Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 asthma due to allergies (& I am allergic to many things related to breathing, like dust, cat & dog hair)I use albuterol occasionally when it gets badso my question-once in awhile I get a terrible taste in my mouth when I cough hardis that from the albuterol or from my allergies?furthermore, if it is my allergies, is it from one specific source (like cats) or can any allergen cause abad taste in ones mouth?also note- I smoke marijuana regularly (have so for 20 years) ### REPLY: Hi and thanks for using this forum. I am so sorry about what you have been experiencing. I am not exactly sure if albuterol or allergies can explain these bad tastes you get once in a while when you cough hard. Furthermore, I think they are totally unrelated. Coughing hard may increase the abdominal pressure and open the sphincter that can release some gastric content back into the mouth that can explain some of this. If it were from the lung, then breathing alone should make you have this bad taste all the times. I personally advise against recreational .  If you wish to consider stopping at this time, please consult with your treating physician. However, if you don't wish to right now, I respect your opinion. If you should change your mindset in the future, please let us know so that we can help you through the process. I 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: I have deteriorating disks in my back and they cant operate and a siatic nerve on the right side the disks are L3 L4 L5 and i go to a neurologist .I also have had 2 TIA in OCT and they tell me to go to a heart Dr but why did I loose feeling all on the right side and it tingles and i drop things im weak on the right side and there is nothing they can do i dont understand whyIM sorry I have no income and trying to get on disability, sorry for taking up your time ### REPLY: HIT hank for asking to ChatDoctorI really understand your concern, as long as the TIA is concern I would advise you to take care of blood pressure if you have high blood pressure then be on medicine regularly, if you do not have it then measure it regularly, watch for blood glucose level, for the disc problem the best way to deal with it is physiotherapy, and some NSAID this will give good relief to you nothing to worry it will be alright soon have nice day (It would be much better if you had mentioned your age and gender) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 started feeling really dizzy today whilst walking my dog - and it hasn t stopped, when i tilt my head back, when i lie down, when i stand up, when i walk. It s really frustrating! When i was walking it felt like i d spun in circles and tried to run ... the gravity of earth pulling me sideways. But when i lay down it s a whole room spinning feeling that you get after you ve drunk copious amounts of alcohol ... please help. ### REPLY: Hi Jessie, there are 3 semicircular chambers in side our ears which are filled up by fluid which would balance our head position and our body posture. If there is some problem with those semicircular chambers it would lead to imbalance of the body posture, it seems you are having this problem, and you need a consult a ENT surgeon and needs to undergo some head tilt tests and might need medications as soon as possible ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 16 days ago, I was in a dog-bicycle accident resulting in me falling directly onto my elbow.  The doctor xrayed it (inside angle only) and said it didnt break (yay!) I still have incredible (8/10) pain when I touch it and shooting pains from my elbow to my wrist and elbow to shoulder when I turn my arm palm up or when i hold things in my hand (e.g., a grocery bag) with my arm by my side.  There is a dime-sized lump right at my elbow joint.  Any thoughts on what this is or, more importantly, if Im causing damage by using it normally (as suggested by the original doctor).  Thanks so much for your time! ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You have history of trauma.  So you may have some hematoma formation and damage to muscle and soft tissue.  You should take analgesic and anti-inflammatory .  Gibe rest yo that part. Choral forte is helpful in reducing swelling.  Don't worry much about that. Just be relaxed. It will heal within few days.  Rest will improve the healing. Activities delay the healing.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there. My name is Toni and I was wondering if a referral to a rheumatologist would be the best thing for me. I take Cymbalta for unknown nerve pain causes in hands arms legs feet, back and neck pain, and I would say tendon problems. also depression which I think was cause from the pain being untreated and facing the unknown future of my heath. after about 6 weeks of being on this I started to mostly feel like my self again so I start doing more housework like I used to be able to do over 5 months ago. little to be known I star having hip and shoulder pain and I would say is a 4 or 5 on the pain scale. I was told by one doctor I have RLS and was put on 50mg ?tramazone? for this originally. then had to be uped to 100mg because it was not affective. new doctor says that not even what that is for and now I have recently just started on Requip for that. my vitamin d level was 15.8 a few months ago and the norm is about 30 from what I hear so I take 5000 iu a day for that. I have only had blood test done. Also emg came back great. although no x-rays no cat scans, no MRI have been done. I don t know what all auto immune disorders I have been tested for but those came back fine. normal blood work ok along with vitamin d, Iron test are in the process. I m pretty frustrated at this point and really want some answers. my new doctor is really nice and seems to care. I just feel its time to see a specialist and want to know what you think about that, what kind of specialist, how to approach my doctor with this? Please help :-( ### REPLY: Hi, from what you have said it appears that you have tried at least 3 different medicines (Cymbal ta, Trazodone and Equip) but still have pain in multiple joints. Normal tests are reassuring. The one thing I did not see in there was physical therapy- if you have not done that I would recommend discussing with your primary doctor about that. It's also possible that you may have an underlying depression contributing to your symptoms (since they improved witChatDoctorbalta, an antidepressant). So, it might be worth discussing with your doctor about behavioral therapy or seeing a psychiatrist to determine if depression is contributing to your physical symptoms. Pool therapy (swimming/water exercises) are often very helpful too. I do not feel strongly about seeing a specialist, I would suggest discussing your frustrations with your primary doctor and the things I discussed above and work with him/her. But if you feel your concerns are not being ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28 and got married 8 months back..I have been having irregular periods from 6-7 years and now I have reached a stage where I have to take contraceptive pills in order to have the periods...Now I am planning to concieve but the problem that I am facing is the egg size was just 8 mm since 10 th day ..it is neither increasing nor decreasing...My doctor has asked me to get HSG test done next month and then she will start the treatment...My question to you is what else can be done in order to increase the egg size...what difficulty can I face in conceiving my first baby? ### REPLY: Hello. Thanks for writing to us. If you are taking birth control pills regularly, the egg size is not likely to increase and reach maturity. You need to stop taking the birth control pills, then wait for at least 2-3 cycles for your ovulation to return to normal and then go for the ovulation studies. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 50 yrs.and had undergone slip disk surgery on L4 -L5 a year ago.My problem is my left leg still feels not normal, in the sense that there is some degree of numbness and weakness.Some time while sneezing, I get shooting pain in my left leg.Do I have some serious problem? Pl. help? ### REPLY: Hello, As most cases post disc surgery have some residual symptoms which can be taken care of by the use of exercise and improve the quality of life. The exercise which I will advise you are - core stability, spinal muscle strengthening exercises, hip muscle strengthening exercises, breathing exercises, static hamstring, static qua .  If you feel then you can take help from a competitive physiotherapist who can help you perform exercise well and get results. If undergoing a proper exercise session under a physiotherapist than max by 10-15 sessions you should be perfectly alright. Hope I have answered your query. Let me know if I can assist you further. Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am a 33 years old and i have been feeling bad all day. I ignored it and continued the day and early afternoon i got a headache and took tylenol and it didn t help. I am feeling worst right now and i have naseau and a headache. I took my pulse it is 48 with oxygination of 94%. I also some have some chest discomfort, should i be alarmed? ### REPLY: Hello, Would explain that this heart rate and blood oxygenation or quite normal.  Coming to this point, I would recommend taking Tylenol or ibuprofen and an antacid.  A viral infection may mimic this clinical situation.  If this situation persists, I would recommend consulting with your GP for a physical exam and some tests: a resting ECG, complete blood count, PCR, ESR.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, This is Sayanti from India ,West bengal. My home town is kolkata. My mother is suffering from many types of problems, and the doctor is giving separate drugs to cover up each problem. now she is just tired to take all those drugs, what should be the proper way to treate my mother, she just hates drugs now. She knows the BP controlling tab, thyroid controling tab, an alzolum group tab and a digetion tab are essential to survive at her physical condition. so, she is ready to take those but many other problems are there. what to do? ### REPLY: Hi, thanks for the query; How old is your mother? Whether she is a diagnosed case of hypothyroidism, diabetes, hypertension (based on blood tests, symptoms & physical examination by a qualified doctor) & hence taking all these medications under proper medical supervision? Also, whether she is constantly troubled by various poorly explained physical symptoms like indigestion, belching, gas, menstrual problems, frequent headaches, sleeping difficulties with requirements of sleeping pills like alprazolam, headaches, body pains etc.? If it is so, then your mother may be in fact suffering from Depression. Too many times' depression tends to occur with diabetes, blood pressure problems & thyroid problems & often gets undiagnosed, untreated with a poor quality of life. Consult your GP/Psychiatrist for assessment of depression, use of .  To treat her symptoms or get back to me for further assistance Hope this helps; good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up sick on Monday with dizziness, excruciating pain in the back of my neck, high fever and nausea.  I broke the fever at 11:00 pm on Monday evening and felt fine when I woke up on Tuedsay.  I was fine until Wednesday morning and I became chilled, have a low grade temp and now have that same pain throughout my spine.  Should I be concerned? ### REPLY: Thank you for sharing your complaint, dear friend your fever rec cured once again with neck/spine pain so I suggest once you should go for investigation like CBC in blood and urine-routine micro to know the cause of fever. If investigations are normal no need to worry. You can take analgesic like paracetamol or for severe pain paracetamol in combination with ibuprofen for relief of pain. If you feel severe symptoms consult your family doctor first. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell in the shower, the hospital said cracked rib, very bad bruising internal liver e.t.c. been nearly 2 weeks ,still very bad to cough ,laugh or especially sneeze, how long will this take to heal please? I keep taking a big breath, and not aware of it coming ,is that normal? Thank you . ### REPLY: Hi thanks for asking question. The healing will take still few weeks as injury seems to be serious according to history given by you. First rule out diabetes by doing random blood sugar. If diabetes present healing might delay. Second do your blood examination also, it may reveal high count suggestive of infection.it also reveals anemia that also delay healing. Malnutrition may delay healing. So Take healthy nutritional diet with vitamin C reach fruit also like orange. Take enough rest and avoid heavy weight lifting. Avoid smoking. If inflammation more at site broken can be taken. Wish you fast recovery with good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I suddenly have small bumps on my shoulders, chest and in my sideburn area. It looks like bacon grease exploded in front of me. They were not itching much and you at first you could see the bumps but not feel them, Now they are slightly raised. They are not on my back or below my chest. I am a 49 year old,Black Male ### REPLY: Thanks or your question completely understand your problem these bumps over chest can be caused by variety off diseases and the diagnosis can be confirmed by a FNAC (fine needle aspiration and cytology) of the swelling. Most commonly it can be just collection of at called as lipomas and if you are having fever, weight loss, loss of appetite it can be due to cold access due to tuberculosis. U can consult a general physician. Thanks/regards feel free to ask more questions may god bless you with good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI! I have a chronic blood clot in my leg from my groin to my ankle. Of course, no idea how long I may have had it. Now, I have had a leg ulcer for almost a year now due to this clot. Of course, I am also under a doctor s care I am having a leg compression wrap put on. It does not seem to be helping. Now, I am having a lot of swelling around my ankle which is causing a lot of burning and pain. Is there anything at all that can be done? I am in so much pain. Thank you for any help you can give me. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have deep vein thrombosis or some peripheral vascular disease. You should go for color Doppler. Furthermore, you should also go for coagulation study. If you are thrombophilia then you should take blood thinner like warfarin according to your doctors' advice. Consult your doctor and take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Bad pain in chest and lungs when drinking a small glass of water this morning... hurt so much i was hunched over, also got very dizzy and short of breath... dont know if that part was from anxiety because i was scared but i almost blacked out... super scared.. whats happening? Thanks ### REPLY: Hello, Sudden onset of these symptoms should always be evaluated for heart diseases. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Sometimes acute stress and anxiety can also cause similar symptoms. So consult a psychiatrist and get done counseling sessions. Try to identify the stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright with all these. Avoid stress and tension, be relaxed and calm. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My dad is 80 years old and is a diabetic. He wants one of his tooth to be extracted. He went to a dentist and he said he doesn t operate on diabetic patients. But my dad is not on constant insulin . He just takes two (5mg) pills of Glibenclamide daily in the morning. What could be the real reason behind his refusal? Would appreciate answer asap! ### REPLY: A dentist cannot refuse to perform any oral surgical procedure if the blood-sugar levels of a diabetic patient are under control levels. If the patient gives history of non-healing previous extractions or any other wound than the dentist can ask for latest blood-sugar reports and may even ask the patients' planetologist weather its safe to do extractions. In uncontrolled diabetes, the extraction wounds don't heal and get infected. At 80, the body becomes physically compromised. Take latest blood-sugar reports of your father along with you when you visit your dentist. Even if the diabetes is uncontrolled, a patient suffering from pain cannot be denied treatment. There are various forms of bleeding controlling .  Find a good dentist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...hi i have a lumb on top of my butt crack that has a red sore and it bleeds sometimes and it comes and goes. It hurts so bad now i can not even touch the sore. Any ideas what i can do now and later? ### REPLY: Welcome to  .1. Generally these kinds of symptoms are seen in the colonial sinus (infected hair) which can be treated easily in early stages with a course of antibiotics.2. If it gets complicated, it may cause sinus formation and fistulous opening and so all.3. You need a surgeon appointment.4.Don't ignore and leave for complications. Hope it helps you. Anything to ask ? Do not hesitate. 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,my name is dorcas please i will like to ask what cause memory damage/unable to remember thing for long period of time and i can even settle my brain.Anytime i feel to speak to someone am notice that is not right things we were discussed  am discuss with the person,is like someone saying A and am sayin B ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. One of the common reason for the int attention and memory problem is the underlying depression and anxiety. It needs to be tackled first. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or Escitalopram, and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.  Also, you can try cognitive retraining exercises. These help in improving attention and memory as well. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you 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: my 4 1/2 year daughter has fever for the past five days continuosly after administration of drug acetaminophin and ofloxacin   syrup she will be ok fpr 3 hrs again the fever starts  ,so i did blood test on the 6th day everything is negative but RBCs has microcytic hypochromic with aniso @poikilliocytosis and WBCs has mild leukocytosis seen.dr whats the reason for this? ### REPLY: Welcome to . I am . Common cause of Microcytic Hypodermic anemia with anisopoikilocytosis and leukocytosis is Iron deficiency anemia. I think that your son is first time diagnosed of anemia. No need to worry because it is completely curable. He will be fine soon. Take care of his diet because diet should be rich in iron. Repeat complete blood count with peripheral blood film to see proper recovery of your son from anemia. Thanx for query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir ,I have a large hair fall from the past 1 year. I have consulted the homopathy doctor but their is no effect infact my hair fall has incresed to a large extent these days. My diet is good . I eat alot of fist and meat. Please tel me the solution. Patch is coming now ### REPLY: Hi, It may be halogen effluvium. There are many causes of halogen effluvium.like stress, anxiety,worries, anaemia, vitamin deficiencies, minerals deficiencies, heavy exercise, traveling,sleeplessness, thyroid dysfunction and other internal diseases. Consult the dermatologist for the perfect diagnosis and proper treatment. After thorough examination and investigations, he may come to some diagnosis, and accordingly he may give treatment. I would recommend you to take biotin 10 mg tablets thrice a day. Apply mild steroid lotion on the scalp. If there is Dan .  Treatment of underlying condition may be done by your doctor. Avoid stress and worries. Take regular treatment for few months to few months. 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 therei do not have a fever neither blood in cough, diet is ok , did not lose wait , how ever have cough since last month almost with fluid, now whitish , it was yellow for couple of days, feeling little pain in chest. xray report is ok what can be the reason ### REPLY: Hello I had gone through your question and I can understand your concern this could be an allergic reaction or infection either viral or bacterial see such patients in my clinic after clinical examination I advise them for few tests like blood for CBC ESR AEC (absolute eosinophil count) sputum culture testy may require a course of antibiotics under supervision of your Doctorow can do steam inhalation and gargling with warm saline water you can use anti-inflammatory nasal spare like fluticasone spray hope this helps you best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor,I am 27 years old girl.yesterday i had severe pain in the abdomen stomach for some hours,then it is decreased and still i am having little pain . i taken urine test everything is ok and only rbc cells looking more 10-15.Is there any problem? ### REPLY: Hi ! Good evening. I am  answering your query. With the short history you provided with, I could think of a UTI or a urinary calculus. However, to confirm or to rule out other pathology, I would advise you to go for some routine blood tests, like CBC, a serum  test, a urine culture and sensitivity test, and possibly an ultrasound abdomen. Further management would depend on the reports of the investigations along with the result of a clinical examination. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My baby had neonatal seizures and is in recovery now. The MRI report has this to say: Multiple small foci of of restricted diffusion in both hemispheres, Periventricular and probably in the paras a chital area including the genus of corpus callosum. The signal is abnormal in the bifrontal cortex. Basal ganglia is unaffected. Small amount of subarachnoid blood and small amount of blood in occipital horns. We are awaiting a formal meeting with the neurologist and neonatal radiologist. However, I d like to know more on this so that I am aware of what my child has gone through and what, if any, steps I need to take to help her out of this unfortunate juncture. Could you help me understand this a bit more and suggest a few questions to ask to gain more clarity? Many thanks. Arun ### REPLY: Neonatal seizures occur most commonly due to Hypoxic insult to brain(during delivery or post delivery if child does not immediately cry), or due to metabolic causes like low glucose, low calcium or low magnesium. Seizures can be due to infections acquired during or after delivery. Small blood in Subarachnoid space signifies trauma to head during delivery which can be normal. Periventricular involvement in the brain is serious. Seizures can be controlled as of now with AED like Phenobarbital but the effect of the condition on the neonatal brain can't be judged at present. What symptoms the child might develop in the future cant be judged right now. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: helllo doctor plz help me out..i have a enlarged liver,showing heterogenous parenchymal echopattern..intra hepatic .biliary channels are not dilated..no sol seen,,liver span at the level of mid clavicular line 15.0 cm in diameters..i am  really worried.. i want to know  from you what kind of disease i may have which results dis liver enlargement..please help me out.. i am a 49 yrs old female.. ### REPLY: Hello, Thanks for posting on , Based on the above description, there are several diseases which could be responsible for an enlarged liver (hepatomegaly) alone. I will present from the most common (given your age) to the least common. It would have been easier for me, if you sited any risk factors you might be having such as alcohol, presence of viral hepatitis, smoking etc. Inflammation or fatty liver may cause an enlarged liver and may result from:- An infection such as a from a virus or abscess-Certain medications- Toxins-Certain types of hepatitis, including alcoholic hepatitis-Autoimmune disease-Metabolic syn .  This may result from:- Cysts-Tumors that start or spread to the During a physical exam, your doctor can detect an enlarged liver on the right side of your abdomen. A variety of tests may also be needed to confirm the cause of an enlarged liver, including: - Blood tests to check for liver enzymes and other abnormalities related to liver disease - CT scan, magnetic resonance imaging (MRI), or ultrasound to view the liver - ERCP, a scope test to check for problems in the bile duct - MRCP, a special MRI test to check the inside of the bile duct - Liver biopsy, an examination of a sample of liver tissue to check for cancer or a fatty liver Ones the cause is determined, appropriate treatment can be initiated. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i a lowerback pain really bad when i try to get up in the morning can barely put my socks on if i bend quick i get a sharpe pain during the day it eases but the lower back has a dull pain and a stiffness, sometimes when i go to the toilet for a poo the pain in the back eases ### REPLY: Hi there. Your symptoms correlate to disease known as Seronegative Spondyloarthropathy.  Firstly ...kindly get a X-ray of the lower spine and pelvis done concentrating on the Sacroiliac joints. Ge a complete arthritis panel blood test done. Start on an anti arthritic medication like Indomethacin. Take as much rest as you can till the pain subsides Short wave diathermy and local gel massage helps. After the pain subsides get training on spinal mobilization exercises by a physiotherapist and do them religiously. I hope my advice has helped Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,Im an uncircumsized man and i have these little red bumps on the head of my penis not painful or itchy at all and I have no burning when i pee. What could this be? I have done alot of research online and came to the determination it was a yeast infection. I started putting monistat cream on the rash/head of my penis and now it seems my penis skin in peeling off. the red bumps are all but gone now but my penis is peeling. Please help im not sure what to do? ### REPLY: Hello, These symptoms and signs are suggestive of STD especially if there is associated pain, fever, urethral discharge and recent sexual intercourse. So this is the first thing to rule out by doing STD testing.  Second, it may be signed of reinfection or urinary stones and some other genital infection, but this is less common.  In every case, antibiotic therapy may be required, so test should be done as soon as possible so that appropriate treatment can be started. Till that try to .  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: Good Evening! My brother got both the kidneys damaged. He has undergone dialysis 2 times within last month. Doctors say transplantation would be the final solution. I have got his test reports scanned with me.Is there any other solution to this kidney problem? Your suggestion in this regard will be highly appreciable.Manoj YYYY@YYYY ### REPLY: Hello Manoj and welcome to . As a Urologist, i can understand your anxiety. Once the kidneys have failed, the only options are dialysis or transplantation. Dialysis is an artificial kidney. It does all the function of a kidney. A kidney transplant is the better option in the long term. Maintainence dialysis is done twice or thrice a week. It can be done as a hemodialysis or peritoneal dialysis(CARD). If you've any other doubts, send it to me as a direct question. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i am a patient of bronchitis asthma and using aerocort rotacaps since last 5 years and truly i am also addicted to it,i use this pill evan if  little whisling produces into my throat. Its really disgusting to live like this,is there not any solution to get rid of it?. Puneet Mishra M.Tech(Instrumentation) NIT, Kurukshetra INDIA ### REPLY: Hello Thank you for trusting  Dear identity trigger of your asthmatic trigger and avoid it. Just note down when you are feeling it avoid that trigger. Avoid cool .  Avoid peanut, air pollution etc. Use tab montelukast and levocetrizine at night. Attend the allergy clinic they will test you all antigens and tell the trigger for allergy. They can do chronic exposure to that allergen in graded manner and reduce body reaction to that allergen. Do yoga and meditation will help, eat healthy. Take it d useful in allergy. You can use sustained release bronchodilators orally. I think I answered to your question if you have more questions please feel free to ask me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 of 46 years is having extreme trouble with what has been described as bursitis of the sciatic. Pain is intermittent and at times he cannot move from his bed. GPS and specialists differ on percentage of disability and I am wondering if you could shed any light on treatments. Thanking you ### REPLY: Bursitis is an inflammation of a sac of fluid called bursa which is present around a joint. Sciatica refers to compression or stretching of the sciatic nerve. Both are different medical conditions. Bursitis can be treated with injection of steroids locally. Sciatica on the other hand is usually treated with Physical therapy, medications for pain. Imaging usually in the form of an MRI helps determine the cause of the sciatica. Sometimes if symptoms do not improve, referral to a Neurosurgeon is appropriate to discuss other treatment options including surgery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 44 year old woman who have been suffering with fibromalaga for 22 year and now I have a lot of pain in my shoulder which I can not move when I walk. I have a tremor in my left pinkie when I rest and now in my thumb also. Do you think I should see a neroliagest ? My father and my grandmother both have parkinsons ### REPLY: Hello, Fibromyalgia does cause pain in the neck, shoulders or back. Your treating doctor may give you muscle relaxants, cyclobenzaprine to help promote sleep. You may be prescribed Duloxetine (Cymbal ta). However, you are suggested to see a GP & get examined, assessed & treated for fibromyalgia. Neglect often results in complications leading to nerve damage or peripheral neuropathy. Medications along with patient education, stress reduction, exercise & healthy lifestyle effectively help fibromyalgia patients. If you are having a tremor in the fingers you should visit a neurologist, get Nerve function tests, Nerve biopsy & EEG, etc. done, get treated at the earliest. Take vitamin B6, B12, Folic acid & mineral supplements.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 20 year old boy. if a just think about sex & anything else ,i get eraction/semen discharge ,some times it happen automatically without thinking or imagination. my hairs are becoming hair, eyesight is decreasing day by day.. and also i have small size of pennis sir what is the normal size of penis?????? i have uesd medicane once selenium1m and a selenium 3x.agnus castus .......... sir kindly help me will be thankful to you ### REPLY: Thanks for asking in  forum In short: If your penis is at least 12-15 cm when erect, it is not micro penis. Explanation: In your age ejaculation during night and when thought about sex is normal. I think you are taking treatment for erectile dysfunction in homeopathy. Self medication is dangerous.  If your penis is erect when you wake in the morning after deep sleep then you don't have any problem. If you think you have premature ejaculation, do visit an allopathic doctor to get yourself examined before getting disheartened. Your hair and eyesight problem is not related to this, this is your imagination and thinking as for as I think. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Misscarried after 8 week and doctor asked go for Semen analysis. Below is the result, please let me know if there is any issue with my Fertility. My age 30 Appearance : Grayish White Liqudiefaction time :30 mins Viscosity : Normal Volume : 2ML Ph: 8 Sperm Count : 18 million/ml Fructose : Positive Motility : 40% Rapid - Linear 20%, Slow Linear 10%, Non Progressive 10%, Non Motility :60% Viability :40% Normal - 50% Abnormal 50% Head Defect :10% Tail Defect 25% Midpiece : 15% ### REPLY: HelloYour semen analysis suggests low sperm count and low sperm motility. Normally sperm count should be at least 20 millions/ml. Sperm count is 18 millions /ml in your case. Sperm motility is also low. Normally sperm motility should be at least 55 %. Your findings suggest 40% motility. Morphology of sperms are normal. Other findings like color, pH,volume, liquefaction time etc. are normal. Besides clinical assessment you need investigations like routine hologram, random blood sugar, colour Doppler of scrotum. You should take nutritious diet and do exercise. If low motility and low count persists then assisted fertilization techniques like GUI can be considered. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a radical nephrectomy of my left kidney on 31/7/13 my cholesterol at the time was 4.8 and was on Atorvastatin which was withheld because of my illness . Recent testing shows cholesterol now at 9 my GP has said not to worry. I had a Heart Attack in 2012 and 2 stents fitted. Why would cholesterol rise so quickly as so high as I can assure you that I have not been overeating and have actually lost 1.5 stones. Thank you. ### REPLY: Hello there I saw your query. Lipids increase in renal disorders even when you don't take it. It's because renal filtration mechanisms are disturbed. Lipid profile deranges in nephrotic range proteinuria(that is proteins in urine more than a gram a day) albumin in the body decrease and albumin to the globulin ratios are reversed. So this in turn is tried to be compensated by liver. And these low density lipoproteins and cholesterol are managed by your liver, so lipids start rising in their levels.  So all you need is to control your kidneys profile. If you are hypertensive or just even renal patient with nephrotic range proteinuria, time to change dietary habits. Reduce salt intake to the minimum possible less than a gram a day. You should start ACE inhibitors as they are renal friendly.the problem is your kidney and it's the kidney leading to your secondary troubles like increased cholesterol, you did not mention but pulmonary involvement (lungs) and heart attack and generalized swelling or simple swelling of the ankles all are attributed to your renal disturbance,so have a renal function tests, get 24 hours urinary proteins, serum albumin, A/G ratios, u/s abdomen and pelvis, flourescent studies of your GBM (renal base structures) and it will be better understood what to be done... I wish you best of luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister used to fell down while walking when she was 17 years old. She also started to forget things. she used to blame others like why you said this to me. After 7 or 8 months she was having seizuers. After that she went in coma and she came out of coma after almost 6 months with the help of brain specilist. Before that she did not had any brain specilist traetment because everyone was suggesting diffrent treatments. When she came out of coma she forgot every thing and she was like a kid(3 years old). Her hands were closed and she wasnt standing straight. With time she remembred some things like her dogs name but she doesnot now about toilet or bathroom. Some times she goes by herself.  Now its been one and a half year she is having same symptoms and doctor said her br.ain is not draining a water back and she need an operation. Could you please tell me more about this we are so worried and do not have enough money ### REPLY: Hello and welcome to . Thanks for your query. I understand that you are concerned about your sisters problems. From the description of her symptoms, this appears to be a serious neurological problem, but with the limited information that you have provided, it is not possible to pinpoint a definite diagnosis. So, I would suggest that you take her to a neurologist for a detailed evaluation and an opinion on further management. You have mentioned that you have already seen a doctor and that she was advised surgery. If so, it is better to have surgery at the earliest in order to prevent further complications. 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: Hi, My 1 year old son is having gastric problem from the last 2 days. The gas goes with loud sound also. And from the last 2 days his appetite is very low, not eating properly. But doesnt seem to have any stomach ache. What can be done to cure his gastic problem? ### REPLY: Hi... first let me tell u...all babies pass gas because they swallow air more than adults during feeding.I am more interested in knowing whether there is any change in his stool frequency and nature(softer or harder than before). If there is no change in stool, no abdominal distension, no vomiting, then don't be worried about the gas... At this age you should concentrate more on solid foods rather than milk. Give 3 to 4 meals per day. One banana, one egg per day. don't use mixer grinder. Make the paste with hand. And very importantly don't use bottle to feed milk...use cup and spoon. Approximately a one-year baby should have 40-45% of the amount of food her mother takes in a day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have just been 2 weeks of work with a very painful swollen left foot. after xrayz showing nothing an ultrasound was issued resulting in the finding of neutromata at the 2nd and 3rd web spaces. in addition a well defined hypo echoic lesion was also found adjacent to the shaft of 3rd and 4th metatersal. the ultrasound specialist recomennded a mri would be useful to find out more but my doctor suggests cortisone injection.. i am normally on my feet 8 hours a day as dog trainer with repetetive excersices and training with nmerous dogs. not getting a chance to have a break in between.. what would you recommend i do please ### REPLY: Hi, Although I could not make out what a "neuromata" in ultrasound means (maybe a typing error), pain and swelling there indicates a focus of inflammation. This can be from a local infection, injury to bones, ligaments or an outgrowth from them. As the monologist suggested, MRI is needed to exactly define the tissue of origin and type of the lesion-which is necessary for orthopedist to plan the management. Since it is an acute painful condition, few days off the job is unavoidable. Otherwise, this will further worsen the condition and delay recovery. Give rest to foot, keep it elevated, and take analgesics like ibuprofen for pain relief till the issue is sorted out. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Ive been with my boyfriend over a year now, Im 18. When we first started having sex I was on the pill. But that messed up my period, and made me constantly bleed none stop. So about 6 months into our relashonship I stopped using contriception all together, so we have been having unprotected sex for 6 months now and I havent got pregnant does this mean I cant have children? ### REPLY: Thank you for consulting in . Let me mention that the effect of pills goes away in a few months and there is supposed to be no more problems in conception in this regard. To become pregnant, you need to have unprotected sex with semen discharge between 10th and 18th day of your cycle which is your fertile period. So maintain the dates and see if pregnancy comes. If it still does not come, I would insist that both of you get yourselves checked. I would insist you to get an ultrasound of the lower abdomen done and a semen analysis of your partner done and then visit a gynecologist who would be able to look into the reports and tell you if things are fine. I would also insist both of you to take polite (folic acid) 5 mg once a day regularly at least till you become pregnant. Taking zinc supplement will also help in enhancing the sperm count of your partner and increase the probability of conception. Hope that helps. Feel free to post a direct question with the reports and I would be 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 have had itchy painful gum/tooth pain for over a month now. The pain now goes up to my right ear and temple. Its all located on the right side and not just one tooth can be pinpointed. I dont have the money for a dentist just yet and Ive taken ibuprofen and sinus meds. Any other suggestions to hold me over? ### REPLY: Hello... The case presents like periodontitis... Please check whether there is bleeding during brushing or if there is any swelling of gums in the area or if there is pus on pressing over the gum in the area mentioned or any generalized teeth pain in that area. If that is the baseplate do following1. Brush twice daily with proper brushing technique2. Use chlorhexidine mouthwash(do not swallow) twice daily3. Avoid snacks in between meals4. Try to avoid sugar foods 5. Painkillers can be used in proper dose only6. Antibiotic course should be taken if there is infection it takes time to recover from this inflammation. Also have a routine health check up. Make sure you are not diabetic...if u have any further questions, am here to hear 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 a sharp, pin pricking-like pain in the middle of my abdomen near my naval.  I lasts only seconds.  I have had it afew times today, I have had it before, but probably at least a year ago.Can this be related to fibromyalgia ?  I do not know that I have this but have looked it up and seems like I may have some of the symptoms. ### REPLY: Hi. Very true, you may have a fibromyalgia or a pinched nerve or just an anxiety as a cause of pin pricking like pain in the middle of your abdomen. Get a consultation of a General Surgeon to get a clinical examination and to rule out any other serious problem. Also go for an ultrasonography of the abdomen, abdominal wall and X-ray Chest to rule out any problem related to the pleura and the ribs. Precaution is always a better thing in Medical problems. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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. Me and my husband are planning to have baby. I was suppose to get my period on 31st August and i didnt. We did home pregnancy test i.e on 9th and 16th of September and it came out negative. We went to see gynea on 16th September and did blood test and it came out negative as well. Doctor prescribed me Primolut Nor 2 tablets a day for 2 days for  the period. And uptil now, 24th September, I still havent got my period. Whats happening? ### REPLY: Hi there, I have understood your concern and I will suggest you the best possible treatment options. Please do not panic. As your blood test results suggest that there is no pregnancy, in such situations I usually suggest to my patients to take Primal N tablets 2 times a day for 5 days. Usually menses start 3 to 10 days after finishing the tablets. I will suggest you to get USG done to know about ovarian volume and echo texture. This will help to rule out PCOS-polycystic ovaries as a cause of delayed periods. As you are trying to get pregnant, please get your post menstrual HSG done-Hysterosalpingography. This will help to know about the patency of the fallopian tubes. Partners semen analysis with 3 to 4 days abstinence, will help to know about quality and quantity of the sperms. Please start follicle study from day 10 of the cycle, to know the day of ovulation. You can opt for GUI or have unprotected sex activity on the day of ovulation. If needed please seek prescription support from your treating doctor for ovulation induction medicines like Camphene citrate. Opt for a healthy diet and regular exercise regimen. Include more portions of fruits and vegetables and salads in daily diet. Avoid refined sugars and deep-fried foods and bakery products. Start on Folic acid and vitamin B 12 supplements regularly. This helps you to prevent various complications during pregnancy and delivery. Meditate regularly. Think positive. May God bless you with a bundle of Joy. I hope this answer helps you. 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 sir,I am rahul & i am 18 years old I have selected in Indian Navy,but in Medical test i am temporary.Because i am Affected by gynecomastia since 1 and half year.But i dont want to do any surgery or Plastic surgery ?I want to cure my disease by Homeopathy.Kindly giving your suggestion.I am waiting for your answer. ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. There is no homeopathic remedy for. Surgery is the only possible solution and all other methods are fake. This is caused by accumulation of fats and glands, and it can be treated with medications. So you should consult plastic surgeon about further treatment. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is Kishore, before my wisdom tooth extration doc advised me to check my BP, it was 120/100 and 130/100...I may be tensed, after 3 days today I checked my Bp it is 150/80, from the next day of tooth removal I was on pain kiler and little tensed after seeing my BP 120/100..again its not Normal  150/80...please advise ### REPLY: Hello, As matter of fact, it may not be the hypertension (Elevated blood pressure) although the reading is boarder line hypertensive just for the diastolic pressure, but it could be due to your consciousness. If the condition need to be ruled out for hypertension then blood pressure needs to be monitored for few days or week along with other test like ECG, x-ray chest, then, and then it will be said whether it is normal blood pressure or not. You have not mentioned your age and weight here because this information matters the great, but overall it is nothing to worry at the moment. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ...i am 52 yrs old in excellent health and an avid gym goer.....i have recently developed this heart pounding...i can feel it in my throat and my doctor told me it was stress....i dont think so...i have also developed a dull headache alot too...any thoughts?...thanks ...michael ### REPLY: Hi, Welcome to . I have reviewed your query and here is my advice. If the symptoms needs to be ruled out for cardiac disease, then EKG is must, without this it can not be differentiated and not just this but for complete clearing the doubt, total cardiac evaluation is advisable. It can be stress but without rule out the cardiac elements, it can not be taken as granted. So in my opinion you need to get done the cardiac evaluation tests. I hope I have answered your query. Let me know if you have any further questions.  Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My dad has been diagnosed with colon cancer and it mestatized to his liver. he had a liver ablasion and is now on blood thinners (Proxaparin shots and Warfarin) but his levels are not at a therapeutic level. What could be the cause of the blood thinners not working/ ### REPLY: Himost of the blood thinners have an action for meatbolisation as well as degradation in the liver. All the clotting factors are also dependent on the liver functioning, with liver metastasis and ablation with diagnosed colon cancer, the whole hemopoietic system of the body remains deranged. Hence there is discrepancy with the achievement of therapeutic levels of the blood thinners. Regular coagulation profile studies with dose adjustment of blood thinners will be of help. All the best 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 multiple fibroids in uterus and cyst in ovary which was removed. no children-age 37. now iam feeling some heavines in my lower abdomen, severe pain on the right side of lower adbomen at times. urgency to urinate one day a clear watery secretion came from vagina.is it cancer? i have hroid problem also &pain on the back-left upper thoracic area ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  Multiple urine fibroid and ovarian cyst doesn't suggest any cancer. If you have abdominal pain then you should go for ultrasound abdomen.  You might have some other disease also.  Consult your doctor and go for investigation.  Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: as per dr. my wife is suffring from parkinson ,her activities is as follows:- slow movement(jurky),micro hand writting, slight speeking problem,right hand is not working normal,good appetite ,sleep well but in deep sleep hand & legs are shaking,her memorry is fine,she fell down many times.drs.provide:- Syndopa plus,Pramitrem0.25mg & S-celepra-10. I like to know the correct medicine for her improvement. ### REPLY: Hi, After going through the clinical history provided, I agree with the possible Parkinson diagnosis. However, some movement disorder can present like this. If the medicines prescribed is working, it confirms the diagnosis of Parkinson. If you have started the medication, as a caretaker you can provide feedback to the doctor. If required dosage can be increased or decreased or medication may be changed based on your review I can confirm you that all these . Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I believe I am allergic to Juniper and Cypress trees because every time I go walking and they are present, I get huge bags under my eyes and the skin under my eyes get red. I take Zyrtec daily, nose spray, and I have a PX for eye salve but they do not stop the bags and red skin. I have to take prednisone for 5 days to calm my immune system down. I have had skin testing but everything came back negative. I do not know if conifer trees were in the test. How can I find out if I am allergic to Juniper and Cypress trees? ### REPLY: Hi, Swollen and redness underneath eyes could be due to allergy. Allergy can be diagnosed by patients' history to the allergens and clinical examination up to some extent but not by any laboratory investigations, although there are plenty of allergic sensitivity testing to food, plant,fruits etc. is being done noways but none of them is reliable and adds only cost to the patient. If your symptoms developed due to that juniper and cypress trees and get subsided by antiallergics then one can say it was due to allergy. The best way to combat allergy is to avoid contact with allergen, although there are good antiallergic . You can go through blood immunoglobulins level and consult immunologist for further advise. Hope you understand my point. 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 6 year old came home from school saying she was very tired. I took her temperature and it was 103.5. Gave her a tepid bath and ibruprofren. It is now 6hrs.later and its down to 100. She has zero other symptoms. Eating and playing. normally. can it be from the heat? it was 97 here today. ### REPLY: Hello. I just read through your question. Though heat can increase core body temperature, 103.5 is pretty high. It is unlikely that the heat alone did this. The most common diagnosis in this age group is a harmless viral illness. Typically, you will see 2-3 days of fever (or less), and then it resolves. If this is all that is happening, I wouldn't worry. If the fever persists beyond 2-3 days, or another uncomfortable symptom arises, I recommend consulting with your doctor. Then the correct diagnosis can be made and the appropriate treatment plan implemented. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 left leg has been swollen between my knee and my ankle for a while now. There s no pain, redness, no tingling, and it s not sensitive to the touch. I do find it odd though and am starting to worry that it might be something bad? Really, we have to pay for an answer? What a scam you guy s are running here! what happen to your Hip-Oath. as a doctor? Sick people need your help, but if they don t have the money- Guess their shit out of luck! Thanks Doc..... ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have swelling in ankle and knee. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy, hypertension, gout, kidney disease, DVT or venous insufficiency. I would suggest you to consult orthopedic surgeon for proper examination. Doctor may order CT scan or x-ray along with blood test and urine test. Doctor may also refer you to cardiologist for cardiac problem or nephrologist for kidney problem, who may prescribe diuretic along with beta blockers. For now keep your legs in hot water tub with Epsom salt for 15 minutes daily and keep your legs elevated while lying down. Doctor may also prescribe allopurinol along with anti-inflammatory 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 am enquiring on behalf of my husband . A few weeks ago he went to A&E with chronic pain,  shortness of breath  & tightness in chest . ECG, XRay, Bloodtest showed that there was no problem with heart or lungs. After 6 hours they sent him home non the wiser, but after resting for that length  of time, the pain  had subsided. Since then he has no energy, tiredness & the pain returns on any form of exursion.  It appears to be more slightly on the right hand side, slightly off centre just above the asoficus. ### REPLY: Sometimes chronic gastritis and herd can give to these symptompsyou can go in for ultrasound abdomens there are sometimes silent gall bladder stones leading to these problem sand at the moment start with cimetidine 150 mg empty stomachs genus 2 SF plenty of warm water may be 3 glasses of warm water at a stretch empty stomach and before sleep if possible give liquids in the form of juices glucose electoral powder 3 - 4 times in one hour even if in small amount but should be taken at 20 to 30 MTS interval soups etc. can be taken ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 told that I have 2 extra ribs in the lower part of my back. These were seen recently in an xray, but xrays from when I was a child did not show this. The area hurts constantly and stops me from doing everyday things. Could you please let me know what can cause this and if there is anything I can do about it? ### REPLY: Dear-Thanks for using our service and understand your concern. If you have extra ribs they should be seen in the plain front rib X-ray. Your bones were very small when you were a child, and sometimes it is hard to see those details in a plain film. The area can hurt due to inflammation of the rib cage, Costco .  You can try anti-inflammatories as ibuprofen to relieve the pain. Avoid very tight clothes and keep your back straight. I hope that my advice has been helpful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a restricted shoulder for months and recently have had pain in the neck and my ear is swollen and sore.  I had an osteoma removed from the ear canal years ago and usually the doctor says he cant see anything but I know that antibiotics usually clear it up.  i have never had a scan but wondered if this could be mastoiditis.  I am in my fifties but apart from this am very fit.  How do I get my doctor to recognise it could be my ear that is causing my shoulder pain ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, mastitis never causes a shoulder pain. It can cause a referred pain up to neck but not into the shoulder. But if you have Osceola than it can be possible that this Osceola can be present in shoulder. This should be diagnosed by bone scan or by X-rays. Treatment can only be possible once the definitive diagnosis is done. Physiotherapy can play a good role in the condition. Various modalities of physiotherapy like heat therapy, exercise and electrostimulation can help to relieve the pain of the shoulder. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 70 yo male who has treated hi blood pressure and had a  quad by-pass 14 years ago.  I have a 2" prominent lump which appears to be just off the left side of my right side shin. It is sore to touch and when the foot is flexed toward the shin it is painful. There is a fairly large slight bruising around the area.  I did not hit anything to cause the lump. It was much more painful 5 days ago on my 10 hour drive home from vacation and the pain was spread over a larger area.I was surf fishing for a week standing several hours a day.  I had some swelling of my lower extremities which has subsided do to the standing and poor diet while vacationing (too much salty foods)!Any ideas? ### REPLY: Hello rearward welcome to .come have evaluated your query thoroughly.* This seems more likely inflammatory lesion from variety of causes - unknown compression or pressure during some act - related to coagulopathy - following unnoticed bug bite - others * Needs proper clinical evaluation with Doppler ultrasound examination for the final diagnosis and further management. Hope this clears your doubt . Wishing you fine recovery. Welcome for any further assistance. 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: Good Day Doctors...My mother who is about 65+ was in for a routiune check up and it was said that she had a Mild asymmetrical septal hypertrophy...can you please tell me what this is and what is the best remedy, she was also a bit high on cholestrol last year which is now under control. Thanks - Kim ( YYYY@YYYY ) ### REPLY: Hi Kim. Nice to hear about your concern. Asymmetric septal hypertrophy per se is not a problem, but it certainly becomes one if it obstructs the blood flow from the left ventricle to the aorta. And it is always wise to consult your nearest cardiologist at the earliest. The treatment are many and range from medicines to surgery and devices but the cardiologist who can see the patient frequently will be the best judge ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 viras 4 6 years docters here left me untreated also heavy thrush internaly and naw have some kind of parasitis inferstation in my hole body docters here wont test me or treat me 4 this can you tell me what kind it could be caused by hurpys viras ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. You must be having some misunderstanding or misconception as parasites and virus both are different thing. Herpes is virus. So if you are infected with it than you need to be treated with the antiviral . If you are infected with parasites as you are saying than you should be treated with the antiparasitic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sometimes I feel like nothing is real. Im an observer, everything is dream-like. Other times I feel like nothing exists outside the scope of my senses. Other times I feel that my bones and organs are made of metal and plastic/rubber (ie my bladder resembles a catheter bag). ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. This happens when you are detached from the circumstances and world around you. When you are in your own world. Everyone feels this. You can analyze yourself with this aspect. Just keep a log of the happenings. Keep a record of thoughts and feelings just before these detached feelings. You day .  Be in your own world for some time. And then you wake up, naturally, for some time, everything feels strange. You feel detached. That is what happens. Nothing to worry. Don't think of or associate this with any mental problems. For more psychotherapy techniques, You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, about a week ago I noticed a lump on my shin about the size of a 50p piece. Since then I have had about 10 more come up on both my shins. I went to the doctor today and he didn t know what it was and said that if they didn t go away within the next week then I would have to have a blood test and maybe one of the lumps removed. They feel like bruises but do not look like them, they are pretty much invisable apart from turning slightly red if I press them. I know it sounds silly but I ve convinced myself it s something awful. ### REPLY: I am not sure whether I should add .  But appearance of lumps on your shins raises obviously whether you are noticing what we call as herald sign of underlying systemic or autoimmune disease. You should recognize a fact that skin is eminently involved in such processes as most characteristic presentations. Your doctor is right in advising you to wait and allow time for more obvious changes to appear that guide the blood test and possible need of removal of indicative piece of lumpy skin for histologic confirmation. Please co-operate and arrive at confirmed diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a slight blood coagulating problem. i had my tonsils and adnoids removed and had a slight bleeding problem when i was 17. they diagnosed me with a very mild enzyme clotting problem that would only affect me if i had a serious surgery. it doesent effect daily life and isnt a serious coagulating problem, very very mild to say the least. well ive heard different storys about how theres waivers and such for this in certain branches. i just wanted to know if the army will take me cause its been a life long dream to serve. and this would be a terrible reason not to get that oppurtunity. i take no medication and this was over 3 years ago. So my main question is it possible for this to get medically waiverd. Thanks ### REPLY: HiT hanks for your query. Based on your query, my opinion is1. Mild clotting factor deficiency can be corrected if the cause is known.2. Clotting factor deficiency manifests with bleeding in deeper tissue/ organs and rarely skin bleeds.3. If you are not having any symptoms then probably your factors are normal.4. However, you can get a confirmation once by going for clotting time, PT, apt and factor assay.5. If its normal then, no need to bother, and it should not prevent you from joining army. Hope this helpsRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 15, Male, and I think I might have a varicocele. Im not 100% sure. I have something above my left testi. It almost feels like a pea( or a little bigger) sized testicle, just not as firm. I did not have any pain or anything until I found out about it, I feel as if my body is making me think I do. What do I have? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. If your detailed description is correct, the condition could a harmless cyst. You are not experiencing any burning or pain. That is the indication for it is harmless. Still, to be sure, you should consult a physician. He may order for an ultrasound scan to testify. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr.herrick , one dr has diagnosed me with hip labral tear and FAI. Whereas another dr says i just have osteitis pubis, and very weak core muscles...is there any way to differentiate where the pain is coming from..i have deep musculoskeletal pain radiating to legs and extrreme foot pain ### REPLY: Hi I am . .  That could be sciatica due to nerve compression, as it may cause radiating throbbing neuropathic pain as mentioned in your give history, numbness and tingling may also be felt.  For my patients I recommend painkillers (NSAIDs) like Tylenol 400 mg tabs when needed, gentle massaging with topical anti-inflammatory gels, muscle relaxants, B12 vitamin supplements, in more severe or chronic cases steroid tabs (vi codeine) or injections and anti-epileptics like gabapentin are prescribed if required.  You may try to avoid heavy lifting, over weighing, obesity, vigorous movements and bad sleeping or sitting postures will be helpful in most of the cases If medical and physical medications failed for 6 consecutive month I recommend you undergo further investigations like X-rays and MRI scans to exclude any spinal injuries or disc herniation and follow them up with your neurologist for proper evaluation and management. Please click and consider a 5-star rating with some positive feedback if the information was helpful. Wish you good health, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 4 month old infant has had a yellow watery diarrhea for 6 days now, goes about 4-5 times a day.... but today she was better  only twice...only, the last diarrhea was alot and had little black, greasy spots present.. i never saw that before.....can you tell me what that is? ### REPLY: Hi, I am sorry for the watery diarrhea your 4-month-old infant is having. Yellow watery diarrhea 4-5 times/day, going on for 6 days now is a sign of possible food allergy or bowel infection. The black, greasy spots present could be parts of undigested food especially if formula milk is given to your baby. I highly recommend sending her to your pediatrician and run stool examination and culture to determine the right cause. Keep good hygiene when preparing his milk (if formula) or when breastfeeding. Wish fast recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i have been having chest pains for about 4 days know closer to my left side. Although i have a very stressfull life from school, friends, family(my parents seperated), I am a very active person. I love weightlifting and cardio, and have been doing it consistently for about 2 years. i have a decent build and i stray away from smoking, drinking, drugs, and drink plenty of water. My diet is great, i only eat whole grains, i eat alot of protein, and veggies, and stay away from fast food. I am 17 years old. but i take zoloft, and wellbutrin for depression and anxiety. I also have been taking pre workout supplements that contain ingredients such as caffeine. my nurse in school said that its probably just anxiety or the weather since it has been rainy and humid for a straight week. I am actually about to go to a hospital right now but before i go i would just like to get another source of help because i am extrememly worried about this. I recently dropped my zoloft from 150mg to 125 mg, does that have anything to do with it? thanks ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of stress and anxiety related chest pain is more. At your age of 17 years, heart diseases are unlikely. And yes, decreasing dose of anxiety medicine can cause worsening of anxiety symptoms. You are also having other stressors which contribute more in your symptoms. So in my opinion, you should consult psychiatrist and get done counselling sessions. Discuss your problems, stressors with psychiatrist and find out the solutions. Don't decrease dose by your own. Counselling plays very important role along with anxiolytic .  Don't worry, you will be alright. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END