Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, thanks for your time. Any attention you can give this is greatly appreciated. I have been getting cold sores since I was a baby, and I am now 32 years old. My cold sores have suddenly increased in frequency during the past year or so from about 4 times a year to being chronic. They are no longer isolated to only my lip, sometimes appearing under a nostril . I originally got them only on one side of my lip. Now I get them on both sides, occasionally the bottom lip as well, and may experience several outbreaks recurrently. When one has nearly healed, if under great stress or if I have a cold, another will start to appear in its place. I am wondering which type of specialist to consult about taking an oral tablet/capsule for the first time, since creams alone are not sufficient or practical in this case. I have hashimoto s disease and bipolar disorder , and take medications for both, so I don t know if I can see my endocrinologist whose practice also deals with immunology in order to address this. ### REPLY: Hello, welcome to . As you are having recurrent cold sore, then there is need to find cause of frequent recurrence. Cold sore outbreaks may be influenced by stress, sunlight, sunburn, fever, deny .  You already have bipolar disorder which increases stress in life. So, control your thyroid condition and bipolar disorder under control to prevent frequent recurrence of cold sores. For medical treatment of cold sore, you can visit dermatologist (skin specialist) 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: hello doctor .my name is maheen..age 20, weight 51,i am married and it is being one year age I am trying to conceive but I am not getting pregnant...I also visit doctor they suggest my huband semen analysiswhich report comes normal then she take ultrasound of me which name is usg pelvis...report is here endommetium appear normal measuring 3mm in thickness..multiple follicles of vaiable size appear in both ovaries follicle measuring 17*19mm in right sided...can you guide me why I am not getting pregnant whats wrong with me..any suggestion you want to recommend me ### REPLY: Hello welcome to  madam maiden you have told that your husband semen analysis report came normal,it should include normal count and also normal motility.if motility is not there.there lies a problem.secondly, your USG report,ovarian follicular size are normal... What about your menses whether they are regular or not.if not go for hormonal studies. If your menses are normal and normal flow,,,then go for tubal(fallopian tubes) patency tests using hysterosalpingography after consulting infertility specialist. Hope you understand my suggestion and answer. Hope you become pregnant soon thank you .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes , just found out today my uncle has just weeks to live , he has pancreatic cancer and blood clot . how long can he actually live , he can not eat has not eaten in 10 days. he had bile duct cancer 23 months ago and has really never gotten better from the whipple operation ### REPLY: Thanks for your question on . Pancreatic cancer is very aggressive in nature and notorious to produce blood clots. These clots can travel in blood and reach to lungs and brain and cause symptoms. So presence of blood clots made your uncle stage 4 pancreatic cancer patient. Only palliative treatment is required. Usual life expectancy is less than 6 months. But since your uncle has stopped eating, I think in his case life expectancy would be less than 2 months. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am nisha. My husband is not feeling well. he is 31 years old and he is having swelling in both legs (foot) without any pain and all the tests are normal (Sugar, BP, Urea and Vascular scan-Venous doppler scan). Doctor s said that it was filarial lymphedema. and also he is having breathing problem. even he is not able to sleep properly. and he is having pain in his upper stomach part feeling like something hard in his stomach. please advice whether its curable.what type of physician should I have to contact for this type of issues. ### REPLY: Hello, Filial lymphedema is a curable condition and occurs due to parasitic infection. If untreated it can lead to complications in the vascular supply and also lead to easy infection.  Since it's curable by the medical treatment you can contact the vascular surgeon for the same. Post having a clinical examination he can be treated with medication for the same. Using lower limb stocking can help reduce the swelling and keeping it elevated over a pillow.  Manage the water intake and output so the swelling doesn't occur much and also avoid the cardiac overload. Simple ankle toe movements with straight leg raise will even be helpful to rescue the swelling. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had a bladder infection in july i think.  I took medicine and it went away.  before my period i had small amount of blood when i urinated.  after my period is gone now i notice it again.  I dont really have any other discomfort like before.  any ideas  i didnt have this when i had the infection before?????thank u ### REPLY: Hi, welcome to  forum. The first thing to ensure is that, blood comes from urinary tract itself, and not vagina. Vaginal blood usually presents as fresh blood admixed with urine,whereas blood from urinary tract presents as cola colored/brown colored urine(unless it comes from urethra, which is very rare in females). An urine routine examination may be useful. Bladder infection usually do not cause blood in urine. If the problem persists even on days away from your periods, it needs detailed evaluation. I hope you will find this information useful. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just woke up with pain in my chest around my left breast. Lasted for about three to five minutes. If I tried to roll over or take in a deep breath. It would feel someone was stretching my heart. My husband rubbed some muscle relaxer cream over the area and it seemed to release. I was able to sit up. But was so scared. I started to have a panic attack. I feel a dull ache still there, feel a little gas in my belly. I dont have a history of reflux. Ive been under a lot of stress lately.  Afraid to go back to bed. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of musculoskeletal pain is more. And no need to panic at all. This pain is mostly due to bad postures during sleep. So first be relaxed and calm. Avoid stress and tension. Avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Avoid bad postures during sleep. Start painkiller and muscle relaxant .  Since, these are prescribed medicines, you need to consult doctor for them. 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: hello doctor i am 20 yrs old i have been suffering from acne and did consult a doc about 1.5 yrs ago.he suggested the following routine that i have been following from past 1.5 yrs. 1.Saslic ds face wash twice a day. 2. Bengel acra 2.5 on pimples 3.acnemoist moisturiser 4.deriva ms gel which has recently been changed to deriva bpo gel My doctor also every month does chemical peeling on my skin from past 1.5 yrs. But i have red pimple marks on my cheeks due to use of retinoid (deriva) and also open pores. should i stop chemical peeling or not? will chemicAL peeling help in fading acne marks and reducing pore size. i still get some pimples on my cheeks forehead ,etc. my doc also said to continue reading all these products( face wash ,bengel ,deriva) till the age of 26 or 27. can i use only these products for 7 - 8 yrs. how can acne marks be faded and pore size be reduced? plzzzzzzz help ### REPLY: Continuous use of the products you're using can only be advised if the doc feels that the benefits are more than the side-effectsand there is nothing that u have to use only these products for so long chemical peeling is not the mainstay of treatment of acne but retinoids Armand how to be used and for how long can be determined by dermal onlybengel need not be given for so long, it can be avoided if the dermal feels.  To reduce the acne marks and pore size u might have to use topical and/or oral retinoids for long duration as suggested by dermal 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 husband has parkinions  he is 86  he has some demencia and has some behavioral problems.  The have him on 2 sericquell and it makes him so groggy. They want to change him to 1 pill of zyprexa  a day to see if he would be more alert.  Do you think think zypreza is good? ### REPLY: I read your query and I understand your concern. As you seem to understand both Seroquel and Zyprexa are used just to control his behavioral symptoms and do not cure Parkinson or dementia. The trouble with .  For that reason Seroquel was a good choice because it doesn't cause parkinsonism. Olanzapine (Zyprexa) isn't as safe on that regard, but still little effect on Parkinson's compared to some other antipsychotics, so since Seroquel is causing so much sedation it is a good compromise. Another option is Clozapine which like Seroquel doesn't affect Parkinson's, but I guess doctors fear another possibly serious side effect of it, suppression of white blood cell production. I hope to have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Soon I will be going on either adderall or concerta to combat my ADD for when I go back to school in January. Im 18 and will hopefully get the good enough marks to go to the university of my choice. I am also very active, weight-training 5+ days a week, and I m wondering whether or not going on concerta/adderall will have a negative impact on my TESTOSTERONE levels and the ability for me to build muscle. ### REPLY: Hello, Thanks for using  for posting your query. I have gone through your question in detail and I can understand what you are going through.That's a myth and concert or Adderall doesn't have any significant effect on your testosterone levels. It will not impair your body building. In fact use of stimulants will improve your attention and will help you in planning your time for weight aerobics. Hope I am able to help you, If you have any further query, I would be glad to help you. In future if you wish to contact me directly, 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: I am 37 weeks along with consistant lower back pain. I took a hot shower for 36 mins tried with pillows behind my back and laying in multiple positions and nothing is helping... I ve been in tears 3 times today due to the pain! Also getting pains down my thighs.. Could this be labor? ### REPLY: Dear patient Back pain during pregnancy is common and occurs due to increased weight of uterus which puts stress on your back and leads to increase lumbar lordosis. If you were having back pain prior to pregnancy there is high chance of worsening of pain during pregnancy. Back pain worsens as pregnancy duration increases and is highest during third trimester. This is physiological during pregnancy. Improve your posture and apply hot water packs and diclofenac gel to your back for pain relief. This pain will subside once you deliver the baby so do not worry. You can also take tab diclofenac 50 mg SOS for pain relief. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son 14 years age has mild TR in echocardiogram, now in chest x ray PA view doctor reported heart is not enlarged, mild prominence of right heart border, some hilar congestion and mild pulmonary vascularity, lungs are clear, no inflamation, no solid mass. He suggested ecocardiography which we already had, his serum Ig E level is high 686. In fact boy has off and on cough problems, sore throat with fever.When he was an infant doctors asked for heart check up, which later I did mild TR little PASP 35 mm Hg with no other defect RBBB in ECG. My boy has got good height say 68 inches but I am worried about his health.Kindly guide me. Thanks and best regards. Rehan Adil ### REPLY: HelloWelcome to Ask a Doctor Service I have reviewed your query and here is my advice. The findings are not suggestive of any disease of illness, and what ever the cough symptom he has that could be due to some allergic condition or may be nonspecific if this is the allergic condition then it is self limiting and no need to worry about this Mild TR has nothing to do with the symptoms he has, you can discuss this with his doctor Hope I have answered your query, let me know for further assistance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ,almost one year I do have lower back pain that I can not seat more than half an hour and when I want to stand up to stay tall it takes some time and there is another thing may be its related is about 3month ago all of my neck lymph nodes came out and I felt lumpy things along with pain after 2 weeks they gone and transferred to my breast close to my under arm I think it was my under arm lymph nodes I did blood test and ultrasound for my neck and my breast and every thing is ok but still I have a weak pain at the same time when I went to specialist for my lower back pain he said you have mild sacroiliac artritis and today he got my blood test and my bone scan result he reffered me to romatologist when I explained all of these to him he said you have autoimune desease.now my question is do you think all of things(my lower back pain and my lymph nodes)are related together which one is trigger for the other since I have lots of weakness as well.Thank you ### REPLY: Here for normal individuals who do not have autoimmune disease, back pain and lymph node problem at neck level cannot be related to each other but since you are already diagnosed with autoimmune disease it can be related in your case. As per my suggestion you should visit rheumatoid specialist and take specific guidelines from him for your back pain. You can also visit physiotherapist who will guide you with spinal exercise program which will help you to improve strength, stamina as well as flexibility for your spine. Another problem what you explain hear about your lymph node swelling I suggest if it's increasing then you should take a note on that and visit doctor and take his opinion. You may go for lymph node biopsy to rule out there is no other abnormality other than inflammation. Here you also need to understand what happens with the people who have autoimmune disease. There are various type of autoimmune disease but the common problem with all these patients are the bodies immune system gets activated against the bodies normal cell so that there used to be an inflammation in the body which will create pain and disturbance in normal functioning of bodies system. Usually we have found people who are on anti-inflammatory diet (omega 3) or anti-inflammatory .  Also doing regular exercise helps to generate certain hormones in body which have healing as well anti-inflammatory effect on body cells. So that also helps with this kind of patients. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my wisdom teeth removed friday morning. Today there is barely any pain at all but today i noticed what looks like a tiny little white puss on the scab/extraction site. Is this normal? If I keep taking the prescription they gave me should I be good? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have symptoms of small pus filled bump after wisdom teeth extraction which is due to naked socket and formation of blood clot. Need not panic about that. This is normal process of healing. I would suggest you to maintain proper oral hygiene by brushing, flossing. Do warm saline rinses several times a day. Avoid having food from extraction site. Visit dentist once if any symptoms of pain and swelling will appear and then start treatment accordingly. Avoid touching tongue to extraction socket and avoid sucking liquids forcefully as it can dislodge clot. Hope your concern has been resolved. Get well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I ve recently taken notice to a bunch of small, raised bumps on my hands. The bumps are no larger than this o and do not itch but do hurt. I get shooting pains when I move fingers or other muscles around the bumps and the bumps normally are in groups of 2 or more. Do you have any idea what they could be or what could be done to get rid of/prevent them? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, in my opinion, you are mostly having multiple neurofibromas. They are tiny lumps originating from nerves. This is the reason for pain on rubbing. Usually no treatment is required. But if you feel very annoying then first get done ultrasound examination of local part to know the extent of lumps. Surgical removal is usually indicated to remove them. 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: what is the problem whan your V.P.M in blood test is more then 10 i have my blood report , and my V.P.M is 12,9. I just wanna know what it signify when it is more than 10 ### REPLY: Hello, if you are referring to the mean platelet volume the normal is between 7 and 11.5. Yours is on the higher side. These are seen in certain conditions like May-Hegglin Anomaly Bernard-Soulier Disease, idiopathic thrombocytopenic purpura etc.it also means you may be in for increased risk of platelet aggregation and activation diseases like stroke.I would advise you to follow up with you physician regularly and get yourself treated with BP monitoring, test for your blood sugars too.I hope I have answered your query. Take care and contact us back at  if you need further help ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear All, I m taking Qlaira now for 3 months but I recently read that I can t take them if I have over 90 kg. Before I started taking them, my gynekologist sent me to make blood examines and everything was ok. Can I keep on taking them or? Thank you in advance, best regards, V ### REPLY: Hi, It may be taken for a short duration. Area is a combined oral contraceptive pill may cause small amount of weight gain as its one of the common side effects.  There may be an increased risk of thromboembolic disease in obese women on prolonged use. So, I suggest you to use progesterone-only pills or depot me .  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: Hi, I have a pain in my left shoulder/ arm and left side of my chest the last week or so. I also have sharp shooting headaches for about a week also. I had a baby ten weeks ago if that makes any difference? When I was in labour I had a severe pain in the top of my spine which also hurts every ow and again. ### REPLY: Hello, As I see that most people usually don't complain of the upper limb pain post delivery, but very few complains have been received. This might be due to degenerative changes in the intervertebral disc.  Taking an MRI of the cervical spine along with lumbar spine after a synced certification would help understand the pathologies better. Using a soft cervical collar will help stabilize the cervical spine and reduce the cervicogenic headache and upper limb pain.  In my clinical practice of over 12 years, most cases post delivery undergo Physiotherapy for better health and muscle strength. Thereby reducing the symptoms and helping them for ease, will recommend you the same. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a general physician.My pt. 34 yrs. male had been in U.S. for last 6months.He developed High grade fever 20days back n the U.S.Associated with chills & rigors esp. in the evenings.Antipyretics brought the fever down with clothes drenched.he became normal duri ### REPLY: Hello there, I am . Hope I have given appropriate guidance to you. There are three most common cause Malaria, Urinary tract infection and Lower respiratory tract infection.TO rule out these you can correlate history which system is infected. If it is malaria it may be relapsed of malaria because he had malaria when he is in previous country and not treated properly it may relapse any time after any long time. So first cause is this. Other cause is rule out by history and then treat it after doing culture test and follow the sensitivity report. If you have any query you can consult me anytime. Give me star rating, helpful vote & thank you according to your satisfaction level. Thanking 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: Hello doctor... I have been experiencing dyspnoea and chest tightness since 20 days. On advice of my chest physican, I Have taken predmet 16, pecef duo, combimist inhaler.. No major relief. Was prescribed seroflo inhaler.. Developed tachycardia!Currently on nebulisation doses.. Ipravent 3 times daily and budecort 2 times daily along with ivabradine 5 mg, predmet 16 and pecef duo for 5 days. Experiencing extreme farigue and heavy breathing. Please advise. ### REPLY: Hello dearWelcome to .come have evaluated your query thoroughly.* There is definite underlying lung issue not diagnosed or not responding to recommended line of treatment.* Strongly suggest getting x-ray chest, pulmonary function test with certain laboratory tests according to the clinical need .* Consult later with reports for final lay out of the treatment. Thanks. Regards dear 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 My father just got diagnosed with the Neuroendocrine Carcinoma with mets into liver. his age is 73, colonoscopy is clear, CT with contrast showed no tumors anywhere else apart from liver, CEA is normal, Hep B and Hep C are also negative, Gamma GT is 100% more than normal, Prostrate is 40G, fasting blood sugar is upper borderline since last two months with no history of diabetes before that, hypertensive since 20 years. had an eye operation for cateract and lense two years ago. ### REPLY: Thanks for your question on . I can understand your fathers situation and problem. Since he is having liver metastasis, he is having stage 4 neuroendocrine tumor. It is a inoperable tumor. So only palliative chemotherapy, radiotherapy, pain management and nutritional support are required. So better to consult oncologist and discuss all these and start appropriate treatment. Hope I have solved your query. Wishing good health to your father. 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 wife drop a broken plate on her arm a few inches from her wrist. There is a very small cut about 1/4" or less. There was swelling but we put ice on it and got the swelling down. She has use of her arm and hand with pain. There is some bruising around where the plate hit and a little wider around the effected area. Do you see any reason to go to the ER? ### REPLY: Cellophane You for contacting . Bruising occurred because blood has accumulated at the site of injury. Its color changes with time. You need not worry. It will resolve itself in few days. I would suggest her following things:> Take rest> Don't touch the wound with dirty hands> Apply poly fax plus ointment thrice a day> Wash hands before and after applying.> take acetaminophen for pain Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. Wishing her 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: Lately been getting tingling sensation in left side of chest area and upper left arm area. No pain , just tingling Seems to come when I eat and sometimes stays around and other times goes right away. When I exercise I feel great and dont feel a thing. ### REPLY: Thanks for your question on Health Care. I can understand your concern. Left sided chest and arm tingling sensation can be due to heart related diseases. So better to first rule out cardiac cause. So get done 1. ECG 2. 2d echo 3. Stress test (trade mill test). If all these are normal then no need to worry about cardiac diseases. Sometimes stress and anxiety can cause similar tingling. So avoid stress and tension, be relaxed and calm. Don't worry, you will be alright. But first rule out cardiac cause for your symptoms. 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: Doctor, I am Thalasmia minor. I am 46 years old male. Height 180cm and weight 76kg. my blood Hgb and Colostrol level always low, what medicine I have to take. What are the precuations I have to take in food. Some times my Hgb goes down and become very tired. Your advise please Hgb 122 g/L Plt 105 WBC 6.3 RBC 5.67 ### REPLY: Hi, If hemoglobin .  Iron, TBC, B12, Folate as well as relic counts and LDH might be needed at earlier stages. Using supplements for iron b 12 and folic acid after the levels may help to rebuild the levels. Cholesterol If low is normal unless HDL so detailed lipid profile may be done in fasting and discussed in follow up. Hope I have answered your question. Let me know if I can assist you further. Wishing you a speedy 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 have a few questiins. 1 my rbc is high 6.17 what dies this mean? 2 my mcv is low 62.1 what does thus mean? 3. My mch is low 19.9 what does this mean? My palatelet is 300 is this normal? My dr said i have hemoltic anemia ,could you explain that as well? Mind you i am a 28 year old female and only 4 7 at 70 lbs and also have heart issues such as a thickend. Leaflet. A target on the ventriculer of arotic valve, pulmiary hypertebtiin shown in echo, ### REPLY: 1/-Your high RBC count means your bone marrow is actively trying to produce more & more red cells. This might mean your red cells have short life span & the marrow is trying to compensate.2/-Your low MCV mean that red cells are smaller than usual. This commonly happens in iron deficiency and thalassemia (a hereditary type of anemia associated with short red cell life span due to increase tendency to die in spleen & bone marrow.3 /-Lows MCH means each red cell contain hemoglobin that is less than normal.4/-Your platelet count is definitely normal.5/-Hemolytic anemia is a disorder in which the red blood cells are destroyed faster than the bone marrow can produce them. The term for destruction of red blood cells is hemolysis. There are several causes of hemolytic anemia which can be clarified by further relevant tests. Your heart condition is probably unrelated to hemolytic anemia. Hope you found the information useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 40 year old woman with a very long history of abnormal cells mainly pertaining to the HPV Virus, I have had numerous cryo-surgeries over the years, I have two children now and am all done with that part, my husband has had a vasoctomy. That was over 10 years ago. 2 years ago abnormal cells were again present and my doctor performed the LEEP procedure. The pathology report after that came back showing remaining cells, then I had I pap or two that would be normal, now back to having low grade abnormal cells. He has in talking mentioned performing a hysteroectomy and leaving the overies. I am meeting with my doctor tomorrow for another 3 month follow up Pap test, and I have really decided that I am ready to be done with all of this. I think it is time to get it over with. My hormonal history is another story it is a disaster, a battle with severe depression, cystic acne, horible PMS ever since my teens, mood swings that my family is just suffering from and I have been treated with medications for anger, irritability to the extreme. My point is this:  Why should it be my doctors decision whether or not I have a hysterecotmy? I have been through over 20 years of this and am out of my child bearing years. I have already had a LEEP procedure that has not worked?? This has gone on long enough? Here is my other question: Why does he have the say so whether or not I keep my ovaries? He told me that I am young and that I need them. I want them gone! I have decided that they are fighting against me. I am already on Bio-identical hormones and we are having a hard time even getting those regulated, because of what my BODY is producing. I am still naturally extremely high estrogen, and it seems to me that with all of the other hormonal issues mentioned above that it may just be easier adjusting hormone supplementation going in from the OPPOSITE DIRECTION?? Without ovaries?? Isnt that my decision? If I am going to have a hysteroectomy? If anyone has any advice I would gladly appreciate it. I am just walking around with HPV and a hormonal disaster, I feel like I dont have the untimate say so. Thank You and I greatly appreciate your knowledge on this subject. emails are fine also! ### REPLY: Hi there ~I understand your concerns and I believe after reading your brief history that getting a hysterectomy would be a good choice for you.  I am glad that you are consulting a psychiatrist for your mental health issues and I believe they will get better after the surgery, as that would be one big thing to worry about less.  About the ovaries, it is up to you to keep them, since your estrogens and progesterone are produced by the ovaries, and you might experience premature menopausal symptoms if you decide to have them removed.  However, you should consult your gynecologist who will perform your hysterectomy about this.  Take care of yourself and have a lovely day! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a question, I have lower abdomen pain, also, have upper right abdomen pain, weak, fatigue , headache . Went to the E.R., they told me that I had pain and my liver enzymes are elevated. I have a doctor appt. this week to recheck my liver and so my doctor can find out what is wrong with me. But now my pain is getting worse and my abdomen is swollen. I need to know what is going on? If you can help me with some information regarding this, because doctors don t know what is going on? ### REPLY: Hi. Thanks for your queenlier will be beneath the Right rib cage in the upper abdomen. So, pain there may be due to some abnormality in the Liver. It may be simple enlargement, infection,abscess, lesion etc. As your liver enzymes are elevated, you should be further investigated like Blood tests for Hepatitis A/B/C, Ultrasound abdomen, Repeat Liver function tests and even CT scan of the abdomen. Swollen abdomen indicates that there may be some collection in the abdominal cavity. It may be simple fluid or pus. You can ask your doctor to aspirate fluid from abdomen and send it for biochemical analysis. Nothing to worry. There is treatment for the majority of liver disorders. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ,today is my husband 58th birthday,we went to lunch & came home took a nap & @ 4:30pm awoke with severe pain in his chest around the breast bone,then started belching then vomiting ,sweating,ect. I was ready to take him to ER but we don t haven t insurance so I googled & believe he had a gallbladder or pancreas attack. He s better now I read to drink apple juices/ apple cider in it so he did & took a pain reliever. My question is will this be more likely now after having this first one to be something that is gonna reoccur ?? Thank you ### REPLY: Thanks for your question on . I can understand your husbands situation and problem. In my opinion your husband had acute gastritis. He started symptoms after outside food. So possibility of acute gastritis due to outside food is more. And his symptoms of severe chest pain and vomiting also favor acute gastritis. So ask him to follow these steps for better 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. Don't worry, he will be alright after these lifestyle modifications. No need to worry about gall bladder or pancreatic issue. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 burning stomach ache from last two days any help. I take spicy food. i always have a problem of pinple on my face especialy on nose, how to control it how to control pimple ### REPLY: Take machine gel thrice daily 15ml each time.  .  Mucaine will help to reduce the burning pain and soothes the stomach wall reduce the spiciness in the food. I sincerely suggest you to see a cosmetologist as pimples get physical examination done it is not related to food. Take these measures along with consulting a cosmetologist never touch the pimples with the hand it is usual that many people keep on titillating them so don't do that wash your face with mild soap at least 4 times a day please consult the cosmetologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE BEEN HAVING A SHARP PAIN UNDERNEATH MY RIGHT RIB CAGE......IT ALSO FEELS LIKE IT IS FLUTTERING SOMETIMES. I ALSO HAVE THESE FLUTTERING SENSATIONS IN MY LOWER ABDOMEN. TODAY THE SHARP PAIN HAS BEEN MORE FREQUENT I AM ALSO FEELING IN THE LOWER RIGHT SIDE OF MY BACK. ### REPLY: Howell come to ChatDoctorYou have not mentioned your age and gender here, this was required here for better advise, your symptoms may be suggestive of hyperacidity, and this can be managed with the medicines given blow, to clear the doubt of any cardiac disease, EKG is must, 1) Tab Omeprazole 40 mg once in day2) Tab Risperidone 30 mg once in day keep the stress level very low, everything would be fine soon, have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am wondering if I should go and see a doctor. I am staying with my inlaws right now and as soon as we arrived 6 days ago I got some sort of rash on the inside of my arms. It appeared after I had a nap on their fold out bed. Although I dont seem to have any allergies I do often have itchy eyes, a runny nose and sneezing when I sleep there. Now I dont have any of those symptoms but I do have the rash which itches intensely and it seems to be getting worse. It now looks like I have mosquito bites all up the inside of my arms, around my armpits and up the sides of my torso. My back is also itchy as well as my tummy and under my breasts but there are not as many visible spots. Does this sound like an allergic reaction or could it be something contagagious? Should I go to the doctor since I have had this for 6 days? Besides the itching I am not really affected. Thank you ### REPLY: Hello, Thank you for writing to us. House dust mite allergy is a likely possibility given the itchy eyes, runny nose and sneezing. Urticaria can happen (itchy hives) sometimes due to the dust allergy but usually unrelated. You will need skin prick tests or specific IGE blood test to find out what your allergies are (aeroallergen panel). Long acting antihistamines like cetirizine 10 mg or fexofenadine 180 mg plus Flonase nasal spray 2 spray/nostril twice daily is recommended for severe house dust mite allergy. You will need to take both for at least 2 months to have a good effect. The antihistamines will also work for the urticaria. I hope that was useful. Best Wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! My fiance recently had an ECG and was told she has a left anterior hemiblock. She has recently complained about numbness in her wrists and hands, as well as some other symptoms. Could these be caused by the LAHB? Also, what will the LAHB mean for her going forward? She is 22 years old btw. ### REPLY: Hello! Thank you for asking on ! Regarding her ECG findings (LAB) it is impossible to find any scientific correlations to This complains (numbness, etc.). LAB is many times normally found in healthy people, and no pathological significance could be .  So, I exclude any pathological indication of LAB regarding that young girl. Regarding her recent complains I would recommend a medical check up by an internist for a comprehensive physical examination coupled with some blood tests. Hope to have been helpful! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have som bumps like things first then i now the larger one have gone but when i scratched that area now watery liquid is coming from the skin not from inside its from the skin which is scratched by me. The substance is coming from the skin in the ball also which i have scratched due to itching....im 16 nd virgin..plz help me ### REPLY: Hi...this looks like an eczema or a skin allergy or urticaria which too is a sort of allergy. Kin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. 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: My name is Ajay and i want to know that is there is any possibility that a woman who doesnt have any children from since 5 to 8 years or more of there marriage can become a mother. I cant tell exactly because she is my aunty and they are my neighbours. Watching Bhavika Kathwadias case some hope is there.Please reply so that i can suggest them & give them some hope that they can become Parents.Thankyou ! ### REPLY: Hello, thanks for using  sure! There are various method of treating infertility, but each is aimed at correcting an exact cause of the infertility. The right cause of the infertility must be investigated in order to prescribe adequate treatment. In couple infertility, both the man and the woman will have to be investigated. The woman will have to do a temperature curve chart, tests such as hysterosalpingography, chlamydia, urea plasma etc. which the man needs to do a program. Its only have this battery of tests have been done that an idea of the problem could be made before adequate treatment. Let them meet a fertility specialist/ gynecologist Best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 22 yr old obese female, recently I ve been having heart palpitations. My heart palpatiations go away when I m active but when I sit down and relax my heart starts beating very fast and I feel as if I have a lump in my throat, it s hard to swallow and I salivate more than usual, but I have dry mouth. My lips are tingling and occasionally I have sharp pains that run through my chest neck and arms. What s wrong? ### REPLY: Hi welcome to . I understand your query and concern. Atrial fibrillation is known to cause Rapid heart rate and fluctuations in blood pressure. I advise you to have a baseline 2 dimensional echocardiography, ECG and lipid profile to assess the basic cardiac reserve of your heart. Restrict the intake of salt to less than 6g/day. Regular physical exercise in the form of brisk walk for 20 min a daily is useful. . Reduce the intake of fatty and fried food. Electrophysiological study with or without Radiofrequency ablation is the procedure of choice in your case. You may also need Coronary angiogram to look for any co-existent blocks in the heart. Consult a Cardiologist and discuss for further expert management. Post your further queries if any. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi gud evening.im  9 week pregnant and finaly have ultrasound my doctor said that may yolk sac is bigger than the embryo the size of my yolk sac is .70cm and the embryo is .19cm no heartbit.please answer me what happend to my baby is he or she safe? ### REPLY: Hi, Presence of embryo is a positive finding, usually we expect a heart beat to be seen once embryo size is 7 mm. So it would be best to repeat scan after 10 days and check for heart beat. Yolk sac more than 5 mm are known to be associated with miscarriage, so I would advise you to have a regular ultrasound scan to track the growth of the embryo.Also, I would like to ask you, are you sure of your dates and do you have a regular cycle? As usually fetal heart should be present by 7 weeks. But it's possible that the conception occurred later or cycles are not regular. Only a repeat scan after 10 days of this scan, will tell us about the growth and prognosis. Hope this helps. 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 treated last week for pneumonia (1/5 of left lung was full), am still on levoquin and feeling better but my now my lungs/lower throat make creaky,squeaky sounds when im trying to sleep. if i cough hard, sometimes phlegm comes up and sound quiets..sometimes not. i REALLY need to sleep, these noises and the stomach pain + insomnia from Prednisone prescribed for same issue are keeping me from getting much rest. Is this sound ok, will it stop eventually, and what do you advise for now? ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* These sound are due to wheezing from irritation of pleura via lung inflammation.* Will come around with the recovery of the lung pathology.  Some suggestions for better recovery - Continue medicines at present given from the doctor.- Gargles with salted lukewarm water and added peppermint oil 3 times a day.- Inhalation of vapors of boiled water with added tincture Benson with blanket over the head for 5 minutes each 3 times a day.- Avoid exposure to excess cold.- Deep breathing exercises, YOGA, fresh air walking must.- Avoid smoking (active or passive)- Avoid exposure to atmosphere with pollen, if necessary use face mask.- Sleep in semi reclining position with back support always till full recovery - Avoid chilled beverages, oily, spicy, excess sugar, alcohol.- Avoid air conditioner, air cooler. Hope this clears your query. Welcome for further doubts. 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: Good afternoon. I just got discharged from the hospital. I have bacteremia, proved by culturing. I am on home health care for antibiotic infusion weekly. I am interested in WBC. Apparently, at its peak, my white count was 18.6. What is considered normal, please? . Thank you. Neal Gilbert Centennial, CO ### REPLY: Hello, The normal number of WBC in the blood is 4,500-10,000 white blood cells/MCL.  These cells play an important role in the immune system by identifying and destroying pathogens (like viruses, bacteria, or fungi). We have five major types of white blood cells: basophils, eosinophils, lymphocytes (T cells and B cells), monocytes, neutrophils. A high white blood cell count may indicate:-infection (like You have),-inflammatory disease (like rheumatoid arthritis or chronic obstructive pulmonary disease)- leukemia-smoking- stress-allergy, etc. Please note that .  These are: corticosteroids, heparin or beta a ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had a lower back injury for about 5 years.The doc I visited after 3 years advised bed rest for a good 10 days.since then my hamstrings have become tight and my quads weak.I ve tried hamstring stretches but can never feel the stretch in my hamstrings.What do I do? ### REPLY: Keep on doing stretches but please with a difference. Pour hot tolerable water over hams and quads. Apply Mahanarayan and Rancagua oils (Ayurveda) mixed. Do gentle massage. Keep for two hrs. If possible do hot fomentation again. Bath with warm water. Again in the evening apply gently Rumply liniment all over ham n quads. May change cycle i.e. armada may be in the morning and other oils at night. But oils are smelly (but very useful). If you can take 1/2 tsp turmeric in a glass of milk or warm water. Or take Hard . Learn and start Yoga postures and exercises too. These oils are available commonly in Indian Ayurvedic shops. Pl report after 6 weeks. Hope it 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 went to the Dr. yesterday and was told I have shingles. They started Thurs and looked like insect bites. The next day there were even more and itched really bad. Finally on Sunday I went to a Doc in the Box and she said I had very early shingles. They are on my right side of my back and a smaller patch on my left hip. I am taking Valacyclovir 3 times a day. They itch really bad but no pain. No blisters, just red bumps in clusters. Do you think this is shingles? Ice packs help with the itching and I have put a cream on them that helps some. ### REPLY: Dear user...sincerely I want to tell u that what your doctor said is true......shingles symptoms matches your words and confirmed by clinical examination ...it is just reactivation of varicella zoster virus.....in the past u were infected with varicella zoster and now when you are stressed reactivation occur .it appears as shingles in certain area of the body .no worry about it just reassurance.... we prefer to administer the vaccine as your antibodies decreased with time . You should discuss with your doctor about vaccination as the vaccine is good for u ...take care of your health wish you healthy life ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, its regarding my mother. She went through a CT scan last month where she was told that there is a 6.7 cm fat containing mass in her kidney and termed it as angiomyliopoma. a benign tumor. She then after a month went to another doctor who performed ultrasound and the report said echogenic mass. Also, it said Medullary nephrocarcinosis and para pelvic lipoma v/s Angiomyliopoma. my question if there is calcium deposits in kidneys, does that mean its cancerous. ### REPLY: Hi, Thanks for writing in to us. Renal angiomyolipomas are benign tumors containing fat, muscle and blood vessels. The treatment depends on the size of the angiomyolipoma. Small asymptomatic lesions (< 4 cm) tend to remain stable but should be periodically evaluated. Medium-sized lesions (4-8 cm) have the most variable behavior. These lesions should be followed closely with serial imaging studies, and if significant changes in size or symptoms are noted, or the patient is at risk for flank trauma, elective intervention should be initiated promptly to increase the chances of renal salvage. Large asymptomatic angiomyolipomas (> 8 cm) will most likely become symptomatic and should be treated electively prior to the development of symptoms and potential complications. Since in your mother the tumor is measuring 6.7 CMS, there is time to wait and watch over next 6 months, for any growth in size and urinary symptoms before thinking about surgical treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my brother has a old skull fracture that has had a blow and now has a baterial infection around skull...green gunk was drawn out of head as it goes down to near his ear, bug was sent off but couldnt detect what bug it was so was sent off again by addenbrooks hospital in cambridge for further tests. intravenus antibiotics were supplied but problem is my brother is now refusing treatment...surgeon/doctor have said this will eventually make way through skull when then he would fall into coma . he is now having hallucinations as talking to walls thinks devil is coming to get him...wont eat as wants to die. yesterday he said he had fell unconsious mind was there but couldnt move at all and when he could nose was bleeding. i really need some advice on length us family may have before he may go into coma? with these recent symtoms? very hard for us all as mental health are saying he is sain but yet it likes how could he be? when refusing treatment as wants to die. please advise?????? kind regards Natalie ### REPLY: Dear friend, welcome to ! It is saddening to know this. He has a skull infection as per your description and is behaving irrelevant, becoming . This indicates chance of getting meningitis or brain abscess. This calls for urgent admission to a hospital, a CT scan of the brain, urgent antibiotics NAD if required, other life-saving interventions. You have to do this despite he's refusing or behaving abnormal and rush him. He may slip into coma soon, throw a fit or worse.  Take care, and please keep me informed of your progress. Good Luck! I hope to have answered your query satisfactorily. Thank you! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had an odd red rash on the back of both of my knees for a few days now. I typically don t notice them unless my jeans rub against them. They kind of look like skin would if you scratched it too much, no bleeding or oozing. The other day I was stupid enough to shave my legs with a barber-shop style hair trimmer (my husband uses it to shave his head, he s in the military ). It s been about 4 days since then though, could that have caused it? I also read somewhere that rashes on the back of your knees could be a sign of HIV . I ve had the same sexual partner for almost 2 years now, and he was tested a few months ago and came back negative. Any ideas or feedback would be great. Thanks! ### REPLY: Hi.thanks for your therefrom what you describe, it appears that you are starting to have an edematous rash behind your knees. You can apply a mild topical steroid for a few days on the lesions and have oral anti-histaminic tabs if it itches. I do it think you are showing any symptoms of HIV due to occurrence of a simple rash. However, since edematous / similar rashes tend to be persistent and recurrent, you should consultant dermatologist to get the appropriate therapy started. 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 Im using karicare aptamil formula for my 3 months baby in Melbourne ,now Im planning to travel to India for few months  so can you pls suggest me the best formula which suits my baby as Im worried about changing formulas and also where abouts is that in Hyderabad. ### REPLY: HI... Almost all the infant milk substitutes are the same. But I usually suggest exclusive breastfeeding till 6 months of age. If that option is not feasible then you can go ahead with infant milk substitutes like - Nan1 or Delay stage one or Lactose 1. I personally prefer Delay stage 1. That's what I used for my kid too. But if the baby develops allergy or blood in stools we need to change the substitute. 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 doc. My son was bitten by our dog last november. He is vaccinated by 5 dose of anti rabies. His last vaccination was just this year january. And he is bitten again yesterday. Do he really need to be vaccinated again? By the way, our dog is also vaccinated for anti rabies. Thanks ### REPLY: Hello Dear. To be on safer side I would advise you to get your son vaccinated again. But it depends on the severity of wound. If it is just minor abrasions then just 2 booster doses on 0 and 3rd day is enough. If the wound is severe or in sites like head, face, neck etc. then the entire course should be repeated. Some doctors may suggest just a Tetanus injection, and ask you to watch the dog for ten days. If there are any signs of madness in the dog in the course of ten days then report immediately and get vaccinated. Otherwise, just a tetanus is enough. This may be the view of some doctors in case you are very sure that the pet dog doe snot have symptoms of rabies and its vaccinated. But still there is a minor chance of risk. Why to take even the slightest risk? Because once if a person contracts rabies then mortality is 100%.Hence, you can contact a physician and let him assess the severity of wound and in case it is a minor wound just ask your son to take 2 booster doses on 0 and 3rd day. Though the immunity lasts for 2 to 10 years but still it is advisable to take booster dose of rabies irrespective of the interval between the previous full course of vaccination, because we don't want to take risk with rabies. Hope I have answered your question. Feel free to contact me if you have any more questions. I'll be glad to help you. All the besting warm regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my daughter is 9 1/2 years old, she was playing roughly this morning at home and she has overstreched herself and started complaining from soreness in the vaginal area, and started bleeding ... took her to the local GP, and he send her back home saying that this is her first period starting...now it has bee 3 hours since the incident, she is bleeding heavily in that area and chuncks of blood are coming out... is that normal for a first period? should we investigate further... ? please let me know. ### REPLY: Hello, First monarch (first period) can be many changes happen before that 2 years, such as growing taller, Breast development, Pubic hair and acne. Normal Monarch start from age 10 to 15. Normal amount in blood loss in with each menstrual flow is 30 to 50ml. There is no practical way to measure the amount of flow. If she bleeds more than 90ml, it is abnormal which is related to immaturity of Hypothalami Pituitary Ovarian axes(part of the brain). Other cause include pregnancy, infection, stress, weight change, bleeding disorder. Less common causes are cervical polyps and leiomyoma such as fibroid. It is not necessary for a girl to see a gynecologist just because they started their period. The first period often very heavy and painful. Your girl 9 years and 6 months, her first monarch is a little earlier than normal but can be normal in some cases. You should recognize the change I had mention above like breast development, public heir happen 2 years before first period. If your child has no those change and keeps bleeding heavily please bring her to see Gynecologist to make sure. 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: Every Time going to Negative Thoughts When we pray or calling to my Dear Allah this time thoughts is become & also not doing a every work i have to perform any work like entertainment films & songs my mind is still in these thoughts my heart beat is so quick please help me urgently ### REPLY: Hi, thank you for using . I can understand your concern. As you said you are suffering from negative thoughts, you also reported quicker heart beat. Do you feel apprehension about some negative thing going to happen? If this is not a recurring thing then not too much of concern but if this is recurring then consult psychiatrist. Most probable cause of recurring symptoms could be anxiety disorder or depression. A detail psychiatric interview is needed for proper diagnosis. Need to undergo some blood test like thyroid function, vitamin B12 level, hemoglobin level. Hope this will help you. 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 calcified granuloma in one of my right lower pelvic iliac chain lymph nodes. I have been experiencing a lot of right side lower back and lower abdomen pain I went to the doctor and they ordered a CT scan it showing that there is more calcification appearing in the lymph node. the doctor has  prescribed 600-800mg of ibuprofen three times a day. is thereanything else that I could do for  the pain it seems like a lot of Motrin, and could this be causing  so much pain? ### REPLY: Hi. This is a very rare finding of having calcified lymph nodes causing so much pain as described by you. Ideally the lymph node should be removed for further evaluation, and also a diagnostic laparoscopy may find the cause of why lymph nodes are enlarged and calcified. Can this is being something like abdominal tuberculosis or other diseases - needs evaluation before a specific treatment is done. The low-back ache can have another reason like sprain or so. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tongue looks awful - it is black and discoloured. This has been an ongoing problem and it s actually getting worse! I ve visited my GP tonight who, other than prescribing an oral gel (Daktarin), says that there is no other treatment. I m happy to try the Daktarin in case there is any oral thrush present, but I m so embarrassed about it - I dont want to laugh or smile because my tongue looks absolutely dreadful. I have taken background dose of antibiotics - Erythromycin 500mg twice per day, for a skin condition for about 13 - 15 years now, and I know these can contribute to the cause. Can you advise of any treatments please? Someone said fresh pineapple works as it contains salycilic acid? ### REPLY: Thanks for your query, I have gone through your query. The discoloration over the tongue can occur secondary to the food debris, or it can occur secondary to hypertrophy of the papilla or black hairy tongue or hairy leukoplakia. Consult an oral physician and get it evaluated to rule out these things. If it is because of the deposits and hypertrophy of the papillae, you need to follow thorough tongue brushing. If it is hairy tongue or leukoplakia, you can get it surgically removed or with the help of lasers. Captain will not help when there is no candida infection. 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: Hi, I have been on Budeprion Sr 150 mg for 4 months.  The longer I am on it the worse I feel, depression, very emotional, etc...  If I have only 1 glass of wine I will get aggressive and/or emotional and cry.  I also tak 5 mg of Buspar daily.  Whats going on? ### REPLY: HiI understand your concern. If you have persisted problem then need to re-evaluate your diagnosis as well as treatment. If bupropion is not effective then need to change molecule is advisable. Sometimes add on medication with SSRI like Escitalopram and sertraline will Useful. Resistant depression can be treated with other modalities of treatment like psychotherapy and ECT. But before that you have to consult your psychiatrist and re-evaluate your illness. Buspar 5 mg is anxiolytic it will help in reduce anxiety. Consult psychiatrist and get help. Thank you. Happy to help you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 36 yrs old unmarried female pts of hypothyroid and having wt 85 kg. imy hairs was to thin and head base is clearly visible from some place. I am suffering from psoriasis and preseanty it is sever in legd base . I started taking Evion 400 once daily , is it help me to come out these problems ### REPLY: Hello, Evion is a supplement that contains vitamin E and vitamin supplements may bring some improvement in patients with psoriasis but are not found effective in treating it. It is important that you talk to your doctor and have medications that are approved for the treatment of psoriasis. Also, if you are not having any treatment for your thyroid function, you will need to take treatment for this as well. Evian will not treat or cure any of these conditions. I hope this answers your query. I remain at your disposal for further medical assistance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Diagnosed with a right kidney upper pole 20 mm simple cyst.  Am experiencing some pain in normal movements like putting on socks on my right side.  Pain is sometimes mild and sometimes strong.  Im 57 and in general good health with slightly elevated blood pressure (taking metaprolol  er succinate 25 mg daily. ### REPLY: HelloSimple renal cysts are generally asymptomatic in nature, and usually it only requires follow-up ultrasound. You may need clinical evaluation and latest ultrasound of abdomen. Renal cyst may cause pain if size increases or there is infection in the cyst. It is important to correlate from earlier findings. It is also important to evaluate musculoskeletal causes of pain. Treatment depend upon findings. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: As a young child and up until I was well in my 20 s, when I developed a fever I would *always* also develop circular rashes (shaped much like hoop earrings) on my elbows, finger joints, knees and at my toe joints. Sometimes the rashes would be both on the anterior and postior portions of the joints. The rashes would itch. Ring worm had been ruled out (although why would the rashes develop only across my joints? Why not somewhere else, as well? I am 70 years of age and have been blessed with over-all good health, with the exception of fibromyalgia and RA (the latter being a real bug-a-boo). You may wonder why I am interested now, after all these many years. Actually, I have always wondered but just never received an answer. Warm wishes, Jan ### REPLY: Hi, Welcome to . At your 20s, you had rash with fever. And rash would erythematous and itchy. I feel, that you had viral exanthem. ...most probably you had erythema infectious. Also called fifth disease. It is a viral disease caused by arbovirus B19. There may be fever with erythematous rash on face, trunk and extremities. It is benign condition and heals without any complication. Your present diseases fibromyalgia and RA are not related with your past disease. I hope you got my answer. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Helo doctor,my problem is from past 3 or 4 days I feel breathing problem..i mean I am forcefully yawing just to take deep breaths...its nthn like severe breathing problem...im doin well throughout the whole day...but I feel tht I just want to yawn forcefully to get relief...another thing im nt sure whether this is due to the allergic tablet citrizine tht I took for 2 days...as i had got itching and little hives on my neck n legs...i visited my dermatologist today and spoke abt ths breathing problem..he said mayb its due to.the anti allergy tablet or acidity which gases r stopping the breath..he gve me acidity tablet and I had it before my dinner...im not sure whether this is acidity or the side effects of the anti allergy....i will b really thankful if u help me to cure this problem ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion it is mostly due to acidity. As levocetrizine can not cause breathing problem. Yawning problem can be due to levocetrizine as it is having mild sedative action and patient can feel lazy and yawns a lot after it. But mild breathing difficulty is mostly due to acidity. So better to avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Start your antacid before meals.Don't worry, you will be alright. If you are not improving after 1 week then consult pulmonologist and get done PFT (pulmonary function test) for the diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ok, I am a 5 yr colorectal cancer survivor, dx at the age of 38. Had a resection and chemo/radiation therapy. Ever since I had treatments I have this excruciating burning in my left ear. down inside and around the top of the outsIde of my ear. It feels as if I am being swarmed by bees..no one seems to take me seriously, but this is driving me crazy. It is absolutely debilitating. What is this and how can get relief ? HELP !!! ### REPLY: From the details you provided I can't get to a definite conclusion whether the present problem is cancer therapy related or not. Please provide some more details like -What kind of surgical resection was done ?-What was the chemotherapy regimen you took and for how long ? Some more medical history would be useful too. Like-Do you smoke ?-Do you take alcohol regularly ?-What is your occupational status ? And from nature of complaint I am of the opinion that you are having Tinnitus which can be the symptom of damage to the cochlea(hearing apparatus in ear). The damage could be due to . Please visit an ENT specialist and get your hearing checked and also try to do a High Frequency Pure Tone Audio gram. Hope I have clarified some of your concerns. Please revert with any further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a vasectomy 13 weeks ago, have ejaculated at least 100 times (daily regimen). My first semen analysis at 8 weeks came back clean . My 13 week analysis came back with occasional motile sperm . They want me to continue testing every 4 weeks until two clears. Did the procedure fail? ### REPLY: Thanks for asking in  forum Sperm growth and maturity takes around 03 months and is a continuous process. So, even after vasectomy some sperms continue to pass through cut vast ill it heals. So, 15-20 ejaculation/3-4 months of time is needed to prevent this. So, use of protection till then/till it becomes negative is advised.  So, you are within that interval and can wait for some more time to say whether your surgery failed/not. 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: Hello I woke up in the morning 2 days ago and it felt like something bit the inside of my penis, I didnt take to much concern but 2 days later there is a red mark with a little bit of puss but the right hand side of the penis is abit swollen what could of caused this , and no it doesnt hurt when I urine? ### REPLY: HelloThanks for query. Based on the symptoms that you have the bump on shaft of the penis filled with pus is due to Staphylococcal infection of hair follicle (Boil) with surrounding edema of the subcutaneous tissue. You need to take broad spectrum antibiotic like Cefuroxime along with anti-inflammatory . Ensure to wash your genitals with warm water and Betadine twice daily. Ensure to avoid sexual encounters till it heals up completely. It should get cured within a week failing which you will need to consult qualified General surgeon and get it incised and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAD A CT SCAN BONE WITH RADIOACTIVE TRACCER IN MY LEFT ARM, I DEVELOP A VEIN INFECTION AND WAS 4 DAYS IN THE HOSPITAL DUE THE INFECTION. TWO WEEKS LAYER THE SAME ARM IS SWOLLEN BRUCES HOT RED. I WENT TO ER AGIAN THEY RAP MY ARM ELASTIC BANDAGE.FROM WRISK UP TO  MY SHOULDER. WHICH SPECIALYST I SHOULD SEE AND WHAT RISK IS MY LIFE ### REPLY: Dear patient. You have acquired thrombophlebitis infection of the vein during iv catheterization. You should undergo complete blood tests and stay for a complete course of antibiotics for at least 1-2 weeks. .i don't recommend using elastic bandage use continuously. It should be untied every 10 minutes to prevent damage to the arm.thombophlebitis is treatable, and it takes some time. Consult an MD IN INTERNAL MEDICINE PLUS A GENERAL SURGEON.BOTH WILL BE BENEFICIAL.hope I have answered your question. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have fought low potassium for three or four years. Finally found a doctor that is keeping up with it. My level today was 2.9. I don t understand how it works. I know muscles and was told by pharmacist that it also could affect the heart. I m very confused. I do have high blood pressure buy that is under control. ### REPLY: Hi I did review your concern. Low potassium can be due to multitude of reasons like a problem with medications you are taking like for blood pressure or a problem with your kidneys or a . A proper diagnosis is required for accurate management of low potassium as it needs to remain between 3 and 5.5. Low as well as high potassium causes muscle fatigue and weakness, so you do not feel like doing anything. Apart from that low and high potassium affects your heart. First there are ECG changes and later on there can be life-threatening arrhythmias. The low potassium you are having can be due to your blood pressure medication or can be associated with your blood pressure. People with high blood pressure and low potassium without use of any medication causing it can have a ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was out in the rain all weekend and now i have a persistent cough. But now that i think about it I was using bleach and CLR on sunday afternoon and now i have a persistent cough that is like a sudden coughing fit and i feel like i could cough at any time. do you think it was the chemicals or being out in the rain all day? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, your cough is mostly due to bleach and CLR use. These chemicals produce Fumes. And when these Fumes go inside airways and lungs, they cause irritation and inflammation. And they intern cause cough. So while cleaning, you might have inhaled Fumes from these cleaning chemicals which is causing you cough. Usually this kind of cough is self limiting in nature in 1-2 days. So .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Since having my daughter 5mths ago, which i got a spinal block, from an epidural, having to push while numb may have caused lots of strain or may not be linked, iv suffered an acute dull ache in my abdomin, which spreads to my ribs, back, chest and stomach and gradualy gets severe, and sore to touch, feels like a band around me getting tighter, its very frightening, and takes my breath away, lasts around 30mins i need 4 painkillers to help ease the pain or else i am curled over in agony, happens in the evenings, and lately i have started to wake during night sleep with this agony pain, im going for test next week, but what couldit be? ### REPLY: HI. Thanks for your query and history properly This is self-explanatory. While you strained for the delivery the normal protective mechanism without numbing got disturbed. We have seen cases where similar problems - classical symptoms as you have explained. These are usually due to slipped discs at thoracic level. Get an evaluation done by a Neurologist / Neurosurgeon. Get an MRI of the thoracolumbar region, and you will get a diagnosis. According to your symptoms, I have a feeling that you will require surgery, be prepared. ### END