Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, lm a 34 yr old mum of 3. Ive had some pain in the rightt side of my chest today, across my breast.Ive also had pins and needles, and a headache. Ive just found a pea sized lump under my right arm pit. I do try to check my breasts regular but lm quiet big chested and they are always quiet bumpy. Im on no mdication at present. Id appreciate any advice you could give me. Thanks Tammy ### REPLY: Hi, Dear Tammy, Good Morning from India. Thanks for your query to  Virtual Clinic.-I studied your query in depth. I understood your concerns.-In my opinion-the right armpit lump, is mostly-a Fur uncle of the hair-follicle.-You need not worry about any breast lump as such, though you would need clinical examination from your ER doctor or Surgeon- to rule out the breast-cancer.-Remedy-Your doctor would advise-a-tb-NSAIDs-b-Antibiotic for 5 days time would regress the lump. Hope this would help you to get normal health fast. Wellcome to  again for any more queries. Have a Good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my names is elizabeth i have had the cold for five weeks now.the past couple off weeks i getting a lot off presure back off my nose back teeth and the right hand side off face my gums really hurt on top right hand side.and i have be getting a lot off sore heads also my cheek bones would be sore now and again. ### REPLY: Hello Elizabeth, Five weeks is a long time to have a cold, and you should have an exam to make a diagnosis. You sound like your condition is spreading and this indicates an infection that needs treatment and the source diagnosed. You may have a dental condition such as an infection of a tooth or the gums. Furthermore, you may have a sinus infection or a resistant infection such as strep throat. Sometimes saliva carries the infection causing agent that can be wiped on the face and cause a skin reaction. Diagnostic tests are needed. Visit your dentist for an exam especially if you have not had a recent checkup and your doctor to evaluate respiratory and throat infections. This will determine if antibiotics are needed and your needed treatment. I hope you find my answer helpful and will act on my recommendation to feel better soon. Some anti-inflammatory medication and warm salt water rinsing may help you feel better until your visit. Thank you for your inquiry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 serious kidney infection And had to go back to the doctor twice after the first visit And the doctor adviced me Both times the infection is still there And continued to keep my on antibiotics. Iv been on antibiotics for three weeks And tomorrows my last day , yet i am still having pain And discomfort. Today i also noticed a Bruise over my right kidney (the one that hurts) could this be somethinf more serious then just a kidney infection? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have kidney infection. You should go for urine routine and microscopic examination test as well as culture and sensitivity test. Furthermore, you should also go for ultrasound abdomen and complete kidney function test. Furthermore, you should take antibiotics like levofloxacin or norfloxacin. It is prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son had a liver transplant almost 7 years ago. He is immune-suppressed and is on aspirin and his hemoglobin and platelets are low, so he bruises very easy. However he has a bruise on his lower right side that has a knot underneath and I am wandering if this is something I should take him to the dr over? ### REPLY: Hello and welcome to , Low hemoglobin levels suggest anemia. A complete hologram and peripheral blood smear examination has to be done to know the cause of anemia and thus its treatment. Low platelet count occurs due to either decreased production in the bone marrow or increased destruction in the bone marrow and in peripheral blood. . Since, there is increased risibility on the body, coagulation tests also need to be performed to know the status of coagulation factors. Consult your hematologist for the problem, diagnosis and thus treatment of the condition. Thanks and take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am currently a Medic in Iraq. I saw a patient in my clinic this morning, who had a deep cleaning done two months ago. Since the cleaning, he has had pain in the lower middle left gums that he states he has been able to resolve with Ibuprofen . Last night, he stated the pain was severe and now radiates into his chin. He states the pain is relieved when he sits up, but at it worst when he lays supine. Any ideas? ### REPLY: Hello, the pain may be due to injury to the gum or bone during deep cleaning. Alternatively, it may be due to infection in the bone. There are also chances that some tooth structure i.e. cementum has been eroded due to improper sublingual scaling resulting in severe pain. Please ask the patient to go for a dental OPG to see the cause. Please prescribe powerful analgesics like Retool and Diclofenac along with antibiotics to give relief till the cause is known and treated. 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: hello sir i have some kind of psychic problem.when i became angry i just behave like a mad person i dont know on that time what i am doing.plz help me.my talking style also change like this is not mine talk.some another person is talking from inside of me ### REPLY: Hi, Anger is an emotion which lets a man lose control over his senses. You just need to start controlling your anger. I would advise you to start exercising on a daily basis. You can also start doing some relaxation exercises like progressive muscular relaxation. Try to note down events every time you get angry and try to understand why you got angry and what could you have done to avoid the situation. You need to start distracting yourself at such moments. If still you are not able to control your anger, consult a psychiatrist. Regular sessions might help you understand and control your anger. 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 doctor,im 23 and have been suffering from something for a few weeks now.  it started off with stomach discomfort associated with vomiting.  I thought it was the flu, but every morning i would vomit.  I had been having spotty blood on my toilet tissue durring this time.  My stomach discomfort turned into abdominal pain in my lower abdomen and then two weeks ago I has a substantial amount of blood loss associated with my painful bowel movement.  I passed out, im guessing i was in shock.  I have been very lightheaded and fatigued.  since then i have not had severe rectal bleeding but it is still spotty.  My abdominal pain is still bad and i have little to no appetite. ### REPLY: Hi ! Good morning. I am  answering your query. With the kind of history you have narrated about going into a kind of shock following substantial amount of bleeding per rectum associated with abdominal pain and loss of appetite, I would suggest you to see a gastroenterologist/general surgeon at your earliest for a proper physical examination and related investigations along with endoscopic evaluation if need be for appropriate management. It might not be possible otherwise to suggest you treatment for such condition over the net. 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: A part of my skin is really itching since the last 2 months. I bought a product named Psoriasis to try to cure it but it didnt change anything. Now im getting scared cause the itching part just gets bigger and bigger (about 7inches by 4 inches). Im not sure it is psoriasis but i saw pictures of that and it seemed the same. Hope you will help me as fast as possible . :) thanks. ### REPLY: Hello, I can understand your concern for the possibility of psoriasis in you skin condition. I can get from your query that you have a plaque which with itching part and is just getting bigger and bigger. After analyzing your query I can make out that you are quite anxious for the possibility of psoriasis in your skin condition. I suggest you to meet a dermatologist and get yourself examined for the same. Not all skin conditions are same and one can get confused for simple eczema to be related to psoriasis. In psoriasis there is presence of red plaques with silver like scales all over body, and it never remains contained to one site only. I suggest you to take antihistamine to reduce the itching. You can also do warm compression with warm water and soaking the affected area and apply an emollient cream till you get a prefer diagnosis. You can meet a dermatologist for further the best guidance. Take care, 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 migraines with prodrome and aura, however, no headache . Recently started to have seizures when I suspect the headach would normally follow. I have seen my doctor and had a scan which was recorded when I was not having symptoms. It returned as normal. The migraines, with or without the seizures, almost always occur during PMS , either just before my period or a few days prior. I was given a diagnosis of migraine variant. No other treatment was offered as I take BC pills and 50 mg of Zoloft daily. My gyno has suggested raising my dose of Zoloft to 100 mg for 10 days out od my cycle. I am considering this, My question is, do you think there could be a different diagnosis or treatment option? the seizures are quite frightening. ### REPLY: Hi, Thank you for posting your query. Migraine and epilepsy (seizures) have common underlying mechanisms, and are probably two ends of the same spectrum. Also, it is not uncommon for migraine and epilepsy to co-exist in the same patient, when it is referred to as migrates. For you, I would prefer either Topiramate or divalproex, as both work against migraine and epilepsy. Zoloft is a good antidepressant and may be continued along with. 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 sitting down and my heart out of nowhere just started beating fast like six beats and then went back to normal. My heart has done this thing where it pause and then start beating again but never has it beat that fast without me doing anything to make it do that. What causes this to happen? ### REPLY: What you describe might be a transient arrhythmia, where the heart misfires for a small-time and regain s normal heart rate soon after, we should know what is the rhythm to know the reason.  Best is to get a EKG done at the time of episode, if it's a happens Daily than a 24 hour holder.  If it's too rare but troublesome something called event recorder.  In some probabilities what you feel might be subject with normal beating of the heart where all the test about may come negative, in such a would reassurance as nothing being wrong either your heart All the above discussion is to find directions the reason behind the increased which you can follow only if your episode is more sever, lasts longer or is frequently happening otherwise you may just forget about it 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 seventeen year old daughter complains often of growing pains in her leg. Only ever one leg and it appears to be in the upper shin/knee area. She doesn t exercise, is neither thin nor overweight, and can pinpoint no specific trauma that could have caused it. Should I get this checked out? ### REPLY: Hello, What it appears to me that there will be some vitamin deficiency in your daughter which is common in many kids nowadays.  Taking an oral supplement of vitamin D along with Sunbath regular for a few days will help improve the symptoms. Rest assured, there is nothing much to worry and your daughter will be fine soon. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My boyfriend s knee is really sore he fell off his bmx and had banged his knee severely he said its painful to touch and he can hardly attempt to climb up the stairs its bruised and cut is there any way possible to heal his knee so I can help him out. ### REPLY: Hello, As he had a fall direct impact over the knee, there will be pain and swelling. Since you will be advice to take at least an x-ray for the safe side if any bony injuries are present shouldn't be ignored. For now, you can do icing and knee brace. This will help reduce pain and swelling. Maybe you can get it physically examined once.  Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am 30 F from India, I am suffereing from PCOS for last 7 +yrs, my gyn who i have consulted has put me on modus+ for 12 days from the 14th day of period, I have taken 6 days of tablet , I am feeling very tide lot of gas problem tideness and pain in my stomach, is this because of the tablet pls let me know what nautural remedy i can take pls help.Thanks ### REPLY: Hello are taking modes i.e. me . Now you are feeling gas formation tiredness and pain in stomach. These are side effects of modes, so you can take antacid or pantoprazole for 5-7 days and all these symptoms will be alright. When patient visit my clinic with PCs I prescribe them to take oral contraceptive pill. Cysts are often caused by hormone changes. Using birth control pills can sometimes help regulated hormones levels so that cysts can be taken care of. Once you atop the oral pills as long as there are no medical concerns, you shouldn't have any problems with future conception.Sometimes also prescribe cyproterone acetate for PCs cases. In my opinion consult one more gynecologist and get his opinion. 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 husband had hernia surgery 5 days ago. Inquinal, right side, mesh used. Tonight he is in excruciating pain and says it feels like something is torn inside. He has swelling of entire area around incision and his penis and scrotum are black and blue and swollen. Should we call a doctor or is this normal? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that your husband has undergone surgery for Inguinal Hernia 6 days back and has developed sweeping of the penis and scrotum with severe pain. Black coloration and swelling are most likely to be due to bleeding inside and needs urgent attention. Please consult operating surgeon for examination and get ultrasound scanning done to confirm whether there is collection of blood (Hematoma) inside. If proved positive he may need to be explored again to stop the bleeding. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 to have root canal on a molar. But i had foot surgery on both feet nearly 4 weeks ago ( bones broken and pinned, bunions shaved etc). My tooth is so painful that it only goes away when standing and after 2 endones. Would ibuprofen be better and can I take it now 4 weeks after surgery? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint in case if you have a severe toothache it can be due to deep decay in tooth that is involving the nerves and irritation and inflammation of nerves cause severe pain. The first thing that you should do is to consult a Dentist and get evaluated, and he can do an IOP AR [x-ray] to rule out the exact cause of pain and advise treatment accordingly. As of now you can take Ibuprofen while if pain is severe you can also take higher painkillers that can relieve severe pain like Tramadol or Motorola. You should get the tooth treated if it can be saved Root Canal treatment can be done followed by antibiotics and painkillers while if there is gross decay extraction is advisable. Hope this information helps. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my child is mild asmatic....he do not use a pump....when he have runny or stuffy nose he may cough dry....when he was a kid he did nebulise a couple of times.......been here in ny for two months never sick but now he walks 40 mins in the early winter to work. so now he has cough what should i give him ### REPLY: Hi, if exposure to cold is unavoidable then he should try to protect hi ear and nose from the chill wind, to receive the symptom he can take some anti-histaminic like levocetrizine, some nasal decongestant like oxymetazoline nasal spray or normal saline nasal spray can be taken, it is good to take an antibiotic within also like ampi-cloxa or co-amoxi-clav or Rothko. He should meet a physician if symptom persists. Thanks and with regard. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor...Several months ago I fell walkingface forward my head onto a low metal coffee table hard resulting in a broken nose and damaging my left forehead while opening a vein/artery. Much bleeding as expected...to stop the bleeding received stiches, Xray and brain scanned.... no concussion.... and was sent home with instruction to see a facial surgeon for nose surgery. Surgery to fix nose completed. The left side vein forehead has forked ; clearly bulging significantly relocated (unlike vein right forehead.) I am a very heathy female (74 years old...normal weight... never smoked, rarely drink, and do not do drugs.These attacks/seizures begin at numbing from top of my head moving with significant numbness down toward the level of my heart and stopping. They last about 3-4 minutes. I feel like I am definitely going to go unconscious... passing out ; URGGENT CARE BRAIN SCAN DID DID SHOW AN INCREASE IN THE WHITE AREA OF MY BRAIN INDICATING RECENT LOSS IN THIS AREA. Continuing....QUESTION: If not escheimic could they be aneuryisms. If these are possibly aneuryisms, DO I REFER TO A CARDIOLOGIST OR A NEUROLOGIST OR BOTH? Thank you for your consideration. Audrey Bower YYYY@YYYY ### REPLY: Hi, Naturally, it would be better to have the full imaging report. However, I don't see any indication of an aneurysm in your account.  Aneurysms are not situated in the white matter. They develop from the wall of the blood vessels, not the parenchymal and usually the major blood vessels (while white matter is supplied by the tiniest vessel).  Therefore, no indication of an aneurysm at all, perhaps there may be damage from the trauma which may cause seizures, but that is hard to say without the report. 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: Any thoughts as to what may cause someone to start having trouble with reading, says he cannot concentrate and it looks like the words are moving around on the page as he reads. Also says that sometimes he has trouble getting out in words what he is thinking and wants to say. Male 21 years old. History of seizures, on Keppra and Depacote. Has something called Syndham Chorea as well. Had an appendectomy a week and a half ago! Any thoughts would be appreciated. ### REPLY: Dear FriendWelcome to  I read your concern and I would like to share my thoughts about his present symptom of difficulty in reading .1) Is this symptom arises at present, or he has difficulty in reading since seizure. If symptoms arises at present then it can be due to progression of seizure complication involving parietal lobe. As you know parietal lobe is meant for touch perception, the integration of sensory information and in visual perception of spatial relationships among objects (visuospatial processing). Parietal Lobe epilepsy is rare to happen, but I would suggest you to do repeat CT imaging study and consult a Neurophysician to get his heath back to normal. You can ask me if you have further queries ... I am here to health you . Regards . Kingston John David ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 wife is a recoving brain injury patient at home now. We have go out on more errands than usual lately and she has some mild to medium adema in her feet, from sitting in her wheel chair more often than usual. There is fuild coming from under her big toe nail, appears from all sides of the nail. Should her feet be elavated more than usual or is there a chance of an infection? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes, it must be an infection. Infection only can cause fluid to come out. I advise you should do Grams staining from the fluid coming out from the nail followed by the culture and sensitivity from the fluid. Once the report is available to you, treatment can be possible thereafter. Antibiotics should be chosen as per the report. Please do regular cleaning and .  This will control the infection. You can use Betadine and detail on the wound. I will be happy to answer your further concern on 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: Please, I need help. I feel extremely short of breath. Like my lungs aren t getting enough oxygen. It s non stop every single moment of every day from the moment I wake up to the moment I go to sleep. It s getting worse. It used to be occasionally now it s my day. I get dizzy, my heart skips beats and flutters and feels heavy and I don t know what s wrong. I live in Bronx, New York and the closest hospital to me happens on be the worst. They never diagnose me the right way. They either find nothing wrong or like the other doctor said I have an inflamed artery. He gave me ibuprofen but that didn t work out. I think it s more than that. Can I get another opinion, please..? Has anyone EVER complained about what I m complaining about..? I feel like I m the only one.. Please I need help.. I feel like my days are numbered. ### REPLY: Thanks for your question on . In my opinion you should consult doctor and rule out cardiac and pulmonary causes. In your case my differentials are1. Cardiac failure2. Arrhythmia3. Valvular heart disease.4. Bronchitis5. Lung infection. So better to get done ECG and 2D Echo first to rule out cardiac causes. Get done chest x-ray and PFT (Pulmonary Function Test) to rule out pulmonary causes. Also get done CBC to rule out anemia as this can also cause similar symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 is 65, for the second time in a few months he has been suddenly throwing up, being very pale and shaking uncontrolably, and saying that he  has a tender stomach. The last time after maybe 4 hours he was feeling somewhat better but continued to feel drained for days. We have no idea what is wrong. ### REPLY: He is either suffering from an infection, a metabolic disorder of his electrolytes, liver, or kidney enzymes, or deny .  You should strongly advise him to seek out a doctor right away by way of his own primary care specialist or take him to an Urgent Care or ER.  Sounds like he needs lab work and perhaps some IV fluids to pump him up a bit. Please rate this a 5-STAR ENCOUNTER and write me at: www.yyy.ly/yyyyyyyyyyy with more questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 23 year old female and have not had any major health concerns over the years. The only medications I am on are the Depo-provera shot for birth control, and a low dose of generic adderal daily. I have recently noticed a lump on the left side of my neck right at my hair line. Sometimes it is small, about the size of a pea, and other times it is larger, and its tender to the touch. I have also noticed I have had worse acne than usual and also constipation, to the point of no bowel movement for days. And when I do have a movement its sometimes blood streaked or has mucus, or both. These symptoms may be totally unrelated, they just are all recent developments. Any idea what it may be or who I should see? ### REPLY: Hi, Dear,Thanks for the query to . I went through your query and understood your health concerns. In My opinion-that lump on your neck is ACNE -folliculitis, which could be dealt by your family doctor.-I would advise you to change your birth control tool, as this neck lump - is the side effect of the depo-provera you take for birth control. For that consult your GAEC doctor / family doctor.-For the stool and mucus in stool - I would advise Stool examination.-As you have constipation also, I would advise ruling out -fissure in ANO or parotitis- for which need to consult ER Surgeon who would treat it accordingly. -Hope this would help to resolve your worrisome query on your next visit with your family GP doctor. Wellcome for further query to  in this regard. Wishing you fast recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an MRI of brain and orbits that indicated a meningioma behind the right orbit. This has caused my vision to go from 20/40 to 20/100 in 6 months. Wondering if surgery to remove the tumor would allow my vision to return to normal. YYYY@YYYY ### REPLY: Hello. I have been through your question and understand your concern. Meningiomas of the orbit are benign conditions, but carry the risk of compressing the optic nerve causing decreasing the visual acuity, like in your case. If such eventuality is progressing, then there is a clear indication of surgery to remove the meningioma. Maybe the vision in your right eye will not return completely normal, but for sure it will not get worse, which seems a concrete possibility if left untreated. I definitely recommend the surgery at this point. Hope this helps, please feel free using MHC for further questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 two questions for you, if you are able and willing t answer I will truly appreciate it. I m really scared of having a stroke, and my question is: Can you have a stroke with normal blood pressure? The second question is: Can the docs see a blood clot or anything irregularity with the brain and their vessels with a CT Scan with out contrast? Went to the ER with tingling in my head and burning in my thigh, and the doc said that the CT Scan came out normal. It still has me worried that I might have a clot, my blood pressure was normal a 120 over 70. ### REPLY: Hi, Yes, there are instances when one can have a stroke with normal blood pressure like in patients who are normotensive with heartbeat irregularities (like Atrial Fibrillation), as well those with blood vessel abnormalities like amyloid antipathy. CT scan of the brain may show signs of either bleeding or infarction, but there are instances when it may be normal especially when done very early in those with infarcts (caused by clots) which may be more evident when done in a few more hours. But the importance of doing an early CT scan is to rule out hemorrhage in those who present clinically with stroke. I would suggest that a consult be done if your symptoms are persistent for further work-up and appropriate treatment.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in my left foot when walking. It varies in intensity. I also have clicking when walking. I exercise 3 times a week. The pain is on the left side of the foot is only painful when I walk. The pain is a sharp sometimes. I broke a bone in my heal 6 years ago. ### REPLY: Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As your chief complaint is that when you walk there is a sharp pain in the lateral side of the left foot, I suspect it to be muscular pain or either neuropathic pain for which a thorough neuromuscular assessment is advised. Also. When there is a nerve impingement in the lumbar spine, it all starts with the pain in most cases on the lateral side of the foot. As you even mentioned that you had a bony injury in the past, there might be a tendency of abnormal gait during that time and shortening of muscles of the spine due to walking in pain. As I feel, by strengthening the muscles of the core, spine, pelvic floor and lower limbs on both sides you should be able to walk. Since the nerve impingement gives the initial symptoms as pain in the lateral side of the foot and progresses over a period of time. So before it gets more on future you can get an MRI of lumbar spine and them proceed with physical therapy for the lumbar spine. In my clinical experience I see cases who initially comes with this sort of pain and later with Nerve impingement diagnosis. So, from past couple of years I have noticed that this is the first alerting symptom of the Neurological pain, so now I deal with first an MRI of spine and core stability. Results come on 3-4 weeks of time and post which in future complaints are less Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with Trigeminal Nueralgia 7 yrs ago and am taking 1900mg of tegrital a day, 1200 mg of Gababentin, 60 mg of baclafen and 30 mg of a very strong pain medication every 24 hrs. Tired of all the pills and finally approved for surgery. I know that blood clot, tumor, or anyerisum putting pressure on T. nerve can cause pain, but can you tell me .... if my pain stems from lower jaw, but has excalated over 7 yrs to cause me pain when trying to talk, eat/chew, swallow especially when food or drink is cold. Note: My dentist said my upper right jaw has dropped and rather than oral surgeon raising my upper jaw back into nasal cavity maxillary surgery? they decided to cut upper right jaw bone and bone graft so that they can make dentures. They said I have plenty of bone and raising jaw not necessary. I want to know if my jaw dropping over the years could have caused Trigeminal Nueralgia, and did I make a mistake not getting a second opinion. I have been in severe pain and with electrical current like pain that is like no other. Makes labor seem like a cake walk :( ### REPLY: Hello, I can understand your concern. I would like to make it clear that the jaw bone and jaw bone loss has no connection with your trigeminal neuralgia as you are having this nerve problem for 7 years. Usually, lower jaw is not associated with the trigeminal nerve. If you have consulted an oral surgeon and a general dentist both regarding this situation, I would advise you to go with the opinion of the oral surgeon as they have higher knowledge regarding the bone height, density and disorders regarding trigeminal neuralgia. It is really difficult to answer you without seeing your condition physically and the description of your case is little confusing, but thesis the best advise I can give for your situation. I hope this information helps you. Thank you for choosing . I wish you feel better soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Son is 3 yrs old blood in stool and has developed 4 red bumps,2 on chest and 2 on thigh. The blood in stool is bright red and clots at times. Dr. is doing stool sample but taking 3 days. still is bleeding. But his overall appearance is fine. still active. ### REPLY: Hi, This could be an acute bacillary dysentery or viral illness as there are skin changes also. If the child is active you need not worry. Unless the kids having low urine output or very dull or excessively sleepy or green bilious vomiting. You need not worry. But are there is blood in the motion she might require oral antibiotics like Definite. 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 I want some advice in relation to contraceptives.  Ive got a Mirena coil fitted which Ive had for 3 years now.  I experience severe ovulation pains, up to 3 days at a time which keep me awake at night and are not relieved by Ibuprofen.  Prior to the coil I took the pill for a number of years and then had 2 children.  I am just wondering if the Mirena can exacerbate ovulation pain?  I have never had pain like this before, even when using no contraception.I also experience bad period pains, but very little actual blood loss.  The ovulation pains appear to start about 3 days after the period pains finish.  I have had an ultrasound scan 6 months ago to check nothing else is causing the pain and everything appeared normal.I am considering getting the Mirena removed as cannot continue with such levels of pain.  Is there an association between the Mirena and ovulation pain? ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You got marina coil fitted three years back. Now you are getting ovulation pains, three days after the period. You also had period pains, but little blood, U.S.scanning show nothing. You are thinking to get the marina removed.  Your decision is correct, marina and other I.U.C.D.s should be changed after three years. Otherwise there will be infection, and the potency also will be decreased.  The infection will cause the pain and other symptoms.  I advise you to consult a cynic, and get the marina removed.  Wishing a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hai doctor actualy ihave many problems like thyroid ,pcod  2yrs before i got  married from  last  1yr  ownwards we are trying  for  a baby  i saw  one  doctor  in  kerala  and he  told  me  that  ;because  of  weight  i am  not  gettting  pregnancy  now i have 71kg.I done PCT and he told that is positive now he adviced me to take tab:Naturogest 200mg.sir i just wanted to know use of this tab and with help of this tab.Iwill conceive or not? ### REPLY: Hi, the naturalist tablet is given to support the implantation.  It increases the chance of pregnancy.  But alone it can't do much. You can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound. When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days after injection.  Take progesterone like naturalist for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father has been battling liver cancer for 12 years now and a couple of weeks ago he had a massive heart attack . Now he has moderate heart failure and went back into the hospital last night because of chest pains and was transferred to another hospital to undergo emergency surgery on his heart. My mother won t answer my questions and all I want to know is is there any chance that he will be alright and what to expect? ### REPLY: Hi, Welcome to  forum.  As you describe, he is a patient of liver cancer since 12 years, and now had moderate heart failure.  Most probably he will be done angioplasty, with keeping the stent in the carotid artery. It can save him from having a second attack, and the load over the liver which usually happen after the stroke.  If these 2 are successful, he will be lucky to have extension of life and comfort of living.  He should be careful, by avoiding the salt, fats, exertion etc. Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About a day or two ago i notice a small, almost quater size lump on my back its right above where my spine should be just about down to the middle of my back. It doesnt hurt constantly, just when its touhed like a bruise should i go see a doctor about it? ### REPLY: Hi, Good Morning. I am . S.CUTS -super-specialist- From India-attending your health query to  virtual-online Clinic--I studied your query in-depth and Understood your concerns.-In my opinion -Remedy would be-a-Consult a Surgeon-who find out the cause of it-? Boil-as its 2 days duration?or bedbug bite- or insect bite.b-Tb-NSAIDc-Antibiotics for 3-5 days time would reduce the lump on the back.-Wish you early recovery. Wellcome for any question if it worries you still. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 nephew suffered a massive stroke 1 week ago when lifeflighted to hospital his vital signs were good his blood pressure was elevated he can.t talk, or open his eyes.but was responding to nurses and to family with our touch, paralized on his left ,side 3 days later he developed a fever 105 and has been on ice packs since then there is no longer any kind of responce and is heavily sedated and no change since then ### REPLY: Hello, The center for control of body temperature lies in the brain. The brain senses body temperature and adjusts to keep it at constant level. There is possibility that stroke may have involved that area, and so he is not able to regulate body temperature. Heavy sedation itself can cause unresponsiveness. Additionally, large stroke develops brain swelling in 48-72 hours and the rise in pressure due to this swelling can cause unresponsiveness. Since you said it was a massive stroke so keep fingers crossed and hope for the best. 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 developed a white growth inside my cheek from biting the cheek involuntarily.  my periodontist discovered this about a week ago and told me it was benign but i am afraid it may not be.  he is biopsying it next week. can you develop cancer from biting your cheek thank you. ### REPLY: Hi, Thanks for writing in. Biting cheek itself is not a cause of cancer. However, many times it is seen that a person bites unknowingly over an area that is probably a lump due to an evolving tumor. If you have a habit of biting your cheek from a long time then there in no concern. Getting a biopsy might help to give you peace of mind and confirm it to be a benign lesion. White patches in the cheeks might be observed for some time but if you have decided to get a biopsy done then that is better for you. However, biting cheek does not cause cancer. 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: Hello. Mom suffers from a RBBB , right bundle branch blockage....she also suffers from diabetes and hypertension . A few years ago (6) her kidneys failed and well fluids entered her lungs and consequently, she is anemic to the point she must be injected with Procrit every other week. Could her blockage be a result of well frankly all of the above? Susan ### REPLY: Hi, Welcome to ChatDoctorYour mother is having Hypertension and Diabetes long-standing(Duration of disease) can cause renal failure and when kidney fail there is Anemia because of hormone deficiency called Erythropoietin. That is why she requires Profit is to be given to treat Anemia, This is good .  We should keep her blood pressure controlled by medications and also keep her blood sugar also with in desirable range. Kidney failure may not be reversible but can always slow its progression and prepare for Hemodialysis in case kidney failure worsens. Take care of diet fluid restriction, low protein, low Potassium diet as advised by your doctor. Take care of her. 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 son three days ago had his tensills removed .igave him amoxicilin and pain medicine . he has terrible stomack pain and i stopped his antibiotic also he started vomitting very hard, also he doesnt drink fluids. he is 11 years old , 175 cm tall and weight 80 kg. help me ### REPLY: Hi. Thanks for your query and an elucidated history. As it is just 3 days post-tonsillectomy, he should be admitted for observation, intravenous fluids and antibiotics, observation, preparation for unseen emergency and all. The stomach pain and vomiting can be due to irritation, unable to accept something which you might have given orally such as a particular thing to .  Vomiting in this recovery phase is very bad as the stomach contents spoil the healing consular fossa. Can cause infection, bleeding and so on. Insist on admission to the hospital. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, so I had oral sex it was her first time going down on a female and she was way too rough. It started hurting so I made her stop and there was a lot of blood. I have what looks like a cut which then kinda created a bubble looking thing. Dr gave me triamcinolone acetonide ointment. It looks like the swelling has gone down (happened 6 days ago on meds for 4) but it looks like the bubble is going to stay like that and it looks extremely gross. dr wants me back in 6 more days, if it still looks like that can the dr cut it off? It literally looks like a ball of skin that doesn t need to be there ### REPLY: Hi, Blister may be due to fluid collection under prepuce skin after vigorous sex, or it may be due to herpes simplex or candida infection. Until examination is done it is difficult to say what it is. Use oral pain painkiller and apply anti-inflammatory medication locally. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doc.im from india and my daughter is having bronchities problem .and the doc has told me to give nebulization with astelin 4th hourly and budecort should be given 12 th hourly .am i correct doc.suppose if i give budecort in the afternoon at 12.45pm noon. it shoud be given againnow at 12.45am now ### REPLY: Hello. Thank you for asking at . The prescription of Stalin nebulization 4 hourly & decor nebulization 12 hourly is perfectly fine for a mild attack of allergic bronchitis/asthma. I would suggest you to please adjust the schedule to comfort of your daughter. For a 12 hourly used .  So schedule the dosing in such a way that your daughter has not to be awakened from sleep and not to be disturbed significantly. However, it is important to adhere to 4 hourly Stalin nebulization as it is a rapidly acting  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, 6 days ago I had an upper tooth removed, not the last one but the second last one on my right side.. the first 2 days my swelling and pain were simply where they were supposed to be.. but after that point, my extraction site feels better (little bit of pink oozing still?) but I believe the actual socket is doing well.. but I was prescribed antibiotics because the original reason for removal was suspected infection.. anyways, on these antibiotics and as I said 6 days later, my cheek is still noticeably swollen.. I have quite a bit of pain in the last back tooth on the right side (which technically also may have been suffering the same problem as the one taken originally) but my main concern now is 1) there is a bubble/bump formed on the side of my cheek directly parallel to the remaining tooth.. 2)my cheek is still swollen.. so much so that I have difficulty smiling.. and 3) the back tooth is extremely sore when it is touched, any kind of liquid including the warm salt water solution I rinse with causes extreme pain... when the tooth was extracted it needed to be sectioned.. the dentist gave me MANY shots of local including atleast one that actually numbed my lower jaw (where some of my swelling is now) I would also wager a guess that my bump/sore is in the same general area where he was probably applying the needles.. it may also be that the remaining tooth could be rubbing up against it causing a very bad canker sore?? but the swelling is what really concerns me... I believe it could be infected as the dentist and the er doctor said, they thought it could be drainage.. the original reason I had the tooth taken was a bad taste coming from between the 2 teeth.. which was originally caused by trauma.. going to see the dentist tomorrow morning but I would really like to hear another opinion about this.. why is my cheek swollen all the way down to the jaw line when I had an upper tooth taken... 6 whole days ago... it was swollen to the point that my hair follicles were visible, looked like goosebumps.. what can I do to get back to feeling normal again ### REPLY: Hello pt-First, fill an ice bag, baggie or even a surgical glove with ice. Then, hold this ice pack against your face in that region directly adjacent to where your tooth has been removed. Leave the ice pack on your face for 10 minutes, and then leave it off for the next 20 minutes. Repeat this cycle for a few hours, or even all the way through the first 24 hours after your extraction. During the time frame 24 to 48 hours after your surgery, any swelling that's been triggered by the tissue trauma created by the extraction process should have come to a peak. Once it has, you can bring this swelling down more quickly via the application of warm, moist compresses. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Heya i have been suffering with severe kidney infections for the last few years. However i think it may be cystitis . I have the implanon bar now in my arm 2 and a half years. It has only dawned on me recently that the implanon may be the cause of it. I suffer from these infections many times through the year and it seems to come more often when I get my period. What actually happens is I can feel the kidney infection/cystitis/ uti coming on and I get excrutiating severe pains. These pains would start inside the opening of my vagina, it would effect urinating as sometimes it would be sore, i would feel like i have to urinate often. But most of the pain is inside my vagina and i get very sharp pains coming from my lower abdomin and all around my vaginal area inside. Usually within the next day or two i would get my period. However this is not always the case. I am getting very worried as the pain i experience isnt natural. I cannot go anywhere or do anything only stay in my bed with howater bottle. I am very concerned as I am only 20 and I can get many of these infections throughout the year. Also, I think sexual intercourse may not be helping as sometimes when i get these infections I would have had sex a day or two before hand. I really want t fing a solution to my problem, I take anti-biotics for this and although it clears the infection up in about a week or so the problem is still there as these infections are reoccurring regularly. I was wondering could the implanon bar be a cause of this? and if so I might change to the pill? is there a recommended pill for bladder/kidney/uti infections??? ### REPLY: Hi, You are suffering from what we call recurrent UTI. It's not related to the arm implant. Since it is recurring frequently you need some investigations to find the cause. You need urine culture, vaginal swab culture, ultrasound of abdomen. Check your blood sugar. You may need an x-ray call voiding cystourethrogram to look for reflux of urine into the kidneys. If everything is normal you may be a person more susceptible for infection because of your genetic make-up. It may be related to sexual intercourse. Empty your bladder before and after intercourse. You might need to be put on long term prophylactic antibiotic. Consult a urologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in a car accident about four months ago and since then, Ive been having shoulder blade pain on my right side but today when I woke up it was really really really bad, it even made me cry.  Can you tell me if this is from the accident still, it is hard to believe that I still have pain after four months. ### REPLY: HAI.u have had a traumatic neuralgic pain. It came usually prolong for long duration. Days weeks or months. The nerve endings get through sudden shock like feelings associated with pain. Maybe u have had wrong position while in sleep. This is usually radiating pain from cervical plexus or brachial plexus. U can go for painkillers like tramadol, or pregabalin with methylcobalOr else go for neurotic blocks. 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: I have been feeling very lightheaded the past three days. Almost like I am drunk, which I am not. I also am feeling clammy. I am pressure in the neck and temples. At one time I was told that I had a decreased amount of blood flow to the brain from swelling. This does not feel the same though. ### REPLY: Hi, Thank you for providing the brief history of you.Apart from the light-headed and pressure in neck and temple other neurological symptoms and signs needs an assessment clinically. Post which you may have to undergo an MRI to see the soft tissues within the body and to understand the causing of the symptoms and the soft tissue changes. Based on the possible comparison of the clinical neurological findings and the MRI report the physician will initiate the treatment. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor, this is vijay my problem is i have unwanted hair on my cheeks n below the eyes. i need to remove the hair. pls give me any suggestions. whether is laser treatment is okay for me are not, is there any side effect in that and is there any creams to remove unwanted hair permanently . please give me good suggestion. ### REPLY: Hello and welcome to ChatDoctorLaser hair reduction (LHR) is a very safe and reliable way for hair reduction. Apart from mild redness after the sitting which usually resolves in 1-2 hours, there are really no side effects at all, if done by a well-trained/experienced expert. Normally 6-8 sittings will give you a good hair reduction. The hair will become finer, the density will decrease and thereby greatly reduced. It is the FDA approved for hair reduction and gives long-lasting results. Creams containing ingredients like efflornithine HY .  They only slow the hair growth rate. 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 my wisdom teeth out on monday and the amount of ibuprofen I took for the pain caused me to develop acid reflux/heartburn. As of yesterday I have not been feeling the symptoms of it anymore and my mouth isnt in very much pain at all. Would smoking marijuana cause these problems to come back? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, pain in wisdom tooth can be due to infection in that tooth that is due to carious or Periodontal abscess or due to smoking also it is bad to health.  Oral white precancerous and cancerous lesion occur due to smoking. So you should quit this habit and consult dentist and go for oral examination, if it is due to infection caries or periodontal problem then go for treatment.  Do warm saline gargle two - three times a day. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was injured last year and my right leg started hurting so I went to the dr and they put me thru physical therapy. My leg started feeling better but my back started hurting.Under further investigation I have a bulging disk and also a herniated disk. The company dr said the leg problem was a result of an injury but is having a hard time coorilating the back as well because of the the time frame in between pain in the leg and then pain in the back. ### REPLY: Hi, From history it seems that you might be having sciatica pain due to pinched nerve due to bulging and herniated disc. If you are elderly then this might be due to degenerative changes in your spines. Due to old injury on the site can also give this problem as it is likely that at the site of injury osteoarthritis changes starts after some time giving this problem. Go for regular back extension exercises. Avoid weight lifting. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: We have a son who has shown unusual signs for some time....this past four years.   He has studied at university, is very talented musicically , and is very athletic and physically fit,  but has shown some extremes .He is 28 yrs and had been working  with GNS Science in field of Geo Physics. He seemed at times disorientated in the latter 6mths out of his working for 2yrs there.  We were very concerned and made inquiries  after concerns where our son was doing bizarre things like running  for hours late at night  or deciding to experiment with physics problems etc to excessive hours etc or seemed apprehensive . Also  lacking insight in some situations where things are appropiate or inappropriate.    In the past he had always been very courteous, responsible, sensitive to needs and peoples situations. So this was quite out of character and most unlike him, and made us realize something wasnt right with him. After making iquiries at his workplace we also  realized he had had treatment Larium  ( Malaria innoculation ) by his GNS Science Co as part of a prerequisite in case of posting in Indonesia.  We wondered if this could have triggered some of the behaviours now evident which point to possible Schizoprenia  especially Catatonic symtoms ( stationary in one position for lengthy periods) social withdrawal at times,explosive reactions, fear of cellphones , Internet, and not wanting to communicate or enter into any decisionmaking.  We have observed a deterioration and isolation, intolerance to light , curtains always drawn, repetitiveness and routine etc,   Because of the Privacy Act  we are not informed by his Dr or Psychologist and so we asked for a referral to privately have an assessment of his Mental state.   He is receiving some help from Psychological counsellors but we would like to see someone who could advise us on how to help our son recognize his need for specialist medical help as we also want to minimize areas of inaccurate diagnosis. We are his  parents and have been supporting him and caring for him but feel very shut out in helping for his recovery plan. It seems that the System is happy to allow his condition to continue for years  while we know that the longer this situation is left untreated the greater the damage can be to our sons health.  Please can you advise  what we should do . and possible harmful side effects ### REPLY: Degree understand your concernsFirst of all let me assure you that there is nothing wrong if a man who is wholeheartedly doing his studies and is so concentrating that he is mistaken as catatonic. Visit any professional colleges, and you will find at least 10% students like your son, and they would be toppers. It is also common that parents don't like these. They want their child to be active, social, lovable etc. Second. Have you talked to your son about this? If not talk now. If yes, what is the outcome. Let me know. I consider this as normal now. Mind you, You cannot judge your son as schizophrenic or catatonic because you are not trained in that area. Nowadays people sit and play video games hours together without interruptions. Will you call them out of world? Please take your time to assess the situation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I know I have chronic lower back pain.  Its in the lower center of back my.  I have had numerous injections and nerve blocks, nothing works.  I cannot stand longer than 5 or 10 minutes without going into a terrible sweat and the chronic pain starts.  When I sit the pain goes away, however, I still have a numbing, throbbing pain that stays with me continually sitting.  I was referred to a Rheumatologist who told me my SED level was 79, he put me on meds that did not touch the pain and Im even more miserable than Ive ever been in my life.  The Rheumatologist has changed my meds at least 3 times and I still am getting no relief.  HELP.  Have I been diagnosed wrong.  What is wrong with me.  This pain came over a period of time and has gradually has increased.  Did I mention I have a small disc, but every doctor seems to think that the source of my back pain could not be related to that tiny disc.  What should I do.  I need relief.  I want to walk without being in pain and Im young with a child. ### REPLY: Dear friend your low back pain seems muscular pain. If all reports are normal then physiotherapy and exercise will help you a lot on long term basis. Presently if you have severe pain then take muscle relaxant medicine like combination of diclofenac+paracetamol+chlorzoxazon and consult physiotherapist.-exercise for low back pain-raise your leg straight from hip joint without bending from knee after sleeping on back and then put down slowly. Same exercise for another leg and then raise both leg simultaneously. Sleep on abdomen and raise your head and chest backward. Do all these exercise 40-50 times per day by increasing slowly daily. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ve been suffering from psoriasis for along time, it covered everywhere but my face. I ve been with a dermotologist for about 4 years, and he had me trying different creams that did not work. It was driving me crazy and also making me angry. So I left his office and found a different doctor who introduced to humira. Man was I so relieved to see the 95% clear up. but Ive began to noticed these big black marks that was left. I talked to my doctor and she said they will fade. its been over a year now and they re still here. Im so tired of hiding. Is there anyway to get rid of them. I just wanna live my life. ### REPLY: Hi there Lizzy. Is Glad Humor has provided you with 95% clearance.that is the best case scenario with these biological agents. Please remember it is not always the case & each person is different. Also, one has to have an experience with biological & there are recurrence rates. For the big black marks, the reason docs are going slow is possibly because they don't want to wake up the sleeping giant ... Psoriasis. However, you must consult with one on the ground for best results. Off the cuff, any HY .  There are many brands & should be available as an OTC preparation; Combine that with regular algebra cream as a moisturizer after bathing for best results. Cheers & wish you a Great Skin 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: hii i jerk my cock daily 2 times .. will it effect to my marriage life..Suggest me will it good or not? And my second question is Is any possible to remove the back patch near and around the penis actually my skin tone is white but near the penis totally black except that, every thing is white Plz give me some tips to maintain the private parts clean......... THNxxxxxxxxx ### REPLY: Degree understand your concerns went through your details. Masturbation daily twice is surely excess. I do not know your age. After 20 thrice or four times a week is ideal. There is no adverse effect on health due to masturbation. But masturbation is energy consuming. Secondly frequent masturbation can trigger anxiety like this questions you are asking. Such questions are simply because you are anxious about the habit you are following. Engage yourself in games and other entertaining activities, career etc. The black tinge of your crotch area is quite normal, and it cannot be changed. It happens because of many reasons including excess sweating and bacterial action. Keep your private parts clean by washing the area with soap twice a day and keeping it . 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. 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: Hello, I have been diagnosed with IBS but I dont think its right because I have a continued to have abdominal pain . It just started up about three days ago, and Ive been on Bentyl for about two weeks. I take one capsule thirty minutes before every meal , as it says to. Is there anything else it could be? Also, I missed my period for five months straight after having a regular one for about a year and half. It just came back last month, and I have never had sex. Im not sure if this is irrelevant but its always seemed a little strange; my hands and feet are cold all the time. Thanks so much! ### REPLY: Thanks for the queries is irritable bowel syn . Have u undergone colonoscopy and an endoscopy? I don't think u have because u would have mentioned it otherwise. Since u have been missing your periods, plus having abdominal pains, plus cold feet. I see something which are multiple medical problems. I best thing would be to get admitted and evaluated thoroughly.  Seek admission in a multi specialty hospital OnlyFans a healthy life ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been having constint chest pain sharp and pressure like for 4 weeks now and i am starting to have unexplaned bruising on my legs and had just found a hard bump on top of my foot with a large bruise i also missed my period for the month but p-test was neg. what could it be? ### REPLY: Thanks for your question on . I can understand your situation and problem. Possibility of hormonal imbalance is more in your case but better to get done ECG first, to rule out heart diseases as a cause for your chest pain. If ECG is normal than no need to worry about cardiac diseases. Chest pain, abnormal menstrual cycle, bruising, lump on feet etc. are seen in hormonal imbalance. So better to get done hormone levels like estrogen, progesterone, FSH, LH etc. If hormone levels are normal than sometimes stress and tension can cause similar symptoms. So avoid stress and tension, be relaxed and calm. 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: I am 25 male i have been having acute chest pain in my upper left chest right at the naval since sunday. Yesterday i started feeling drugged out of nowhere, dizzy, cloudy, just not right. I also find my self confused, i work as a machinist i have been doing things and forget what im doing while im doing it, or walk into a place that with out know why. Everyone is telling me its anxiety, and that its in my head i would really like to think that. but its not going away. ### REPLY: Hello, I passed carefully through your question and would explain that your symptoms could be related to anxiety.  But, before coming to this conclusion, I would recommend first checking thyroid hormone levels in order to exclude thyroid gland dysfunction, fasting glucose and an EEG in order to investigate for possible focal epilepsy seizures.  You should discuss with your doctor on the above tests.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been put on medication because I have a duodenal ulcer. The doctor prescribed Eso kit, Motilium & No spalgin. I realized the No Spalgin is a paracetamol and I dont feel its necessary for me use it for 14 days so I am only taking the first two, does the No Spalgin have any benefits to my healing process and what are the side effects of the others? I am 34 years old, 5.2 weigh 60 kgs and I have never had any serious ailments. ### REPLY: Welcome to  Good Paracetamol is given to prevent you from experiencing fever or mild pain as headache is sometimes associated with Duodenal ulcer. Mot ilium is Risperidone which is given to prevent vomiting sensation. It may cause mild abdominal discomfort in some patients as side effect, otherwise relatively safe. ESO kit is to kill the bacteria causing Acid Peptic Disease called H.pylori. Continue taking all the medication as the Doctor ordered. You should be fine after the treatment for 14 days. Did you get an Endoscopy done before? ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 type two diabetic.  I just found out that I have stage 3 chronic kidney disease. What medicine should I take to help so this disease doent get worse?  I walk atleast two miles a day and work for another 20 min.  I take Glimepride 2mg two pills twice a day and Metformin 1000mg wice a day alonf with Losartan 100mg once a day.  I also take synthroid .075mg oncw a day.  Shouild I see a specialist?Thank You ### REPLY: Hello sir thanks for the query CKD chronic kidney disease complication of diabetes.the bitter act of diabetes is that a doctor can only delay the onset of complications and delay its progression but can never prevent FRM complications occurring.in your case metformin is NT prescribed if creatinine is more than 2.5 and u r losartan will take care of progression of complications...but once u r diagnosed as CKD a detail work up is required as to assess when u require dialysis and any plans for transplant...ANF to evaluate other diabetic complicationsThank 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: Breast cancer - 37 positive lymph nodesMy mum was operated for breast cancer last month. She had tumorectomy and lumpectomy with 40 lymph nodes removed (after previous sentinel node biopsy) of which 37 resulted positive. I have never heard of so many positive lymph nodes.  She has been diagnosed with a 1.2 mm DCIS with a large radius of IDC. The tumor was really small, but it seems it has already  attacked the lymph nodes. The diagnose after surgery showed that MIB-1 was 10%, ER were 100% positive and the PR receptors were negative. The results for the Her-2 receptor are still unknown. The main diagnose was: breast cancer T1 N1 MX. The doctor told her she will have to undergo chemo, radio and hormonal therapy.All these results seem quite contradictory. On one hand she had a small cancer (T1), while on the other hand she had 37 positive lymph nodes (diagnosed as N1...which I do not understand). Every doctor we have spoken to so far seemed quite perplexed by the results. The only thing I can deduce is that she is either a "phenomenon" or she has been misdiagnosed. Do you think such a diagnose can be possible? I would realy appreciate any useful information. Thank you for your help! ### REPLY: Hi, dairy have gone through your question. I can understand your concern. There is some misdiagnosis in her case.  According to size her stage T1 is ok.  But if 37 lymph nodes are positive then it can never be N1. It is totally wrong diagnosis and no doubt about that.  Best thing to do is review.  You should take your slide and blocks front hat doctor and ask for a review in other laboratory.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi  A friend of mine can not walk,stand or sit, she has an extreme high pain tolerance but now is crying from the pain in her lower back. She cant move or have anything touching her back.  The pain runs from her back, hip and down to her knee. She called an ambulance to take her to the emergency room after 10 hours and an x-ray was told that it is her siatica.  She is given morphine but still feels the pain.  She is told to go home and take T3 until she sees her regular doctor.  I am concerned it is not the siactic, can this be misdiagnosed?  What can she do to have the doctors check all possiblities. ### REPLY: A lumbar radiculopathy, or "sciatica" is one of the most common causes of low back pain that radiates down the leg. They would likely have done screening blood tests in the ER to look at other remote possibilities. In addition to Tylenol #3 she would probably benefit from a prescription muscle relaxant. Otherwise, physical therapy, and then possibly lumbar epidural steroid injection/nerve root block would be the next option. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my mother is 88 notice a focusing issue and mood swings she has had strokes in the past also headaches she lost her ability to speak now she is diagnosed with a 5 centimeter tumor on her frontal left lobesix months ago had a mri can a tumor grow that fast or is it normal don t no if it is cancer or not just happened Thank you Annette at her age what are her chances ### REPLY: Hi, I am .  I have read your question and understand your concerns. Let me try to help you Questions : Any suggestion for 88-year-old having 5 cm tumor on frontal left lobe? Answer : We need to first do a minimally invasive Biopsy of the lesion to know nature of the tumor Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have noticed swelling on the right side of lower neck around 15-20 days back.  The FNAC report is strongly suggestive of Tuberculosis. Can you please let me know if I can start the treatment? I need to know when the treatment starts, how can I come to know that I am relieved from TB and when my nodes will heal? Also let me know the precautions to be taken and how can I start my treatment. Whether this is infectious? And what are the reasons for this disease. ### REPLY: Thanks for your query at !In my opinion you are suffering from tubercular lymphadenitis infection. As your FNAC report also suggest the same. Absolutely it is high time you start the treatment with first line anti-tubercular .  You may get registered if centers for treatment if provided in your country like DOTS in India where you get free treatment. You might have to undertake repeated aspirations for swelling if it persists and send sample for ZN staining and culture for AFB and sensitivity test for the same. There are special tests like Chains which can be ordered at that time for genotypic testing from aspirate. Yes this is infectious you need to take precautions and follow hygiene practices. After 2 weeks post treatment you will become non-infective. The reasons for the disease is living with a person suffering with TB or you may have contracted it through coughing by infected people who commonly move in public places. Sometimes latent TB gets activated with declining immunity. It is curative, so don't worry. Strictly adhere to treatment of long duration to avoid emergence of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 noticeable bump on the upper right back of my head & im not sure how long it s been there. I just thought it was part of my lumpy head. Now my daughters have me concerned to have it checked out. Who should I contact? I only go to my Primary care physician once a year for a physical, & consider myself very healthy. I haven t had headaches, or any sign anything is wrong. ### REPLY: Hello! Welcome on  ! The bump in this region could be related to different possible causes (an old trauma in this region, vitamin D or calcium deficiency, inflammation, a lipoma, etc.). Anyway, it doesn't seem to be anything serious as you are feeling OK and have no fever or headache. Anyway, I would recommend consulting with your GP for a physical exam and performing a scull X-ray study and some blood lab tests (complete blood count, PCR, sedimentation rate, calcium and phosphorus plasma levels, vitamin D levels). Hope you will find this answer helpful! I remain at your disposal for any further questions. Best wishes,  ### END