Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doc is there any treatment for Azoospermia due to Maturation Arrest nowadays? If complex operations like heart transplants can be done, why is Maturation Arrest in the testis incurable? Going through articles saying it is irreversible is indeed devastating for hopeful fathers like me. ### REPLY: Hello,Azoospermia means zero sperm count. If you have been diagnosed as azoospermia based on one report only please repeat it again in a standard laboratory to confirm the same. First you need to analyze cause for azoospermia. Hence, please get examined by a urologist. You need to get scrotal Doppler ultrasound scan done to see if there is varicocele or small size testis. Based on above 2 tests you need to get hormonal evaluation mainly FSH and Testosterone. The treatment can be offered after seeing above reports. These measures may help start taking .  Stop smoking and alcoholReduce weight and do excerciseDont ware tight underwearThank you. Void trauma to testicles ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: no appendix ( it is removed 1994) no right kidney ( it is removed 1999) . left kidney is working well. and all other organs working well. all cbp, urine, ct scan, ultra scan are normal. after removing kidney i am suffering with heavy pain at the place of appendix and it is form to right kidney side after some time its locate left kidney side and left front side. mainly it starts and locate near appendix place. i am suffering this pain since 2006. urologist (who kidney removed) no problem. he suggest me go to gastroenterology doctor. i went there. they also tested me. no problems. in 2008 they gave normoxin tablet for 2 months. after taking that some relief for few months. the pain starting suddenly and heavily. taking pain killers (tablets are injections like overan) pain relieves but gas trouble . doctor changed injection Tramadol . i have no gas trouble and relieve from pain. it is only 5 or 6 months. now tramadol also not working. no pain relief. in hyderabad institute of asian gastro entrology , they gave ketorol injection . pain relieved but upto 48 hours full gastric problem. after that they gave ib set tablet for one month. thanking you sir. No abnormal bowel movements.  sir i have only pain what i wrote. after taking the tablet no daily motion and irregular once in three days. before taking tablet i didnt have no motion problem. no digestive trouble. all my recent reports uploaded. after motion trouble i went to the doctor. he gave one medicine Cremadiet. i am taking that daily. but the motion trouble continued.what can i do ?without abnormal bowel movements along with abdominal pain why the doctor prescribe that tablet (ib set)? ### REPLY: Hi and thanks for the query, The clinical scenario you describe warrants exclusion of a tumor. The association of a pain at the level of the appendix and the kidney could indirectly suggest a tumor from one area that had to spread to the other. It would be interesting to know if a histological evaluation of the tissue that was removed / appendix was done. An abdominal ultrasound could be most useful in checking for any masses that could be in the abdominal region and deciding an appropriate treatment option. 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: Hi, im 26 years old, and over the past couple days, ive been having this pulsating feeling over the left side of my rib area. Its not painful, but it is giving me some discomfort. I dont have any previous medical conditions that are related too this. Any idea what it could be? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you are mostly having stress and anxiety related palpitations. But better to rule out arrhythmia (disturbances in heart rhythm) because this can actually also cause similar symptoms. So get done ECG, 2d echo and Holder monitoring (24 hour continuous monitoring of ECG). If all these are normal then no need to worry about heart diseases. Stress and anxiety appear more likely in your case. So avoid stress and tension, be relaxed and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, I am a 32 yr old women, and quite recently in started feeling a pricking pain on right side of my abdomen , just besides navel. The pain is more is more severe when I bend my self to pick something or get up from bed even. I feel something sharp is hurting me from inside. I need help for this. What it could be and what shall I do? ### REPLY: Hi ! The symptoms you have mentioned goes more in favor of appendicitis. Do you get nausea or vomiting ? Any fever ? Any urinary symptoms ? When was your last menstrual period ? You have to go for an ultrasound if you have got any history of a missed period. I would suggest you to get yourself examined by your family physician/surgeon, who may advise you for some routine blood and urine test apart from an ultrasound abdomen. Wishing you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 27 guy and my cousin who a guy, 21 years old and living with me masturbates alot when he thinks I am asleep. I caught him several times already and I even tried talking to him about it to tell him to stop but he wont stop... Is he psychologically ill? ### REPLY: His admire your positive outlook and congratulate you for the attitude. Now I guess you have a little knowledge about masturbation and have some myth about it. Like sex, it is safe and give sexual pleasure. There is nothing wrong in it. Once or twice a day, a person can do it to get sexual pleasure. It has no sexual or mental side effect.  I think, you need more sex education to overcome.  For this you need experts guidance by psychiatrist or psychologist. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, In 2011 ,October I had back pain and my doctor (ortho) diagonised it as IVDP 3487 (???)..I had taken bed rest for few days and he showed some excersices,which I did n practice once the pain had gone.(my mistake) Now again this pain came to me,with a needle pain in toe ,numbness feeling on legs,joints and back pain.. I had consulted with another ortho dr and he had prescribed a pain killer for 10 dys and told me to see him after 10 days.. just want to know what is my exact helth issue,is this curable..i am 35...and drives a lot..today i could nt apply accelarator properly after a long drive... I have uric acid issue also in blood and this fluctuates from 6-9 some times.Taking now medicine to control tht as well Need help/advice Thanks Rajesh Ram ### REPLY: Dear Mr. Rajesh, As your orthopedic doctor has probably rightly diagnosed you with a PIED (prolapse intervertebral disc), your symptoms are very typical. In simple words, it is called slip disc. Your long .  Just wanted to know if an MRI was performed or this was just a clinical diagnosis. Initial treatment is pain medicines and rest. If symptoms are not subsiding in 2-3 weeks, an MRI should be done (if not done already). Depending on the severity of the disc prolapse on MRI and your symptoms, further treatment could be an epidural injection or a microscopic Discectomy. This condition is very much treatable, safely. Recovery is almost immediate, and you can resume back to your normal life in 2-3 days, barring heavy activities. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with CKD Stage 3a.  I am having difficulty with being authorized to see a nephrologist.  My doctor Verna Liss, MD has known I have CKD, yet failed to let me know this for the past three years.  I am very concerned about the lack of treatment and information I am being given, and need help.  Also, the lab tests ordered by Dr. Liss are not being paid by my carrier, Anthem Blue Cross.  I cannot afford to pay for having my question answered.Linda Florey09/04/1949 ### REPLY: HIT hanks for your query. The general measures which help control the progression of CKD include:1) Control of blood pressure (BP2) LDL cholestrol3) Strict control of blood sugars (if you are a diabetic)4) Quit smoking5) Use of a class of medications known as Arms under the supervision of a doctor6) Appropriate diet (need to know more reports)Specific measures can be taken once we know the cause of CKD Hope this helps Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a line or it seems to be a tunnel on my face, that seems to be a fungal infection. I looked up ring worm, but this is not circular. It is in a line. It s red a used to itch but I have been using some anti-fungal liquid. I m not sure if its helping or not. But I am wondering what this actually is? I can t seem to find any pictures of fungus or worm infections that are in a line like this is. Thanks. ### REPLY: Hi Dear, Understanding your concern. As per your query you have symptoms of mark on face possibly caused by fungal infection, well yes it could be Tina corporal which is a fungal infection. Another cause could be skin reaction due to hormonal change during puberty, an .  I would suggest you to exfoliate gently once or twice a day with a salicylic acid-based exfoliant. You should apply fluconazole ointment for local application. You should take fluconazole tablet for oral intake. Wash your face using a mild soap or cleanser and lukewarm water. If condition doesn't improve in a week then consult dermatologist for proper diagnosis. Doctor may prescribe oral antibiotics like clindamycin, Isotretinoin or Hormone Therapy. 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: Hi, I m a 27 y/o Caucasian male. I have trouble with memories creeping in, and if I m not fond of these memories even if its unwaranted I get the overwhelming urge to shake violently if I m alone. If I m around people they manifest with eye clinching and then rolling them up or to the side until the urge passes. As long as i m engaged in conversation or there is a lot of noise around these urges come maybe once an hour sometimes not for weeks. Everytime I think I m done with them they come back. However one constant is they are always accompanied by a memory of me doing something or saying something, typically very vivid almost as an unwanted day dream. They could be memories from 10 days ago or 10 minutes, and typically are as simple as me saying something to someone and it not coming out the way I wanted, and regardless of the response it got I get that urge to have a pseudo-seizure. My best guess is its psychological in nature and just a stress factor. Possibly, because they happen more frequently when I m alone and it is quiet enough for my mind to drift uninvited, they are just my mind keeping itself awake and getting my body involved by going through pathways that are associated with something other than pleasantries. Maybe its just that the memories were not formed properly and it causes me to remember them differently then I would have liked to which stresses my brain. Anywho I m no doctor so I m interested if anyone could tell me whats going on. I don t want this urge to have a pseudo-seizure to become too strong to control in a place like work. Good to note that the eye clinching did not start happening until recently, probably the last year or so, while the shaking in private has gone on for more than 10 years, so there is a trend that its growing harder to control. ### REPLY: Hello, welcome to . Your repetitive movements and thought process appear to compulsive behavior to decrease anxiety related to obsession. Obsession and compulsion are seen in obsessive compulsive disorder (OCD). Pseudo seizure is not apparent from your history. OCD is a type of anxiety disorder and frequently associated with generalized anxiety disorder. If these disorders are not treated early they can lead to depression because of distress and dysfunction. You may need assessment and treatment with psychiatrist to treat your OCD. It is not clear if you received any treatment in the past. As you are having multiple symptoms then combined treatment in form cognitive behavior therapy and .  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: Every time I get allergies , I end up wheezing and coughing, even after I ve taken allergy medicines. I ve tried Zyrtec, Claritin, Claritin D , and even a cough/cold medicines (not all at once, but on completely different days). My paternal grandfather has asthma, and my mother has had many issues with bronchitis(most likely due to smoking, but not sure). Is it very likely that I have a form of asthma myself, and If so can it be tested for even if I don t have symptoms at the time. p.s. I ve only felt like I can t breathe at all one or two times, one was induced by running. However, any time I run, I tend to lose my breath very quickly ### REPLY: Welcome to , I think you are developing bronchospasm same as the asthmatics suffers. Do a spirometry. You would better start, antihistamines+mast cell stabilizer combination as prophylaxis and bronchodilators + inhalation steroid combination if you are suffering it now. I can't write the medicine as it is not allowed in . Anyway, here in  I always advise going to a doctor before taking any medicine. Wishing you an early recoveryThanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 non cancerous mass removed from my groin area near lymph nodes 10 days ago. I am swollen and feel a hard lump underneath. below the stitches are short brown curved lines and I am numb in that area. both legs feel like sand bags and I am exhausted. I called my Dr.s office last Friday to see if I can come in for follow up before the scheduled May 3 date and they said my Dr. is on vacation. Should I be concerned? ### REPLY: Hello welcome to  In the query you didn't mention the mass which was removed.was it a lymph node/hematoma/cyst.?regarding that groin area,most common mass that arises is hernia....usually hernia contains either intestines or bladder or both.it needs surgical correction of underlying abdominal wall rather than removal. Regarding the sutures and numbness,sutured area means that small place of cutaneous nerves are cut.and you get back to normal with in days.no need to worry about this numbness... hope you get answer from me.consult your . . Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a head cold since 9 days and last night I used the nettie pot to clear my sinus and my head. When I blew my nose, I had a screech sound come out of it and now it is not allowing me to hear properly, it feels like I can hear my hearbeat in my head when I try to sleep and last night I almost felt dizzy when I was trying to sleep. Is there anything I can do until I get to see my family doctor on Monday? ### REPLY: Hello! Thank you for your question on ! Thy troubles you have are caused by occlusion of the Mustache tube which connects the nasal cavity with the inner ear, and helps maintain the pressure balanced in the inner ear. It can be blocked by inflammation during upper respiratory infections. It can lead to decrease of hearing or noise to the ears. There is nothing to worry about. I would recommend nasal decongestant . Hope to have been of help! 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: I play a lot of tennis, so baturally I will develop some pain in my arm. My elbow has started hurting for a week or 2 now and at some points I find my arm shaking while just trying to support it. I think I have tennis elbow but it only hurts when I play(but excruciatingly). Around an hour after I stop playing, the pain stops. Is it something I should see a doctor for, or will the tendon heal with time? ### REPLY: Hifirst of all tennis elbow is due to inflammation of common origin of muscles which supply the back part of your forearm in simple words or medically extensor compartment. It is named tennis elbow because of certain positive of form which predispose this origin of muscles under stretch and pain. Usually in tennis elbow you cave pain around elbow region, pain worsening when you try to squeeze a cloth or try to lift a chair etc. For accurately diagnosis this condition and starting treatment for this my opinion would be to you to get proper clinical examination by orthopedic surgeon. Examination would help in ruling out any other illness which mimic tennis elbowWishing you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hiiiii am saranya frm chennai ........actly i used melacre fr past 2month i quit recntly my face becme dark........my marrige is on nov 2nd week .........just suggst any cream which ill nt damge my skin n keep my skin fair...................................thank u ### REPLY: Hello and welcome to  You did the right thing by discontinuing Delaware forte. This cream is a prescription product and should never be used without a dermatologists' advice. Dermatologists commonly prescribe it for facial hyperpigmentation/plasma. However, it should never be used as a regular fairness cream and in any case not for more than 2-3 months since the steroid content of this cream can cause various side effects like acne, photosensitivity, skin thinning and telangiectasia and facial hair growth (hirsutism) which is specially troublesome in females. I would suggest that you use a broad spectrum sunscreen, throughout the day. At night, you could use a glycolic acid cream (Glycol -A) Or Comic acid cream (Comic cream) to obtain the desired results of brighter complexion and even tone. You could also opt for a few peeling sessions from a dermatologist e.g. Yellow peel (Retinol CT peel) Or Glycol peel Or lactic peel. 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 got tested for hepatitis and I don t understand what my results mean. This is what it says : Hepatitis bs antigen NEG Hepatitis bs antibody NEG Patient does NOT have immunity for hep b Hepatitis c antibody NEG Hcv signal to cutoff ratio 0.02 And then there is a footnote I don t understand ### REPLY: Hi, Thanks for posting your query. I am . K and I am pleased to assist you. You have been tested to see whether you have -1. Hepatitis B infection2. Got vaccinated /protected against hepatitis B infection3. Hepatitis C infection. As per the report -1. You do not have hepatitis B infection2. You do not have any protective antibodies against Hepatitis B which means you were not vaccinated against hepatitis B or had any past infection. So you are susceptible for hepatitis B infection. You can get protected against Hepatitis B by getting 3 shots of hepatitis B vaccine.3. You do not have hepatitis C infection. I hope that answers your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is jesse, i have had some issues with my neck slash shoulders over the last year, after a ct scan and some other type of scan it seems i have 3 compressed discs in my neck. tonight i was playing rugby and i got hit in my neck and my whole upper body went numb then sharp pins and needles came. it has been 3 hours since the incident and i still have severe pins and needles in both hands and slighty down both forearms. have i just hit a nerve, should i wait till the morning to see if its still there or should i seek medical attention asap ### REPLY: Dear Jesse, Thanks for using the . As you are suffering from compressed disc and with that any injury over that area might have compressed your nerves. If there is any swelling due to injury it'll further compress your nerves and can damage it. Kindly seek medical help asap. Hope I have answered your query. If you have any further questions I will be happy to help. Thanks get well soon.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had tuberulosis in 2000 I took the whole treatment for a year after which  the  doc tor gave me a clean chit,for the last week it has been phenomenaly cold here & I have a bad viral attack..I still have a cough & my old lung scar hurts when I cough.I have an asthamatic condition as well.Do I need to get retested for TB ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you are mostly having worsening of asthma due to viral infection and previous tuberculosis. Viral infection in asthmatic patients cause exacerbation. And this exacerbation may cause pain in TB scar. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray 3. PUT (Pulmonary Function Test). Chest x-ray is needed to rule active tb lesion. PFT is needed to know the severity of exacerbation. Based on PFT values, treatment is given. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). So possibility of recurrence of tb is very low but better to get done chest x-ray to rule out this. 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, i am having an habit of masturbating for the past 10 years.... Now my penis are become very small and the sperms are coming very quickly. Now i stopped masturbating. But how to overcome from this problem. Can you please advise and suggest some medicines to increase my sperm count and penis size? ### REPLY: Degree understand your concerns went through your details. Masturbation is normal, natural and never unhealthy.  Masturbation is not the reason for your penile length decrease. In face penis length never decrease.  You are worried and anxious just because of lack of sexual knowledge.  I suggest psychological counselling. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Please feel free to post follow-up queries. Available for further clarifications. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi - I have been getting upper left back pain for quitea while now - I can t sleep on my back as I feel as if there is something there. I have a 2cm hiatus hernia (diagnosed about a year ago) am about 15 stone , with most weight in mid abdominal region. Was given omeprazole but no benefit to back pain. This now constant. Sometimes helps to eat, sometimes worse on eating - pleass help !! and thanks ### REPLY: Hello. Thanks for writing to us. The pain in your back can be a referred pain from the hiatus hernia. Some lifestyle modifications like avoiding oily and spicy food, sleeping with head end of the bed raised and taking omeprazole can help in relieving the symptoms. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had a stent put 4 wks ago and have had soreness in center of chest, then about a week ago started getting heavy phlegm, big globs of it enough to fill a pint jar not real green, some clear, some with streaks of blood, a heavy convulsive cough normally brings it up, I am taking warfarin, what should I do ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. You should immediately stop warfarin because it is anticoagulant and can cause blood in sputum. So stop warfarin and get done PT (prothrombin time). If it is higher, then you need to take vitamin K injection to control PT and revert the anticoagulant effect of warfarin. Also get done chest x-ray to rule out lung infection. Because heavy phlegm with blood can be seen in lung infection (pneumonia). So chest x-ray is needed to rule out pneumonia. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello , I am 56 years old and have been taking the metosartan 50 for the past 4 years , my BP is quite normal . Last couple of days I am observing slight swelling in my anles... though there is no pain. what could be the reason for this swelling. Regards ### REPLY: Since u r 50+ years. And you are on medication already. No medicine can lead to swelling as per my knowledge. Kindly contact a physical therapist as he might be able to assess u better and guide for proper exercise. If you provide a proper care to your legs. Then try doing contrast bath technique which will be available on Google for procedures. Post that elevate the leg above the level of heart for venous return. Please do ankle toe movements which will help gain some hemodynamic of the metabolic waste. Kindly get check with your venous return. It may be a DVT or may be an occlusion in the venous .  Last words I wish to mention is follow all guidelines provided by a specialist. They are all siting down to help people. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sitting here watching tv and i I was sitting here watching tv and i felt my heart beating irregular i felt my pulse and it was as if my heart would beat twice then pause then twice and pause. It has since then returned to normal I just recently saw my doctor for palpatations that have been lasting for weeks the attempted to. ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that your symptoms could be related to cardiac arrhythmia. Anxiety could also mimic this clinical situation. I recommend consulting with your doctor for a careful physical examination and some tests: - a resting ECG and a cardiac ultrasound to examine your heart structure and function- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during the day-lab blood tests (complete blood count, thyroid hormone levels, blood electrolytes). I recommend discussing with your doctor on the above issues. Hope to have been helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am 25 years old married women, and today morning i got gare and unstable for some time and after that severe pain in lower right side stomac and i have visited doctor and they scanned and they said no problem report is clear and they said its only some food poision like that, is it correct or if have any idea about my symptoms please clear it for me its very usefull for me ### REPLY: Hi ! Good morning. I am  answering your query. If you had some food from outside, food poisoning might be a possibility. However, it should have been associated with loose motions and vomiting as well. Normal ultrasound excludes the possibility of a right sided ectopic as well. If I were your doctor, I would advise you for a urine routine, microscopic, and culture sensitivity test as sometimes a urine infection could also give rise to such symptoms associated possibly with fever. I would also clinically examine your abdomen to rule out the features of acute appendicitis, which is more of a clinical diagnosis than an ultrasound or other supportive investigations including a stool routine test for ova and cyst. In such a situation, I would advise you to wait and watch, and if the pain increases in intensity, to revisit your treating doctor for a review assessment of your abdomen. I hope this information would help you in discussing with your family physician/treating doctor in planning your treatment. Thanks for using the  forum for your query on health. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have been recently diagnosed with H pylori.. i have been give the triple treatment of calithramycin, amoxxicilin and omeprazole.. is dis something very serious and does this have some long term implications etc.can u plz give some detailed information about Hpylori. thnx ### REPLY: HiT hanks for choosing  for your query. I appreciate your concern towards H pylori infection which normally causes break in the lining of the stomach (peptic ulcer). H pylori is an exceptional bacterium which can survive in the acidic environment of the stomach producing tissue damage result in ulcer. Since this is a bacterial infection, hence antibiotics are used for 2 weeks to kill H pylori. Along with antibiotics Omeprazole is given for a period of 4-6 weeks to suppress the acid production and to increase the healing process of the ulcer. It is not a serious condition, usually triple treatment is sufficient to cure this condition. You must avoid taking Alcohol, hot and spicy foods, NSAID painkiller, smoking, caffeine, carbonated sweetened soft . I hope all your doubts have been clarified in a simple language,Feedback in this regard is highly appreciated. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I gave blood for the first time last Saturday and now I m getting theses little red bumps all over the area they took the blood from. They re very itchy and I would like to know how to calm them down or even get ride of them I would also like to know how I got them. ### REPLY: Hi, Thanks for posting in . Blood donation is quite safe, and you have done a good thing by giving blood. Little red bumps appearing at or around puncture site and itching sensation is just an allergic reaction due to the use of adhesive plaster material. You can take Tablet. Levocetrizine 10 mg once a day for 3 days. Your symptoms should gradually reduce and disappear in a day or two. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sirs,in 2005 my both kidney failed then i went for kidney transplant but it failed after 4 years. i am also HCV+ since 2005. could it be possible for me to go for re-transplantation after rejection? will it be successful? and also tell me is it necessary for me to go first for treatment of HCV? i need dialysis twice a week and my blood reports are Creatinine 12.0 after one week.please answer my questions. ### REPLY: Hi,1. Yes, retransplant is possible even after loss of first kidney transplant. You will require HCV treatment and liver biopsy, if the Liver is fine you get for HCV and undergo transplant. Your chances of successful transplant are very good, and it is not an uncommon problem .2. I would suggest thrice weekly dialysis in your case, as it is clinically proven that patients undergoing thrice weekly dialysis do very well post transplant compared to twice-weekly schedule patients ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir. i am suffering from depression since 2009. from that time i have taken regularly medicine and performing my job. now i am so confidence but worried about that if i have leave to take the medicine then again i will go under depression. plz give me ur valuable advice ### REPLY: Hello, Depressive disorder is a type of mood disorder and this occurs in episodes and show recurrences. But that doesn't mean that you have to take medicines regularly for life. As per guidelines, if a person remain symptoms free and function normally socially and in personal life for around 2 years on treatment then the treating doctor can think of gradually reducing the doses. Since, you have mentioned that you are doing well on medicines you can discuss with your doctor and ask for reduction of the doses. 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: whille i was 37 years old i have suffered with sudden 100 percent blockage in right artillery. i did not have high B.P., Sugar or cholesterol. My B.P. was 80-120, and cholesterol 149. since then i started a daily walking of 5km, jogging 2.5 km, push up 40-60, other different exercises for 15-20 minutes. i do not feel fatigue or pain. i do not have problem of BP, sugar or cholesterol. can i still have recur of same problem.Jamnagar ### REPLY: Hello, Thank you for your query. Yes it is possible for the artery to be blocked again. Your lifestyle modifications do help in reducing the risks of future blockage significantly along with medications, but the risk is still there even if it is a low risk. I recommend :-continue the healthy routine -go for regular check up and follow up-monitor your glucose levels cholesterol, Thyroid, clotting parameters as advised by your doctor. -quit smoking and alcohol (if you do) -maintain minimal stress in life and practice meditation, breathing exercises regularly. -get half hour of sunshine every day. Avoid between 10 am and 3pm. Hope Ive answered your query. Please let me know if there is anything else I can help you with. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I tore my calf muscle about five years ago , and on and off I have had pain in it when I do any exercise But today I was walking up a steep slope ,when a friend accidentally hit me on the same calf with a stick he had in his hand , and the sharp jab almost crippled me , . I have applied ice to the injury ,which I think would be bruised as well now , am I doing the right thing with ice pack or should I massage it ? Jim Campbell ### REPLY: Dear Jim, the most concerning thing about hitting on the calf is the intact less of your tendoachalis tendon. If that is ok, then any muscular injury has to be ruled out. You will need an examination to see if what you are saying is similar to what has happened, It's essential to get USG done of the area to see the inexactness of the tendon. For the time being, talk rest and analgesics, and see if pain improves, once that is clear, than you should proceed to other options of investigations. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i had hip surgery 12 werks ago and have numbness on the outer.thigh as expected.but i have started getting an occasional pain in the numb area which feels like a sharp prick sensation, could this be that the feeling is starting to come.back. Thank you. ### REPLY: Dear patient Pain and numbness over outer thigh after surgery may be due to 1. Injury to cutaneous nerves during incision for surgery 2. Compression of lateral cutaneous nerve of thigh due to edema post surgery.  Depending on the approach taken for hip surgery area of numbness may very. This needs to be investigated with NCV of lateral cutaneous nerve of thigh.  You need to consult expert physiotherapist and get yourself tested. Meanwhile, start tab regain plus vitamin B12 combination one at bedtime for 10 days. Please consult expert neurophysician with report.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is 34 yrs old and obese(about 300lbs) and now his blood work shows elevated liver enzymes as well as a gallbladdder number that is not normal. his tryc.,his sugar,his colesterol are all high. what can he do quickly to get on the right track. the dr is doing a 2nd blood test to make sure the first one was correct.he is already on blood pressure pills,including fluid pills. I am so worried about him and knew his over weight problem was going to turn into something much worse. he is a very stubborn guy but he is scared now,really scared. He might see that a Mom does know best and he should have listened to me.help! ### REPLY: HelloElevated liver enzymes may indicate liver injury. It may be due to many reasons like hepatitis, alcohol intake, altered lipid profile, medicines,autoimmune causes, obesity etc. High liver enzymes may be due to altered lipid profile in your sons case. Findings also suggests altered lipid profile. He may need few investigations like routine hologram, viral markers, ultrasound of abdomen. I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients. It helps in regeneration of liver cells. I also suggest combination tablet of atorvastatin 10 mg and fenofibrate 160 mg single dose at night after dinner. It will control increased lipid level. He also needs diet and lifestyle modification. He should avoid saturated aft and go for brisk walk regularly. He also needs medicines for diabetes mellitus. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor. I have a very severe premature ejaculation. I went to Urologist and gave me zoloft and I had very bad side effect from it. I went back to him for the 2nd time and he gave me paxil which didn t do anything at all. I didn t go back to see the Urologist after that. I m having a problem now with having a hard erection which I think caused by the anxiety I have knowing that once she touch me ill ejaculate rite in there. It s kinda 2 problems now. Any advice from you please ?? George G ### REPLY: Degree understand your concerns went through your details. I can understand. You said you have severe premature ejaculation. Psychology based premature ejaculation can be treated with the help of awareness, psychotherapy and relaxing techniques. You should also know that, you can engage in sexual activities for a second time, after you experienced premature ejaculation. Go for the second time. You will be alright. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. 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 had suspicious breast tissue biopsy and will hear results today. They found irregular persistent density in the 9 o clock region of the left breast. Focused sonographic examination of this area reveals a hypoechoic structure taller than wide and measuring 1.2 x 0.9 x 0.8 cm. Are these usually cancer? ### REPLY: Hi, Thanks for writing in. Focused breast ultrasound helps to determine characteristics of doubtful lesions in the breast. As described above, there is a dark area as seen on ultrasound at the 9 O clock position. This is marginally taller than wider if we take measurements as 1.2 x 0.9 x 0.8 cm. In some research studies, it has been found that 74 to 80 percent breast lesions which were taller are malignant. This way breast biopsy is the best confirmation, and you have already got it done. By appearance, I will say that please do not worry as the lesion is slightly taller than wider, and we can still hope for a benign finding. The final result is by biopsy. 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 am 72 years old women and recently came across a 95 year old man that has overturned his mobility scooter. I managed to lift up him and the scooter up, he was shaken but not hurt and went on his way. This was 2 weeks ago. The following day I had sharp pains in my chest and in the shoulder and upper back so I really have hurt my muscles. I been taking co-codimal and this does ease the pain. I cannot take Ibuprofen as it gives me palpitations. It did ease of a bit but even lifting a kettle or small bag sets the sharp pain off again. I have not seen a doctor as I don t think anything else can be done. But how long will it take for the muscles to repair.? Please advise. Thank you. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have painful muscle spasm. I would suggest you to take complete rest, apply warm compresses to shoulder and shoulder, do light stretching for shoulder and upper back and take over the counter painkiller. If condition doesn't get better in 2-3 days then consult orthopedic surgeon for proper examination. Doctor may order CT scan or MRI co rule out other causes like disc problem or soft tissue injury. Doctor may prescribe muscle relaxant along with anti-inflammatory and recommend physical therapy and particular exercises.  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: hi, I was diagnosed with squamous cell carcinoma of tongue . I underwent hemiglossectomy with neck dissection in Jan 2012. Then i underwent radiation therapy and cetuximab chemo . It has been 3 months since conclusion of radiation therapy. now i experience severe pain over the area of the tongue where i had the surgery that radiates to my ear. I also have tenderness over the same side of the neck. The pain is not constant, it is aggravated by chewing. I have started going to work now but i never have any pain while at work. I usually get the pain while at home in the afternoons and also early in the morning. what coukd be the probable causes of this pain. ### REPLY: There could be a number of reasons for your pain and a thorough clinical examination is necessary to rule them out one by one. It could be simply related to your surgery and radiation therapy as it can sometimes lead to inflammation of the nerves in this area leading to a neuritic pain that commonly radiates to the ear. It could be a local infection in the operated site compounded by the radiation. Worst possible, it could be a recurrence of your cancer. I would have liked to know the stage of your cancer as that would have helped me assess the risk of recurrence. I suggest you start on Tab Ciprofloxacin 500 mg twice daily + Tab Paracetamol 650 mg thrice daily + Tab Sanitizing 150 mg twice daily + Tab Gabapentin 1 tab twice daily. That should take care of the pain and infection. Meanwhile, get an appointment with your treating oncologist and let him have a look. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 weight is 60 kg. I was taking DicorateER1500mg, and Topaz 200mg. Then i was prescribed Lavipil1000mg, and Epsolin300 mg alongside it. But still i had convulsions, rescently my weight became 55kg, and i was taken to a different doctor for a check up, who prescribed me DepakoteXR500mg, twice a day, Topaz100mg twice a day and Eptoin100mg twice a day. What i have noticed is i have pain in my lower abdomen , as if the taste buds are gone, problem in reading. ### REPLY: Hello, Thanks for the query, I understand your problem Before I respond to your query, Let me tell you that just like fever which can be due to many causes (fever can be due to viral fever, urine infection, chest infection) and the treatment depends upon the EXACT TYPE of fever, same is the situation for epilepsy. In order to classify the exact type of epilepsy, we need a detailed clinical history of the patient, EEG (A test which can tell us the area of the brain which is abnormal and tell us if there are changes suggestive of seizures/epilepsy). Some patients need prolonged EEG and/or genetic tests to find out the cause of epilepsy I am sorry that I do not know what exact type of epilepsy you have. The data that you have posted suggest that your abdominal problem could be related to Topaz. You may do an ultrasound of abdomen to rule out a stone in the kidney which is side effect of Topaz. The other problems that you have are also related to Topaz I urge you to get re-evaluated by an Epidemiologist (a neurologist with advanced training in epilepsy) who will help you select medications related to your epilepsy, and he will discuss if surgery can be done after evaluating your case in detailed.  Hope this clarifies Best wishes .  .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mom is 43 years old and has had four kids. she is now pregnant and is a fragile person. She has had two cesearan sections already and has to have a third one, a month early so she doesnt rupture. her docter has retricted her freedom to basically nothing. She isnt even aloud to carry a gallon of milk. She also has a atear in her stomach muscle, and i know that the docter thinks theyr may be a problem with getting her sewn up after the c-section and that it oculd be life or death. but that is as in depth as anybody will tell me. What is the possiblity she wont have a problem getting sewn up, recovering and liveing, verses the fact that this pregnancy and surgery will lead to her death?! ### REPLY: Hi, Your mom definitely has a lot of high risk factor from age 43 years, previous 2 cesareans, abdominal hernia. With previous 2 cesareans the chances of bleeding during surgery is more also if the placenta is attached to the previous scar its separation can be difficult and surgery may be prolonged. But with blood ready for transfusion if required, delivery in a hospital with facilities for uterine artery embolization and ICU beds, the chances of maternal death are extremely rare. The quoted risk of death during cesarean is 1/10,000 which makes it very, very rare. Best if your mom has a detailed discussion about her risks and precautions with her consultant Gynecologist. Hope this alleviates your anxiety. 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 brother in law had shoulder x ray done for upcoming surgery, the X-Ray showed glass like substances on part of the lung that showed in the x ray, he smoked many years ago, and over the last 3 weeks got a cold like illness, coughing, running low grade fever, what can cause this he was never knowingly exposed to asbestos ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion your brother is having infection in lung either bacterial pneumonia or tuberculosis. Because the glass like opacity in lungs on x-ray is known as consolidation. He is also having low grade fever, cough since 3 weeks, so possibility of lung infection is high. So I advise you to consult pulmonologist for your brother and get done1. Chest x ray2. Sputum examination for AFB to rule out tuberculosis.3. Sputum culture and sensitivity to rule out bacterial pneumonia. Consult pulmonologist and start appropriate 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: I have stomach pain in the centre of my stomach around the naval area above and below this area, have had it for 3 days, thought it was my IBS but have taken ibuscopan which usually clears the pain. But this is having no effect. I cannot sleep now with the pain it is worse after I eat ### REPLY: Hi ! Good evening.  I am  answering your query. With the severity of the pain you have narrated which is disrupting your sleep, I would not advise you to seek help over the net, but to get yourself assessed in the ER of the nearest hospital. Till that you could go for a proton pump inhibitor, and an anti-spasmodic . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My Mom was diagnosed with liver cancer. They tried to operate and remove the left lobe that had a tumor but found it spread to the duct area and it was too risky to try to remove. They now give her 2 months to 1 year with or without treatment. Shes having chemo treament once a week for 3 wks/1 week off/ then 3 more weeks and then scans to see how the cancer is responding. This cancer did not masticize from somewhere else. My concern now is that shes been really tired, which I guess from the chemo, but have been reading its the liver cancer symtom also. Her legs just strarted swelling TERRIBLY and hurt her. They have blisters on them, too. Is that a symptom??? Shes taking water pills but isnt peeing like she should - hardly. Is THAT a symptom too that her kidneys are failing? Also, her coloring is good and she still has her appitete.What PHYSICAL conditions are we to expect as her health continues to decline?Thank you. ### REPLY: HI WELCOME TO ChatDoctoriHAVE GONE THROUGH YOUR QUERY. I am really pained and concerned to know your mothers condition. As you know I am not oncologist cant advise you much about that subject Pls carry on her treatment as per her treating doctor . But surely I would like to suggest few supplements which can improve quality of her life & support to lessen her pains. Give her Balanced nutritious diet and add a lot of anti oxidants in her meals1. Give her mixture of extract of Lemon, ginger, garlic, bark of Maringá tree, vinegar or Coconut water & Honey. These all are antioxidant and nutritious ingredients, give strength and disallows growth of bacteria .take all in equal quantity, dose of 20 ml with equal quantity of water before meals, thrice for 5 days and then increase the dose to 30 ml continue for 21 - 31 days as required 2. Give her a level Spoon of turmeric powder with a cup of hot milk. After meals, Meals should be simple nourishing and easily digestible. Take care she does not to have constipation. Do Panama - Deep breathing slowly, according to her age & capacity & Walk for resistance against diseases and to strengthen the vital part of the body. Many heart and cancer patients have been benefited from the above regimen. Can give her a dose of Homeopathic Carcinogen every fortnight 3 doses You Can also apply Treatment by Magneto Therapy, is very simple and effective treatment gives resistance against diseases, is curative as well as preventive method of treatment, having no side effects. Regular fort nightly or monthly check up from treating doctor is highly appreciable . Hope this gives reply to your query Take care. All the best & Wish her get well London hesitate to get back if you have any further query any doubt get back at . Com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have a broken wisdom tooth and i require surgery to have this removed. It is painless unless i chew down on it but i am flying to the states a week on sunday for a trip from the UK and i am concerned that this may cause pain during my flight. I have purchased paracetamol and ibuprofen which my dentist has advised i can take together. Am i likely to get pain from the cabin pressure throughout my flight? Thanks, Kelly ### REPLY: Hello, Thanks for consulting , Read your query, as you have pain in decayed wisdom tooth don't be worried so much this pain can be due to formation of apical periodontitis for this I will suggest you to go for removal of tooth after coming back from your trip, In meantime you can take dispensable tablet of Paracetamol or Retool DT for pain if you are not allergic to these .  Hope this will help you.  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: can anything in instaflex raise blood pressure like glucosamine or turmeric I have RAarth and I take methotrexate advil for osteo arth want to drop the advil and take this for inflamation and pain I am 72 and still very active hope this is good news thanks Dianne in tx ### REPLY: Hello! Thank you for asking on ! Regarding your concern I would explain that Installed is generally safe except for one of its ingredients, that is Cayenne pepper that may influence blood pressure and contribute to high BP. Nevertheless, when taking that medication you should consult your prescribing doctor and perform frequent check up to assure that your blood pressure has not been influenced so much. If high blood pressure is a persistent finding, then you have to modulate your antihypertensive therapy in order to appropriately manage your BP values. Just keep in touch with your doctor. Hope to have been helpful to you. Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 kidney stone problem for 4 months.. i had back pain during first 3 days and after that i had no pain.. i have taken medicine..neeri, ural tablet and tonic.. 3rd time i have taken US scan.. its still showing stone in my kidney but i m not having any pain.. last 1 month i didnt take medicine...do i need to continue medicine.. ### REPLY: Welcome to , and thanks for your query. Medical treatment for stones is not a success. More than anything, if the stone does not require surgery as assessed by your urologist, You need to take plenty of oral fluids including water. Avoidance of red meat and alcohol if you happen to take would be beneficial in the long term stone prevention, pls discuss with your doc if the medicines are really needed! Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father (86 years old) is a stomach cancer patient  taking oral chemo therapy (Xeloda 500 mg 3 times a day for 15 days - two courses already over). Now his palm and fingers turned black. Is it due to the side effect of this tablet or any other cancer complication is developing ? Pl. guide me. ### REPLY: Good morning. Blackening of palms fingers and soles is a side effect of Melody therapy. It is known as hand foot syn .  It is a commonly seen side effect and need not worry. As long as thee is no ulceration and peeling of skin it will not cause any harm and treatment need not be discontinued. You can apply some skin emollients and moisturizers to keep skin moist and thus preventing peeling of skin. 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 writing for a friend.  She has chronic back pain is in lot of pain. she needs a shot put in the nerve in her back the dr. she was going to go to has cancelled her twice what can you do or  can do what is your recommendation she to the point she is crying with it  PLEASE HELP ### REPLY: Hi there. From the nature of your friends complaints I assess that she is suffering from a disc prolapse and all the conventional forms of medications have not done her much good. The kind of injection you have mentioned is most probably an Epidural Steroid injection which is administered around the nerve. Unfortunately it can only be administered by either a neurosurgeon or an orthopedic .......and not by some nurse. Take appointment from some other doctor. In the meantime put her on opioid medication like oxycodone a some oral steroid like me . Complete bed rest is must. I hope my advice has helped 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: 60 yr old woman, dying of pancreatic cancer.  Given 1/2 normal dose anabolic steroid to help reduce abdominal and leg/foot edema. Within 12 hours, heart rate up, difficulty breathing, BP low, and was told that IF the distance between systolic and diastolic gets less than 20 points, she needs to call for help.  Can you explain WHY that is a risk, what it means?  Also, wouldnt you expect BP to be higher with a steroid??  thank you ### REPLY: Thanks for your question on . I can understand your concern. Yes, you are right about rise in blood pressure after steroid injection. But it is not true for all patients. The woman in question might be having heart failure. Heart failure can cause breathlessness, low systolic pressure (hypotension) and edema feet. In this, steroids won't help. Diuretic and other cardiac supportive .  In heart failure, systolic pressure decreases fast then diastolic pressure. This is due to poor force of contraction by failing heart. So difference between systolic and diastolic pressures come down to less than 20. And when this occurs, patient needs urgent treatment in the form of isotropic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir,i am age of 56 Yr.i have problem of teething grinding in sleep.sleep of my wife is being disturb when she wake up in night.please advise me what actions have to take and any exercise i have to do to prevent from above.Thanking  you,Pinakin ### REPLY: Hi, Grinding teeth in sleep or nocturnal bruise can be due to a number of causes like stress and anxiety, alcohol abuse, smoking, snoring, sleep apnea, excessive intake of caffeinated .  So if any of these are responsible in your case you should try and eliminate the same. Secondly start doing meditation and deep breathing exercises. Avoid alcohol intake if you do. Consult a dentist and get examined.  A night guard can be made for you to wear at night. At times low doses of into anxiety medicine can be advised. Jaw alignment exercise can be demonstrated and can help in improvement.  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, 20 year old male who is worried about a number of problems regarding my sexual health. I think I m suffering from chronic masturbation and it s affecting my sexual arousal. I tried cold turkey once for 2 weeks straight and I was able to retain a very strong and firm erection. But after I saw these great results I just kept at my old habits and now I m back to square one. I also noticed a small hard lump and at the base of my penile shaft that s feels internal. I did some research and I found out it is probably a lymphocele. I m seeing my girlfriend in 6 days and I don t wanna disappoint. I bought some Panax Ginseng and Zinc tablets to alleviate this ED . I just want some advice to combat this horrible habit ### REPLY: Degree understand your concerns went through your details. Erectile dysfunction is basically caused by psychological problems rather than physical problems. Instead of worrying unnecessarily and being anxious about your sexual problems and doing self treatment, please consult a physician and psychological counselor for treatment.  If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 35 year old male and a Tubercular Lymphodenitis was detected through biopsy of lymph nodes in the neck in April 2011. I am taking medicine since last 40 days. But my lymph nodes in neck are started enlarging and giving lots of pain and also, started discharging one of the lymph node. I am not sure whether I am responding to the treatment or not. Please let me know how long it takes for lymph nodes to go back to its normal size? ### REPLY: Hello sir. I did review your concern. This is a very difficult question to answer. Generally with proper treatment the tuberculous lymph node shrinks in size, but if it has already become fibrotic and calcified as seen with chronic lesion of tuberculosis, it does not shrink to its normal size and takes years to get normal. But the important thing is that, with proper treatment these lymph nodes although you look slightly big they are treated microbiologically and pathologically. So there is nothing to worry about. They contain fibrosis and old granulomas and some calcified material which is noneffective. My advice would be to continue regular tuberculosis treatment for designated 6 months period and in most case scenario it will shrink. I hope this helps. Thank you for using . Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE SLIGHT UP SGPT SGOT WHICH IS NOW IN NATURAL RANGE AFTER CONSUMING UDLIVE(ursodesoxycholic acid)300 MG FOR 16 DAYS , BUT I HAVE  MUSCULAR PAIN IN MY LOWER BACK..  I THINKING IT IS SIDE EFFECT OF UDLIVE(ursodesoxycholic acid)I M FEELING MUCH UNEASYNESS IN MY STOMACH AFTER  A CUP OF TEA  or a glass og COKE   etc  i dont have constipation ......... My Gall Bladder in Constricted  it is shown a detailed  ........... what i have to do please SCANN ### REPLY: Hi, Welcome to . After going through your query in my opinion it is muscular pain as pain is mild. Rest and analgesics(diclofenac/ ibuprofen) is its treatment. Sometimes vitamin D deficiency can cause this so serum vitamin D test is advised if it is lower than vitamin D supplementation will be required. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. You need to do MRI TO RULE OUT other causes. Consulting with treating doctor is advised. I think your query answered. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey! I am a 23 year old woman. I eat very healthy...lots of fruit and veg everyday, whole grain foods and porridge, low fat dairy products, drink plenty of water and exercise regularly. how ever recently I have developed cellulite around my upper abdomin and I also seem to have a bad flatulants problem. I m quite confused as I like to think I lead a very healthy lifesytle with a healthy diet . Could I have a liver problem? What would cause these two problems of mine? Any advice would be greatly appreciated! Thanking you in advance! Patrice ### REPLY: Hi, thank you for the query. Every thing you practice is very good for your health. Cellulite may be due to some extra calories you are taking comparing your daily activities. This may be taken care of by doing some power exercise and taking advice from physical trainer.flatulence may be due to some g i disturbance giving rise to indigestion if the flatulence persists please get a consultation with physician and get advice. Avoiding constipation and spicy food will help to reduce flatulence. Hope you remain fit and healthy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has been losing weight very rapidly and has no energy ,lack of appetite and can t get a restful sleep ! Has enlarged prostate and has been having a brown color in his sperm ! We have had a lot of test run like blood work and everything has come back normal ! He has been on cholesterol medicine for about two months , but stopped it about two weeks ago . He takes uroxotrol for enlarged prostate and a low dose aspirin is all he takes on a regular routine . We don t know what else to do ! We have gone to his Urologist and his PSA is 4.9 . He doesn t seem to be concerned ! Please help us !!!!! ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern.PSA antigen above the value of 4 is considered as a malignancy in the prostate and should be biopsied. Though your PSA is not much high, but it should be rechecked after a period of month or so. Brown discharge and every thing points towards the malignancy. Biopsy report will diagnose the type of malignancy and its extent. This will help us in the further management of the prostate malignancy. Prescribed medication are right and should be continued. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am Deepa age 21,, i have a hairloss since 2years ago and thats is continuing and i have been using Ervamatin a lotion made from Brazil Forest and i had used moxidile and had used many kind of oils as well but still the same,,, could you help me out of it give me some solution please... ### REPLY: Hi Dear, Understanding your concern. As per your query you have symptoms of hair loss fall which could be due to fungal infection, stress, hormonal fluctuations, improper hygiene and due to nutritional deficiency. Need not worry. I would suggest you to make sure about complete nourishment of scalp and maintain proper hygiene of your scalp. Consult dermatologist for proper examination and go for required testing done and then start treatment. Doctor may also prescribe supplements containing biotin, Acetylcysteine, copper as active ingredients. You can use finasteride preparations as well. Hope your concern has been resolved. 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: Hi, I m having really bad stomach pains right after eating. The pain subsides after an hour or so, and I feel hungry again, but after I eat, I feel the same pain. I m usually a very healthy person, and I m not sure what s wrong! I recently have been sick with a fever and nausea and bloating never seem to subside. Can you please help me get this sorted out? Thank you so much! ### REPLY: Hi. Thanks for your query. Noted your history oh pain in abdomen on eating, which subsides after one hour. This is indicative of gastritis. This may be related to the problems you are having of fever, nausea and blowing or caused by the medicines. The cause can be enteric fever or so. I would advise you to go for clinical evaluation by a Doctor, investigations as suggested and proper treatment. Till then get started with Omeprazole, dompridone, antacid gel and symptomatic 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: Hi My sister is suffering from hallucinations that some one is scloding her and looking at her ,she was fine untill she went to US to do her MS,after she gone to US to do her MS she returned India after one year ,from then since 4 years she is behaving like this,I concerned many doctors and used the medicines but no use she is still like this ### REPLY: Hello She is having belief that someone is scolding her or looking at her. Most likely she is having delusions of paranoid type. Such type of symptoms usually occur in Psychosis or in Schizophrenia. Schizophrenia is a chronic disorder, and it takes times to see improvement. I would advise you to consult a good psychiatrist for her treatment. Medicines take time to show their effect, so you have to be a little patient. Hope this helps you, thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: do you think i could be bipolar, BPD or hormonal, im a 15 year old girl. this is the stuff ive been experiencing.. -weird thought or dreams.- i talk really fast at times and at times slow.- ive been more interested in sex. i know thats the whole point of hormones bubt its like ALOT like i used to think it was yucky nad gross even when i started my period, which was 2 years ago. -MOOD SWINGS!. like one day ill be laughing and the next ill be crying. my self esteam suffers from this and my moods range from anexity, extreme anger, extreme sadness and doubtfulness, happiness wherer i cant stop laughing for no reason and cant stop smiling and i think im better then anyone even though i know thats wrong.  its litterally like gears in my head that i cant feel turning but cant do anything to stop them- constant abandonment or feeling empty and alone. i always feel alone, no matter how many people are with me and i feel like everyone could leave me at any minute.- ive gone through alot in my life and its been REALLY HARD. please my mom doesnt believe me and im underage so i cant go by myself. Im scared of whats happening to me and i just want some sort of answer to go by. ive tried online quizzes and tests but i know that doesnt count as a real diagnosis. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the symptoms you present, I don't see the reason to classify this as bipolar disorder. You could be having stress disorder. Usually due to disappointment in life after a series of stressful events. Prolonged stress and disappointment combines to create lethargy and mood swings temporarily. I assure you, these are temporary. Concentrate on your career studies and be active. Ignore these symptoms. Do consult a psychologist if symptoms did not vanish within 15 days. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. 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: My 16 year old complained on Friday about some pain in the upper rib cage, right bellow his left arm pit, he didnt complain again until Sunday, he was feeling awkward and uneasy most of the day.  I put some ointment for muscles and took him for a walk which seemed to ease the discomfort.What could it be? ### REPLY: Thanks for your question on . I can understand your sons situation and problem. Possibility of musculoskeletal pain is more in his case. But better to rule out heart diseases first because he is having left sided chest pain. So get done ECG and 2d echo. If both are normal than no need to worry about heart diseases. Musculoskeletal pain is more likely. Ask him to avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Avoid bad postures in sleep. Apply warm water pad on affected areas. Give him painkiller and muscle relaxant .  Don't worry, he will be alright. Hope I have solved your query. Wishing good health to your son. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, How long does it take for panic disorder to go away? im 21 yo, 70KG, 182CM height, i started suffering it from 1 month and 15 days ago, fortunetly lot of improvements, i couldnt do even normal walking, the first panic attack happend during my push-up exercise so basically i had phobia of exercise! couldnt walk up the stairs, do dumbles, no more pushups-pullups,completly loss of confidence, i talked to a doctor, he gave me citalopram which was somehow helpful and been using it for over 45 days now and each night only half a pill, so how long should i take these pills? will panic attacks come back later in life? ### REPLY: Hello, Its good that you have responded nicely to citalopram as it is a mild .  It's good to take it for 3-6months and then taper it and stop completely. Taking it for such long duration has been decided by- lot of research, and it is based - on the fact that the relapse rate is minimum after taking med for this much time. Stopping it before carries more chance of relapse compared to that witChatDoctorpleting the course. Wish you good luck. Taking the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.i want to concive from 6 month.but unfortunataly i m not successd. my periods ae regular and its repeat about 24 days befor the last one. after sex to two or three days later i feel teander breast and bloting and crampes and same ituation bfore my periods. but still not pregnent.my hb is 12. uti are normal .i have no type of infaction. ChatDoctor are 0.200 just. now my dr pescribe premarine 0.625 on the first day of periods and use 10 days. 2:tab cerophene 50 mg on the third day of eriods and use 5 days. 3:tab g-folic regularly twice a day. what its help me out to concive? plz help me bcoz i really want to concive . ### REPLY: Hi, You did not mention your age. As you are trying since 6 months only let me clarify you that chances of being pregnant in each cycle if everything is normal is hardly 10-15 %. As your cycles are pretty regular so mostly you don't have any issue with ovulation. Aerophone basically is an ovulation induction agent that will help to those not ovulating and remain will cause endometrial lining growth if your lining is not up to appropriate. The symptoms you have told may be a part of PMS & it can never predict pregnancy. I think further plan is basically depending on your age. If You are more than 30 You need to consult your doctor along with your partner to get a baseline evaluation done. If you are younger you can safely try for a couple of months more before taking any medications. ### END