Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 feel hungry but I am not able to eat much. I feel nauseating all the time, have heavy chest and so unable to breathe easily. Am forced to take burps as it releases little pressure as I feel. I dont know what to do. Feeling miserable and uneasy. ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are having HERD (gastroesophageal reflux disease) mostly. It is due to laxity of gastroesophageal sphincter. Because of this, the acid of the stomach tends to come up in the esophagus and cause the symptoms like nausea, gaseous feeling, burping, chest heaviness etc. So better to follow these steps for symptomatic relief. 1. Avoid stress and tension. 2.  Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Start proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2-3 pillows under head in the bed to prevent reflux. 7. Avoid alcohol and smoking if you have such habits. 8. Lose weight, if you are obese. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on benicar , low dose 20 mg.Over the last month for some reason my bp has been about 152 over 110. I have (without cunsulting my physician) increased my benicar to 3 times a day  (20 mg).I feel very bad, shortness of breath, feeling very bloated,  pain in chest ir maybe back, cant tell,so all encompassing. Still bp remains high. Is it safe to excercise in this state? ### REPLY: Hello. Thank you for your question and welcome to . I understand your concern. Physical activity has a prominent positive effect on the circulation and, thus, on arterial hypertension. So, it is highly recommended that you exercise while with hypertension for 60 minutes a day: jogging, swimming, brisk walking, going to the gym or other light to moderate physical activity alternatives. Losartan should not be adjusted to 60 mg a day and I would strongly recommend you to not change the treating regimen without consulting your curing doctor. If these figures of blood pressure are a constant finding, then I would recommend adding a second agent to your hypertension treatment. So, a beta-blocker, calcium channel blocker or a diuretic would be a good choice. The aim is that the blood pressure be maintained under 140/90 mmHg, because it is proven that long-standing higher than these figures cause gradual end-organ damages. I hope I was helpful with my answer. Take care. Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was on 3 different birth controls. Depo, necon, and tri sprintec but its been 2 yrs since Ive used any birth control my boyfriend want a baby and have been trying we have sex often unprotected. I have never gotten pregnant its been 2 yrs of trying am I unfertile? ### REPLY: Hi, I think you should go for evaluation first.  Do a thyroid profile and prolactin levels and an ultrasound for your uterus and ovaries.  If everything is fine, you can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days after injection.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months.  Hope I have answered your question.  Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 27 yrs old.i have polycystic overy.can i get conceive?height-5ft. weight-50kg. i am taking clomid followed by ChatDoctor injection.recently i feel severe pain in the abdomen at the begining of cycle which persists for some days.please help me. i got married before 1 yrs. ### REPLY: Hi, I think you can conceive with pro problem.  You can try with closed for 3 to 6 months.  Track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles. Be in contact with your husband every 2 to 3 days after your periods stop.  Take progesterone for next 2 weeks after the rupture of follicles.  Do a urine pregnancy test at home after that.  Pain on 1st few days of periods is very common and is normal in most cases. You can take painkillers for that. Hope I have answered your question.  Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have an 8 year boy who had a bowel abstraction and know complains of perching pain on different parts of his stomach area. He has had all the test done EKG ct scan ex rays he had an ultra sound test today. We live in the er lately and were looked at like crazy people. What else should we ask for ### REPLY: Hi.... I think your kid is having habitual constipation. I have certain questions and suggestions for you. Questions:1. Did your kid pass motion or meconium on day one of life?2. Since how long is the kid constipated?3. Does the kid have any bleeding along with hard stools?4. How much milk does the kid consume per day?5. Does the kid eat fruits and vegetables (fiber diet) appropriately? Suggestions:1. Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in Indian type of lavatory daily at the same time will help a lot. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. Wish your kid good health. You can approach me at the following link. Please find the link below.www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My brother-in-law has stones in pancreas. His age is about 35yrs. I want to know where he can get better treatment in India. He lives in Kolkata, India. So, if theres any good hospital or doctor where he can go for treatment please let me know. ### REPLY: Hi, He might be having stones in the main pancreatic duct or its secondary branches. In the past, treatment for painful obstructing main pancreatic duct stones was a surgical lateral pancreaticojejunostomy and open duct stone removal. In recent times and over the last 25 years, endoscopic techniques to remove main pancreatic duct stones have been developed using methods similar to ones applied in bile duct stone removal. Simple stones can be extracted using various endoscopic techniques such as balloon or basket techniques. Larger and impacted stones typically require lithography or surgery. Medications do not help much in the treatment of pancreatic duct stones. Oral pancreatic enzyme supplements, a low fat diet, and analgesics are standard management for patients with chronic pancreatitis with or without duct stones. These therapies do not affect stone size or stone formation. There are many good hospitals in India offering treatment and this is treated by gastroenterology surgeons. Doctors at Post graduate medical institute SSKM in Kolkata might be consulted for treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im depressed trying to get back into school working sleeping on a floor struggling with bills and my father hates me and my coworkers constantly laugh at me and call me gay. I want to kill myself and I suffer from alcoholism and anorexia. Do you know of any antidepressents that would be good for me? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. You have a severe depression and will require intensive treatment. Do consider visiting a psychiatrist. There are good .  If required you can also be considered for the ECT. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you need any further details about your query, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I just started taking birth control. I am currently taking Lo Loestrin Fe. I have been taking the pill for 9 days now. For the first 7 days I took the pill every day at the same exact time precisely and I read that if you do so you are protected right away. On the 9th day my boyfriend ejaculated inside of me. Am I okay? ### REPLY: Hello dairy understand your concerned not worry. Lo Holstein Fe is highly effective in preventing the pregnancy. It has just 0.5 % failure rate. No chance of the pregnancy as you have taken regularly at the specific time. Not to worry about unprotected sex was done on 9th day. You are completely safe, and also you did sex on the safe period of the cycle. Make habit to take pill regularly on specific time every day by putting the reminder in the mobile. Avoid stress, take healthy diet, . Hope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been experiencing leg pain in my inner thigh, buttocks & sometimes the back of my leg. I noticed a few days ago a lump on my inner thigh just below the groin. It hurts when I touch it. When I drive or sit @ work & get up to walk, I limp from pain. ### REPLY: Here you need to get it checked what kind of lump it is.  May need to undergo for excision and biopsy too.  So go ahead and check it with proper. Medical treatment and based on biopsy report only we can come to know what to do next.  If it is a normal lump then will be fine in few days but if it is related to any benign or malignant lump then need to do proper management. Hope this was useful for you.  Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have multiple sclerosis and have had iv steroids a couple of times and also a couple of oral courses of methylprednisolone. Someone told me that this can affect my sperm count and I should get it frozen in case it does. Is this correct?ThanksChris ### REPLY: Hello, Thank You for consulting  ! True that improper use of steroid effects the health of sperms, but it cannot be generalized with your case which says the only couple of courses of iv and oral steroids. It is a side effect but not a mandatory thing. You need an physical exam to confirm if this is happening to you. Stay healthy, and thank you for consulting! You can contact me again anytime, if you need clarifications or further assistance in the future. Kindly rate the answer if you are satisfied. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, Ive had an ongoing problem with an anal fissure for about a month, my inquiry is about home treatment. Is there anything I can do at home to help solve this problem. Im not comfortable going to my family doctor, in order to see another doctor or a specialist in the gastroenteral field do I need to get a referral? ### REPLY: Hello, Welcome to . From your Query I understood that you are suffering from Anal fissure. It is just a small tear in anal mucosa. It is usually due to hard stools and constipation. Not all the anal fissure needs medication and treatment. It usually heals of its own in six to eight weeks with proper lifestyle changes. You need some lifestyle changes1. Increase fiber diet in food especially soluble fiber diet.2.  . 3. Do exercise regularly, at least for 20 minutes per day.4. Please avoid straining during any work. You may apply the nitroglycerin externally to promote healing of anal fissure. Most of anal fissure do not need surgery. Hope this helps. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am suffering from ocd for a long period. i was releifed from the problem and doctor told me to continue maintanace dose (fludac 20). but i withdrawan capsule the medicine myself and i am feeling the same problem from last two years after taking the medicines ( fludac 60 + amixide ). can you advise me how can i get releif. thanks & regards dipak datta ### REPLY: Hello and welcome to . Thanks for your query. OCD is a usually chronic problem and requeries long term medication. Sometimes medication can lose their efficacy if used irregularly. 60 mg of Fluoxetine is a good dose of the medication. If you are still continuing to have OC symptoms, then other treatment strategies have to be tried. Further treatment options include a change to a different class of anti-obsessive medication or trying psychological and behavioral therapies. I would advise you not to make any treatment decisions or alterations on your own, but consult a psychiatrist near you, so that you can have a detailed psychological assessment and further treatment can be planned accordingly. Wish you all the best.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor,Good moning am Divya Maniar from Kammanahalli past four years am suffering from bad cough andin the night no sleep at all. I consulted Dr. Hemanth of ZION HOSPITAL he also tried many medicinesnot effecting. Doctor during bad cough i feel vomitish but its not coming.Doctor please suggest effectable medicine which cure from the root and past four years am  not   -geeting good sleep and my medical test reports are also normal, please help me for my health.Your patient,DIVYA MANIAR. ### REPLY: Hi. I can understand your concern. You are mostly suffering from asthma. Asthma is most common allergic disease which is not a curable disease but definitely controllable, by controlling the same you can lead a symptom free life. Usually presents with cough, wheezing, difficulty breathing and chest tightness. If not treated appropriately can be life-threatening. 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 asthma. It will also tell you about severity of the disease and treatment is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)You can consult me at my clinic based in herbal tempura for the same. For appointment call - 00000000 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: I know  that there is no simple answer to this question. What are some of the many reasons that cause a person to have uncontrolled rage almost all of the time? This person does not abuse drugs or drink alcohol, and I am becoming terrified for my daughter.Thank you.. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Anger is a state of mind. Your daughter could possibly a teenager. At teen anger tantrums are quite normal. But you should also note that it can cause behavioral problems if not controlled. The possible reasons for this are role conflict, mature-immature conflict, inability to accept the realities, hormonal changes etc. All these should change when they establish them self and identify them-self. That is their developmental task. You can take your daughter to a mental health counselor of spiritual guru. Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. my hands gets yellow small pus and peel it hurts it gets red and some times bleed. it is hard for me to work with my hands. i some times rap them up.i tryed all kinds of stuff but dont work. it gets on both hands and fingers.people are scared to touch my hands they think they might get it. so can you tell what it may be ### REPLY: Thanks for contacting ChatDoctorYou are concerned about a rash that is causing blisters and weeping sores on your hands. From your description I would say that you have something called pustular eczema. This is a real severe eczema, but it can be controlled. In my practice I start with dexamethasone ointment twice a day. Try to reduce the amount of handwashing as this makes the skin .  This will take several weeks to get control. I also recommend at night before going t sleep. Put on the dexamethasone and then put on a white cotton glove. The glove keeps the medicine in contact with the skin and also prevents the ointment rubbing onto your bedsheets. Hope this answers your question. Please contact us again with your medical concerns and questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have mild cirrhosis (compensated) from alcohol. I havent drank since being diagnosed. My last 3 blood test show my ast drop from 23,to 19 to 18 within the standard range. Alt from 21 to 19 to 18. All blood work is within normal range except platelets which are stable at 90-100.Should I be concerned with ast and alt getting clap to low range? My low platelets are due to enlarged spleen. Will my spleen ever reduce in size ? ### REPLY: Hi, Thanks for writing in to us. Splenomegaly is a common complication of cirrhosis. Many cirrhotics have platelet counts in the 60,000s. It is not something to worry about. And it doesn't need to be treated. You have plenty of platelets to properly clot your blood. Blood flows from the spleen...through the portal vein...then through the liver. Scar tissue in the liver (cirrhosis) can interfere with that blood flow, causing pressure to build up in the portal vein (portal hypertension), and the spleen to enlarge (splenomegaly). As the spleen enlarges, it traps platelets. (The amount of platelets in the bloodstream is reduced because the spleen is busy trapping them). So usually people with cirrhosis end up having a problem with portal hypertension and an enlarged spleen, and a reduced platelet count in the bloodstream. As time goes by, the liver may try to repair itself by growing new cells. If there is a lot of scar tissue already present the new cells grow between scar tissue (and result in abnormal nodules). The nodules and scar tissue further interfere with blood flow through the liver. So over time people with advanced cirrhosis can end up having a problem with more and more abnormal nodules and scar tissue forming which interferes even more with blood flow through the liver which makes the spleen continue to enlarge, and the platelet count continue to . The splenomegaly is usually not reversible. Please go for regular medical follow up. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Total bilirubin 1.1mg/dl; conjugated (D. Bilirubin) 0.3 mg; Unconjugated 0.8 mg; S.g.o.t 72 u/l; s.g.p.t 102 u/l; alkaline phophatase 182 u/l; total protein 8.2 gm/dl; albumin 3.7 gm/dl; globulin 4.5 gm/dl; a/g ratio 0.82; g.g.t.p 86 u/l Plasma glucose fasting 424 mg/dl; total cholesterol 131 mg/dl. Pt ratio INR 1.11 Tsh 19.27 Please advice what will I do. ### REPLY: Welcome to . Thank you for posting your query. I can understand your query. Let me analyze your report.1. Total bilirubin - raised2. GOT - raised3. SEPT - raised4. Albumin - low normal5. Plasma fasting glucose - alarmingly raised6. INR - normal7. TSH - raised8. Cholesterol - normalize reports are suggestive of hepatitis. At the same time what is alarming is the fasting glucose. It is very high. You need immediate intervention through insulin or other medications. You also have hypothyroidism. I would suggest you to immediately visit a clinician. He/she can examine you, recheck the blood glucose and correlate clinically. Get an ultrasound of the abdomen done to look at the liver and gallbladder. Get a postprandial blood glucose and HBA1C done to look at the blood sugar control. Avoid oily, spicy food. Avoid sweets. Regularly exercise for 30 minutes a day. I would start tablet Thermoform. Your doctor can guide on the exact dosage. Hope this helps. Write back to us. 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 torn a ligament in my left knee fout or so yrs ago. Sense then ive used my right knee alot more to keep left from popping out of place. Now in my right knee I have a crackling sound about the time I completly straighten & go to bend it again. I also have some pain & burning.w hats the diagnosis doc.?. ### REPLY: Hi... Your pain and popping sensation in your knee is due to excessive wear and tear in that knee... Nothing to worry... I recommend you to. Lessen the load over the painful knee... Do rehabilitation for both knees to avoid any more complications... Do a lot of icing in the painful knee. Gentle massage over the front thigh muscles to lessen the compression forces on knee cap on knee. Do strengthen of gluteus and hamstrings.core stability... Hope this is helpful for you. Kindly revert in case you need any further help in this regard.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A person I know has jaundice, blood in urine, and her ALT level was at 430 when she was admitted to the hospital. After being in the hospital for a week, her levels are still in the 200 s. She has had both kidney and gall stones in the past. The doctors are wanting to remove her gallbladder now. She was passing out and also has diverticulitus and crohn s disease. What could this mean for her. She is in her mid-60 s. She also has diarrhea and can t keep much down for food. ### REPLY: Hello, In most cases this is sign of reinfection or kidneys stones. This is mainly self limiting and doesn't require any specific treatment, and you should just be patient and have fluids to promote urination.  Less likely it may indicate possible bleeding in urethra, bladder or kidneys from popped vessel or some other cause.  If this continues you should do urinalysis, monoculture and kidneys ultrasound to rule these main causes out. You should .  Also, avoid sexual intercourse and have keep good hygiene. You should reduce salt in your diet as well since this could lead to increased risk of urinary stone formation.  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: heyi am deepak shah from india 48yrs oldim suffering from blood pressure from last one month and was also having weekness hence doctor has suggested me to take meganeuron so can you please tell its used for what?the side effects and how long should i consume the medicine???? ### REPLY: Dear Deepak Shah, His can understand your problem of high BP. Incomplete data like the BP readings are not mentioned & for how long you have been having this problem.First I would like to say Meganeuron is not used in the treatment of high BP. It contains (Methylcobalamin, Alpha Biopic acid, Pyridoxine & Folic acid) & generally used to help prevent a deficiency in vital nutrients and to treat or prevent some of the conditions that can be caused by a lack in them, such as nerve pain or neuropathy. This medicine is safe to use, however it can cause nausea, heartburn & gastritis. For your high BP I would advise you to consult a physician for proper evaluation and certain lab tests like fasting blood glucose (to rule out diabetes), serum lipid levels, kidney function tests and ECG. Your doctor may prescribe you medications like Losartan or Amlodipine for the effective control of BP. Hope to have answered your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mouth sores, my tongue has sores, my lips burn like I have been sucking on a jalapeno, my teeth hurt, and my gums hurt. I have a TERRIBLE headache, and I have diarherra. I have been sick like this for over a month now. I have been to my Medical Doctor, and she doesn t seem to find anything wrong. She sent me to an Allergist who simply prescribed a $99.00 mouthwash which my Insurance wouldn t cover so I didn t get it- obviously. All of this started after I used liquid Burdock Root- 12 drops under the tongue 2-3 times a day, which is supposed to cleanse the blood. I need something to heal the sores and stop the burning. My doctor is worthless so far. I m ready to switch doctors. Please help. ### REPLY: Thanks for your query, I have gone through your query, as per your presenting features you might be having allergic dermatitis secondary to the use of the liquid. If I am your treating doctor I would have suggested you to stop that liquid and use topical anesthetic and analgesic(Anabel) and topical steroid(0.1% triamcinolone acetone) 3-4times daily for 5 days. Do soda bi core mouth wash. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 60 years old. Two hours ago I checked my temp.because I felt col and hot at the same time. First time it was 100.5 then an hour later It s 100.6.I checked it again 30 mins ago and it went up to 101.5 .I have a lower back problem but it s been hurting so bad.I could not take meds. because am scheduled to have a knee replacement on Wednesday,Feb.15,2017.I am about to check my blood pressure.I am very concerned and afraid to go ahead with the surgery,it might be an infection or some kind of stomach issue.Do you have any suggestion ! ### REPLY: If you are still running a fever then the doctor will definitely postpone the operation and wait till your vitals are stable. By the symptoms you describe, it seems you have a viral fever. Normally a blood panel is done along with NS1 antigen test to rule out dengue and an anti-malarial antigen test to rule out malaria. If however you are from a developed country the above-mentioned conditions are rare. I suggest you discuss the possibility of a kidney issue with our doctor. In the meantime take paracetamol 500 mg 6th hourly for the fever and if the back pain does not subside take a tramadol (Ultra) 50 mg twice a day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr. Sir my mother 4thstage in breast cancer. The terment is going on H. C. G. Cancer hospital . The khemho therorph is given but she can t go for motion since 4days.They gave hole medicine everthing but also .she is very difficult go for motion so please help me. ### REPLY: Hello how are you? I have read your question. May God bless your mother witChatDoctorplete health recovery. Stage 4 breast cancer is an advanced stage of the condition which mostly requires palliative care for providing maximum pain relief and comfort to the affected person. However, treatment options are always employed with good chances of success. Local treatments such as surgery or radiation might also be used sometimes to help prevent or treat associated symptoms. Stage IV cancers which spread beyond the breast and nearby lymph nodes to other parts of the body cause serious complications and spread usually involves bones, liver, and lungs. Chemotherapy is beneficial for the patient, but serious side effects occur like the problems your mother is facing. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sir,my father s age is 79 has got esr level of 120.there are no other symptoms of any otrher kind only slight fever of about 98-100 for the last 10-15 days,slight swelling on the face.all other tests for kidney, liver are ok and no symptoms of RA.he has prostrate cancer for which he is undergoing regular treatment.pls advise the incresaed level of ESR is due to what? capt.alok r. gupta ### REPLY: Hi, dear He has high ESR. It may be due to many of the cause. Tuberculosis, inflammation, anemia, autoimmune disorder, paraproteinemia or malignancy can cause high ESR. He may have high ESR due to his prostate cancer. Or he may have some other reasons. So consult your local doctor and search for the cause. Then you should take treatment accordingly. 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: Hello About 6 weeks ago, my dermatologist removed a small benign tumour on my scalp (top of head) - she froze it off.  About 3 weeks later it formed a crust and peeled off.  Since last 2 weeks, I have been losing lots of hair around this part of my head.  Is this related to the freezing treatment?  Will my hair grow back quickly in this area?  I am writing to you as my dermatologist is now on holidays.  Many thanks  Marian   YYYY@YYYY ### REPLY: Hi. As per your case-history we need to find out the exact damage the benign tumor did to scalp skin. If it was deep enough to cause damage to dermis of skin then there is possibility of scarring alopecia patch at that site and hair coming back at that region is less.Don't worry at present. Use tacrolimus 0.03% ointment at that site for 4-6 weeks. Consult a dermatologist if complain persists. 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 recently b was on anti biotics, and wasnt eating my yogart. Well I got a yeast infection and treated it with monistate one day, its been a couple days since and today I noticed a creamy yellow discharge and wondering if its just the after effects of the monistat? ### REPLY: Hello, I read carefully your query and understand your concern. The yellow discharge is more likely to be relate dot the yeast infection. I suggest continuing using monist at cream for local application. I also suggest using Fluconazole 150 mg one tablet a day for three days. I recommend maintaining a good hygiene. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a hard upper abdomen for about 9 mths now, my lower stomach (pouch) area has gone down loads but upper is hard and swollen.. I dont believe its ibs its hard to touch and sometimes swells so much I look 9 Mth pregnant... I cant deal with it anymore I feel so down and depressed ### REPLY: Hi ! Good evening. I am  answering your query. There is no need to get depressed without knowing what you have. This any way is not going to help you in relieving your problems. Therefore, I would advise you to take an appointment with your family physician or a general surgeon in your area or go to the ER of your nearest hospital for a definitive diagnosis after clinical examination and related investigations. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was carving a pumpkin and stabbed myself in my wrist on my left arm right below my thumb.  I went to the ER and got two stitches. Now, three days later, there is a large bruise from the bottom of my thumb on my same arm that goes down the middle of my wrist and it is about 3-4 inches long.  Is this normal?  Does it indicate more complication or possibly and infection? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint due to getting stabbed there has been sharp injury to the soft tissue and also there seems to be injury to the blood vessels leading to spillage of blood into the soft tissues leading to bruising and you not to worry about it as gradually when the blood will disintegrate the bruising will also disappear. You can do alternate warm and cool compresses over the bruised area and also apply heparin containing gel like Thrombophob gel or other brands available at your local pharmacy as it will help in faster disintegration of the blood and bruising will resolve. You can also apply an antibiotic ointment at the site of cut to prevent infection. Hope this information helps. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter has thrush (age 4) she has been suffering with this on and off for over 3 months and had a water infection about a month ago, she is now showing signs of another water infection (frequent toilet with just a dribble and stinging sensation) the GP says this is just thrush and we should just continue to use the cream prescribed 6 weeks ago that we have been using on and off since prescribed, he did not test her urine so how does he know she does not have another urine infection? ### REPLY: Hello, As per your complaint thrush is a fungal infection, and it can reoccur if the previous infection has not yet subsided, and also if the child is being given antibiotics for some infection. Also, frequent urination and . I would suggest you first consult a pediatric dentist, and get evaluated, and he can do microscopy of the scraping from the tongue done to confirm that it is thrush. In case if it is thrush, then you have to continue applying antifungal mouth paint like Candid mouth paint and along with it gives plenty of probiotics like Yogurt and garlic. Feed with plenty of fluids. 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 husband just retired work at a carton shop after 43 1/2 years.  When he sits in his chair for a any period of time he had to stand because of the intense burning with a little ppain. He has to sit on the edge of his chard which is not comfortable. Years ago a dr. told him that he had the back of an 80year old. Another Dr. told home he had so many bone spurs and some were big. What does he have and does he need to get a referral to see a neurosurgeon?  I understand he will need a MRI first. ### REPLY: Hi, I had gone through your question and understand your concerns If I were your treating Doctor for this case of severe back pain, I would come up with two possibilities, these include: The first possibility is Arthritic changes between the vertebrae(spindle degenerative changes) and this may be the cause of the bony spurs. The second possibility is disc herniation, but this usually cause articular pain in the lower limb. I prefer doing MRI lumbosacral spine, wearing lumbosacral belt a, bed rest and some medications as NSAID and muscle relaxant. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 many CTs over the past year due to a large septated ovarian cyst that was scheduled to be removed in Sept, but my husband lost his job just a few weeks before it was to be done and we lost our insurance so the surgery was canceled.  Last week I ended up in the ER due to pain from the cyst leaking again and on that CT a 7.5mm low attenuation mass was found in my liver that had not been on any of the previous CTs.  Should I worry about this new small mass since we do not know of the ovary is cancerous or ignore it as an incidental finding? ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. If there are no malignant characteristics of this mass then you should not be worried. You need to have frequent follow-ups with ultrasound and check liver markers from time to time and do tumors markers to see if ovarian issue is benign or malignant. Treatment is usually not required for benign lesions. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been experiencing numbness in both my legs when i sit for long periods of time that ha now been followed by aching right leg i am a 27 yr old active female i was diagnoised wit hpv but later was told i was cleared (was giving antibotic and a cream) could this still be harming my body ### REPLY: Hi, thanks for sharing your health concerns with !  If I were your treating Doctor for this case of leg numbness, I would consider only one possibility that is neurological problem; possibilities are: 1. Some silent trauma or displacement of nerve due to bony defects like osteoporosis, osteoarthritis or pathological fracture2. Ischemia due to vessel changes in diabetes, cholesterol or smoking or chronic pressure3. Vit-b12 deficiency No way this is related to HPV...! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I hope you can help me or give me some advice. I have already had 1 Lettz & 2 cone procedures done, 2 months ago I had a transformational cerclage put into 2 months ago, pre pregnancy. Was told yesterday by the fertility clinic that the don t thing I can now get pregnant naturally because of all the procedures? Is this through? They are also sending me for a HSG , which my doc said they might not be able to preform because of the TAC or it might be very painful, please could someone give me some advice ### REPLY: helloWelcome to  With 3 procedures done on the uterine cervix - the pre-pregnancy circle was the ideal treatment to overcome the problem of incompetent cervix in pregnancy. These procedures can lead to narrowing or stenosis of the cervical canal. This can lead to a technical difficulty like passing a cannula through the cervix. The HSG - as you mentioned can be tried by your consultant under general anesthesia to overcome this problem and to see if the fallopian tubes of the uterus are open. Hope to have answered your query .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On vacation this summer in Santa Fe NM USA I experienced difficulty breathing for 3 days. I traveled on to Flagstaff Ariz USA and was fine, next day to the south rim of Grand Canyon, difficulty breathing for 3 days. As soon as I was out of higher elevation I was fine. A few weeks later I flew from Tx to Nv and while in flight experienced the difficulty breathing. I have been checked for any blood clots, none (d-dimer) What could be the problem? ### REPLY: Thanks for your question on . In my opinion you are having allergen induced bronchitis. In this type of bronchitis patient feels breathless only for the duration of allergen exposure. Once allergen is removed (go to another place) patient becomes alright. So you may have this. Better to consult pulmonologist and get done PFT (Pulmonary Function Test) to rule out this. No need to worry about embolism as your d dimer is negative. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 anus is red raw , when I look at it it is raw like the top layer of skin was off , it has been like it for over 6 weeks ,it is tender and moist like a raw layer of skin off , after bowel moment and during it is sore ,the area is moist and weepy ,  when starting to need the toilet you can feel it pressing ,it just does not seem to get a new layer of skin on. ### REPLY: Hi Thanks for your query You seem to be having Candidiasis of the perianal region. First some general precautions: Wear cotton clothes and undergarments in order to reduce the sweating. Do not apply any kind of oils / moisturizing lotion over the affected area. Just give warm saline compresses over the affected area twice a day and then apply clotrimazole cream. Also, you will need to take oral antifungals in the form of fluconazole 150 mg once weekly for 2 weeks... In case of severe itching, take some antihistamine like levocetrizine once a day. If inspire of the above measures, the lesions continue to persist or increase, then you might have to see a dermatologist for proper assessment and management Hope it helps .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I live in Houston, TX. I have 4 severe disc herniations in my lumbar region, 2 of which are pressing on the nerves on the left side. As well as several in my neck. The laws in Texas for pain medicine are extremely limiting . I understand why but that only makes it harder for someone like me to get proper treatment. My pain doctor recently switched me from percocet to ultracet, which didn t work, so then put me on tramadol 50mg. Still unable to function normally, but after 11 years on opiates, and now being 9 days without opiates, my head is clearer, which makes me happy. I detoxed at home which was horrible. My questions are: Is tramadol an opiate or a narcotic? Will I need to detox from tramadol like I did the opiates, because if so, I think rehab is in my future? Finally, how can I handle the chronic pain without these medicines? ### REPLY: Hi, Okay. Several treatments / approaches. Acupuncture probably would pass FDA scrutiny if it was required to get it. Physical therapy is advised as a standard, but there is whether the back is stable enough for it. If it is possible to do physical therapy, then there are a few reasons why it is one of the most effective non-medication interventions: it builds up the support muscles of the back. It increases pain tolerance, it changes emotional and psychological state, and cognitive therapy approaches seem to be non-zero in their effect on pain. Hope I have answered your query. Let me know if I can assist you further., Addiction Medicine Specialist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 30 years old. I am pregnant for the 1st time. My pregnancy is in its 14th week. 10 days before I had very nominal bleeding with substances that comes out during period. On that day my doctor advised to be in complete rest and start taking Susten-100 and Duvadilan twice daily. But next morning again I had bleeding, little bit more than previous day. Again I consulted my doctor and he suggested the HUCOG 5000 injection (9th may). After taking that my bleeding stopped completely. After 2 days I again took the same injection, as prescribed by the doctor. Today (18 th May) he has suggested to take the same injection again. But I have started facing another problem, with which I am very much nervous. I am passing small size tissues in the toilet, but there is no bleeding or pain at all. Please advice me what to do. For your kind information, I am taking iron tablets (Folvite), Uvolan SR tablets and Genozyme syrup since my pregnancy was detected. I am also taking Doxinate OD to prevent vomitting. ### REPLY: Hallow Dear, From your history, it is not clear whether the Progestational (Sustain 100) pills with uterine relaxant (Nevadian) and then HU COG injection was prescribed to you after ultrasonography. Your picture correlated with the history of bleeding is suggesting the possibility of miscarriage. The white tissues you are passing are most likely to be the products of conception. Please get your ultrasonography done which will inform you about the status of the baby. Along with get pregnancy test on urine done. It is more than 10 days that you had bleeding. So if the baby is non-viable, by now the pregnancy test would become negative. If the ultrasonography reveals that the baby is not viable and still some products are in the uterine cavity, you will have to undergo evacuation of the uterus. If the uterus has already passed all the products, you need not take any further action. Now since it is about 15 days or so that you started bleeding, it is better you get following investigations done on your blood to rule out clotting disorder (DIC):1. Clotting Time & Bleeding Time2. Prothrombin Time3. Fibrinogen Degradation Products. 4. Platelet counting case of non-viable baby, please do not waste time lest the risk of complications like infection, DIC, etc.  I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I came off my horse, landed on my back, got the wind knocked out of me and hurt badly. Between my shoulder blade on the right side and my backbone, then in my chest on my right side near my sternum. There is a tightness in my chest that goes from my breast area to the middle of my back. I had b-day but they showed nothing was broken. It has been 4 days and not my back pain has increased. Is this normal or should I be concerned? ### REPLY: If X-rays been done for chest and spine and show no fracture perhaps you may have contusion of soft tissues, ligaments. Take ibuprofen 400 mg thrice a day after meals, Tramadol 100 mg SOS for severe pain, rest in bed and do hot fomentation avoiding all movements for 3-4 days. If muscle spasm is there then take chloraxazone tab 500 mg twice a day after meals. Take one pantoprazole 20 mg tab nonempty stomach once a day before breakfast daily ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what dose the combination of these lab results mean or the most important ones inicate:Bun-23.8   Crea-1.5   Co2-29.6    Cal-10.8   Glu-1.4 The Creat has shown a slight increase  from 1.2 over last 2-mos. Patient has been on on lithium for 30 yrs ### REPLY: Hi, The given results of the lab tests are suggestive of chronic kidney disease due to Lithium. Lithium is a medication used in the treatment of bipolar disorder. Its long-term use of lithium may be harmful to organs, such as the kidneys. Kidney damage may include acute (sudden) or chronic (long-term) kidney disease and kidney cysts. The amount of kidney damage depends on how long you have been taking lithium. It is possible to reverse kidney damage caused by Lithium early in treatment, but the damage may become permanent over time. So, Lithium should be discontinued and an alternate effective, but a safer medication like atypical antipsychotic should be replaced to treat bipolar disorder. Hope the suggestion given above would be useful. Feedback is appreciated.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Age - 7 years, weight - 17 kg , name - vansh (male)fever for past 11 days now , max upto 102 deg, TLC - 16700 & so DLC also not good. WIDAL OK, MP- negative. Pain in chest , sometimes seems like vomiting.Pls suggest medicine , doctor given OFLOMAC + Crocin but more fever after 2 doses of it. ### REPLY: Hello welcome to the  according to history provided you are having higher leukocyte count and your WBC differential count also not within limit so kindly let me know your differential WBC count for giving comment on that. You can be prescribed antibiotic course and complete the course of prescribe antibiotics to you. I need to check your platelet count also and investigate with Sept and got as well. After seeing report I can comment for the and let me know if I can guide you further hope this will help you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my elderly mother has lung cancer in the past with removal of half her lung and one third of the other lung. She thought she had a cold and was treating it as such and today she started wheezing and having hallucinations. Should we take her to the emergency room at our hospital. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  She should go for emergency treatment. Vshe may have severe lower respiratory tract infection like pneumonia or other.  Her respiratory capacity is also not good because of surgery.  So she may need external respiratory support.  Consult your doctor and start treatment urgently.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, I m type II dm. currently on Metformin 500 (xr) & glicazide 60mg BID. came down with the flu associated with a bad cough and cold. my diabetologist prescribed augmentin 625 BID and bifilac BID for 5 days therapy to address the flu , this is after i took OTC flu meds for 14 days, since it was persistent he wrote the above. my question is will these meds affect by sugar levels, also since the first dose, I m getting weak and drowsy. please let me know should i continue the meds with my diabetic meds also I m on finofibrate 145mcg qd . thank you. ### REPLY: Welcome to . I went through the history you have provided here. It seems from the history that you are having that you are a known diabetic on treatment with Metformin and Glucoside tablets. The treatment prescribed for fever, cough and cold by antibiotic in the form of Augmenting is in correct direction and these tablets will not affect the sugar levels. You need to continue the treatment as advised by your doctor along with the diabetic medicines. Hope this is helpful to you. Do write back to me for further questions. Thank you for writing to us. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 kid i suffering from wheezing problem sometimes...she is bit allergic...recently doctor suggested to use Asthalin inhaler 200 m doses and seroflo inhaler 125 m doses...she is 5.5 years old....can you please give more details about this ### REPLY: Hi, I had gone through your query and understand your concern. These medicines are prescribed by the doctor thinking of probable asthma. Asthalin inhaler acts as a reliever whereas Aeroflot inhaler acts as controller as well as reliever of attacks. If I were the treating physician, I would first look for triggers(cold, dut, exercise etc.), personal history of atop, family history of atomic diseases (asthma, eczema,hay fever etc.), sleep disturbance and other typical symptoms of asthma like cough, breathlessness,chest tightness. I would then perform objective test if possible to confirm the diagnosis of asthma and exclude other diseases like bronchitis, brochiolitis etc. If asthma is suspected, then I would start treatment according to step care management guideline of asthma. Seroflo inhaler is a combination of albuterol and fluticasone. Salmeterol is a long acting . So my suggestion is :please consult with a respiratory medicine specialist to confirm the diagnosis and get proper step care management. Hope this helps you. Wish your kid 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: Abdominal pain , pain spreading to belly, farting, bloated, increase in pain before gas HI, I m haveing lower abdominal pain that started 3 days ago. It hurts so much now that it hurts to walk. it started on my lower left abdominal area and now it seems to have spread across my lower belly . I ve also now noticed that I have been frequently farting, not a whole lot, but much more than normal. I want to say that I kinda feel bloated but not entirely. Also I have pinpoint pain when I press on the area. It s getting to the point where it consumes my whole day, by that I mean it hurts all day long. I also should mention that the pain gets real bad right before I pass gas. Do yoiu have any ideas? thank you. ps, just in case you need to know, I still have my apendics. ### REPLY: Hi Lawson ! Take dicyclomine for abdominal pain. But we still don't know the cause. You can go for stool examination for occult blood, it will show is their any internal bleeding. But if result is negative still pain go for full abdomen ultrasound. I am sure you will know the cause. And if stool examination is positive go for contrast x-ray or endoscopy. Will relieve you from your doubt. Take care. Bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dad has a history of adenoid cystic carcinoma.  It traveled to his left hip.  He had radiation to that hip and his tumor was gone. He is taking a chemo pill as a preventative measure.  One week ago, he was walking/ moving perfectly.  In the last three days, he said that his left leg was sore.  Yesterday, he couldnt move it at all.  I thought that maybe he was too active with this leg given the damage from radiation.  His last scan (3 months ago) was clear.  Could a tumor cause this so quickly? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has metastatic adenoid cystic carcinoma. It may be due to tumor itself or some nerve damage.  He should go for ct scan to find any further tumor spread or not.  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


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 swong a golf club way too hard and hurt my lower left side of my back. I was able to finish my game but in the morning, besides just my lower back ache I had a burning sensation in my upper left thigh with very sensitive skin to the touch. It still bothers me after almost a week and sometimes it migrates further down my leg.Usually it is the tenderness that bothers me the most then an aching pain, but sometimes I get a sharp pain in the upper left thigh. ### REPLY: Hallo dear friend, thanks for writing to ChatDoctori have studied your case this is you first episode or repeatedly having same problem lumbar disc prolapse leads to sudden pain acute muscular sprain due to heavy lifting weight, spondylolysthesis can lead to same picture you need methylcobalamine, muscle relaxant with analgesic take rest,, hot or cold fomentation avoid lifting weights sit with taking support to your back continue spine extension exercises physiotherapy - SD, IF TWILL HELP for further query contact on my profile directly ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 37 year old male.  Tonight I noticed a lump the back of my right leg just below the calf muscle.  It would best be described as a roll about half an inch tall from top to bottom and running across the back of my leg.  No pain.  I occasionally have a little swelling around my dress sock line, but this appears to be different. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma., dermatofibroma. Or some benign cyst or ganglion cyst.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 masterbate daily 2 to 3 times i m getting weak i want sex but i dont have girl friend i never made any sex in life i m 23 male ### REPLY: Hi, Thanks for writing in. It is said that masturbation is normal 2 to 3 times a week. At your age, even if you want to do daily, please do not do it more than once a day. You need to keep yourself interested in other areas like study and work. Eat healthy food and go for regular exercises. Do not allow sexual thoughts to come to your mind. Having sex with unknown partners can be dangerous and give you diseases like HIV and STDs, besides if you have a sex addiction then it will be difficult to control your impulsiveness and this can cause further trouble. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 thumb sized lump on the front of my lower left leg. Half way between my knee and foot. It is jut to the left of my bone, and I can only feel it when I crouch down and put pressure on the leg. It doesn t hurt, but I have been having shin splint lately. Are they related? Could it be a tumor? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some hematoma formation healed with fibrosis or some soft tissue tumor like lipoma or neurofibroma. You should go for ultrasound study.  If needed go for biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. Per an MRI report done 6 years ago, I have bulged discs at L4 & L5 with S1 involved. After doing aggresive yoga last March, the back flared up and I now have hip and groin pain that sometimes radiates down the front of my leg to the foot. I also have CRPS. I had a block done for L3 & L4, started pool therapy, and nothing is helping. Are there any PT exercises that might help? My doctor is ordering another MRI. ### REPLY: Hi, thanks for writing to . As you have Lumbar disc disease in multiple levels, you are not supposed to involve in any activity that produces strain over your lumbar spinal musculature, which worsens the disc prolapses. Physiotherapy will have little help in alleviating the articular pain (radiating pain) and is useful only in treating Chronic low back pain. A repeat MRI scan is always helpful in assessing the present condition of your disc disease. The general management guidelines for a lumbar disc disease are as follows -- Maintain optimum body weight, if you are obese-Avoid lifting heavy weights as it imparts more strain on your back-Avoid excessive forward bending activities as it will worsen the disc protrusion. If you want to bend forwards, do it with your hips and knees flexed.- Use a lumbosacral back support to stabilize your spinal muscles- Intermittent pelvic traction might be helpful to cause a regression of the protruded disc- Physiotherapy is needed to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.- Use analgesics like Advil or alive and muscle relaxants as needed. Vitamin B12 supplements & Pregabalin may be helpful. If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. Hope this information is helpful. Good day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: for the last couple of weeks ive had a more or less constant headache, on and off pain in the stomach/pancreas area, light-headiness when going from sitting to standing position, nausea and feelings of low blood sugars. please help me to find out what it is ### REPLY: Reading your symptoms indicates you are suffering from hypoglycemic attacks or lowering of blood glucose levels in the body. There are certain condition that can cause hypoglycemia. Most important to rule out is tumor of pancreas which can cause excessive insulin production and production of symptoms like fainting, light headdress, blackout attacks, perspiration, tremors, headache etc. These symptoms can be relieved by taking sugars. Also, some time in some persons there is excess insulin production in body which can lead to these symptoms. After certain surgeries on the stomach, these symptoms can be produced. So first thing you do is get your fasting blood sugar levels and insulin levels done followed by USG abdomen if necessary. Kindly note whether yours symptoms are relieved after taking sugars which is very simple test and it confirms whether your AR actually suffering from hypoglycemia or not. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was involved in a mini domestic explosion cause by gas in the kitchen. I had some burns which were treated with antiobiotics and creams. It has been a couple of weeks now and I have a bloated stomach with pain on my left abdomen - are the two related? should I be worried? ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern here you have a history of antibiotic therapy and antibiotic induces the abdominal pain and some time loose motion too because this disturbs the intestinal flora, this can be treated with the "Lyophilized Lac to bacillus" and for the abdominal pain the best option is" Dicyclomine" hope this information helps you, take care and have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My one month old baby is having problem with stool, hes on formula also on breast fed hes having enfalac which was working out quite well but since last two days he hasnt poo. What shall I do .he cries and is very cranky also gives alot of pressure when he wants to poo but doesnt help. ### REPLY: Welcome to the ChatDoctorI completely understand your concerns but don't worry. Infants can have wide variations in frequency, consistency and color of poops. The most common reason for hard stools is deny . I would recommend you to try for exclusive breastfeeding as it is easier to digest and good in long term. In case you have to continue formula feeds, then give with proper constitution and hygiene. Ensure regular feeds to avoid deny ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had the implant for 1 year and 2 months with no bleeding whatsoever. Recently i have been bery ill with a chest infection and norovirus but im on antibiotics and recovering, about 2 days into my illness ive saw spotting when i wnt to the toilet, now im heavily bleeding and got tummy pain this has been going in for 3-4 days now! (before the implant i hardly bled it was very light and only lasted 2-3 days)... Why am i suddenly bleeding? ### REPLY: Hi, Thank you for choosing . Your periods may change significantly in the first year of using a contraceptive implant. You will usually have irregular periods and may have heavy periods, shorter and lighter periods, or your periods may stop altogether. These changes may settle down after the first year of using implants, but they can sometimes continue as long as the implant is fitted. Although these changes are not harmful, they may not be acceptable for some women. Your GP may be able to help by providing additional medication if you have prolonged bleeding. Please ask if you have more questions. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son has broken his wrist on the 19 of dec he had his first xray and all seemed fine but since then he s ulna bone has moved since being in a cast, they are doing another xray in a couple of days to see if it has moved and if so they will be putting a pin in. now my question is if his ulna bone has nt moved again and no pin is needed can he fly 17days after his break or is the pressurized cabins in an aircraft still going to affect him and make more swelling and is there any reason that a doc can t cut his cast for a 4 hr flight and then be replaced once off the plane ? ### REPLY: Hello, It may be due to fracture. For further assessment you may require X-Ray after orthopedic consultation. Further treatment mainly depends upon the underlying condition. You may require surgical intervention after surgeon consultation. For pain, you can take tablet acetaminophen. Till then use sling support. Restrict your movements Hope I have answered your query. Let me know if I can assist you further.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ive been of work due to something that happend, my visiion went like a black out and i fell back into the wall and snapped back out of it straight away after wards i was shakey and heart was racing i get headaches at the front over my eyes quite alot and this is when i get this sinking feelings and dizziness ### REPLY: Hi, I am .  I have read your question with care and understand your concerns. Let me try to help you Question : What causes blurred vision along with headache and dizziness? Answer : Increased of Pressure inside your skull can cause all the symptoms you have mentioned. Increased pressure is an emergency and has to be dealt at once Please consult a Neurosurgeon at once Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have dark brown patches on my neck , chest face, arms and legs. when i itch these marks appear. i have been to two dermatologists and each one has a different diagnosis. I need help as i am scarred and this is increasing. My next appointment with another dermatologist is in may and I am also haveing breakouts of pimples . ### REPLY: Hi. Thanks for your query You have two different concerns.as for the brown patches, you might be suffering from an edematous disorder. They are frequently recurrent and moderate to severely itchy. Topical steroids/ tacrolimus/ pimecrolimus are he mainstay of therapy. You can start oral anti histamines to combat the itching, as the itching creates an itch scratch cycle which perpetuates the lesions. Keep the areas moist, it reduces the recurrence. As for the acne, you can start application of Clindamycin gel twice daily n face. Use Detail Cleanser for oily skin .you can apply the Retinoid creams topically at night starting with alternate night application and as your skin tolerates it, you can use it daily. Do not use heavy creams and stick to gel based moisturizers and sunscreens. Hope this helps. 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 am a female, 25, living in Mumbai, India. I have been having severe headaches since past 3-4 days. I got the WIDAL test done for typhoid, and it showed a value of 1.4, which confirmed I got typhoid. I got a temperature of 100+. The doctor has prescribed mahacef plus tablets for 5days. I want to know if it is something very serious. I have never had typhoid before. Also, I stay away from home in a PG. Can my sickness spread to others living with me also? Should I take an off from work and go home for a week or so? Or is it possible for me to get back to work? Please suggest. ### REPLY: Hi, During the first week of fever, typhoid can be confirmed only by blood culture and not by Tidal - which should be used to diagnose typhoid only from the 8th day of the fever. Also, Tidal is a test known to give false positive results also. I recommend that you get a blood culture done for yourself. It will take a minimum of 3 and a maximum of 2 weeks to get the results of the blood culture. The main advantage of this test is that it precisely gives details of the antibiotics which are capable of acting against the Salmonella bacteria that caused your infection. Given the widespread antibiotic resistance that we see in typhoid, it is important that this test is done. In the interim, until the final results are out, you should start an antibiotic. You can continue with Managed itself, which you have already started taking.  You can change the course after seeing the results of your blood culture. I would advise you to take off from work if this is indeed typhoid. Your urine and feces will contain these bacteria. Remember to wash your hands thoroughly after you visit the bathroom every time. You are capable of disease transmission for at least 3 weeks after your complete recovery, as the bacteria keeps getting shredded in your feces until then. You do not have to be paranoid about this. These are general precautions that are adopted for all communicable diseases. Hope this helps! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am undergoing RCT traetment for 10 teeths of upper jaw,I have started feeling inflamation in my cheeks and inner skin of mouth fewweeks back, I consult with the dentist yestareday , he told that you are suffering from litenoid reaction and suggested me the Dentogel liquid. But still i am feeling discomfort in my mouuth. ### REPLY: Hello and welcome to  forum,first I would like to inform you that it is licensed reaction if I am taking you right, this is an allergic response which occurs due to a number of factors, some of them include;oral medication or . Therefore, do not worry these symptoms subside gradually once the irritating agent is removed and as you mentioned your dentist has already checked and prescribed you a topical gel. This will definitely resolve the symptoms, you just have to make sure to maintain your oral hygiene by using antibacterial mouth rinse. Also visit your dentist at regular intervals, to make sure that this reaction has subsided. Just be calm and keep applying the gel, i wish 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 There, My name is Michelle. I am 22 Years old and i have been smoking crack once a week for about three years now. I am now coughing up black flem with pitch black dots in it and i am really scared. I know it is self inflicted but right now i am coughing so badly there is so much flem that wont come out and i dont know what to do i am really stressing ### REPLY: Thanks for your question on . I can understand your concern. Cough with dark phlegm is suggestive of bronchitis more. Any form of smoking can cause bronchitis (inflammation of airways). So better to quit this habit as soon as possible. Consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). You will need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 8year old son has had a fever for the last three days ranging from 100.2. To 102.7.   He has never has a fever higher than 100.1 before.  He keeps complaining of a headache, and hasnt done anything but lay around for three days.   Should I take him in to see his doctor or to you think its just viral ### REPLY: Most often such episodes of high fever are caused due to certain viral infections. Treatment with antibiotics does not help and irrespective of the treatment, it takes 5-7 days to recover. I would not get concerned if the child is active and fine but if the child grows lethargic or .  If the fever lasts more than 7 days, other causes like typhoid might need to be considered. On the other hand, if the fever is associated with chills and rigors, it could be due to malaria or a urinary tract infection and tests to detect these conditions might be needed without delay. Headache or body ache are might not be specific for any cause and should get relieved with paracetamol. But if severe, medical advice should be sought. So, depending on the associated symptoms and the general well-being of the child, you should be able to decide when the child needs to be taken to a doctor. ### END