it will induce pain to that region, so SYVICOL isn't a bad idea after all. , it needs time to heal, but I recommend an X-ray first I 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: My daughter, age 23 is having severe abdominal pain. These stabbing pains are lasting about 5 minutes. She went to the doctor yesterday, before these symptoms started and was diagnosed with a probable uti and prescribed antibiotics. There are stomach bugs running around our town right now. ### REPLY: Hi! Good evening. I am  answering your query. If I were your family physician, I would have advised your daughter for a urine routine/microscopic and culture sensitivity test before starting the antibiotic. Also, a routine blood test like a complete blood count and a stool test for ova and cyst would be worthwhile, and treated if positive. If all the reports are inclusive, I would not hesitate to get her examined by a gynecologist along with an ultrasound of the abdomen to rule out any pelvic infection and pathology. Further management would depend on the findings of physical examination and results of related 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: what does mild indentation of the thecal sac at l2-l3 and l3-l4 mean? multilevel spondylosis? scoliosis (kyphoscoliosis) ( idiopathic )? osteitis condensans ilii bilaterally? small air in sacroiliac joints bilaterally? reactive bone at the iliac margins of the sacroiliac joints bilaterally? conus ends at l1-l2? levoscoliosis (lumbar) with apex at l3? sacroiliitis? I am 32 year old female with all these things wrong with me. I had spine surgery from t11-l5. and MRI shows quoting notes there are postsurgical changes of the left lateral rod and vertebral body screw fixation from t11-l3 without change in hardware alignment ### REPLY: Mild indentation of thecal sacs are no problem unless some underlying pathology is active and may further produce selling or indentation as a result of inflammatory/space occupying selling. In your case since spine has been fixed internally by plate/screw it shall prevent mechanical torsion in that area. Under cover of anti-inflammatory . My only advice would be you keep on some form of medication for arthritis and avoid violent bending or jerk to back. Your physician should evaluate the nature of arthritis viz--osteoarthritis-infective arthritis, rheumatoid or septic or secondary to trauma-- all said and done your doc. Should keep you covered up with periodical (3 monthly) evaluation to keep underlying pathology contained. He should evaluate neurological power of limbs from time to time ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How can the intake of 5 mg daily intake of Acitrom due to Aortic valve replacement in Jan. 2000 by a 63 years old can be co-related to the problem of sensory nerves weekness, including the problem of ED. Also pl. let me know if there is any more safe alternative to Acitrom or lesser dose of Acitrom, for maintaining INR at +2 level in the increasing age. I also start feeling numbness from knee till ankle and medium level pain in left foot after standing for 15 -20 minutes or walking for about 1.5 - 2.0 Km., which presently disappears after a rest of 5 minutes and i can walk another Km or so only. How can i lead a reasonably comfortable retired life with an hour+ of Yoga and Pranayam daily in the morning, followed by a walk of 1.5 to 2 Kms.? I am otherwise a tea totaller and pure vegetarian, not even eggs or fish and non consumer of alcohol or beer etc. ### REPLY: Hi! Welcome to ChatDoctorAcitrom is an anticoagulant that helps in prevention of formation of any blood clot so minimizes the risk of stroke or anywhere arterial occlusion by any thrombus. The present problem of numbness feeling of foot is the peripheral neuropathy where your peripheral nerves are affected. You are telling after a long walk of 1.5 to 2 km you get the numbness feeling. So it means when you walk for a long time your legs muscles require more blood circulation and also there is muscular contraction during a constant walking. So the muscular contraction and little feeble circulation due to weakness of arterial wall of aging process combined put some stress on your peripheral nerves, so you feel numbness. If you have diabetic history that also another cause of peripheral neuropathy. Those are the expected cause of your neropathyNow regarding its treatment if you are following the below-mentioned things will be very helpful1) Do the yoga regularly for 30 minutes. It will help to keep active all your hormonal system. It will also help to give some mobility support to all muscles, tendons, cartilages. Furthermore, it will help to maintain a normal blood circulation to all parts which is very much required2) Add more fruits and raw vegetables with your daily diet menu. Take all seasonal fruits. It will help to provide all natural micronutrients to your body. Avoid all sorts of artificial, fast, junk foods. Avoid all types of nicotine or alcohol. Avoid taking raw coffee or strong coffee if taking. You can take green tea. Take your meals in time.  .  3) daily 30 to 45 minutes morning walk. Do the Panama daily which will help to proper oxygenation of all your cells by stretching your lungs alveoli. 4) Take homeopathic treatment for your numbness of foot complain. Homeopathy will help to relieve the symptoms in a short days' duration. Here is homeopathy medicine you can take for the peripheral neuropathy symptoms. Chamomilla-CM - Take one dose just before walking for constant 4 days then give a gap 3 days, again take 4 days. Then stop and can communicate with me further. No more reputation. 5) You can continue citron. Hope it will be helpfulThank 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, a few hours ago i went to the A&E for chest pains, had an x-ray and an ecg with normal results..i was diagnosed with having an inflamed chest wall and given ketoprofen slow release capsules and paracetamol. I took 100mg of the ketoprofen and 1500mg of paracetamol and i am still experiencing pains, in fact it seems the pain has worsened. When i take a deep breath there will be a sharp throbbing pain. Is this normal? ### REPLY: Hi thanks for contacting . You are having chest wall inflammation... So pain is present .... For pain, you had taken paracetamol and for inflammation relief fetoprotein... Here continue anti-inflammatory .  . Avoid strenuous work for few days.... Hot pad application can be useful ... Avoid bad sleep posture ... Avoid movement causing pain... Take rest for few days ... 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 mother is 92 years old and last Friday bruising started showing on her forehead. She had fallen a month ago and hit the back of her head. There was a bruise and lump. The bruise has remained and the lump seems to be the same. The extra bruising on her forehead and now the crown of her nose is recent and today is more black and worse. any suggestions as to what is going on? She is on Warfarin. my e-mail address is YYYY@YYYY ### REPLY: Hi, thank-you for the brief history of your mother. I am sorry to hear that at this age she had to undergo so much pain and aches. Without wasting time, as you told she had a fall, and post that only this blackness on her forehead though it is a month-old injury. I think she had a fall and internal bleeding, that is the reason of the black spot and swelling. Usually any swelling should come by a maximum of week or so. Human body is a self medicine for itself, so body removes the excess waste from the excretory system. Also, I am unsure if you have met a physician that day. If not I will recommend you to meet one and get checked. Also, I am not sure, where at this age she is mobile or no because continuous lying down can also lead to pressure sore at this age. As we age the human body loses its capacity to quick healing. Just on a safer note I recommend visiting a physician and get checked once. If all turns out fine then you can help her by just requesting a physical therapy services at the door step. They will work out behind the breathing exercises, simple passive or active movements which will help the functioning of the lungs and the hemodynamic to the optimum again. Also, kindly take her out in the sun for sun baths and provide good nutrition. Sunbaths will help her to .  I have been seeing old cases between 60-100 and I deal with them by providing regular breathing exercises, active or passive exercises, sunbaths, proper diet and care, this has led my old patient to help them functionally motivated and also have helped them to be energetic and avoid falls as well. I wish your mother the grace of God and a good health soon. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been having recurring mouth sores, usually on roof of mouth, feel terrible when I have them, been on acyclovir for years for preventative care, had an outbreak that lastest 3 weeks & Dr changed my med to Valacyclovir, I dont like how I feel but its slowly taking the sores away, how long should I take ? Any help would be appreciated, thanks ### REPLY: Hello, It looks like you have cold sores due to herpes simplex virus 1 infection, and it is the cause of recurring sores. It generally has a duration of 2 weeks and commonly tends to resolve in 2 weeks time. So my suggestion is to continue the antiviral medication as advised to you and along with it, you can also apply topical antiviral medication over the sores. If the sores are painful you can apply numbing gel containing Lidocaine. Take soft and bland foods to avoid further irritation. 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 my father has experienced pneumothorax, has a chest tube but already taken out. his doctor said that he s got inactive tb and suggested that he will take quadtab (3 tablets 30 mins before breakfast). the bandage from the chest tube is still intact and yesterday he couldn t breathe and has fever. is quadtab good to take even if you don t have active TB especially he just had the pneumothorax? ### REPLY: Thanks for your problem on . I can understand your situation. I don't advice to start anti TB treatment if your father is having inactive lesions. Pneumothorax is not an indication to give anti TB treatment in inactive lesions. I advise you to get done repeat chest x-ray to rule out pneumothorax at present. Because recurrence in pneumothorax is common especially within 1 month. And he is having fever with shortness of breath, these also suggest possibility of pneumothorax. So get done chest x-ray immediately. If pneumothorax is present then this time get done pleurodesis (adhesion of pleura) to prevent recurrent pneumothorax. So consult pulmonologist first and discuss all these.Don't take anti TB treatment at present. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 38 years  about 120 pls  with a constant yeast infection. I just treated with gyno travogen cream in november and its back again, what can i use..it is so uncomfortable, my marriage is suffering.. i ave seen countless doctors and tests always say it is a yeast infection ### REPLY: HI, thanks for using  Some women may have frequent recurrences of yeast infections. This is defined as at least 4 infections a year. When this occurs there are medications that can be used to reduce the frequency of infection. Medication is used for a 6-month period. Examples of those used are fluconazole, clotrimazole pessary, itraconazole, ketoconazole. The dose and frequency of use varies. You may want to speak to your doctor about this option. I 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 and good morning, My Friend is in severe condition at the moment, and what frustrates me is that the doctors who are attending her in ICU cannot give us any final diagnosis about her illness, the 3 doctors have different opinions each time we visit the patient, she is now in the ICU for 12 days...her condition as follows; - Female - 23 yrs. old - No History of Alcoholism and No Drug Abuse usage - She was admitted to the Emergency Area for Avute Pacreatitis - then the doctors have admitted her to ICU because of a very high lipid presence in her blood - she had received a Plasma Exchange (about 6 times or more) - she is undergoing a slow Dialysis everyday as (the doctor claims) she had rhenal failure and the dialysis will help her recover her kidneys - she is under a ventilator or an oxygen and this is helping her breath - what we cannot understand is why now she is under going blood transfussion (the doctor said that her hemoglobin is very low and the transfussion is needed) - her other vital organs are normal ( liver and hearth is stable) What confusses us is that the doctors in Macao still cannot determine the cause of her illness and we are afraid that she is being treated as a guinea pig... I hope that you can help me with my problems and any advice is deeply appreciated. Thank you for hearing me out and may god bless you all. ### REPLY: Just an update... she is now breathing on her own but still with a help of oxygen support. The doctor said the is still producing a very alarming level of lipids of cholesterol and the plasma exchange will continue, she is also still undergoing a slow process of dialysis to help her kidneys, and her pancreas is still not cured. But her Liver and hearth condition is still normal her BP is 156/97 and sometimes 168/79 or /89 the doctor still at the moment is at lost of the origin of her illness. I hope that anyone of you good doctors out there can give me a fair opinion on her case... Again thank you for your kind attention and looking forward to hearing from you soon God Bless ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 9 yr old daughter has a lump/knot in her arm pit that I just noticed tonight.  It is apparently painful to the touch.  She is a swimmer so I wondered if it could be a sore or pulled muscle but now am more wondering if this could be a swollen lymph node?  I have not noticed any infection or illness & she has not seemed to feel bad.  It is larger than a quarter size.  How concerned should I be?  Should I make an appt with her pediatrician right away or just watch it?? ### REPLY: Hi and thank you so much for this query.If am so sorry to hear about this swollen lump in your daughters' armpit. Chances are high that this could most likely represent and abscess. There is no need to rush to the doctors right now. Monitor it over the coming days and if it should fail to regress, then you may want to seek for medical consultation. If it is a minor abscess it could regress or even pop open all by itself. Try Tylenol and Ibuprofen to relief her of the pains associated with this. I hope this helps. I wish her well. Feel free to request for more information if need be. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 heart sometimes adds an extra beat.  I can feel it when it does and it makes my chest feel funny and makes me tired.  It comes and goes.  It just started doing it again a couple of weeks ago.  It hasnt done it for about a couple of years now all of a sudden its back. ### REPLY: Hello. Thank you for your question and welcome to . I carefully read your query. This extra heart beat, with the highest probability, is what we call extrasystole (a skipped heart beat). It is a premature heart beat that is generated from another area of the heart, not from the normal pacemaker of the heart. After this, there is a pause, as the heart "resets" and the next beat if more forceful and perceived from the individual experiencing it. This is called a palpitation. They can happen when you are tired, when you exerted vigorously, when you have had alcoholic beverages, and they can happen to anyone. In most of the cases, they are totally benign. However, it is not a good sign if they happen often. Therefore, I would recommend you a 24-hour Holder rhythm monitor, to check how many times these phenomena happen throughout a day, and if they exceed the "normal" limit, proper treatment should be started. My opinion is that you should not hold back from everyday activity. I hope I was helpful with my answer. Wish you a good health. 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 a 41 year old lady who recently had a operation to remove a lung cancer on my right side followed by 4 rounds of chemo,but now i have a burning pain in my ribs on the left side and shoulder pain.i also have terrible indigestion.am terrified this is a new cancer.had a chest xray 8 weeks ago which was clear.please help. ### REPLY: Hello, Your symptoms could be related to gastroesophageal reflux. For this reason, I recommend taking a PPI (omeprazole, pantoprazole, etc.) and see if it helps improve your situation. If it does not help, I would recommend going to the ER for a physical exam and some tests:- A chest X-ray study- A cervico-thoracic spine X-ray study- Amylase and lipase plasma levels- LDH plasma levels, CEA plasma levels should discuss with your doctor on the above tests. 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: Hello.. I had typhoid a week back. I ve taken leflox with panadol and still taking it. my typhoid is gone but I still got temperature, at night it s 100 and whole day its 99. plus got severe chest pain, bodyache and pain in joints. Please tell me what to do? thankU ### REPLY: Hello, Typhoid lead to weakness in body. All this can be due to depletion of body nutrients during your fight to typhoid. Although fever should not be there so take care of that if it continues to be there for long time then consult to your doctor. Take a healthy, nutritious diet full of green leafy vegetables and minerals. You may concurrently take a multivitamin supplement. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, im a 22 year old male, i have had sudden testicular pain in my right testicle, first felt like i was kicked in the balls, now the pain changed, feels like the pain is in the veins, i had a blood test and ultrasound and both tested negative..what can this pain be ? thank you for your help ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some infection like epididymis orchids, or you may have torsion of testis. You should go for examination. If needed to take a course of antibiotics. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . 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 HUSBAND HAD NECK SPINAL STENOSIS SURGERY AND IT WAS SUCCESSFUL. HOWEVER, HE HAD TO BE TREATED 2 DAYS LATER FOR A PULMINARY EMBOLISM AND IS ON WARFARIN 3 MG FOR 3 MONTHS. HE IS RECOVERING FINE BUT NOTES ABOUT 2 NIGHTS A WEEK HE WAKES UP WITH SWEATING ON HIS CHEST AND NECK AND THERE IS A LOT OF IT! WHAT IS CAUSING THIS? THE NEURO SURGEON HAS NO RESPONSE - DOES NOT KNOW! PLEASE ADVISE! THANK YOU. MY HUSBAND IS 60 YEARS OLD AND IN GREAT PHYSICAL SHAPE AND NOT OVERWEIGHT . ### REPLY: Hi, I have gone through the details submitted with diligence, and I am sorry to hear about your husbands problems. Prolong surgeries are known to cause vein thrombosis; and It's good to know that he is recovering from it and the spine surgery. In this circumstance, increased perspiration on his chest/neck cannot be explained by any medical condition. But yes, we can get clues if we could know the reason for his awakening in the middle of night. Perhaps this could be hyperthermia or palpitation or other causes.  You may also check his blood sugars through a glucometer to rule out hypoglycemia.  Discuss with your husband to learn about the reason for his night awakening and review back to your doctor along with his blood sugars. Your treating doctor may be able to explain what is happening then to you. Hope this helps.  Good luck!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with Hashimotos Disease approx 1 year ago.  I started having chest pain & was given a echo, that was normal, & a stress test that showed the EKG that was abnormal toward the end & for the first few minutes afterward.  The doc did an angiogram (assuming that I had blockage) & I didnt have any blockage at all.  Should I assume all is well? ### REPLY: Please change your diet and lifestyle. What medication are you taking is it T4 or t3 T4 is not the active harmony First you should get a proper diagnosis of hypothyroidism You have to do all 6 tests which is never done even by specialist doctors TSH, FREE T4 FREE T3, REVERSE T3, REVERSE T4 TPO and TG antibody title before starting any medication for Hypothyroidism. Do also a ULTRASOUND OF YOUR THYROID T4 is not the active hormone T3 is the active hormone T4 has to get converted to T3 which requires adequate stores of Iodine, Iron, zinc, B12 and Selenium don't use any fluoride toothpaste. It will displace Iodine needed for making thyroid hormones otherwise T4 or Elton will not work do the right tests and go to the right doctor to get the right treatment ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hypertension.I just took my blood pressure = 149/84.I am taking Amlodipine, 5mg. My doctor recommended me to increase the dose of Amlodipine to 7.5mg.What studies would you suggest to find out the source of my hypertension, instead of just increasing the dose of medication? ### REPLY: Hello, Regarding your concern, I agree with your doctor recommendation on increasing the dose of Amlodipine in order to have a better control on blood pressure values. I would also recommend performing some tests to investigate for the possible causes underlying high blood pressure:- A chest X-ray study and pulmonary function tests- A cardiac ultrasound-Complete Blood Count for anemia-Fasting glucose-Thyroid hormone levels-Cortisol and aldosterone plasma levels for possible a . You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a DVT in June 2013 when I had a knee arthoscopy and was on the pill at the same time. I was on warfarin and clexane for about 3 months. I m flying from Australia to Istanbul next months and I will resume taking the pill again. Should I have a shot of clexane before I leave? Female/ 23 years old/ very active ### REPLY: Hi, Thank you for providing the brief history of you. A thorough musculoskeletal assessment is needed. As you had a knee arthroscopy in the past, and you were on medication, i don't think you need to take any for time being. As the medicine you had was for the symptomatic relief and the course is completed. If you have any problems in your travel you can take the same which should help you. Also, undergoing proper physical therapy for DVT and Knee related issues. As per the research physical therapy has been helpful in controlling the pathologies and also improve the overall condition of the health. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had surgery on my left ankle to get a bone growth removed because I have osteochondromatosis and it was causing problems. However, 2 weeks later, my foot still has a very noticeable discoloring on the top of my foot. It starts towards the ankle and continues up through my big toe (the darkest area). I thought removing the growth would make the coloring go away but it s just gotten worse. Any opinions? Thanks! ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have discoloration on foot after undergoing ankle surgery. Well there can be many reasons for symptoms you mention in query pigmented purpuric dermatitis (chambers disease) or psoriasis arthritis. It can also occur due to hematoma caused by internal bleeding, infection like fungal or bacterial or necrosis. I suggest you to apply a moderately potent topical steroid e.g. triamcinolone acetone 0.1% cream Or mometasone furnace 0.1% cream, twice daily for a few days apply ice pack twice a day, also take vitamin C tablets for a week for quick recovery. If condition persist then consult your surgeon for proper examination and treatment. Doctor may also refer you to dermatologist. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Do I have some sort of mental disorder if I use change to cope with stress? I like change. Some of my friends find it really weird that I change the placement of things in my house a lot or the fact I change my appearance a lot compared to other people. ### REPLY: Greetings ! Well changing settings of home or changing your appearance in the wake of stress shows that you have developed this unique defense mechanism to help self in enduring stress and to overcome it without getting overwhelmed by it and impairing your functioning ability. So this is not a mental disorder but a stress enduring defense mechanism. Each one of us have a way to endure and fight stress, yours is this. I hope this helps. Wish you all the best. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 19 year old male, for many years i have exsperienced aprehension or panic attacks (usally something im looking forward to) over the smallest of things genually! the physical symptoms come and go genually in the sequence, hand trembeling , then leg tremeling, tightness in stomache growing very tight, then causing nausia and then throwing up in some cases (in some cases muscel twiches usally small ones around the eye). which due to the smallness of the sitmulus eg. seeing friends, catching up with friends, before an interveiw, at work if im asked to look after a friends child for a shot period of time. they usally last around 10minuts start to finish sometimes as a cycle, then go and im fine, i have tryed controlling my breathing, cutting out caffine, sugars, saying to myself this is rediculus. starving myself, but the no or little effect. they seem to be getting worse and harder to hide them, so i would like any help or serjestions. its like my body is over reacting like mad and dumping enough adrenerlin to last bloody years. any help? or ideas ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Panic attacks always happen due to underlying anxiety. Therefore, you must add .  Please understand anxiety and related problems. Once you understand your anxiety, you will be able to keep yourself away from panic creating situations. Therapy always starts with avoiding such situations along with coping techniques when forced to be in such situations. Start slowly, progress gradually, attain neatly. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with a l5-s1 disc herniation that only surgery can fix.  I have been waiting over a year and now my sciatic is really painful in my buttoch and shooting pains down my leg....in mornings my back spasms so bad I cant pee...what do i need to do to get the hospital to admit me for surgery? ### REPLY: Hello! Welcome on  ! I understand how you feel, but you should know that the decision on a possible intervention should be based on the type and degree of disc herniation and on your symptoms. For this reason, I recommend performing a lumbar spine MRI study, coupled with a nerve conduction study to examine your nerves. The next step would be consulting with a spinal surgeon and discuss surgery based on the above tests results. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my grandmother is 92 years old. She is on blood pressure medicine. She went into the ER for abdominl pain and was told she had gall bladder stones she was diagnosed with cholecystitis, and was told to see a suregeon that she would need her gall bladder removed. she was given pain meds and sent on her way. My question is, is a gall bladder removal the only option?would it be risky? ### REPLY: Hi, Well, there are some nonsurgical methods, but these are mostly unsuccessful. You need to change your dietary habits first.  Need to avoid fried food, carbonated .  You should eat more milk products, vegetables and boiled food. Ursodeoxicolic acid may be used for smaller stones and may dissolve them and ultrasound waves may do it as well, but success is very limited.  If there is no improvement on lifestyle or dietary changes, then surgery is recommended.  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 had pain in the lower right side of my ( i want to say stomach ) but i feel it is a bit lower, about a month ago, it went away and now it is back, i have been having weird bowel movements and sometimes cannot go at all. When i had intercourse 3 days ago we were in the missionary position when that same spot had a sharp shooting pain through it. It now just feels irritated more than anything except for the occasional sharp pain, and I cannot pass anything at the moment. do you have any ideas? ### REPLY: Hello, Lloyd, The location of the pain and some changes in your bowel habits point to some problem with your large intestine or the colon. If you are over 40+ years of age I suspect you may haveDiverticulosis or pockets on the colon wall. This is more common on the left side of the colon although you can involve any part of the bowel. If one of these pockets get infected, then you can have significant pain, fever, chills and even bloody diarrhea. In many cases, this is associated with spasms and the symptoms are similar to IBS or irritable bowel syn . If you have not had a screening colonoscopy, you should get one. At the minimum, you can get a Barium Enema to see if there are any problems. If you have any family members with history of colon cancer, then you should have the colonoscopy. Same things true if there are any signs of blood in the stool, weight lessor anemia. Have your stool tested for blood and also get a complete blood work. For constipation, you can take stool softeners that arereadilily available in  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: it appears to be that I have an abcessed tooth.  I got a bump on my gum 4 months ago and had pain.  I then took antibiotics to kill the infection and the little sac on my gum never went away. now 4 months later, puss is coming out when I push it.  I have been gargling with salt and water.  and going to see a dentist tommorrow.  Will I lose my tooth?  because I waited so long? ### REPLY: Hi. Tell me about your pain... is your pain continuous .is there any hole or cavity on your tooth. In such case you can save your tooth by doing root canal treatment .BT if no part of tooth is left and your whole tooth structure is lost that in such case you have to remove it. Bt not to worry there are any option for tooth replacement like implants, crown, bridges etc.so DNT worry have root canal treatment and save it ....... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Why am I so unwell after Gall bladder removal? I did not have stones but a gall bladder that was not pumping. I am now suffering from nausea ,and if I don t have that I have the runs. It feels sore and tender inside like it was just operated on. Feel like crap most of the time. I have also had a stool test done which showed very low in digestive enzymes. My operation was 14/8/2014. Many Thanks ### REPLY: Hi.noted recent gallbladder surgery and post-operative nausea. Recovery after surgery is different from one case to another, depending on the pre-operative condition/co-morbidities. Are you eating well? Even those who has been operated on several years back, could occasionally experience pain/discomfort on the operative site, but tolerable in character and resolving spontaneously. It is best if you do a follow-up consult with your surgeon for physical examination and clinical evaluation. Diagnostics (such as scout film of the abdomen, ultrasound, electrolytes, etc.) and management will be directed accordingly. Hope this helps. Good day!! ~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I got a a mall after about 30 minutes I feel disoriented,and terrible especially while I lift my head and keep looking at the stalls, is it vertigo. My doctors has given me vertin 8 mg and as soon as I take it ,my discomfort does reduce. What exactly is my problem. ### REPLY: Hi, Thanks for writing in. Our brain has an inbuilt balance mechanism by which we adjust our balance with change in posture. This is done by the cerebellum and the inner ear mechanism. The cerebellum is the small brain and controls the balance and gait centers. The inner ear has the vestibular system that gathers the information regarding change in posture and relays it to the brain. The information in the inner ear is transmitted by the hair cells and endomorph in the inner ear. There are conditions when these hair cells do not function properly with change in position and are unable to send the right information to the brain. This leads to a confusion of the brain in processing the change in position and adapting to it. The result is dizziness and vertigo. It might help to get detailed investigation done under guidance of your doctor. Vermin is a medication that helps send the correct information to the brain and prevent dizziness. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had Davinci robot removal of the prostate 13 months ago with good success but PSA went from .01, .02,,.05 and now .1. My regular doctor said after my blood test said I may have an infection-UTI. Since I have no prostate can infection cause my PSA to rise ? ### REPLY: Hi, I don't believe that infection in the urine can cause an elevation in the PSA because as you said you don't have any prostate anymore. But of course we have to hope for the best, so we will see I repeat PSA after you take the antibiotics prescribed to you. If there is still rising PSA after the course of antibiotics then we may say that you may have prostate cancer recurrence after surgery. Your doctor might give you hormone therapy or addition depending on your clinical data. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir  am 25 year old.last one year i met serious allergy as well as some troubles in my nose while breathing. 4mths before i was consulted one ENT specialist, he told you have heavy sinus affection imediately you have to surgery your sinus.but that time i was trained in chandigarh..i want to meet a good ent specialist in trichy.can you pls suggest specialists in trichy?also suggest pls which is best either herbal side or medicine? ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I would like to know about your symptoms in more details like - do you have sneezing, running nose, nose congestion, fever, headaches, breathing problems, facial pain, loss of smell, etc.2. Were I treating you, I would prescribe you a 10-14 day course of an antibiotic plus daily montelukast and levoceitirizine. I would also suggest you daily steam inhalation.3. I would suggest you allergy testing which will help you identify the substances you may be allergic to and also to know how to avoid exposure to them.4. Furthermore, I cannot name specialist according to terms & conditions of . Sorry for that.5. As you have asked about herbal or medicine, in my opinion, you should combine both. The most important concern should be identified what exactly you have and also the cause of what you have. Allergy testing and an ENT consultation will help you to know what exactly you have. Once diagnosis is confirmed, you can manage yourself with appropriate medications (allopathic or herbal) as both have their own pros and cons. Combining both will reduce duration of your treatment and also minimize side effects, provided both the allopathic and herbal doctors are co-operative to each other. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you a quick recovery and the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have many deep bone ach in my shoulder, then left ankle, then goes over to right thigh, never at same time but it is very severe......take 50,000 units of vitamin D once a week, have been for a year....have generative disc disease since I was 20 and Kennedy s disease runs in our family.... My uncle died 2 years ago, my brother has it and I am the carrier and my son has it... All my female grandchildren are 100 percent carriers. Same as my brother.... is this symptom part of the kennedy s disease.... I bet you have not heard of it... Very rare.... ### REPLY: Hi, Thanks for your query.* It seems you are suffering from degenerative disc disease & it occurs due to repetitive overload or stress to the disc & it increases the risk of disc herniation spinal canal stenosis. The main treatment of such pain is bed rest along with painkillers and muscle relaxants. Muscle relaxants can help with your symptoms if used in appropriate dosage in combination with a potent analgesic. You can get the appropriate . Meanwhile, you can follow these measures:- If the pain is severe, you need bed rest till the pain resolves. - Get some analgesics prescribed and apply analgesic spray or ointments.- While resting, keep a pillow under your knees if it doesn't bother you.- Avoid lifting heavy objects.- Back strengthening exercises and stretching exercises daily as advised by a Physiotherapist.- Avoid exercises in times of pain. - Improvise your posture while sitting. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im on a lot of opiates and benzos for legitimate pain for about 8 years now and my tolerance is so high that they are not even working. am thinking about about trying subutex maintenance for pain or even thc. I don t abo abuse my oc=xycontin or oxycododone or use street drugs. what is your opininion? ### REPLY: Cannot say in your particular case. The hallmark of buprenorphine is that it has a maximum effect that is not increased with increasing the amount that you take, while other narcotics keep going up. Although buprenorphine is strong in the effect per milligram, the maximal effect it can do is less than with any other narcotic. If someone is on a lot of them, then the buprenorphine will NOT be able to achieve the effect of other narcotics. It will more or less fail. THC works on pain by a different method. If you don't have narcotic receptors, THC still works. It does NOT increase the risk of narcotic overdose except by making peoples judgement be worse, and then they do silly things. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mom has been in hospital for three days and has had six blood transfusions because of internal bleeding,the doctor also says that her liver is in a very bad condition what does this all mean and how bad is it.she is 46 female has a bad history with alcohol ### REPLY: Hi, I had gone through your question and understand your concerns. I suppose that your doctors are talking about esophageal or gastric varices bleeding which is late consequence of liver cirrhosis.  This is serious issue and may be fatal in30% of cases. However, in most cases bleeding is stopped with endoscopic procedures but liver problems remains and should be treated with liver transplantation as a permanent cure. Quitting alcohol is the most important thing that of course, if the damage isn't to too severe already. But as I said, at this point it is most important to stop bleeding and stabilize her viral function. Later, other surgical or endoscopic methods may be considered to prevent internal bleeding and liver failure in the future. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing 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: my 10 year old son was diagnosed to be suffering from primary complex, he just started his medication yesterday per instruction of his doctor..my fear is whenever afternoon comes he has always fever..how long will such fever subside since he already started his medications? ### REPLY: Welcome to the  I completely understand your concerns but don't worry. Once you start the proper course for primary complex tuberculosis, symptoms including fever and anorexia improve within 10 days in most cases. In rare instances when the fever persists, then visit your doctor for re-examination to rule out any pus collection and review of treatment. Hopefully this will help you. I would be glad to help you in any further questions. 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 9 month old daughter MRI scan showed following: The high frontal subcortical white matter superior and middle frontal gyri shows T2 hyperintense signal suppressed on FLAIR suggestive of gliosis(R L). Structural anatomy and parenchymal signal pattern of remaining brain are normal in brain stem, cerebellum and both cereberal hemisphere. Focal structural lesions, diffusion restriction, edema and mass effect are absent in brain. Ventricular system of brain has normal size and configuration. CSF cisterns at base of brain, around mid-brain and over cerebellar and cereberal surface are clear. Cranial nerve segments in cerebello-pointe angles are normal bilaterally. Major intracranial arteries have normal course, calibre and flow-voids. Petrous temporal bones have normal symmetry. Sella and juxta sellar regions are normal. Orbits and their contents reveal normal anatomy. Impression: MRI head scan reveals Mild gliotic changes in high frontal subcortical white matter bilaterally, prominent on right side. My daughter was not giving social smile till 6 months and hence we were worried. She has started smiling now from 8 months onwards, but has squint in her eyes. She s 9 month old and have not started crawling or sitting up yet as well. We are worried day and night if there is some issue with her and trying to get all medical check ups done. She had viral fevers and lot of blood in her stool when she was 6 months old. Doctors were not able to diagnose anything and after some medication and a week at hospital, she got better. The latest gliosis has scared us and we are worried if it has impacted her brain and caused any brain damage, which could hinder her growth. I would be extremely grateful if you could shed some light on what could cause gliosis, and whether it has any side effects that we need to take care of, any treatments which we can start at early stage so that her growth is normal and she doesn t get any impairments. ### REPLY: HelloGliosis is reparative mechanism in brain in response to injury. Injury may be due to ischemia, infection etc. Small gloss in your daughters' case may be due to perinatal ischemia. Gliosis is due to proliferation of glial cells in brain. It is a healed stage and this specific finding doesn't require any treatment. Your daughter may need supportive management only. She needs to be properly examined by a neurologist. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I feel excruciating pain in my tooth whenever I drink something cold , even it s just mineral water. The pain doesn t go away until I take a medicine (Ansaid). These days it s become so strong that even if I take a tablet, it doesn t subside completely and prevails. Sometimes my tooth starts aching even when I haven t eaten anything at all. ### REPLY: Hi, Pain due to cold is an early sign of nerve irritation. As you have been taking painkillers for this problem the problem has reached a chronic stage when even those do not help. If your tooth starts aching on its own and specially if you get up at night due to sudden tooth pain then these are the symptoms for infected tooth. It can be treated by root canal treatment which your dentist will confirm after taking your X-rays. For emergency relief of pain, you can put clove in your mouth on the tooth which is hurting as it will give you temporary but instant relief. I strongly recommend you to visit your dentist and get the required treatment done. 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 5 year old has had a cough for 6 days now. For the past 5 days he was at 99.0 now today he is at 102.0 I took him to the doctor 3 days ago and they said everything was clear. But it just seems to be getting worse. Should I bring him in agian? Thank you In advance. ### REPLY: Hi welcome to ChatDoctorI understand your query and concern. Your symptoms are suggestive of Acute upper respiratory infection. I advise you to get an X-ray PNS and CT PNS to confirm the diagnosis.Meanwhile, I advise you to take Tab. Amoxiclav 625 mg twice daily for 1 week, Tab.Exocet twice. Avoid allergic foods like tomato, brinjal etc. . Avoid cold baths. Consult your physician for expert management and follow up. Hope I have answered your query at the moment. Post your further queries if any, 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: Born with Hemangioma Vascular Malformation to the Left of my face (Internal & External) Cheek, bottom lip, tongue, to the back of throat. Can this cause shortness of breath? I am now 44, but had been treated in my late 30s from my Plastic & Radiologists Surgens. (NZ Maori Female - Gabe) ### REPLY: Thanks for your question on . I can understand your concern. Hematoma is benign tumor of blood vessels. It can be seen in all organs like lungs, liver, kidney, spleen etc. but commonly seen in face and mouth. In lungs, this Hemangioma can cause arteriovenous shunting of blood. This means, Hematoma causes mixing of oxygenated and deoxygenated blood. So body will sense low oxygen and so increase respiratory rate to compensate. So Hematoma in lungs can cause breathlessness. So better to get done CT pulmonary angiography and if Hematomas are there then you will need surgical removal of these Hematomas. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having up to 6 bowel movements a day, some diarrhea some hard and some normal. Today I felt a hard lump under my belly button then I pushed on it and gushed some blood.I had my minstral cylcle on the first.my tubes were. Tied 4 years ago.no I am barly spotting blood and having little cramping. My stomach still feels hard ### REPLY: Hi, Welcome to . You seem to have Boil in early stages below the belly button, as only blood gushed out when you pressed it out.Hence, I would suggest you to get Second Opinion from Surgeon, who would direct for its management after needful physical and radiological check up.-Treatment-Cold Compresses.-Tab Anti-inflammatory under guidance from your doctor.-Antibiotics to treat boil/fur uncle causing that lump below belly button.-Test Blood for FBS /PPS/ and Thyroid profile, to rule out any accompanied primary or hypothyroidism with secondary diabetes as you had diarrhea concurrent to the lump.-Surgeons consultation and needful further treatment as directed from him. Hope this would help you to plan treatment with your doctor. Will appreciate your review write up and hitting thanks, to help needy patient visitors like you at . Welcome for any further query in this regard. Good day!! . N. Senior Surgical Specialist. M.S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: does occipital nueralgia pains cause symptoms similar to a seizure...the pain causes my arms to draw up towards the pain on the left side of my head..sometimes my legs extend outwards. this episode w the pain last no longer than 10 sec... i am alert during this episode but my speech is slurred. was on dilantin for 18 yrs for partial seizures.. off meds in may this year..symptoms returned but my neurologists said its occipital neuralgia..tried several meds plus a nerve block..didnt work..head pain episodes usually the same time everyday for a few days then change to different times for a few more days at the same time..have you any idea what this could be? ### REPLY: Hi, Thanks for writing in. Occipital neuralgia IA a condition due to the over stimulation of occipital nerve which supplies part of skin at the back of head. Symptoms of occipital neuralgia might include the followingBurning, and throbbing pain that typically starts at the base of the head and radiates to the scalp. Pain on one or both sides of the head. Pain behind the eye. Sensitivity to light. Tender scalp. Pain when moving the neck. A severe attack of occipital neuralgia can sometimes trigger a seizure. The typical occurrence of occipital neuralgia involves symptoms for a period of seconds to minutes after which the patient returns to normal. If you experience other symptoms lasting for a longer duration then the possibility of a partial seizure cannot be ruled out. For this you should get an EEG done and results discussed with the neurologist.  .  Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have notice there is a bruise look a like right on my spine . There is no pain on it either however I do have back pain for about 2 months know I am 20 years old female....this morning my back really hurted on my right middle side right abouve my ribs....most of the time its my upper back that is unbearable. I was told by couple of people that I have a lot of nots on my back ...help worried ### REPLY: Hi welcome to ChatDoctorForum. As you have described it appears to be herpes infection a viral infection with severe nerve pain. Watery shiny boils seen along the course of the nerve. It should immediately be treated with anti-viral .  If my diagnosis is correct. Ofcourse there are other possibilities also so I advise you to consult a dermatologist for diagnosis and treatment. don't worry what ever it is curable completely if it is treated promptly and complexly. 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: hai doctor.i just got my MRI result. Could you please interpret for me? L5-S1: central annulus tears with focal central protrusion of disc. The central herniated disc compressed the Cauda Equina. Bulging disc also causing narrow neural foramina bilaterally resulting L5 existing nerve root impingement. what the different between posterior central protrusion and focal central protrusion disc? ### REPLY: Hi, There is a soft Kelly like tissue present between two vertebral body which is the disc disc protrusion is a type of disc herniation characterized by protrusion of disc content beyond the normal confines of the intervertebral discuss protrusions are further divided into:broad based : base involves between 90 and 180 degrees of the circumference focal : base involves less than 90 degrees of the disc circumference In case of focal central protrusion, focal and central part of disc is protruded In case of posterior central protrusion, the central part of disc is protruded posteriorly (back that is towards spine)Hope you could understand .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a car accident a month ago. I was driving and while driving someone plowed into the rear of my car. Totaled it. About a week later my head started to hurt my neck got stiff and cranky and my back started to hurt. Now my scalp is sore and sensitive. ### REPLY: Welcome to  I have gone through your query and understand your concern. It may be possible that you got injury to your neck. Most probably it is muscular sprain. But fracture can be excluded by x-ray of cervical spine Anteroposterior and lateral view. You need rest and analgesic such as ibuprofen. Muscle relaxant such as ibuprofen is helpful. Vitamin B and C is helpful in recovery. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a 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 have allergic cough ...initially there was flem...but now it is mostly dry. had a throat infection initially. Now after around 1 week, teh throat infection has disappeared, but the dry cough is persisting. I cough almost 2 times in a minute. Please suggest a remedy ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I usually suggest my such patients' levocetirizine + montelukast for at least 14 days.2. Regular warm saline gargles twice a day will soothe your throat and reduce coughing.3. Please avoid exposure to dusts, smokes and air pollution as much as possible. Have plenty of warm fluid during day and light diet. This will help early recovery. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...My husband had bowel cancer surgery in 2009 and has just had a CT Scan and has been told the cancer has returned to the pelvic area and lymph nodes and cannot have further surgery. Does this mean he is terminally ill? ### REPLY: Hi, Thanks for writing in. Bowel cancer is difficult to treat in some patients and your husband might have had a recurrence lymph node involvement. In this situation there is disease spread to the regional lymph nodes and this make it difficult to operate. However, treatment should be started after COSI . Many patients can have good response to chemotherapy and radiation therapy and show significant reduction in size of lymph nodes. This can then be assessed again and a staging can be done and if possible then operated at a later date. Bowel cancer is also seen to spread to liver in nearly half the patients, and therefore it will help to check on the liver from time to time by ultrasound scan or CT scan. Lungs should also be screened regularly. Hope he recovers with treatment. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? I have a knot on my left side ribs. It is about the 2nd or 3rd one up from the bottom of the left rib cage. I was wanting to know if this could be a symptom of a swollen spleen or hopefully not a symptom of liver cancer.. please help ease my mind, until i see the doctor nest week. The wait is killing me. ### REPLY: Hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. Based from your description, it could be a cyst (a sebaceous or a gelatinous type), a fibrous or a lipoma. These lesions can occur anywhere in the body and have the tendency to recur.  Management (medical and surgical) will be directed accordingly. Splenic problems and liver cancer do not present the way you are experiencing these signs and symptoms right now. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...Sir my wife aged about 28 years alwaya complaining about her chest pain. Most of the time when she get angry or get shocking news she feel pain in her chest & also having breathing problem. Kindly advice ### REPLY: Hi welcome to the  Here chest pain and breathlessness seems to be either from stress induced panic attack or by cardiac cause Work up done as follows... -Auscultation-Blood pressure measurement -EKG -Tread mill -echocardiography if needed -anxiety history According to cause further specific treatment given Hence with keeping all this in mind consult her to pulmonologist or cardiologist for examination Take care Hope your concern solved ### END