Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband is working in kuwait and he has been coughing non stop he coughed so much he couldnt get his breath back and was rushed to hospital they xrayed his chest and found white mist patches on his lungs he was given an inhaler? he is 30years old non smoker?he was also given an antibiotic that was 3 days ago and he says he doesnt feel ant better but feels worse and the breathlessness is getting worsre? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of worsening of underlying pneumonia is more in your husbands case. White patch on chest x-ray is suggestive of pneumonia. His symptoms are not improving, rather getting worse after antibiotic. So his pneumonia is not improving, and it is worsening. Best treatment of pneumonia is identification of causative organism and start appropriate antibiotics. For this he should consult pulmonologist and get done clinical examination of respiratory system and sputum culture and sensitivity report. Culture will isolate the causative organism and sensitivity report will guide about effective antibiotic treatment. Don't worry, with appropriate treatment, his cough and breathlessness will also improve. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. 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: The mucous is very thick & gluey and is particularly bad first thing in the morning. I feel I am choking on the stuff and it takes me about an hour to get it coughed up. Most of seems to start off high in my throat, about the level of my chin, but then a lot goes down to the base of my throat (where the little hollow is) during the day. For most of the rest of the day I try not to cough too much & just clear my throat when necessary but it gets very bad again after I have eaten my evening meal and I am coughing again right up to bedtime. I use an electric steam inhaler 1-2 daily and that does help to loosen the phlegm. I also use a Asthalin inhaler and an expectorant cough mixture. Im not sure if either of these help but Im willing to try anything. The excess mucous,severe cough and the breathlessness are seriously affecting my quality of life now and I am desperate to find relief, but so far have had no answers. ### REPLY: Hello their understand your concerned are doing the right thing by taking the steam route and that's helping you. You have not mentioned your age and neither do I know whether you are? Were a smoker. I believe it is certain indistinguishable allergy which has brought about this cough. A course of antibiotic with azithromycin will surely help and a bit of montelukast added will look after the allergy partially. I feel the inhaler and the plain expectorant is not much help instead a bucolic expectorant would be a better choice should be better within a week Hope that was helpful to 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 am 19 weeks pregnant and for the past week I have felt nausea and the past few days I have started to have horrible pains in my right upper side. A few times it has hurt so bad I could not even walk or move. I had to lay down in a certain position. ### REPLY: Hi, Thanks for asking. I understand your concern.  Normally upper right abdominal pain is seen in pregnancy due to problems of digestion caused by pregnancy hormones.  But you seem to have severe/ unbearable pain, You need exclusion of liver disorder (infective/ blood group in compliance)/ gall bladder disorders. Sometimes heart problems/ trauma to the part with injury to bony cage./ respiratory problems, can lead to unbearable pain in the area.  I would advise a consultation of a physician followed by investigations he advises,,, to pinpoint the cause & take specific treatment advised.  Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor,i am 27yr old and i have the past history of pcod and thyroid problem taking the tablet metformin 500mg and eltroxin 50mg,since 1 year am trying for to get preganant,so we had taken treatment with clomid 50mg for 5 days and done fs,that time egg was not ruptured,nd again on aug we done the fs that time egg was ruptured and  done iui,so dat time also not conceived,but  in this month again done the fs with clomid tab,the follicle size is 20mm on left ovary and 14mm on right ovary,and done ChatDoctor injection,so this is the 16th day,dr told to take duphastone tab till 28th day,so my question is any hope to conceive on this month?and whet is the use of taking this tab duphastone? ### REPLY: Hi, In second half of the periods after follicles rupture, progesterone hormone is released (same as Duphastone) which will make the lining of uterus favorable for the possible implantation of the baby. It will make the bond between baby & uterus strong preventing early pregnancy bleeding & abortions. If your follicle has ruptured after injection & is healthy & if it meets a healthy sperm it will form a healthy pregnancy. Man can control only till the step of sperm meeting the egg, rest is controlled by God. You should try your best & pray well. If you are not lucky, try to find some other cause. Like any hormone problem like Thyroid still not normal, Serum prolactin, abnormal blood sugars, Blocked tubes (tested by HSG or SSG or Laparoscopy), repeat semen analysis at different center, preferably at infertility center, done by an . Hope I have clarified your overall 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 was a little worried as i have been taking Codien for a bad injury for quiet some time and latley i have been taking 5 at a time then maybe a few hours later another 5 and i was reading somewhere thats about 5000mg of paracetamol and can be danger i aloso take still knox to sleep ### REPLY: Hi, Paracetamol overdose (by taking more than 3000 mg/day may not cause symptoms for the first day. However, nausea, vomiting may occur a few hours after taking the overdose.  After 24 hours there may be pain under the ribs on the right side (where the liver is) and there may be yellowing of the whites of the eyes and the skin (jaundice). This is indicative liver damage or failure. Later on brain and kidneys will also be affected. Codeine is an opioid pain reliever medication the overdose of which can cause . Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sticky saliva in my throat for the past 5 years, my tonsils removed , but still have sticky saliva and odor in my mouth always, this causes stress , when am in a car , i feel stress and restless , please help me ### REPLY: Hi, As per your query symptoms of sticky saliva and bad odor in the mouth is mainly due to poor oral hygiene and dermatitis. Sometimes underlying medical condition could be the cause of your symptoms:I would suggest to:-1- Maintain proper oral hygiene by brushing and flossing twice a day.2- Do antiseptic mouthwash (Listerine) rinses.3- Do warm saline rinses 2-3 times a day. 4- Suck on sugar-free mint candy.5- .  Consult a dentist for proper examination to rule out a condition like oral thrush, hypersalivation and other infection. The dentist will perform complete oral prophylaxis and may prescribe anticholinergics. 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 never had the flu/cold in my life . However I do now have nasal congestion . No sneezing / runny nose . I have a head ache to my bilateral temporal part if my head . My knees are swollen and painful to touch . No fever. I had a sore throat which went away by itself . ### REPLY: Seat I read your scenario you should take tablet Bast in(Astatine anti-allergic) and take tablet Azithromycin antibiotic. You should take broken painkiller .also take Tablet Omeprazole once daily before breakfast according to our clinical practice. You should use Cytosine nasal spray (oxymetazoline) act as nasal decongestant .if you have any problem regarding this issue you can ask me otherwise you can go near doctor thanks for asking. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: If first dose of Anti rabies vaccine is given in gluteal muscle than it will be effective or not. My first vaccine is given in gluteal and second is on deltoid at 3rd day, but my Dr is saying we will consider 3rd as to 0 day. I am little worried and afraid please give me answer asap ### REPLY: Hello, Welcome to , Dogs are known reservoir of rabies virus and can transmit to human beings by biting. Rabies is 100% fatal, but it is 100% preventable by proper and adequate treatment. Anti rabies vaccine should be taken to deltoid region not to gluteal region because of more fat in the gluteal region. When the vaccine is administered into the gluteal region the vaccine will enter the fat cell, and it will not stimulate the immune system to induce protective antibody titles. Preferably it should be administered into the muscle. As you were administered first dose of anti rabies vaccine into gluteal region it may delay the induction of protective antibody titles. It is better to start the fresh regimen from the day 3 doses. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 17 years old and have had a reoccurring knee injury every year throughout my softball season. Normally it takes all summer to heal which isn t a big deal, however I am leaving for the Airforce in August so therefore don t have time to stop exercising and let it heal. It retains water under the kneecap. Also it is terrible pain trying to stand out of a crouched position and walking upstairs. I was told it was jumpers knee however symptoms of this seem to be the opposite of what I have. Normally it hurts going downstairs with jumpers not up like it does me. Also it hurts to run. Which is a necessity to be able to train! So is it jumpers knee or not? Also what should I do treatment wise if I don t have time to stop and rest? ### REPLY: Hi, thank-you for providing the brief history of you thorough musculoskeletal assessment is advised.Also, the pain is limiting your functional ability of climbing stairs and also from crouched position to stand up. If your physician mentioned a jumpers knee, I will advise to take an MRI scan of the knee as for me, it appears to be a more of a ligament sprain in the knee joint. But only with thorough musculoskeletal assessment and MRI scan the diagnosis can be made. With proper exercises and Rehabilitation program you can have a better knee, and you can join air force as well. 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: My 16Yr Old Daughter Has Little Swollen Front Glands And Recently Small Sore Lumps Have Appeared On The Back ,Side Of Her Neck. Both Sides At Base Of Skull, And Urine Has Darkened.. Lumps Are Growing A Little . About 3-4Days Into These Symtoms.. Also Sore Tummy Left Side At Bottom Of Rib Cage ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has multiple enlarged lymph node.  It can be due to reactive hyperplasia, tuberculosis or lymphoma.  Chances of reactive hyperplasia are more. She should take a course of antibiotics like azithromycin, amoxiclav or levofloxacin. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and 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: I have been feeling dizzy for 5 weeks, tinnitus, ear pressure and recently diagnosed with hemochromatosis. I am getting phlebotomies, had an MRI and CatScan, ENT Dr.The dizziness is keeping me from working. I do not know if it is from allergies or not. Is the hemochromatosis an autoimmune disorder? Most importantly how do I get rid of the off balance and dizziness ? Taking no medicine at this time. I am not nauseous and the room does not spin. Dizziness comes from either standing still, closing my eyes will cause me to lose my balance, or walking to slow makes me sway. Almost like a slow rocking boat is bad, but I can walk a straight fast line ahead I hope that this makes sense. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. You should not take self medicines for any health problems. Consult a physician for diagnosis and treatment. You are saying you have all the given problems like dizziness and swaying etc., and am I wondering why you have not consulted a physician? First things first. Your doctor is the person who is trained to examine you visually, physically and pathologically and diagnose. You cannot assume diseases or physical conditions. Also requesting online help without proper diagnosis is also dangerous. Consult a physician as soon as possible. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome your problems. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Brain MRI without contrast came back w few nonspecific punctate foci of T2 prolongation and left temporal encephalomalacia along the lateral cortex. Radiologist recommended CSF . Saw Neuro for the 1st time and he walked in and within 2 minutes stated that he didn t think i needed the CSF. Ordered EEG thinking i may be having mini seizures- tech stated that it appears normal. Have not seen Neuro yet. Tech closed the door before EEG and said off the records, i think you should get a second opinion ?? She stated that i should see Neuro that specializes in MS ?? ### REPLY: Hello Thanks for the query, First I would like to tell you that the interpretation of MRI should be done only in a given clinical context., has to be correlated with the clinical data. In the absence of clinical problem of a patient it is difficult to say if you need CSF or not. I am sorry that i don't know your age and if you have high BP, diabetes and cholesterol problem.  You need not see a consultant who specializes MS, but you need c, clinical evaluation by a neurologist. If you are not happy, better go for a second opinion. The clinical interview will clarify so many things, and we will be able to guide you better. 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, may I answer your health queries right now ?  Please type your query here... I am a healthy 30 year old woman with chronic pelvic/abdominal pain for 4 months and recent blood work showed my WBC is 12,500 and my CRP level is 42. My next step is a ct scan of my abdomen and pelvis. What are they possibly looking for? ### REPLY: Hi. Thanks for your query. They are possibly looking for the following:-PID- Pelvic Inflammatory Disease.-Problems related to the uterus, tubes and ovaries like Salpingitis, TO mass.-Cystitis and UTI.-Enteritis, pelvis peritonitis by say tuberculosis-Appendicitis in pelvis position. -Or any inflammatory disease that has raised your WBC and CRP. Hope CT scan helps you and your Doctors to find the cause. And you get a proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been TTC for 1 year and 5 months now with no luck.  My doctor is an HSG and all of my tubes were open.  I have very low progesterone, last test after provera induced menstrual cycle and Clomid on days 3-7 results came back at 0.4; the doctor said anything under 10 for progesterone is considered too low.  I am now on Metformin 500mg.  I was taking it 2x per day up until last Thursday, now I have been taking it 3x a day going on day 4.  I finished provera 10mg for 10 days 8 days ago now and still have no sign of a period?  Also, I have been noticing an odd odor during urination and bad cramps in my stomach followed by a burning sensation in my vagina.  Any idea what the cause may be?  Please help? Thank you! ### REPLY: Hi, Thanks for the query. As you are not getting periods even after progesterone challenge, there is possibility of both estrogen and progesterone deficiency. So you better consult your doctor and go for combined pills to induce bleeding. And also there may be some vaginal infection as you are having pain abdomen, burning in the vagina etc. Get examined to rule out the infection also. And if there are any signs of infection go for antibiotic therapy. For more details you can ask me through: http://www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: iam 41 yrs old recently the dark pig mentation around eyes and mouth are very prominent. i consulted kaya skin clinic they suggested skin lightening alternated with mesoglow treatment once amonth for 4months. but they gave partial success in the whole process.iw ould like to go for second opinion. is there any other alternative procedure for my problem. ### REPLY: Hi, Visible pigmentation in human results from the synthesis and distribution of melanin in the skin, hair bulbs and eyes.Hyperpigmentation can result from excessive sun exposure, use sunscreen with SPF 30. Some natural remedies are-mixture of lemon juice and cream; apply on face. Put lemon juice onto basil leaves. This is great for getting rid of pigmentation marks and dark circles that may have been a long-time problem. Apply lime (NIMBY) to the affected area, and after 15 minutes wash it off. This needs to be done on a daily basis. Other remedy is Comic acid cream which lightens up the dark spots but takes some time. However, mellow is a facial treatment using Vitamins and Mineral injections to add that healthy glow to skin which radiates energy and vitality. Subdermal vitamin injections rejuvenate the cells, making them more active and thereby stimulating the production of collagen and elastin. Overall it reduces dark spots; effects seen faster than comic acid. You can continue same treatment for dark spots along with natural remedies and sunscreen creams. Take care. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have patello femoral osteophyte formation is present with minimal changes at the posterior aspects of the patellae which may represent osteo chondromalacia, I have lot of pain on top of my patella, I can t go up stairs and up to a chair, I am 51 years old, should I do for a surgery to it fixed? ### REPLY: Hello, As this indicated that there us malt racking of the patella. This means that when there is an extension of the knee the patella moves upwards to lock the knee joint. You can take help of the physiotherapists who can teach you the VMO exercises. It's very important to do the VMO exercise to correct the malt racking of the patella. You can even try in later stages balance board training will also help to improve the muscle imbalances. 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 have had ongoing symptoms (6 months) of abdominal and back pain. 2 late periods,  were never late before. Several kidney infections, Shooting pains in lower abdominal area. Achy sides and feels like a bruised coccyx. Both sides and edge of abs area are very tender to touch and often ache. The skin also feels rough in these areas. I have had both an ultrasound scan and blood tests which have all come back as normal. The pain is often very bad and can make general daily activities very difficult. ### REPLY: Hi. Thanks for your query and an elucidated history. The history of so many varied symptoms some related and some non-related with normal ultrasonography and some blood investigations are suggestive of you need to have:A detailed clinical and Physical examination by a MD Physician. This is very important as there can be some syn .  You say the following history:Abdominal and back-pain- are indicative of retroperitoneal structure involvement; 2 late periods can be general ill health and may not be a major issue unless accompanied by heavy bleeding or so. Achy sides and bruised coccyx can be due to fibromyalgia associated with infection, stress and anxiety of not getting well. The same goes for the abs and both sides of abdomen. Skin can be rough due to deficiency of vitamins. Since you have not noted any sum, ptoms related to the intestinal problems like bloating, loose motions or so, all these problems can be related to the kidney infection which is not diagnosed and treated well. I would hence advise you the following:First get the urine and blood culture and sensitivity done to get an idea about the infecting organisms. Routine tests of blood, urine and stool. Intravenous paleography and CT scan of the abdomen. Cysto-urethroscopy and Urologists opinion. Once a proper diagnosis is made the treatment can be planned perfectly to get the results. This will be in the form of a long-term antibiotic, multivitamins and so on.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have just had an MRI done and it reflects cystic gliosis on the right frontal lobe. The scan reveals a portion of the lobe that is missing or a hole in the lobe, the doc says iy should have occurred from a head injury from an accident or blow to the head, perhaps even have caused a bleed on the brain however, I had no accidents, no falls or any head bashings since I was born. I am 40yrs old. Is there anything else that could be the cause of it ? Thanks Megan ### REPLY: Hello dear Cystic gloss usual lyrics is loss of some brain parenchymal with secondary CSF filled space. This occurs secondary to head trauma, small infarct, some congenital malformations. At age 40 if its present without head injury you should get your blood pressure and blood sugar checked. Best would be to consult a neurologist with all your records. Nothing to worry, most of the time it is of no significance and do not progress Hope you recover early God bless you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Dr did blood work and it came back with abnormal bone marrow. She sent me to an Oncologist and al he has done is blood work and complete bone exr ays. My number is at 27, but do not know what that mean either. Now I have a Menegioma brain tumor which causes me to have seizures. Next my Dr sathyroid is messed up. I have severe pain in the bones in my legs, back neck, and bad headaches. Can you tell me anyhing about al this? Plus I have had several types of rashes and the worst being on my legs from the calf down to my toes, so severe it felt like I was standing in a fire. Aso all of a sudden my legs swell so bad that sometimes I can t bend my ankles or even walk sometimes. ### REPLY: Hi, I am .  I have read your question and understand your concerns. Let me try to help you Question : What causes severe bone pain in body when suffering from brain tumor? Answer : Meningioma causing Pain in Body is very rare. The headache can be attributed to it. This pain in body and rashes are most likely to be related to your abnormal bone marrow and several types of rashes 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: Dear Doctor I am a 40 yrs unmarried male I regularly masturbate,but sometime if i fail to masturbate my area new my penis starts paining along with back-pain,as i masturbate i get relief ,this happen frequently with me ,i think i am suffering from vasocongestion or congestive prostatitis .Please advice me if there is any Homeopathy/ Ayurveda remedy for this. Thanks Regards ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The problem you are mentioning could never be due to not masturbating but is due to the ill concepts.  Masturbation is normal, natural and not unhealthy. Even animals masturbate. Your problem must have arises out of anxiety from the ill concepts of masturbation. Back pain and penis pain are due to anxiety and imagination from your end. Therefore, do not worry. You might need sexological counseling and sex therapy. You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi yesterday I noticed a painful area on my arm whilst itching today I have the same issue however I have noticed this is on my mole... nowhere around the mole hurts only when the mole is touched it feels like a very painful mole... can you advise what is may be? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have Hi Dear, Welcome to . Understanding your concern. As per your query you have itchiness and pain in the arm. Well there can be many reasons for symptoms you mention in query like muscle strain, tennis elbow, allergic reaction, contact dermatitis or ulcerative colitis. I would suggest you to apply cold compresses for itchiness, take Ben .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir, i m 24.  i had an accident recently causing blood through penis. doctor says that hereafter i cant hav intercourse and said tat my sperm mixes with urine......... please tell me whether any remedy present now-a-days for tis problem.......... plz do reply sir...... ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern you have not described the nature of injury that you have you simply said that the "Penile Injury" and that is not enough to answer your query you should have described this injury in detail to have some opinion form , I would advise you to have a second opinion if the injury is serious, hope this information helps you, have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I worry about my boyfriend who will be 38. He smokes a lot , and he recently complains that his throat hurts inside , and the pain doesn t go away. He has also strong acid reflux, and feels like vomiting every morning, when smoking his first cigarette. His Dad almost died of colon cancer, and his Granpa died of colon cancer. I am afraid he has advanced throat cancer that has low chance of survival. ### REPLY: Thanks for your question on . In my opinion you should first consult pulmonologist and get done chest x-ray and Bronchoscopy to rule out any pathology of throat. The pain mostly from HERD only. And smoking has deteriorated effect on HERD. It actually worsens HERD. So if chest x-ray and Bronchoscopy is normal than no need to worry about throat cancer. His symptoms are mostly due to HERD. So cessation of smoking is needed in his case. Along with these do following things for better control of HERD.1. Avoid oily and spicy food. 2. Avoid heavy meals, instead take small meals.3. Avoid stress and tension.4. Start proton pump inhibitor. 5. Go for walk after meals.6. Keep 2-3 pillows under head in bed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was bitten by a tick while in Germany about 2 months ago. Since then, I have been experiencing extreme fatigue and have had many headaches and a lot of stiffness of the muscles and joints, especially in my back. I did not get any kind of rash where the tick was, but do you think it could possible be Lyme Disease? ### REPLY: Dear I can understand your concern. I would like to inform you that yes Lyme disease can cause all these symptoms such as extreme fatigue, headache, stiffness of neck, joint and muscle pain. So in my opinion you discuss about this with your physician as soon as possible because at an early stage it can né managed very easily with antibiotics. If left untreated this may cause more troubles such as may affect heart and nerves also. Hope this will help you dear.  If you have any other concerns please feel free to message me.  Thanks for contacting . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here...I just had a baby boy that all seems to be well with, but we (and the doctor) cant feel his testicles anywhere. I had one undesended testicle that was brought down by surgery when i was five. Surely they are there some where, right? ### REPLY: Hi, From history it seems that he might be having descended testes having scrotal empty. Many a time there might be having swelling in inguinal region due to presence of testes there. By the end of six months they might descend and if not then Orchiopexy operation should be done. Now due to new modern technology diagnostic laparoscopy can be done after six months. Consult pediatric surgeon and get examined. 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: I had medullary thyroid cancer and a thyroidectomy 2 years ago .(Men 2b , multiple endocrine neoplasia ]. I have had an infection of saliva glands 2 times now . The hard lump on the side of my neck under my jaw is hard and the size of a dime . I am 58 years young and am wondering if this could be just a growth or cancer of the lymph nodes ? I also had a complete adrenalectomy 2 years ago and have put on a lot of weight from the prednisone .I am a school bus driver and cannot afford lots of tests . Thanks for any input on my condition ,Kathy ### REPLY: HI, Thanks for the query to . Treatment for hard lump on side of jaw-In my opinion, its a lymphadenitis with infection from salivary glands mostly. As you had old thyroid cancer, your apprehension could be reduced by arranging an Antibiotic trial with your ER Doctor, as you are short of money. If it responds and reduces-then forget it. If not you need to consult Surgeon and treat it after FNAC Biopsy. Hope this would help you to plan treatment with mammography and ER doctor. Welcome for any further query to . Hit, thanks. Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a dull ache that comes and goes in my right lung area near my sternum. It can move around at times as well. I would not even call it it pain its very mild but you know its there.......I smoked for 25 years and quit 8 months ago. My Doc has listened to my lungs and a ok. I had a chest axray about a year ago and it was ok. ECGs and blood work showed normal as well. ### REPLY: Thanks for your question on . I can understand your concern. First, no need to worry about major heart and lung diseases because you're all reports are normal, and you have left smoking. Possibility of musculoskeletal pain is more likely. So follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid movements causing pain. Avoid sudden jerky movements of chest.3. Apply warm water pad on affected areas of chest.4. Take simple painkiller like paracetamol or ibuprofen.5. Also start calcium and vitamin D 3 supplements.Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My cousin has been suffering crippling and debilitating headaches for a couple of days now. She suffers from high blood pressure and her blood pressure right now is 169/113. Is this causing her headaches? And her blood pressure medication doesnt seem to be working. Should we take her to the ER? ### REPLY: Hi, Headache due to hypertension is less likely in this case, but it could be due to other reason and most common is migraine, if blood pressure is not responding to single molecule then second molecule can be added and for that you can discuss with cardiologist even the blood pressure need to be measured by physician itself. 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 am starting to hate my mother.  She has stolen most of my friends and tells them lies about me.  One has been a friend of mine for over 50 yrs.  Right now she is in California  on a two week vacation with a friend of mine, (of over20 years)  I had to figure it out myself as neither one of them would tell me.  Of course I havent talked to my so called mother since October, when my friend  of  over 50 years came to  visit me from Wi.  She wasnt here 24hrs. and was  on her way home after 2hrs. of being  with my  mother,  ( I  had to leave  for about a couple of hrs.)  only one  of my  friends  would tell me what she said about me, and it was a lie. ### REPLY: Degree understand your concerns went through your details. I can understand your frustration. People lie for different reason and circumstances is the real base for these lying behavior. When they realize they were lying, the damage done would be irreversible and therefore usually they won't admit to that. To detect a lie, you should be cunning and assertive. That is not easy and comes from experience and genetics. In the given cases, your mother is a party and talking to her might solve all these problems. Talk to her passionately and she, as aged mother, should tell you everything. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I sprained my ankle on May 27th and went to the doctor the following day and received an air cast. I ve been wearing the cast pretty much non-stop, as when I try to walk without it, I often feel pain. Every so often when I walk (wearing the cast or not) I feel a pop in my ankle and a severe pain for about 10 seconds. I haven t really thought much of it, but pretty much all day today I ve felt a burning sensation and was wondering if this was normal since I haven t felt this until now (aside from when I had the air cast too tight, but I felt that within about a minute). ### REPLY: Hello, If the cast isn't helping them to leave the cast will be good. I will advise using the normal crêpe bandage or ankle brace which will help maintain stability. Since you didn't mention the grade of injury of ankle sprain we suspect it to be grade two and in this crêpe bandage or ankle brace can be used. Do hot water fermentation and allow crêpe to use for stabilizing the ankle joint. Post the 21-28 you can start slow range of motion exercises for the ankle joint and do simple static Qua .  In the long run after 8-10 weeks doing balance board training will be helpful in stabilizing the ankle joint better and correction of any muscle imbalances. 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: i have been to doctors after doctors and then in hopkins county memorial and was admited for 6 day now i have a cathider in my left arm that leads to the main arterie in my heart the doctors are saying that i have a bactirial infection in my lungs along with scar tissue on my lungs as well as my white blood cells being low i believe there is something more please i think they are not telling me everything i need to know what is wrong please what is your professional oppenion what would you think they have ran every test first it was tb then it was cancer and now its supose to be a bactiral infection please help ### REPLY: Scar tissue of the lungs is not a disease. It is the tissue that can substitute normal lung tissue that suffered an inflammatory injury, as result of a severe infection for example. Some diseases are difficult to diagnosis and sometimes clinical symptoms, signs and tests findings may be inconclusive or misleading. A strong relationship of trust with your physicians is extremely important to overcome the challenges of your treatment and rehabilitation. Your physicians will not hide from you anything related to your condition if openly questioned about it. The anxiety in the presence of a condition that is not completely understood or that does not improve may sometimes lead us to look for opinions of many specialists. However, this conduct can also cause prejudice as sometimes it is difficult to establish and follow a sequence to diagnosis and treatment. Talk to your attending physician, expose all your doubts and questions and if you feel assured that you are being well cared, continue your treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 4 years old she is suffering from high fever for the past three days, her tonsils are inflamed and are red, she is wheezing as well with constant coughing, we are giving levolin .63 for wheezing , do we need to give her an antiboitic as her fever is not coming down ### REPLY: Hi Dear, Understanding your concern. As per your query your child have symptoms of high fever which seems to be due to strep throat which is a bacterial infection. It could be due to poor and compromised immunity of body. Need not panic about it. I would suggest you to 1) Avoid giving child spicy and rough food. Take diet rich in soft food.2) Sip on lukewarm water and take throat lozenges.3) In case of fever you can take Cal pol or paracetamol for relief as well as it will relieve throat pain too.4) Hot milk with a pinch of turmeric boiled with it at bedtime for 2-3 days as it has antimicrobial action. 5) Take anti-inflammatory . If symptoms keeps on persisting visit pediatrician once and get it examined. Maintain oral hygiene. Take proper course of antibiotics. Get blood tests done if required. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having stomach aches several times a day.  The usually occur about 20 minutes after eating.  I also have profuse sweating while feeling cold.  This has been going on since May and my doctor has not been able to identify the cause.  What do you think?  What are some of the less invasive tests I should have? ### REPLY: Hi, Having stomach aches several times a day, about 20 minutes after eating and associated with feeling cold might be related to: - duodenal ulcer- postprandial hypoglycemia suggest to: - run upper endoscopy-do abdominal ultrasound-measure your blood sugar at the moment when you have the pain episode and run other diabetes testing to exclude hypoglycemia. - do a complete blood work to exclude anemiaDepending on the tests results, specific treatment will be prescribed. Unless, you are taking any medication on regular basis. Hope it helped! .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently, I have been having Heart Palputations at night. I could finally be drifting off to sleep, then suddenly my Heart gives off a hard pump and wakes me up for a while. I have also been having pain in the area of my ribs, and deal with this daily. I have Winter Asthma, and recently I ve had to take the larger solution two to three times a day, and its usually because I ve been feeling weaker and numb in worrying areas, like the back of my skull, over my face, and in parts of my body. I ve delt with Acute Bronchitis recently and Acute Sinusitis, and those seemed to have gone, but my condition has gotten worse. Like, how yesterday, there was a large numbness all over most of my skull/brain, but after taking the solution, it went away and my body felt better, somewhat. This all started around a month ago, when we though it was just a cold or the flu. Then in the second week, I got Bronchitis and all those other things, the third week Ibwas getting better then had to go to the ER, and now its the fourth week and Im getting worse... I think my body isn t generating enough blood, and my body makes me take the solution to help my heart pump and send out more blood throughout my body. I have been taking 2 peptobismo chewbles a day, one in the morning, one at night, to help with acid reflux, and three Bayer s chewable asprins everynight, to help with rib and heart pain, and it worked for a while, but now its just nothing. I have also been getting ice cold on the inside, but hot on the outside. Breathing is so-so but its alright, but the pain in my ribs and heart hurt horribly everyday multiple times a day. I have also been somewhat stressing and may be gaining anxiety recently from all this, as I have never been sick this badly, so it s all new to me, and I had to go to the ER from an allergic reaction to a type of penicillin a week and two days ago, and this severe pain only started recently, on Jan. 29. The ER had given me Benadryl and a Cortiosteriod (May have miss spelt that) when I was there, and gave me more benadryl Take for 10 days as needed for allergy symptoms and I don t know if it meant I had to take them for 10 days, or when I had allergy symptoms. They gave me some more cortiosteroids to take two days after on Jan. 28. I did, and had a horrible pain attack that night, so I set up an appointment with my doctor on the 29. I went, and he ignored basically everything pain wise and didn t know about anything that was happening. In the car, the entire roof of my mouth was blue. Its been getting better from that, but its still slightly blue down the middle. I did a few errands, and by the time I got home, I was in so much pain, and then proceeded to have an asthma attack. Then ever since then, I had to take the solution once everyday, and the last 2-3 days I have had to take it more than one, ranging from twice to three times. I have tried exercising the past three/four days, where I go outside for a few minutes (5-10, really) and that really makes me feel better, but it always causes me to need the solution an hour or two afterwards. I also believe I am loosing large amounts of weight, which is slightly terrifying to me. I weighed myself early and as my normal weight was 180lbs before all this (The sickness has been going on for over a month now.) and I was 165lbs. I drink around 2-3 bottles of water a day, eat soup, a turkey and cheese sandwhich, some eggs and swiss cheese scrambled together with a tortillia and then bananas. Since I ve been having acid reflux, I stop eating large solid foods at 7pm, and stop eating in general and getting ready for bed around 10pm, but if I do feel extremely hungry (Which I ve been having problems with recently aswell) I eat a banana or some crackers. (Very few though, as I had a horrible reaction with acid reflux recently (When the heart palputations started, really) and thats also when I started getting really sicker and was pale yesterday,and in so much pain I almost fainted. I am going to go to the Doctor s in a few minutes today actually, and we re going to see what he says, maybe do an x-ray to see if I broke a rib, a blood test, to see if I have anything, like cancer, or low blood sugar/ High blood pressure/ anemia. So, If you nees to know anything more, tell me in the email or whatever you are going to send me, and I ll tell you and what the doctor will say. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you should first be relaxed and calm. Get done ECG, chest x and 2d echo to rule out heart and lung diseases. If all these are normal then no need to worry about major diseases. You all symptoms are mostly due to stress and anxiety related HERD (gastroesophageal reflux disease). HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of chest pain, burning, chest pressure, tightness etc. HERD can also worsen asthma and bronchitis. So we should first control your stress and anxiety to control your HERD. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Avoid stress and tension, be relaxed and calm. Take proton pump inhibitors and prokinetic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have falling hair since i was a teen and its only getting worse..homeopatChatDoctoredicines dont help. They make it worse..i have alopecia and thinning hair all over but specially at the crown..i have been advised proanagen freya and novophane plus.. But only textire has improved. No hair regrowth. Plz advise ### REPLY: Hello, Thank you for posting on . I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, acute or chronic medical conditions, . Since you have not mentioned relevant history and description like sex, pattern of hair loss(patchy/diffuse), family history etc., It's difficult to put a definitive diagnosis. Still, it seems you are suffering from either An ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ate a bunch of packaged cookies recently and I found out today that the expiration date of those cookies was 5 months ago. I slept through the night while itching myself constantly, and when I woke up this morning, I developed rashes in the areas where I scratched myself.. How do I make this rash go away as fast as possible? ### REPLY: hellos you have told that you have rash over the body with itching and the reaction was delayed after eating expire food this reaction is known as allergic reaction type 1the the best treatment will be to vomit it out, it its late you will have reaction till the food in inside your body and will finish when you will go to washroom take a bath will cool down the itching get any antihistamine like loratadine, biphenyl .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dr.samuel,i am 34 years old woman and i have a problem in my stomach since 2007.I feel pain and burning inside my stomach,its usually at its worst in the morning and after dinner.But its on and off pain.I had painkiller like panadol and some herbal remedies but its still the same.Hope you can help me please!THANK YOU. ### REPLY: Hi, thank you for your query. The complaints you give point towards gastroesophageal reflux disease (HERD) or "heartburn".HERD is usually caused by, impaired expulsion of gastric reflux from the esophagus.it may be triggered by consuming food in large quantities, or specific foods containing certain spices, high fat content, or high acid content and lifestyle choicest treatment of heartburn depends on the underlying cause. Medicines such as H₂ receptor antagonists or proton pump inhibitors are effective for gastritis and HERD, the two most common causes of heartburn. Antibiotics are used if H. pylori is present also healthy lifestyle changes like eating and sleeping at regular intervals and regular sleep patterns.thank you, wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, In December 2013, My younger brother met an road accident. After the Diagnosis in nearby hospital, He is suffering from brachial plexus.After the operation of brachial plexus, Now he is continuously going for physical therapy. The Doctor suggest me it will take 8-9 month for recovery as operation is done on March month. If he took Neurobion forte tablet everyday. It will be useful for quick recovery without any side effect. ### REPLY: Hello. I have been through your question and understand your concern. The mos important thing in these cases is the physical therapy. Other treatment have not shown any clear benefits, but are routinely recommended, because they sometimes can help. Still, if any side effect appears you should stop taking them. Till then, you can take them with no problem at all. Hope this helps. Please feel free using MHC again ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lump under my left armpit that hurts and when i squezz on it pulse comes out and it smells. i had one under my right armpit once before and i went to the ER and they said it was a boil. They cut it open then drained it...could it be another boil ???? ### REPLY: Hi, Dear,Thanks for the query to my  clinic. I studied your query in depth. In my opinion -it's another boil under your left armpit. Treatment-advised would be-a-Surgeons opinion b, under his cover-Tb-NSAIDs, c-Antibiotics-which would reduce the boil, and you would recover. If not you need to . Hope you have cleared your worry. Would welcome you to  for any more queries on it or on other health-problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hip replacement 7 weeks ago. 10 days ago i had a crush injury to the toe 2nd toe on the non surgical leg. I did a follow up dr. visit and found out the toe is infected, maybe staph? I am on sulfa drugs that seem to be working.I went to the emergency room because I couldn t get the injury to stop bleeding, within 4 hours. The emergency room doctor said my toe was bleeding from the inside, broken blood vessel.I was not given antibiotics at the emergency room. I am worried about having infection at the site of my new prostesis. did i catch it in time? can i ice my toe. I m keeping it elevated a lot. ### REPLY: Thanks for posting your query to . First I would like to explain to you that any minor internal bleeding stop spontaneously within few hours if there is no any other problem to you. Second internal bleeding leads to collection of blood at tissue of toes form hematoma, Chances of infection are present there so you should be alert about sign and symptom of infection like increase in pain, swelling, fever, malaise etc. So if these warning sump appear you should imminently consult to clinician, meanwhile do following thing :Prevent further injury. If there is skin breach . Take analgesic Paracetamol 500 mg two times a day .also you can use ice to get receive. Avoid prophylactic use antibiotic if you are not having any kind of infection. Hope you have got answer of your query. If you are satisfied with my answer kindly rate me. Feel free to further contact.regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having chest pain/tightness since last night and when I went to my doctor my blook pressure was 149/100, I felt dizzy and nausious (sp?).  My doctor was more concerned with my prior surgery than how I was currently feeling.  Rather than helping me, he basically interigated me to the point where I started crying,  In the end I walked out but I still dont feel well.  My left arm is still weak, I feel sick and Im light headed.  Should I be concerned??? ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain and give you my opinion. You should know that typical heart pains have some characteristics. They are usually retro-sternal pains likes quizzing, tightness or heaviness. They may irradiate to both arms, neck and jaw and last from 5-20 minutes. It is possible to feel tachycardia, difficulties in breathing deeply, dizziness, nausea.  Pains that last all day long are not typical heart pains. Sometimes stress might give a little high blood pressure and a chest discomfort. Even though, if I was your treating doctor I would recommend some examination to feel sure that every thing is all right. I will recommend an electrocardiogram, a cardiac echo to evaluate heart function and walls, a full blood analyze with cardiac enzymes and if it is possible a stress test and a holder pressure monitoring. After all this we can be sure for everything. So I will advise you to stay calm, it doesn't seem to be something to worry about but just make an appointment to do what I mention above. Hope I was helpful. Best regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 8 yr old son is suffring from astma. When he gets attach we give him levoline and seroflow pump as per dr suggestion. Now dr suggests us to give him half telekast l tablet every day. I am affraid about the side effects. Generally he gets cold and cough in 2,3 months. He has suffred with astma attach for 3 -5 times in last 2 years. Pl suggest ### REPLY: Hellos you have mentioned your son is suffering from Intermittent asthma. Management of this condition is inhalation bronchodilator (leveling or Aeroflot) as and when required. Montelukast is actually used in treatment of persistent asthma (attack more than one time a wk), sometimes physicians prescribe it in intermittent attack also because it reduces bronchial reactivity. Side effects of montelukast are very few like restlessness, irritability etc. I hope this answers your query effectively. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Please accept my answer in case you do not have further queries. Wishing you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir,i m 21 year old i miscarried last month 26 dec 2013.before that i had a pcod problem in sonography done 6 months before.then i started exercise for regulising periods. it worked  and i had periods near to date.and i got pregnant in nov lmp=12 nov with clomid 50mg.on the day of miscarriage my sonography report shown remark :uterus bulky size is ms,76*54*37 mm with thickened ET. ms.16.8mm. that was my first pregnancy. igot married before 2 years. please suggest me should i get D&C.?can i get pregnant soon? ### REPLY: Hi, Thanks for the first query. Size of the uterus and endometrial thickness will increase in pregnancy. After miscarriage, it will take some time for these things to come to normal level. As you underwent ultrasound on the day of miscarriage, that might have shown bulky uterus and thickened endometrium. As there are no retained products, if you are not having heavy bleeding, no need to undergo D&C. The endometrial thickness will gradually decrease. Possibly after next menstrual cycle it will come to normal level. Better to take at least two months gap for next pregnancy. By that time your reproductive organs will come to normal level and your general health will improve. After regularization of your menstrual cycle, track the ovulation and plan intercourse around that period. This will increase the possibility of pregnancy. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son woke up one morning with verdigo. He went to the dr. and he gave him an antibiotic and antihistamine. He is still having problems, especially trying to sleep at night. Can he try an over the counter sea sick med. while on the other meds or what is your suggestion. ### REPLY: Hi there, if vertigo is what your son is currently experiencing, I would recommend he try over the counter meclizine. I would either wait until the courses of the antibiotic and antihistamine are finished or ask your pharmacist what the antibiotic/antihistamine are and just make sure there are no known dangerous interactions with meclizine. It is also a bit sedating, so it may help your son sleep at night.  I wish you all the best and hope my answer was helpful for 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: Throughout the whole day my left chest and mid to upper left back has like a throbbing pain. When I smoke marijuana sometimes have panic attacks that feel like heart attacks. My heart races like crazy. And yes I have chronic anxietys throughout the day if I leave my home ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you are mostly having HERD (gastroesophageal reflux disease) related chest pain. But better to first rule out heart diseases. So get done ECG. If ECG is normal then no HERD is more likely in your case. Anxiety and Marijuana smoking are risk factors for HERD. They cause laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of chest pain, palpitations etc. So first quit Marijuana smoking. Stress management is very important to relieve HERD. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Take proton pump inhibitors and prokinetic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had underlying medical problems which have never been properly treated, i.e. hashimotos, salivary gland infection with stone, and now I started out with a severe sore throat 2 weeks ago, went to doctor, who took culture and claimed I had no strep--gave me nothing and sent me away. 3 days later my ear was painful and seemed clogged and my lymph glands in neck were swollen. again went to doctor, looked in my ear and would not give me any antibiotic or antiviral. told me it was a virus (how would he know--just guessing in my opinion) recommended Tylenol and sent me away. now my lymph glands are swollen and I realized I had just eaten so it may be in conjunction with untreated salivary gland problem. I note that hot compresses help, but shouldn t I get somewhere that I can get an antibiotic? if so shouldn t I ask for Pencillin than to mess around with all these derivatives? ### REPLY: Welcome to , Swollen lymph nodes occur due to infection. Inflammation and neoplasms. Investigations to find out the cause of enlarged lymph nodes needs to be carried out. However, simple investigation like aspiration cytology of the lymph node will help to know the cause of lymph node enlargement. In this investigation, cells are sampled from the lesion, spread on a slide, and stained with appropriate stain. This investigation helps to know the origin and character of the lesion. In case tubercular infection is present, the causative agent can be picked up and treatment for tuberculosis can be commenced. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am Sujan,I have been facing a problem since 6-7 months. when I do latrine every day in the morning or any time, when I pressure to do latrine a huge sperm come out from my penis. everyday I am facing this problem. but Its not come out when I do urination,just the time of doing latrine...... ### REPLY: Welcome to  ! Do not worry about it. This happens especially when person suffers from constipation or passes hard stools. When you apply pressure, hard stool gives pressure on prostate gland and seminal vesicles, causing this fluid to come out. The most important thing is to ensure your water intake is adequate at least 2-3 liters per day, if you sweat a lot then still more. Increase intake of dietary fibers-salads, fruits. Avoid fried, spicy foods. Take laxative for a week. Exercise daily for minimum 45 -60 minutes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i had a chest xray after having some tightness around my chest and these are what was found: -Prominence of both hilar regions with lobulated densities suspicious or hilar lymphadenopathy -Mild widening of the superior mediastinum suggesting possible additional mediastinal lymph node enlargement. - the lung fields and pleural spaces are clear What does this mean and should i be worried? ### REPLY: Thanks for your question on . In my opinion you should get done CT THORAX with contrast. In your chest x-ray bilateral him are prominent with widening of superior mediastinum. This suggests enlargement of lymph nodes in Hilary area and superior mediastinum. Chest x-ray will not clearly tell you about these lymph nodes.  As bony sternum is overlying it and makes difficult to interpret. So CT THORAX is needed for better evaluation. This will also give you the idea from where biopsy can be possible. So CT will give a lot of information for diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up this morning and hoped out the bed when I went into my closet my left leg gave out making me fall to the ground I got back up and walked to the kitchen to grab some water and my left leg felt like it feel asleep should I go to the doctos office? ### REPLY: Hello, I think if this problem you are experiences does not go away within 5 minutes then is a serious problem, and you should see a doctor. The giving away of the lag and numbness happens if you slept in an award position compressing the sciatic nerve, but that will resolve within 5 minutes after you change position and walk. If not then there are some other causes more serious such as bleeding on the brain or stroke or brain tumor etc. which need a doctor evaluation.I wish it is the first case and not the later 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: I have multiple pulmonary embolisms in right upper and lower lobes, only symptom prior to diagnosis SOB. Hemoglobin 10.5, eosinophils low, otherwise CBC within normal ranges. 53 years old. No DVTs, no history of PEs, facotr V leiden negative. Im trying to figure out cause. Some physicial changes point towards Cushings. Have history of parathyroid adenoma. Worried about malignancy. ### REPLY: Thanks for your question on . Pulmonary embolism without DVT (Deep venous thrombosis) is less likely due to malignancy. So no need to worry much for malignancy as a cause. There are other causes like1. Connective tissue diseases2. Storage diseases3. Primary pulmonary hypertension. 4. Protein C deficiency. 5. Protein S deficiency. 6. Hypervitaminosis k.7. HIV infection etc. So better to rule out these causes first. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 years old. Last week I was hospitalized after being in severe pain and diagnosed with kidney stones . 5 of them. I have had kidney infections about every 2 months for years, always thinking it was because of drinking soda . After this episode I noticed very dark purple bruises on my thighs. Only on my legs no where else. I am realizing that I ve had these same bruises a lot. And usually around the time i am having kidney trouble. They go across my thigh and some are round. Very large, dark purple, but do not hurt. And opinions on what this could be caused by and what I should do? I have pictures if needed. ### REPLY: Hi, many thanks for the query! You need to do- USG PUB, X-ray PUB, CBC, FT, Urine (Culture & Sensitivity). You haven't mentioned size & location of the stones. Till then take antispasmodics, diuretics, painkillers, with your doctors opinion. Take antibiotics as per the report of Culture & Sensitivity. . See your Dermatologist for dark purple bruises on your thighs as these doesn't seem to be related to kidney stones/infection. Wish you a good health. Take care. 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 took ampicilin for five days 500mgs every eight hours. My last pill was on Friday. Had unprotected sex on Monday took plan b within ten hours. I ve been on bc for almost five months have not missed one pill at all I take it everyday at the same time. How protected am I from pregnancy? I m stressing big time! Please help ### REPLY: Hello dairy understand your concernAmpicillin generally decrease effectiveness of the birth control pill and cause pregnancy. But you have used posting 2 with in 10 hours and also on regular use of the birth control pill, so there is no chance of the pregnancy. No chance of the pregnancy as you used double protection. Avoid stress, take healthy diet, . Hope this may help noncontact  for further heath query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I m a 56 year old male with some shoulder pain. Not sure what it is, maybe arthritis, rotator cuff or a combination of the two. I take blood pressure medication and a low dose aspirin per day. A friend I train with mentioned Glucosamine & Chondroitin w/MSM for joint health. Should I be concerned with taking this with my pressure medication. In your opinion , is it worth? ### REPLY: HiT hank you for asking . I have gone through your query. Shoulder pain can be due to frozen shoulder which is common for your age, or even it can be rotator cuff tendinitis or tear. Rotator cuff tendinitis is associated with pain for certain movements. Frozen shoulder is associated with pain and stiffness of movements in most of the angles. A physical examination by an orthopedic is well appreciated to rule out the condition. X-ray followed by MRI of shoulder might be required in case of positive signs. Glucosamine and Chen .  You can take it if you have osteoarthritis which will evident in X-rays. Hope this may help you. Let me know if anything is not clear. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, my 10 year old son has been running a fever above 100 the last 3 days now and i have been alternating back and forth from Motrin and Tylenol. He has been having diarrhea as well with cough and running nose. What else can i do. I took him ti urgent care and they tested him for strep and it came back negative. I am just concern about all this pain meds going into his body for so long. ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump that feel bruised on my shin and can feel slight pain when I walk. It has been there for 2 months and doesn t seem to be getting any better. Should I be worried? I can t recall banging my shin although I could of done so rushing around but forgotten about it ### REPLY: Hi.noted history of painful lump on your shin. It may be a fibrous (fibrous tissue formation), lipoma (fatty deposit) or a cystic formation (sebaceous or gelatinous). It is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. Diagnostics such as X-ray and/or MRI will be requested accordingly. Management (medical and/or surgical if indications are found) will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got my wisdom teeth removed a month ago. I ended up getting dry socket and an infection so the doctor gave me more medication. I started to heal and even flushed out the sockets. Not I have a lump along my jawline that is tender to the touch. Is it possible that food got stuck in the socket? ### REPLY: Thanks for your query, I have gone through your query. The lump over the jaw line can be because of the infection of the bone that is garret osteomyelitis. Nothing to be panic, complete the course of antibiotics particularly amoxicillin and metronidazole combination. Keep the socket area clean by rinsing with saline. If it is not reducing in a week, consult an oral physician and take an causal radiograph to confirm the diagnosis. I hope my answer will help you, 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: Been sick for month,Dr. first said ear infection,throat infection and Bronchitis.Now on third antibiotic-Avelox,cough is better,swollen glands went down,but still fatigue,fever blisters healed but gums are different in mouth and have white spots on lips....should I see another doctor? ### REPLY: You have not mentioned anything about the lab investigations that were done for you. Were any samples/swabs collected from you? Was the causative organism determined? What are the results of the antimicrobial sensitivity tests? If none of these were done, and you were prescribed antibiotics just on the basis of a physical examination, then you should definitely see another doctor. Just taking one antibiotic after another without ensuring if the antibiotic is capable of attacking the causative bacteria will not help you. The lesions on your gums and lips are probably a fallout of prolonged antibiotic treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Advanced liver mets + jaundice from HER2+ metastatic breast cancer. 2 weeks ago SGOT- 650, SGPT 350, Bilirubin 18.Now SGOT- 390, SGPT 190, Bilirubin 24. Patient on weekly Herceptin (150mg)+ carboplatin (100mg) dose since 2 weeks. Taking ciprofloxacin and linezolid for infections.Advice request: continue carboplatin OR change chemo OR which tests to determine next steps.What might be causing increase in bilirubin? Please suggest. ### REPLY: Sorry to hear about your problem. The most probable cause for rise in bilirubin is metastasis to the liver. This can explain the rise in the enzymes and bilirubin. This can be confirmed by a simple ultrasound of the abdomen. Metastatic breast cancer can be quite challenging to treat. Carbonation and Herceptin are some chemotherapy agents used to treat such a disease and do not lead to a rise in liver enzymes. As the patient is HER positive, it is prudent to continue Herceptin. If the patients' disease is progressing on carbonation, you can discuss the change of this agent with your oncologist. Hoping for the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m 33 weigh 135 lb height 5 3 and im 5 months pregnant and have cramps with light pink discharge. What could that be? My second main question is what can I do about my panic attacks, I don t take anything since I found out I was pregnant. Before I was pregnant I was taking gabapentin and trazadone. Please help me. ### REPLY: Hello dear, I understand your concern. In my opinion the pain abdomen with pink discharge needs to be evaluated. The physical examination needs to be done to check for any cervical changes and any threatened miscarriage need to be ruled out. The causes for this like any thyroid abnormalities, progesterone insufficiency, any short cervix should be found.Don't worry once the cause is treated it will subside. Avoid stress, physical strain and intercourse. Take adequate fluids up to 3 liters per day as deny . My aim is not to make you tense but just giving you the probable suggestion. Ultrasound helps in knowing the status of pregnancy. So I suggest you to consult doctor for further work up. Hope this helps. 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: Hello, i had done my ivf embryo transplant on 23rd wednesday, march 2011. when shoule i be getting the positivity for pregnancy??? today is 30th march, & i did my ChatDoctor urine test , it showed nagative. what is my dpo day today??? my last period was on 27th feb.2011. please answer my 3 questions in detail thanks, ### REPLY: Hi Welcome to  If embryo transfer was done in same cycle after ovum pick up then you can do beta  on 12th day, counting day of ovum pick up as first day. Kindly mention in detail which day ovum pickup was done and which day embryo was transferred.  Beta  becomes positive about 12 days after egg retrieval, 9 days after a day-3 embryo transfer and 7 days after a blastocyst transfer, the woman should have a quantitative beta  blood pregnancy test performed.  Urine test will be positive only one week after serum beta . Take care. ### END