Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 history of cold sores, and am currently dealing with an outbreak.  I have been using Abreva, but I believe there is an infection because my lip and glands under my chin are extremely swollen.  The sore is not healing as quickly as it should be.  This has happened in the past and my doctor prescribed an antibiotic to help with the infection so it didnt spread.  What antibiotic will help with this that I could call into my doctor for? ### REPLY: Hi. Can understand your concern. As per your complaint cold sores are caused by viral infection, and it is a HERPES SIMPLEX VIRUS 1. The virus can remain dormant within the nerves and can get re-activated at any point of time and can cause an outburst. The severity of the symptoms depend upon the severity with which the infection has occurred, and it is not always necessary to have mild or severe symptoms and can vary at every outburst and in cases when there is some reduced immunity of the body the infection can occur with higher severity. As the antibiotics acts only against bacteria so taking an antibiotic for viral infection can no way cure the infection. Swollen lip and submental lymphadenopathy or swelling can be due to infection outbreak only. I would suggest you to consult an Infectious disease specialist or a dermatologist and get evaluated. You will be prescribed with oral anti viral like Acyclovir and Acyclovir for preventing further outbursts. Although the antivirals do not cure the current infection, but it prevents the further outbreaks of the infection. Applying Rivera which is a topical antiviral ointment can help and should be continued. Avoid making intimate contact wit other individuals as it can cause them infection as well as use personal things like towels, utensils etc. without sharing with others to prevent transmission of infection as it is a communicable disease. Hope this information helps. If you find the answer helpful kindly write a positive review and click on found this answer helpful as a token of appreciation. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doc my husband is dx as severe oligospermia.. He is using lineator capsules and b rich capsulees now which doc has prescribed for 3 months.. We hav been trying for children from two years.. But not worked out till now... Are they useful in improving count nd motility.. R else wat wud b best ### REPLY: Dear member, Thanks for writing to . The medication mentioned improves the count in most cases. It is important to check for causes of low count and treat it. Only linear will not help if other factors are present. Following investigation required. Thyroid profile. FSH, LH, TESTOSTERONE. Scrotal ultrasound and Doppler for varicocele. Detailed semen analysis and semen culture for infectionPlease write back with these reportsThanks .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 47 years old and was recently diagnosis with type 2 diabetes and recently I noticed I have bad vaginal itching only in the evening. I went to my doctor several times and they said it might be the soaps but I have used the same soaps before it. Can you please tell me what can cause vaginal itching? ### REPLY: Hello and welcome to ChatDoctorI have read your query hope this will helpDiabetic patients have decreased immunity to counter infections. Often in female diabetic patients vaginal itch secondary to infection is the only presenting symptom at time of diagnosis... You might be having VAGINAL CANDIDIASIS which is very common in female diabetic patients... I will advise you to visit a gynecologist and have your vaginal swabs taken for examination. And receive medications according to the results. Meanwhile, good diabetic control and local hygiene are necessary. The response to treatment is excellent most of the time. Thanks .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 48 year old Male 2 years removed from an open appendectomy and subsequent pyogenic liver abscess. My surgical incision for the appendectomy healed by second intent and my issues with the Liver abscess were resolved through drainage and long term administration of antibiotics.  My only other surgery was a vasectomy approximately 10 years ago in which my only subsequent complication was a sperm granuloma that developed and resolved over a few weeks.  Now to the present.  Since my abdominal surgery I have developed numbness in my outer left thigh which occassionally cause a tingling / prickling sensation.  I have also developed some sexual issues including difficulty getting and maintaining an erection a reduction in the volume and intensity of ejaculation, and many times, I will have a pain in my lower abdomen at the moment of ejaculation.  I have noticed a decrease in sensation in my penis such that I have difficulty obtaining an erection even through masturbation.  I have explored these issues with my family physician, but it is difficult to know where to head with it based upon whether I am dealing with separate issues and causes or maybe just one cause.  For example, I thought that maybe the issue was nuerologic due to a compressed nerve, but an MRI failed to reveal any such problem.  I thought my problem may be related to trauma to one of my abdominal nerves during surgery, but my physician seemed to think this was unlikely.  I had tests done for my testosterone levels and prostate and all revealed that I was well within normal limits.  I even treated on antibiotics to see if the condition might be prostatitis but it really had no impact.  I am really not looking to circumvent my own doctor, but rather searching for ideas on what the best course of action, process of elimination or method of obtaining a differential diagnosis might be.  Can you help? ### REPLY: Hi, Id agree with your surgeon. It's unlikely your pelvic nerves were affected during the surgery or the liver infection, as the nerves in this area don't travel to the penis. Are you diabetic? This can sometimes have an effect on nerve function, and diabetics can have neuropathy, which causes nerve dysfunction. Another possible cause is this could be a delayed complication of the vasectomy.  If an MRI showed no issues, then it could simply be due to primary erectile dysfunction. Another possibility is Erich syn .  This is due blockages in the internal Iliad arteries, which give blood supply to the pelvis.  A CT Angiogram would help diagnose this. (MRI would not show any potential blood supply symptoms). This would particularly be a problem if you have a history of high blood pressure, coronary artery disease, or any smoking. I hope these other ideas are helpful. Please let me know if you have any further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr. Since 3 months, my 29 monthls old baby is not able to free motion. When i consult pediatric, he has priscribed EVCIT syrep. eventhough it is not working fine. Can you suggest what syrup can i give for free digestion. Thanks in Advance, Bhanu Prasad ### REPLY: Hi Read your question Connection in child is common in some baby. U have to give her lots of water a day. And also food contain fiber which are cereals, pulses, banana, apple with piles, almond, walnuts Boil Potato with his skin EVICT is not responding then use Lopez sachet of fourths company Dose :One sachet at night with one glass of milk It is given for 15 days then gradually stop But first u have to regulate her diets And follow your pediatrician advice ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 20yr male an about 2 days ago i started gettin real sharp pains in upper abdomen the fades down an feels like a lot of pressure  I get the pains every 5 to 10 mins Ive lost my apatite my stomachs rumbling but I feel full an Ive got this crazy smokers like cough an Ive never smoked in my life Im goin on day 3 of the pain.  Does this sound like a serious problem that I should go see the local doctor ASAP? ### REPLY: HelloThanks for writing to ChatDoctorYes, you need proper clinical examination by a surgeon and need few investigations. There may be various causes for pain. It may be due to cholecystitis, pancreatitis,gastric ulcer etc. Investigation includes routine hologram, RBS,LFT, RFT, Ultrasound of abdomen, Urine RE/ME, Chest X-ray (PA view). Ultrasound of abdomen can exclude many conditions. Proper treatment depend upon clinical findings and investigation reports. Hope I have answered your query. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m new to taking Althea contraceptive pills. My dermatologist recommended it to me for skin improvement and if possible also for birth control. 1. Would a contraceptive vaccination be better for birth control? Would it also have the same effect on the skin as althea pills? 2. What type of contraceptive vaccine would have the same effect as althea? 3. In the simplest sense, how should I take the althea pills? Will I still expect menstruation when I use them? And when would sexual intercourse be safe to do the moment I start taking them? Thank you! ### REPLY: Hello, and I hope I can help you today. The Althea contraceptive contains a combination of estrogen, progesterone and an ingredient that is an anti-an .  You take the pill every day (at the same time if possible) every day for three weeks of the month.  For one week a month, you take no pills, and should have your period start during this time.  You should start the pill on the first day of your next period, and it will protect against pregnancy immediately.  Birth control pills are 99 percent effective in preventing pregnancy, and usually give you a short, light period every 28 days or so. So you finish the three weeks of pills, and then start a new pack exactly 7 days after you finish the old one. The birth control injection, called Demo Proverb, has only the hormone progesterone in it, so it doesn't have any known benefits for your skin.  You get the injection every 3 months and usually the shot causes spotting and irregular bleeding for the first 6 months followed by no periods at all.  The shot is nearly 100 percent effective and you don't need to remember to take a tablet every day, but many people dislike the injection due to the bleeding side effects. I hope I was able to adequately answer your question today and that this information was helpful to you.  You can also google Althea and read the instructions for taking the pill on the pharmaceutical website. 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, my husband was diagnosed with pancreatic cancer a year ago. Went through whipple surgery. Nov he went into remission until just yesterday when we found out that ithas come back and spread to liver, abdomen and nodes. He is now experiencing severe chills and shivers. Is there anything i can do to calm them. Thank you, Jennifer Verges ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He had pancreatic cancer, and now he has remission with metastasis to liver, abdomen and node. It becomes stage 4 cancer. Surgery will not help him now. Only treatment of choice is chemotherapy and radiotherapy. But it will not cure the disease. It is just palliative treatment. Despite treatment prognosis is not good. Life expectancy is not good in these cases. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, my name is Maureen. I had Uterine synechiae following my miscarriage on 5/8/12. It has been treated and i took in last yr March. The pregnancy resulted into Ectopic in which my right tube was removed on 23/5/13. Since then, i ve not be able to take in. What are my chances of taking in again. My left tube is okay. ### REPLY: Hello Ms. Maureen, I have gone through your query and understood the concern. It is so sad that the conception resulted in an ectopic pregnancy. In the current scenario, the tubal motility of the remaining tube, its patency and the status of the endometrium, whether it is capable of holding an embryo safely etc., should be evaluated by an expert in high risk pregnancy. You may need to take a break temporarily to allow proper tissue repair. Once healing is done, given the parameters are good enough, you can try for another pregnancy. As you have no ovulation defects, your chances of conception are good if the tubal function is normal. Hope your query has been clarified. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there my gp believes I may have kidney stones and is awaiting a ultra sound to confirm this over the last 4 to five days I have had pain around my belly button and off to the right side of my body and around to the middle of my back am I mistaking this pain for a possible appendicitis or are this more likely the kidney stone thing the pain in my lower front is like the feeling of having a bug and needing to pass a bowel motion.If this is kidney stones I long can I expect this discomfort/pain in my front/side/back to last ### REPLY: Hi, Kidney stone has symptom of pain which may be sharp / dull aching type at lumbar region on same side which may / may not radiate to groin thigh testicle/ labia umbilicus mostly during early morning but may have any time associated with nausea vomiting. Someone there is no pain abdomens.  Pain of appendicitis occurs at rt Iliad fossa or MC Burns point or umbilicus may be gross of dull aching /cramping type mild to severe in intensity associated with nausea vomiting.  Pain abdomen needs to be examined clinically and accordingly investigated including USG, X-Ray and later CT scan of whole abdomen.  So in my opinion wait for USG report and till then take plenty of fluids , analgesic (NSAID), anti-spasmodic, PPI (as your GP must had prescribed). Hope this ll help Thanks n 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 iam 35 yrs married women. i have regular periods, still my Dr suggested me a femilon tablet is their any side effect & we are planning for a baby is any problem to get pregnant? my friends told that taking femilon tablet is very low to get pregnant is it right please suggest me.. ### REPLY: Hi, Femilon is a birth control pill. It is taken to avoid pregnancy. If you are planning for a baby, you should NOT take this pill. Were you pregnant any time before? If you have had no pregnancies before and if you have been trying for pregnancy since 6 months, you should consult gynecologist and get baseline subfertility investigations done (hormone tests and fallopian tube patency test for you and semen analysis for your husband). Take a tablet of folic acid daily. I hope I have answered your concerns. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 small soft lump on my neck under my left ear.  It is so small the doctor could not feel it but i can.  Additionally, I have had shoulder, neck pain and my left arm and face tingles at times.  I told the doctor about this too.  She says its not fibromyalgia and I must be dehydrated because it really only comes in the winter.  Are these unrelated or should I see an orthapaedist, rheumatologist, or chiropractor.  P.S. I have a lot of srtress is my life now ### REPLY: Hello and welcome to , A small lump below the ear can be due to lymph node enlargement. An aspiration cytology of the small lump needs to be done. In this investigation, cells are aspirated from the lump with a needle. The aspirated cells are spread on a slide and stained with appropriate stains. Examination of these cells will determine the exact nature of the lesion and hence treatment. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So my mother fell down two flights of stairs at the post office just over 2 weeks ago. She went to the DR. immediately and got an xray nothing is broken but she has since lost the functionality of her arm. it doesn t hurt all the time but just when she tries to use it. I am worried about her she has her arm in a sling and has been resting it. She has no insurance and I told her to alternate ice and heat on it for 10 minutes out of every hour. Is there anything else she can do? ### REPLY: A problem which needs attention from the physiotherapist !!perhaps your mother is about 50 +, and as she fell the whole body weight must have been taken by the shoulder. In such injuries the damage is due to injury to the muscles and nerves. So the movements become painful and restricted. So, at this time a consultation with an or tho / physio would be helpful, as a diagnosis is essential. You are doing well with rest and heat to the part. But gentle exercises must be started such as taking the arm out, small circular movements with the arm hanging in front of the body, taking the hand to the back of the neck, You will agree that these are best demonstrated and taken up in a gradual manner. To help in local repair you may use Diclofenac cream massage, three times a day after local fomentation. The cream used should be up to the middle crease of your index finger. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, My age 26. I have heavy anxious mind. one day I saw car accident and many death of man. I was suffering huge anxiety . after that day i am feeling overhead headache and my ear is closed. If i take antidepressant medication such as Clonazepam 0.5 mg, I am feeling good. after taking one month when i leave this medication. after i am feeling same overhead headache and ear close. I have no hyper or hypotension . Can you please help this. ### REPLY: Hi, welcome to  Probably you are suffering from post-traumatic disorder. In this disorder patients have severe anxiety after exposure to a stressful event, and anxiety may manifest in the form of somatic symptoms like headache and ear close. It is treated by use of antidepressants (clonazepam is not an antidepressant) like sertraline, Escitalopram, fluoxetine; along with psychotherapy. Treatment should be continued for at least 6 months. So you should consult with a psychiatrist for a proper treatment as longer duration use of sedatives like clonazepam will make you dependent on it. Best of 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: It is my feeling that my wife of 46 years hangs on to too many things. She many collections . Our pantry is filled with excess food and she constantly buys more food than we can possible consume. We have 3 sets of steak knives, for example. We have just slightly downsized in to a new house. She did get rid of a lot of stuff. But, she is trying to cram everything else in to the new house. It s my feeling we re overstuffed now, and there s a huge amount of items laying around and half of a two-car garage full of additional items. I don t know how to approach her on this so that it results in a positive outcome. I ve tried bringing it up and she just gets angry. ### REPLY: Degree understand your concerns went through your details. In psychiatry / psychology we call it Compulsive buying disorder (CBD), or Monomania. CBD is characterized by an obsession with shopping and buying behavior that causes adverse consequences. Compulsive shopping may be considered an impulse control disorder, an obsessive-compulsive disorder, a bipolar disorder, or even a clinical addiction, depending on the clinical source. Treatment involves becoming conscious of the addiction through studying, therapy, group work, etc. Treatment with medicine has limited success. You should consult a psychologist for counseling and Cognitive Behavioral Therapy. Take care. 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: have 100 with chills for last two hours, starting saturday extreme pain on right side of neck going down right side of back, also fullness in spleen area (have slightly enlarged spleen_...I have severe erosive gastritis and cirrhosis...do i need to go to ER yet? ### REPLY: Hi welcome to . After going through your query my opinions is that you are suffering from disc prolapse/ cervical spondylitis. Have an MRI of cervical spine done. Avoid lifting heavy weight, pillow. Start Hales regime physiotherapy for neck. If pain is very severer than wear soft cervical color and start physiotherapy as soon as pain resolve. Take analgesics, muscle relaxants, hot fomentation. Visit orthopedic surgeon. For your problem of cirrhosis and spleen visit gastroenterologist. Hope your query get solved. Welcome further queries ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 17 years having ZEPTON - 100mg morning and 100 at evening for one week, advised to have 200/200 for second week and 300/300 mg for following third week until next doctor s advise. She has convulsive disorder with CP seizure. Above medicine has been prescribed by Neuro physician, before right after having seizure we had immediately rushed to visit Neuro surgeon and as prescribed by him, daughter has been taking Lavera 1000/1000 bd with valparin 500 bd for week. By next week physician asked to stop above drugs. Having Zepton cr her unconsious frequency has reduced and yesterday she fainted 10 times. She would cry, laugh and speaks about some issues at the stage of unconscious. She is absolutely unknown about all shorts of these activities. We would love to know, after how many days my daughter would be perfect to see her teachers at her college. Doctor please advise us what should we do ? Would you tell us when the seizures will be stop? ### REPLY: Hi, Thank you for contacting . Your daughter is suffering from complex partial seizures (a type of epilepsy), as per the description you have given. Treatment for epilepsy is long-term, and the medicines need to be continued for at least 3-5 years and in some cases, even lifelong. However, improvement is seen within a few weeks of starting treatment. It may be reassuring to know that a person with epilepsy can have totally normal life, including education, job and married life. The choice of .  All medicines that you have mentioned such as SEPTAL CR, LEVER and VALARIE are good  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ve had a bump on my leg for years. Every now and then it itches and the top layer of skin will slough off leaving a red exposed wound. It only bleeds if I squeeze or pick at it, but I can tell it s an actual hole and when the skin heals there is still a bump, but the last month or two it won t heal. It scabs over, but itches and if the scab comes off there is just a hole that oozes clear, sometimes red. But it won t go away. It keeps busting open, then healing, then busting open again. I can see under the layers of my skin. It s the size of pen tip just about. ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear You seem to suffer from Venus Ulcer with Eczema with accompanied dermatitis, which explains the typical history of your case. Proximity of the shin-bone and the Venus lump of legs causes repeated crusting / scabbing / itching and oozing wounds with a pen tip hole over the wound. Color Doppler study would fix the DVT or the incompetent perforating vein which is causing this Venus Ulcer in the Saphenous Vein System of the leg.ELT(Endoscopic Venus Laser ablation Treatment of the incompetent valves with Polyvinyl springs blocking the feeder vein would fix this Venus Ulcer wound with Venus Eczema in your case. Treatment of the perforator vein to block the Venus lump would resolve the issue for lifetime. Rest/Elevation/Veno-Stockings with antibiotics and wound care prior to planned ELT with spring or Polyvinyl balls embolism blocking the feeder vein would be needed in your case. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my lower back usually is sore. Im only 17 and already have back pains. But today, Ive been having lower pains by my spin, but of to the right a little, near my butt. Usually when I have back pains, I lay on a hard flat surface and it feels like my back shifts into place, but this time when I did it, it cracked about 7 times, then I felt a major pain so I rolled over to my stomach, cried for a few seconds, and stood up. I thought the pain was gone, til I started walking around again? I already been told my back was mis aligned. but I have no clue what this is. ### REPLY: Hi, Thanks for posting your query. From description, it seems you might be suffering Mechanical back pain. It is a common medical problem. Mechanical back pain implies the source of pain is in the spine and/or its supporting structure. The surrounding muscles and ligaments may develop reactive spasm and pain.1. Lie on hard bed2. Taking muscle relaxants in combination with mild painkillers will help you.3. Hot water fomentation to back 2-3 times a day and applying a local analgesic gel on the affected area will also help in providing a relief.4. Physiotherapy - Inferential therapy (IT) to your back will help you relieve the pain5. Avoid .  These activities can increase your back pain. You can start with swimming and mild aerobic exercises. These do help a lot in the back pain. Do adequate warming up before starting the exercises daily. Taking calcium and vitamin D 3 supplements will also help in early recovery. You can get these prescribed from your orthopedic. Hope this will help you. Feel free to ask me if you have any further queries. Wish you 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: Had every blood test .kidneys. liver.all that blood work all fine. Biopsy of uterus. Ok. Mri of brain . Lumbar. Cervical.  All fine. Disk bulges in neck and lumbar. Cbc ok white cell count down very little. Have bone scan tomorrow.  Do you think  I could have bone cancer?  Always have chronic pain in body. Legs arms neck. Pain all the time. Very scared.  Been reading on line about bone cancer. Did markers for  arthritis. All fine.  Please help me..:( very scared! ### REPLY: U have not mentioned anything about your age. From history I can assume u as female. I would like to know whether u attained menopause. If so the calcium level may be less, and it can also cause the symptoms mentioned in your question. The chances of it being bone cancer are very rare. Anyway you get your bone scan done and c whether the bone mineral density is fine. Ur basic problem is fear. U have read something from net and is worried about that. For your satisfaction and to be confirmed THT u don't have bone cancer u can take a PET Scan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 56 normal BMI coeliac disease (well controlled) and have had intermittent Lt anterior thigh neuralgia type pains, no obvious precipitant, last a few seconds up to a minute, varying severity. Goes away for couple days then reoccurs. No weakness no other symptoms. Any ideas. ### REPLY: I'm sorry to hear about your concerns. Likely the symptoms in your left thigh and your well controlled celiac disease are unrelated. Now if the symptoms are more anterolateral on the thigh this could represent neuralgia parenthetical or lateral femoral cutaneous nerve compression. If the symptoms are strictly anterior this could relate to lumbar articular pain, or pain due to nerve root irritation/compression in the lumbar spine (likely L3 or L2). You should make an appointment with your PCP or an interventional pain physician to be examined and possibly attain an MRI. I hope this helps you and I hope you feel better soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 26 yr old woman, i am got cough and cold almost once in two months from last last 6-7 months and some times breathlessness also, my esr value is 32 mm/hr.. what does it mean? is there any serious type of infection? Is it curable by taking antibiotics? ### REPLY: Hi. I can understand your concern.  Chronic cough is commonly seen in bronchitis and lung infection. Since your chest x-ray is normal, no need to worry about lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. 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: can cilacar 10 is appropriate medicine for treating isolated systolic hypertension without reducing the dyastolic hp and heart rate. I am aged 72 YEARS - A DIABETIC PATIENT TAKING INSULINE 30 UNITS AND UNDERGONE BYPASS SURGERY 11 YEARS BACK IN 2004? ### REPLY: Hello. Thank you for your question. I read your query. Clinidipine and other calcium channel blockers that do not act on slowing the heart rate may be effective as a single- .  However, every measure that is made to decrease the workload of the heart, helps it maintain its function better. The aim for blood pressure levels in a diabetic patient is to keep it less than 130 mmHg systolic and 80 mmHg diastolic. Depending on your blood pressure levels, I would recommend adding a  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 space out a lot, and when I do its like im brain dead and i just stair at a random point and after a while my eyes will start to go blurry. I snap out of it when someone says my name or I hear a loud noise that scares me, but sometime someone will have to say my name 3 times before I snap out of it. Is there something wrong with me? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  From the description, I do not think there is anything wrong with you. Such scenario happens with every one. When we are preoccupied in some thoughts, we cannot notice what is happening around us. That is not a mental disorder, but just what we are made of. I also can see you are exaggerating your symptoms. Forget it. Don't even think that these are abnormal. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my lower right stomach is hurting. when i walk, move, poke it, or inhale a deep breath. it hurts when i poke it but feels better when i relise it... ive been quite gassy today as well. I dont have a loss of appatite and have not vomited... no fever, just sharp pains sometimes and they get better and worse. it has been happening when I woke up this morning. the more i move the worse it hurts... AHHH!!! what is wrong with me? ### REPLY: HI. Thanks for your query and an elucidated history:: I have read your history and understood the problem. The probable causes of such pains as you have described can be due to the following reasons ::-Hernia with stretched muscles as you do not have intestinal symptoms.-Nephritis, meaning inflammation of cecum.-Rare chance of a mass in the right lower abdomen or appendicitis. I would advise you the following:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen, *Colonoscopy This is imperative as the mildest of the symptoms can have hidden big problems. So do not take this lightly ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 actually have regular chest pain and have been attending hospital for a while they have told me i have water in my lungs and swelling on my feet. i alos feel as if there is something wrong with my kidenys. when i have chest pain i actually cant breath proparly and my skin goes paler. please could u give me some advice ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, we should definitely rule out heart and kidney diseases for your symptoms. Heart (congestive heart failure CHF) and kidney (renal failure) diseases cause pedal edema, pulmonary edema (chest pain and breathing difficulty). So better to consult doctor and get done blood pressure monitoring, ECG, 2d echo and stress test (trade mill test) for the diagnosis of CHF. Get done ultrasound of kidneys and renal function test (RFT) for the diagnosis of renal failure. Treatment of these diseases are different from each other. So better to consult doctor and first diagnose and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I just got off the implanon a wk ago, and I had gotten off my cyclea 2days before removal. 8 also had sex the night before removal and the night of removal. I started to bleed a day after removal for 3 days, and I have been havin flu like symptoms soar throat,  chest hurt, headaches, I also been nauseas,  and light headed and dizzy,  could I be pregnant ### REPLY: Hi, Thanks for the query. The possibility of pregnancy is less in your case, as when you had intercourse you were still under the effect of the implant. The bleeding you got after removal of the implant could be with .  If you do not had intercourse after removal of implant the possibility of pregnancy is very less. The symptoms you mentioned could be non-specific due to some other cause. If you do not get periods one month after with ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 daughter is 7 yrs old she has been bittne by a 4 yr old dog that has a history of roaming loose in the neightborhood all hours of the night. animal control confirmed with me yesterday that the dog has no current rabbies vacine, my daughter has about 15 small puncture marks and three large claw scrathes all of which bleed some have gotten swollen and red. its now going into day three of injury. the local er says no need to have anti rabbies but I dont agree with them what are your thoughts. She ran a fever in the first 24 hours and then has vomited from the augmentain she cant keep it down?? ### REPLY: Hello In my opinion Your daughter should get anti rabies vaccine as early as possible. Post exposure prophylaxis of RABIES. Human rabies immune globulin (RIG). Administer 20 IU/kg body weight. If anatomically feasible, the full dose should be infiltrated around and into the wounds (as she is having 15 small and 3 large wounds, so this is feasible) . Vaccine=== Human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCEC) 1.0 mL intramuscular (I M) (deltoid area), one each on days 0, 3, 7 and 14. In my opinion anti rabies vaccine in most important for your daughter. Get it as soon as possible. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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,My daughter is 18 months old. She had a lump in her left breast. A local doctor advised us to have some lab work done for her to check for precocious puberty. I went two different labs for the same hormone testing and 2 x-rays (for skull and palm growth), but no doctor to interpret what they mean. I have included some information about my daughter, the lab results and my questions.1)My daughters info: Born date: 12/18/2009; weight at birth: 4kg; height at birth: 54cm; As of 05/17/2011: weight 13.4 kg; height: 83cm.2) Lab results for hormones:Lab 1: (FSH =1.07 IU/ml), (LH=0.1 IU/ml), (Estradial(E2)=4.3 pg/ml);Lab 2: (FSH=1.5 mIU/ml), (LH= 3) My questions:a) Are these ranges normal or abnormal for a 18 month old toddler to be qualified for precocious puberty?b) What other testing should be done for the lump in her breast?Also, I have 2 x-rays available. How can I show them to you? Im willing to pay to have your medical opinion on those x-rays.Thank you very much Doctor,Regards,-Tuvshee ### REPLY: Hi dear, I went in depth of your query and would advise with following stepsa-consult pediatric and GAEC doctor and have second check of your daughters breast lump- after that with their advice ask opinion from Surgeon and endocrinologistYour baby is chubby and needs more study before labeling her as precautious puberty.Don't worry please feel free to send your X-rays to me with your lab reports for study and detailed advice to you. Hope this would solve your query. Wellcome again for further query to . 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 11 month old daughter was diagnosed at birth with 45X Turner Syndrome with a COA and PDA..today she had a seizure while in the swing at the park..should I be worried she s never had this happen before. She acted whiny and sweaty afterwards, but other than that normal. Who should I see, should I treat as an emergency? ### REPLY: Hi, Thank you for posting your query. There is no need to worry about the seizure in your infant. She should be shown to a neurologist, who may order MRI brain and electroencephalogram (EEG). If she has a recurrence of seizure or if EEG is abnormal, then, anti-epileptic medications should be started. She would be alright with medications. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 30 year old female with elevated liver enzymes and elevated D-Dimer. I went to the ER about a month ago for chest pain. I had been having it for 5 days and was really scared. They did a D-Dimer test on me and the result was elevated, therefore I was checked for a pulmonary embolizm which was negative. Im wondering why these results were elevated, I got no answers from the ER physican (except it was probably GERD) and no answers from my primary care physican. Since pregnancy Ive suffered from chronic pain, weakness, and migraines. Im exhausted from the pain and I dont know what to do. Because Im young, every doctor I go to just blows me off. Please help! ### REPLY: Thank you posting your query.it maybe a false-positive result (D-dimer). Maybe sampling error for the elevated liver enzymes.i advice re-evaluation. Kindly repeat following test:1. CBC (complete blood cell count)2. Liver Function Test3. Clotting Profile (PT, apt, D-dimer)4. H. Pylori (Stool antigen test or urea breath test)Then you may post the test results to me OR any gastroenterologist@ChatDoctor OR visit your treating physician. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish 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, So me and my gf had unprotected sex tonight and I pulled out when I ejaculated, getting some semen on my hand. I then wiped all I could off with a towel. About 10-20 minutes later I fingered her then had unprotected sex again. I was wondering if the dried semen on my hand or the semen that dried around the tip or in the tip of my penis could cause concern for pregnancy. We were thinking Plan B if this is the case. Thank You ### REPLY: Hello dairy understand your concernPregnancy is not possible due to . But in your case as you have unprotected sex in which pre-cum before ejaculation enter into the vagina unknowingly. For safer side you can have to take plan B to prevent unwanted pregnancy. It is very effective if it should take with in 24 hours of the sex. But you can take up to 72 hours of the unprotected sex. Hope this may help noncontact  for further health query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,my name is Pam.I was just sitting down for a moment.My heart jumped in my chest like it skipped a beat and caused me to cough as if the air was forced out of my lungs!I dont think this is serious, but I do wonder what causes it!I sometimes feel as if my lower rib cage is aching afterwards!!Many thanks :) ### REPLY: Hello Pam and thank you for using . I carefully read your question and I understand your curiosity and a little concern. But as you thought It's nothing serious and you don't have to worry. As you describe, my opinion is that we are dealing simply with an Exstrasystol. These is irregular beats, originating from the heart. They are premature electrical impulses independent of normal sinus rhythm. They originate in some part of the heart other than the normal heart impulse. Furthermore, they give this sensation like an escaped beat, a palpitation or an anxiety sensation. In young and healthy people this are quite normal. They are caused sometimes by stress, excessive consumption of Coffey or caffeine products. If you feel that these episodes are increasing or are interfering in your daily live, onliest than I will recommend you to consult your cardiologist to make some examination. Until thank you don't have to worry. Hope I was helpful. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my daughter is 6 and has been compaining of an upset stomach for 3 days. She isn t eating and she is sleeping alot. This morning she started complaining about body aches-her legs, throat, ears, stomach. And she has a low grade fever of 100.2. Is this something to be concerned about? ### 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. 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: Recently I noticed almost like a rash on both my upper legs. . They look similar to mosquito bites but have heads almost like an ant bite would. They don t itch, but they are sore to the touch. . I have no idea what it is, but that is the only place they are. . ### REPLY: Thanks for your query, I have gone through your query. The soreness in the leg can be because of the hair follicle infection. The other possible cause can be because of the allergic reaction also secondary to insect bite. Nothing to be panic, consult a general physician and get it evaluated.Meanwhile you can take a course of antibiotics like amoxicillin and metronidazole (if you are not allergic). You can also take a course of antiallergic agents like cetirizine.  I hope I have answered your query, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 36 weeks pregnant, and had a sharp muscle pain/ cramp in my upper abdomen. It was so painful, I couldnt stand up from the couch. I sat on the couch for a while and every time I tried to move or lay on my side it would hurt. Laying on my back was fine. The cramps lasted a few minutes, and was sore when I got up from the couch after about half an hour. There is no pain anymore and havnt experienced anymore cramps of this nature. It has been about 3 hours now. Baby seems to still be moving. Is there cause for concern? ### REPLY: HI. Thanks for your query and an elucidated history, although very atypical in nature. The probable cause of the pains you had at the 36 weeks of pregnancy in the upper abdomen is :The loaded colon goes up as there is no space for this to be in the normal position. The stomach rotates upwards a bit and causes the pain like you described. Do not worry. Take lots of fibers in the diet, you can use Dulcolax suppository to evacuate the colon, and you will be dined. Do not use cathartics as this is contraindicated in late pregnancy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a white tongue condition for over a year now. Have tried multiple rounds of fluconazole and nystatin and did nothing to cure it. Tried many home remedies and mouthwashes,  no change. My current doctor put me on clotrimazole and that is not working. I can brush it off mostly but it grows back. It has moved to my lips where it dries them out and makes them wrinkly and sticky. This started after going from anal to oral. ### REPLY: Hi, As per your complaint, white coating over your tongue seems to be due to a number of causes like reduced immunity, intake of steroids and antibiotics, diabetes, intake of oral contraceptives, .  You should consult an Oral Physician and get evaluated, and a thorough clinical evaluation can help in diagnosis.  In case of Thrush antifungal medicines like Statin mouthwash and Clotrimazole lozenges and taking ample of Probiotics like yogurt and garlic will help.  Oral antifungal medicine like Itraconazole can be advised. Do warm saline gargles and chew sugar free chewing gum.  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 a sharp, burning sensation on my lower left rib cage. Kind of under the bottom, and it is also painful to the touch. It came on sudden and has now lasted over two hours. When I move my body or even take a deep breath it also hurts more. Sitting still the pain is bearable but when I move, touch, cough it gets very severe. No discoloration, no swelling or bloating, not sick to my stomach. What could this be? ### REPLY: Hello Thanks for writing to us, I have studied your case with diligence. As per your history there is possibility of rib contusion or Costco . Rib contusion is visible on X-ray. I will advise consulting to orthopedic surgeon. Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt. You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Iam having a question.......i want 2 concieve,on wat days after my periods we can try..........can u plz tell me in detail wat days we can try fr concieving......... ### REPLY: Hello Welcome to  forum14 days before due date of next cycle i.e, date of ovulation Sperm have fertilizing power up to 48 hours once they have entered the female vagina, to achieve pregnancy intercourse must be done on the days when woman feels sensation of slipperiness at the vaginal opening and the mucus has a stretchy, clear appearance of egg-white, or when the sensation of slipperiness is present and little or no mucus is seen at the vulva. Life span of ova after release is between 12 -48 hours.  Wish you good healthDisclaimer ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! Im sick right now, ive been to my OB gyne last tuesday and she prescribe me a antibacterial and suposutory. Does it cause my fever right now? Im scared that this is a symptoms of TB coz i have a active cought it just came yeterday afternoon. And the mucus are lot! I feel weak and body aches. ### REPLY: Thanks for your question on . I can understand your concern. Possibility of Urinary tract infection and vaginal infection is more in your case. But better to rule out tuberculosis because you have contact with active patient. So get done sputum examination for AFB (acid fast bacilli-bacteria causing tuberculosis) and chest x-ray. If both are normal then no need to worry about tuberculosis.  .  Continue treatment you have prescribed. Keep proper hygiene of private parts. Avoid unprotected sex if you are sexually active. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a temporary crown put on 5 days ago.  I started having around the #31 molar with crown.  Had pain in my jaw and an ear ache.  I went back to the dentist today and he took a good look at it and adjusted the crown a little and did a couple of tests.  He did not think the tooth needed a root canal and thought it would get better.  He gave me some antibiotics.  I do not have sensitivity to cold and hot.  When I chew on it their is some sensitivity but not terrible.  He thought tooth was ok.  I am hoping the antibiotics help but I am getting tired of the pain.  What are your thoughts? ### REPLY: Thanks for using . Read your query, where you have not mentioned what test the doctor had done. I would advise you to go and X-Ray done to evaluate the condition of the tooth and if needed to get the root canal treatment done. Continung with the antibiotic you can take a painkiller (ibuprofen) if you are not allergic to any medicine. I recommend u to get the x-Ray done. Hope this is useful. Thanks and regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old granddaughter has Molluscum contagiosum. Her Dr. said there is nothing that can be done about it. It is very bad behind both knees, red and yellow looking. It does not seem to bother her but it definitely bothers me. It is awful looking. She does have Escema and attends a daycare. What can we do??? ### REPLY: Hello, The key issue here is that she receives the correct diagnosis. Generally, Molluscan contagious will just appear as small bumps on the skin. It should not change color from yellow to red or look awful as you describe. It sounds like she might have a different type of infection that needs treatment. However, if she does have molluscan contagious as your doctor says, there are no real proven treatments for it. Topical cryotherapy, imiquimod, salicylic acid, etcetera have worked for some patients. Ultimately, I do not believe she has a molluscan contagious infection if it appears as you describe. It sounds like she needs to see another doctor for a second opinion. 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: My daughter is 4 yrs old and has weight 13 kg consistently for past 1. 5 yrs. Also she is frequently ill by day to day cold, fever and vomiting. We have been taking every care regarding hygeine. Also she suffered from chicken pox 20 days back followed by post viral fever. Her cough also is frequent. In past 4 months she has been infected by sometimes bacterial infection, diarrhea, viral fever resulted of lymph nodes at sides of neck, still in small amt visible. Please advice some kind of medicine/immune system strengthening tonic for her. ### REPLY: Thanks for asking. I have gone through your question and I understand your concern. Your daughter who is 4 years old is not doing well since last one and half year. She has having recurrent cold cough, and she is also episode of chickenpox 20 days before, and you are interested some medicine to boost her immune status.  If I was your treating pediatrician I would suggest you multiple vitamin that can contain and vitamin A. In India it is marketed by the name of spy A to Z. If she underwent blood investigation and her hemoglobin was below 11 you can add iron. Hope I answer your question ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my question is regarding blood in urine. i never had a problem with it, but today i thought i saw it while showering. and i should mention i did get hit in the genitals with a soccer ball very hard prior to the shower. i still feel pain in the lower abdomen and occasional pain while walking in the area between the anus and the testicles.  should i see my doctor or will it get better with time? ### REPLY: Welcome to . 1. The history and symptoms suggest there is possible cause of trauma. 2. Hematuria cause should be evaluated - otherwise it may complicate and stricture formation can occur.3. I would recommend you to see your GP and get examined and request for an ultrasound scan.4. Ultrasound of scrotum will help to assess if there is in infarct of the testis, blood supply, vascular inexactness. And pelvic scan will help to analyze possible causes of hematuria.5. It will not heal on its own - need to evaluate the cause and treated accordingly. Good luck. Hope I have answered your query,anything to ask do not hesitate to ask.http://doctor.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having extreme pain in my right shoulder, right side of my neck and down into my right arm, it feels like a pinched nerve. It has been going on for 4 days. I have tried soaking in a hot tub and advil migraine and it feels like it is easing, but then it comes right back ### REPLY: Hello, I have studied your case. Due to compression of this nerve root there is tingling numbness in your arm and fingers pain associated with it. I will advise you to MRI cervical spine for better diagnosis. It can be due to various causes like sudden jerk to spine, due to facet arthritis, degenerative. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Local injection may help if pain remains persistent. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you are satisfied with answer do not hesitate to rate this answer at end of discussion. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is only 26 he has suffered with abad back for 4 years but has been terrible for 2 years now he finaly got his gp to listen and had a mri scan and has seen specialist. He has a herniated l2 all they will offer is physio under the nhs which he is still waiting to be seen his appointment is not for another 4 weeks . He has been in terrible pain for a week hardly can walk his back is so arched stomache stuck out his antinflamatories do not seem to help and pain killers solpodol just knock him out . As a young person he has no quility of life his work is affected all the time as a self employed plasterer ### REPLY: Hello, Thank you for contact us, For back Pain you should follow instructions described below -Best medicine for Lower back pain is Rest. Resting for some days will heal the muscles which could be damage because of jerk. Muscles need some time to heal so give them time for the same. Another way is to take message with hot or cold water, Some people take cold water and some takes hot for massage. If pain is because of any accident or something big issue than you have to concern good doctor for the same. Other exercise should be done as doctors suggest after checking you physically. Hope it will work for your back pain. Good luck, Take care. Thanks & 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 an enlarged prostate and the Dr. wants to do a procedure called Prolieve, I have concerns about this procedure, am not really having any uncomfortable symptoms, but after a cystoscopy the Dr recommended I have this procedure.  Some people are saying I should get a second opinion and that I should not have this done. Could have more serious problems after. ### REPLY: Hi, Thanks for writing in. The Relieve is a medical device that both heats the prostate and dilates the prostatic urethra and treats prostate enlargement. During the procedure, the physician will insert a catheter into your urethra. When microwave energy is turned on, it will be transmitted from a special antenna inside the catheter to provide heat to your prostate. The heat will reduce the enlarged tissue of your prostate. A small balloon that is also part of the catheter will inflate within the section of the urethra close to where the prostate is located. During the entire 45-minute procedure, water will be circulating inside the catheter through your urethra. This is a new technology, and you must discuss with your doctor before getting treated. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ? ggtype your query here... Good afternoon dr my 30 years old daughter was diagnosed borderline in spain by dr sastre rubio y brought her to venezuela where we live i cant find a terapist to treat her right now is taking pills for depresion, i am trying to find the best place where doctors know whow to treat this illness willl you please help me, thanks a lot ### REPLY: Dear Mother, Need not worry, Like any disease, mental health issues are also treatable albeit, it may take some time. Have patience. The mental illnesses are largely due to faulty interactions of the individual and the environmental factors such as society whose members are parents, relatives, friends and the responses of the individual to any situations. As a result of these interactions there might be certain unresolved emotional issues which affect the secretion of the chemicals in the brain and vice versa. A hereditary element which gets triggered with the social interactions can also be a cause of the mental health problem. Just like the digestive enzymes in the stomach, we have some chemicals in the brain as well. These chemicals enable a person to deal with situations in hand. For example, you felt happy when your daughter scored a good result in her academics, and now you are sad when you see her suffering. Both this happiness and sadness and other related emotions like anger and disgust etc. are regulated by the chemicals in the brain. The medications prescribed by the Psychiatrist will work wonders when collaborated with the services of a Qualified Psychologist who can facilitate the resolution of the emotional issues as stated earlier through patient listening, interpreting and rendering therapeutic techniques for a behavior and lifestyle modification. An unconditional support in all respects from persons significant in her life is the need of the hour now. Happy days ahead for you and family ! .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive taken clomid on days 3 to 7 of my cycle. I had a follicle followup today via transvaginal ultrasound and a 10 mm follicle was present. Since I am on day 15 of my cycle does this mean I won t ovulate? I did take an ovulation test yesterday which resulted in a smiley face; which gave me the assumption I was going to ovulate. ? ### REPLY: Hi, You took Closed form 3rd to 7th day. Size of follicle is 10 mm only. That follicle will normally grow to 18-24 mm at time of ovulation. So your follicle size does not indicate ovulation. When follicle size reach 18-24 mm, it has high chance of ovulation. Rupture of follicle in USG scan suggests ovulation. USG is better tool to know ovulation time compared to ovulation test. You can ask doctor for Tablet Metformin to induce ovulation  shot, Progesterone and Ova care pill. If medicine will no response then go for ovarian . Avoid stress, take healthy diet,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good day i have hpv and therefore have abnormal cells. i have had 2 colpolscopies and now my dr wants to do a 3rd. the last time she told me that i had some stage 2 cells on my cervix. i am tired of doing the same routine and nothing has changed, they seem to be getting worse. please advise how you would proceed. Thanks ### REPLY: Hi thanks for contacting ... Noted here you are having grade 2 abnormality in cervical biopsy... So mostly it can be Cervical intraepithelial neoplasm.grade 2... Here routine follow up required with wait and watch approach... Usually it can be healed by its own.... No surgical or other management needed. If it seems to be increasing by doc then further treatment option is there like with liquid nitrogen abnormal area can be burnt called cryotherapy. Laser therapy also available... Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I jus have a question I ve been off depo since August an I ve been having this brown discharge for about two months me an my partner had sex on nov.5 while I still had the brown discharge but then I started bleeding on the 19th so I thought it was my period but then it started to get light an it only lasted for 2 days an when I m on my period it last for 7 days so then I started looking up implantation bleeding on pregnancy an it said that it only last for 2 days an its a pinkish color when you wipe so when I wipe I get a pinkish color or nothing but I took 3 pregnancy test an they were negative so I was wondering if u can help ### REPLY: HI. The symptoms you are presenting with could also appear due to a hormonal imbalance that can occur after getting off the demo shot. This can occur in women until 6 months after getting off the shot, and can present with symptoms like inter-menstrual bleeding, spotting, weight gain, menstrual irregularities, etc. Although pregnancy should be adequately ruled out, especially if you are experiencing a delay in your period, visit a doctor for an ultrasound by the 6th week from your LMP, and confirm/rule out pregnancy. 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, for a couple of months now I have been having a lower abdominal pain. The pain is like a crampy pain and when I pass gas it goes away but comes back almost instantly. When I push down on the lower part of my abdomen it hurts. If thought about possibly being allergic to glutten or being lactose intolerant but I haven t changed my diet. Also, there has been pain on the left side of my testicle that radiates to my left leg and left butt cheek. Do you think these pains can be related? I ve had cat scans done and a testicular sonogram and they both showed nothing abnormal. I m only worried because the pain is here literally all day everyday and won t go away. Obviously it s a pain I can live with as it does not interrupt my fault routine but it is aggravating. ### REPLY: Hi. All to elucidate history of symptoms and normal ultrasonography of the scrotum and CT scan of the abdomen are suggestive that you are suffering from IBS- the Irritable Bowel Syn . I would advise you the following in such a case ::Treatment of the stress and anxiety by Mediation, Medication and whatever way you can ... Medicines for intestinal spasm. ProbioticsChange of job, routine, atmosphere help a lot. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last night i went to bed and I had pain from my left knee all the way up to my hip on the outside left leg. A deep pain. I couldnot walk or lay down since I hurt so bad. I was almost in tears. I finally found some pain salve and applied liberally and it eased up after about 10-15 min. I woke up again about 1 a.m. starting to hurt pretty bad and put more medication on the leg. Today, I have had some pain, but have also had some pain in th left groin area and it seems like the pain is situated also somewhere around the area of y kidney. What should I do? ### REPLY: Hello, I have studied your case. Due to compression of nerve root there can be pain in your hip to knee. I will advise you to do MRI spine and if required MRI hip. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I had Hepatitis A 4 years back and it got severe that time. after that im diagnosed having fatty liver and my sgpt / sgot levels are 70-161 . Doctor suggested to take Live 52 . Is it suggestable ? will it bring it down to normal ? Im not a alcoholic or smoker. But im overweight, as i started gaining weight after the jaundice attack. Can i take Liv52 along with other English medicines, as i take cantex for skin issue. ### REPLY: Hi there, Thanks for using . Hepatitis A is a self limiting disease affecting the liver. Liv 52 may help the damaged liver cells to recover. But Liv 52 may not be of much help for fatty liver disease. You need to treat the underlying cause. Obesity is the risk factor in your case. Try to reduce weight. Check your blood glucose and cholesterol levels as these can also cause fatty liver. 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 had anxiety last month. I stopped panicking. I was having chest pains. And they went. Now my back and chest hurt. I feel like pooping but it comes out very little. My left arm gets tight and earlier today my chest started to really hurt when i turned to grab something while sitting. Am i okay? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  Your problem could be health related anxiety, called Hyperion .  Any form of anxiety can cause weird symptoms in your body. The most affected regions are always our torso, especially chest and shoulder region. Anxiety and pain triggers obsessive thoughts regarding the health problems. Obsessive thoughts increase the anxiety and anxiety increases obsessive thoughts. Proper understanding of your body function and anxiety is the key to cure. Please consult a psychologist for psychotherapy treatment. Start with these simple steps Step 1 - Practice Deep and full breathing whenever possibles 2 -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suspect I have parasites and my doctors ignore me. How do I get diagnosed and treatment? I feel something squirming in my nose at night, severe constipation, allergies, food intolerances, severe kyphosis, and I have long white mucous covered strings in my stool. I have taken Diatomaceous Earth and there will be lots of pieces of the strings in my stool and my muscles will burn. Please help ### REPLY: Hello and thank you for your question. It is important that you find a doctor that will check for stool infection and for parasites in your stool. Try adding a fiber supplement for the constipation and .  Completely eliminating all foods that you are intolerant to is also important. Adding a probiotic may also help your symptoms resolve. If you have kyphosis you would need to get a bone density test to rule out osteoporosis. Good luck to you in finding relief from your symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed about 15 years ago with hep c.i was just wondering how long before it turns into something that will eventually kill me.im 46 and have a 11 year old as well as a 12 yearold. Aisoi wondering what some of the later symptoms may be. THANK YOU ### REPLY: Hello, Hepatitis C has a natural history as follows. About 80% patients continue with chronic hepatitis C, which then progresses to fibrosis and eventual cirrhosis. Now, only 2 to 6% of people with cirrhosis per annum convert to hepatocellular carcinoma. The rate of moving through this is highly variable and not something that everyone will go through, as I mentioned with the stats. You should not worry yourself over this. Go for regular checkups, eat healthy, exercise regularly. If things do start to go bad, there will be an alteration in your liver function tests, you may start having abdominal distention and swelling of your feet. I would like to reinforce, that you should not live in constant fear of the same. Careful vigilance is all that is needed. 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 a male 34 years and currently going to a pain management doctor for severe pain in my back. I have had two surgeries on my back. Recently they give me a urine test and they said the results came back saying that there was no pain killer medication in my system. I take the medicine every day as prescribed by my doctor and the results should have showed it. Can you tell me if the is any medical reason why my results would come back like that? I drink Mountain Dew and I pee alot, my mom says that maybe that has something to do with it. Please help me because the doctor took me off of the medication because he said it s a state law that he has to do that if it doesn t show up in my urine test. I need the medicine to help get rid of my pain. ### REPLY: See Mr, what for you got done two surgeries?I hope you went for lower back pain Elysee it is quite difficult to detect painkillers in urine since they undergo metabolism(catabolism=break down into short chain prouducts&appear in urine), NOT ALL SOME MEDICATION EXCRETED IN URINE UNCHANGED. BUT problem here is why do you want to know in urine, at last see, IN HUMAN BODY NATURAL PAIN KILLERS LIKE ENDORPHINS WILL Produce IN RESPONSE TO PAIN, THEIR LEVEL MIGHT HAVE COME DOWN DUE TO CONSTANT worried about back pain, which eventually increases pain&visa versa. Go for YOGAASANAS CONTROL YOUR MIND FIRST OTHERWISE IT ACTS LIKE ENEMY&EXPAND YOUR MIND&ENLARGE YOUR WORLD, THEN ONLY MEDICINES GIVEN OR SURGERY CONDUCTED WILL HELP.GOOD LUCK. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father has stomach cancer and is having cemo. he has a red sore rash on the top of his butt crack similar to the rash on his heels. could this rash be caused by the cemo like the one on his heels and he also has 2 small lumps on the edge of his anus which have been there about a week. what could they be? ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  Rash after chemotherapy is common.  It is due to side effects of chemotherapy.  He may have low platelet count.  His mass near anus may be piles. He should go for per rectal examination.  Then he should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END