Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently I have developed a pain in my lower back with gas pain and bloating and pain on my lower right side. This increases before I urinate. I had a work-up a few days ago saw a gastro- xray showed alot of stool and maybe some liver swelling. I am in alot of pain that goes away throughout the day, but comes back about 1 hour after eating around belly button. Can you help? Coiuld this be an ovarian cyst? I am female 54 years old- had a hysterectomy and usually have good health except for a cervical disc & nerve problem and Hasimotos thyroiditis. ### REPLY: Hello, Liver swelling may not be visible in X-ray of the abdomen. Only span of liver may be measurable in few cases. Confirmatory diagnosis by ultrasound abdomen or CT scan. You may be suffering from acute gastritis or irritable bowel syn .  Until examination is done it is difficult to say what it is. Use upper GI endoscopy and stool examination. Ultrasound abdomen and if necessary colonoscopy. Avoid spicy food and caffeine  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having cystitis regularly for about 9 years but in the past month I have had it pretty much every other day. Went doctors on Tuesday and they have suggested an internal tomorrow. Problem is I have it again today feeling awful. Sick, hot and belly and back pain and really worried how bad it will be tomorrow when they have to prod about. Can u please tell me why they would have to do an internal. Thanks ### REPLY: Welcome to . Recurrent bladder infection for 9 years for evaluation - Possibly the doctor want to evaluate the bladder internally and acquire a biopsy / sample form the bladder wall. Depending on the cells one can conclude the treatment. Understanding that it's not a pleasant investigation - but once for good final evaluation will be done - Good luck. Hope it helps you. Wish you a good health. 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 good day!!i have question.. My husband is having xray yesterday for his 1 of requirments.. the result of the xray was this Pulmonary Koch s Infection. minimal infiltrate in the left upper lobe with at 1.7 cavity. i just wanted to understand whats the meaning of this because he has a previous illness before about tuberculosis..also known as TB.plz i really need the answer. ### REPLY: Thanks for your question on . I can understand your situation and problem. Your husband s current x-ray report says he is having cavity with fresh infiltration.  These mean active TB infection. Cavitory lesion on chest x-ray has high chances of having active, infectious TB. If he has previous TB than this can be a healed lesion. But for this you need1. CT THORAX2. Bronchoscopy and BAD (Bronchi Alveolar Lavage) analysis for TB. CT THORAX gives excellent visualization of lung parenchymal and much better imaging modality than chest x-ray. So if both are negative for TB than this is probably due to past tb infection. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went to the bathroom just a few hours ago and when I pee d, if I spelled that correctly. My penis tingled a bit, I was not sexually aroused. I have not had sex yet, and I am 17. So I know it can t be an STD or something. What could it be, because it scared me. ### REPLY: Hi, Thanks for writing in. You might be experiencing a normal sensation if it has happened only once. Tingling in penis on one occasion while passing urine is not a sign of sure disease. However, should it be happening regularly then you might need to be tested for urinary tract infection and less likely sexually transmitted infections if you have used public washrooms or even had close non-penetrative sexual contact. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My wife was doing some working activies in the lounging room and suddenly she accidentally hits the sofa pole. Her knee is now swollen and it is getting a bit bigger day by day. 3 days have passed. What is your recommendation please? Eventually we are thinking about doing an X ray. Thanks for a kind answer ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to accumulation of fluid in the knee joint, secondary to the musculoskeletal injury.X-ray of the knee joint will be helpful to rule out any fracture or other pathological causes. Symptomatic relief can be obtained by heat therapy, application of analgesic & muscle relaxant gel, intake of analgesics like Diclofenac+ Serratiopeptidase (to be taken after food) and Pantoprazole (to be taken 30 minutes before meals). Supplements of Calcium & vitamin D can be included in diet which will help in strengthening of bones. Physiotherapy exercise will also be helpful. If symptoms still persist, kindly consult an Orthopedic for proper clinical examination.Also, she should maintain adequate HY . Wishing her a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had a vehicle accident which caused 2 herniated cervical discs, torn muscle in right shoulder . I am being treated with physical therapy . Since the accident, I have developed a strange sensation or pain down my left arm when I urinate. It feels like a tingling in the veins and involves my entire left arm. My doctor doesn t kniw what it is ### REPLY: Helga the latest MRI scan of the full spine is required to know the extant of injury and current status of intervertebral disc;spacing ;compression on nerves etc. AS a psychiatrist I analyze your symptoms as following It is sympathetic representation of right-hand injury on to left hand Such a phenomenon is more commonly seen in eyes disease. The details of your accident is not available but it's occurring during micturition stage may have to do something psychologically with your accident ; type of accident; posture in which you were at time of accident etc. If MRI scan is normal and Neurologist can not explain symptom on basis of MRI findings and neurological examination please get in touch with a counselor for helped well soon .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a rash on my buttocks that may have been acquired from an infected toilet seat;  I have applied anti-fungalcream, cortizon cream, Vitamin A& D ointment;  they appear to help in that the scaling goes a way, itchynessgoes away, but discoloration of skin remaines.  However, these creams unfortunately do not clear the rashcompletely.  Once I stop application, rash is there with discoloration of skin; the itch returns and scaling setsin once again.  What do you think might be going on? ### REPLY: Hi, thanks for your query. It seems you have a fungal infection on your buttocks. For this you need to take oral antifungal medicine by prescription along with local application of antifungal creams. Don't scratch the lesions instead take oral antihistamines for itching. Avoid applying cortisone cream as infection may flare up with a steroid. You may apply vitamin A&D ointment. I suggest you to meet a dermatologist for exact diagnosis and treatment. Hope this helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with a kidney infection almost 3 weeks ago. had 2 different types of antibiotics,  and it seemed to have past... pain has returned not as extreme, so I went to a walk in clinic. they doctor says there in no infecton showing but there is blood and protein in my urine. Wondering what can cause this, and can it be related to my endometriosis that i was diagnosed with in 2008. ### REPLY: HelloThanks for query. Based on the facts that you have posted your urinalysis has revealed presence of protein and blood in urine. It is not related to endometriosis that you had in 2008. Presence of blood and urine signifies disease of Glomeruli (Urine filtering unit in kidney) and needs to be investigated Consult qualified Nephrologist for clinical assessment and get following basic tests done to establish diagnosis 1) Urine culture 2)Estimation of total proteins excreted in 24 sample of urine 3)Renal function tests 4)Blood coagulation profile 5) Estimation of C reactive protein 6) Microscopic examination of urine to detect presence of Dysmorphic RBCs7) Ultrasound scanning of abdomen. Further treatment will depend upon result of these tests and final 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: My 22 year old is experiencing chest pain (severe), back pain , 170 bpm, tired, clammy, she also has a spot on her left shin that hurts her as well. We have been to the emergency room 3 times in 2 weeks but noone can figure this out. She has had a chest xray , blood work, ekgs, everything was normal. The only thing they have done is give her a shot of dalauded (?) with no diagnoses. It s like they can t figure it out so they give her a shot and tell her to go home and she should feel better in the morning. And of course she s not. Please will you give me some kind of information so I can help my daughter. Thank you for all your help, Candy ### REPLY: Hello. Thanks for writing to us. The symptoms that you have described could be related to a generalized viral infection, acute gastritis, hiatus hernia or an electrolyte imbalance. A detailed evaluation is needed to find out the exact cause so that treatment can be started. 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: I have had a spot like bump on the floor of my mouth for around two months, it is never painful but it bursts after growing then disappears for a few days, clear puss seems to come from it when burst, it grows right next to my salivary gland and I am becoming quite concerned as I thought it may have resolved itself by now any help would be much appreciated ### REPLY: Hi. Thanks for the query As per your complaint it looks like you have formation of a mucous cyst also known as a Muscle. It is associated with salivary glands when the duct of the gland gets obstructed or damaged leading to accumulation of mucous/ saliva into soft tissues forming a lump. It is a harmless and self resolving condition. You can do concentrate salt water rinses as it helps in regression of the lump. But in case if it is recurring then surgical removal of the same can help in preventing further recurrence. Hope this information helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband is having pain in the lower back/hip area,  then the front area near his hip but then the pain is severe in his calf- where cramping travels from the calf all the way up the leg.  he has prior sciactic problems but this is different.  any idea? ### REPLY: Hi I am . .  In my opinion I think your husband may have a sort of arthritis in his hip joint that may have exaggerated his old sciatica problem.  Arthritis is a type of inflammation that happens within the joint causing swelling and making more pressure on his spinal nerve roots and increasing his pain.  For my patients I may recommend Advil tab when needed, hot massages with topical gels, B12 vitamin supplementation, avoid standing for a long time and over using his joint, vigorous movements with some elevation of his legs, healthy lifestyle and low salt and proteins meals will be effective for most of the cases. If his pain persists I recommend a visit to his physician 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: Hi, I fly a lot and occasionally during a flight (not the take off or landing) I get a stabbing pain in the left side of my chest.  It typically lasts about an hour.  If I apply pressure to the are, the pain subsides somewhat.  I would estimate that this has happened about three times over the past two years (during which time I have taken about fifty to sixty flights).  Otherwise, I am generally healthy.  Any ideas what could cause this?Thank you in advance! ### REPLY: Thanks for your question on . I can understand your concern. Since your chest pain is subsided by pressure, possibility of musculoskeletal pain is more. Awkward Sitting position in flights can cause muscle spasm and throbbing chest pain. So musculoskeletal pain is more likely. But better to rule out heart diseases first because your pain is situated on left side. So get done ECG and 2d echo. If both are normal then no need to worry about heart diseases. For musculoskeletal pain, you should avoid awkward sitting postures. Sit with proper back and chest support in flight. Application of warm water pad on affected areas is also beneficial. You can take simple painkiller like ibuprofen for pain. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m having a lot of low back pain and was diagnosed last week with some blood trace in my urine. Currently taking metrezonale(?) 3 x s a day, but my back pain is no better. My Dr. recommended I see a G I DR. but my earliest appt. was for a whole month from now. My back pain seems worse and I only feel comfortable laying flat on my back. I have not had any injuries to this area other than a UTI. I made an appt. with my Colonoscopy Dr. for 8 days from now. Will this Dr. be able to diagnose like a G I Dr?I had a cat scan that showed a cyst near my colon. Could this be causing the pain? I m 69 yrs. old female. ### REPLY: Hello, At your age, Lumbar spondylosis is very common. You should an orthopedic no and get an x-ray for lumbosacral spine (AP & lateral). As you mentioned, you feel comfortable by lying flat on the floor Lumbar spondylosis is the probable cause. If it is the case, then you should get physiotherapy for back muscles strengthening. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having lower back pain on both my left and right side - very uncomfortable to sit at this point - and have had frequent urination - no burning sensations - this morning.  I am a 57-year old female.  Could this just be some kind of kidney infection? ### REPLY: Hello, I have studied your case. Back pain can be due to muscle strain or gall bladder disease or renal calculi. You may need x-ray and Ultrasonography. And also check your it B12 and it D3 level. Medication like methylcobalamine and analgesic will reduce pain. You can do yoga exercises and focus on spine extension exercises. You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case. If required you may need MRI spine. Hope this helps. Wish you a speedy recovery.  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: HelloI am a lung cancer patient, I just finished chem and radiaton. I also have had 30 percent of my left lung remeved. The last week I Have had episodes of a burning pain in the center of m chest. I am taking a lot of meds , I don t have any pain in my arms,shoulders or jaw. Although my adams apple also has discomfort and then it seems to just go away. ### REPLY: Hello, Most probably an acidity, gastritis and reflux disease. Do you also have upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, these are the other symptoms and may be associated?  You should avoid fatty, oily and spicy diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg or omeprazole risperidone combination before breakfast once a day for 2 weeks. If not adequately relieved, then you should add SYR sacral O or genus two teaspoon three times a day for a week. Hope this helps you and get back if you have any doubts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 question for you Doctor, just concerned with my itchy skin, i just read something that some sympthoms of having itchy skin is about having a problem with your kidney. I have kidney disease & my creatinine is 142, does it mean it has something to do with my kidney? ### REPLY: Hello and welcome to . As a Urologist, I must advise you that, kidney disease can cause itchy skin.It's the reverse of what you were thinking. Normal urea levels are below 40. Probably, it's your urea and not creatinine, that's 142. Kindly check again. Normal creatinine should be below 1.2-1.4. Along with urea, creatinine also rises in kidney disease. Once the stage of kidney disease increases to higher stage, in uremic state, uremic skin has a smell and itchiness, which is what you may be experiencing. You should check your blood pressure, potassium,and restrict salt intake. Consult your nephrologist urgently.  If you've any other doubts, you may send your question as a direct question to me.  .  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: Hi good day,I have been taking pills irregularly because I forget sometimes. The last time my menstruation is very early and now I am delayed for two weeks. Can I conclude that I am pregnant? And if I am is there a possibility to post phone my pregnancy? What is the best thing to do to post phone my pregnancy? Can I buy over the counter medicines? PLease help me..... ### REPLY: Hello, thanks for using  Irregular in take of contraceptive pills is the number one reason for failure when using contraceptive pills. Pills are hormone based and irregular intake creates hormone disequilibrium that could account for the irregularities in your menses. It is also possible that the irregularity is due to a pregnancy. However, only a pregnancy test with early morning urine taken after the expected date of menses could clarify if there is a pregnancy or not. If the pregnancy is already there, it will be unfortunate for you because it can not be postponed. Pregnancy can only be postponed by effective use of contraceptive you have not been using effectively. Hope this helps you. Best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up to crushing chest pain and went to the doctors.  They ruled out that it was my heart.  I am supposed to take Prevacid when I feel like I need it.  I have been taking it for 10 days know 30mg 2x/day.  My esophagus hurts/burns continually now.  Is it the medicine?  What could it be? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of HERD (gastroesophageal reflux disease) is more. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of burning esophageal pain, chest tightness etc. You are taking antacid (pantoprazole). Only .  You need to follow below-mentioned lifestyle modifications also for better symptomatic relief. 1. Avoid hot and spicy food. Avoid junk food. 2. Avoid stress and tension, be relaxed and calm. 3. Avoid large meals, instead take frequent small meals. 4. Keep 2-3 pillows under head in bed to prevent reflux. 5. Quit smoking and Alcohol if you have these habits. 6. Go for walking after meals. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My liver is slightly enlarged(16.4) , margins are smooth and parenychymal echoes are coarse and enhanced (generalised . No focal abnormal echoes seen . Vascular pattern is normal . Intrahetic biliary ductules are normal , non dilated. GALL BLADDER - Few echogenic foci with posterior of artifacts seen in fundal region likely suggest adenomymatosis......what does all these reports mean in a simple language ?? ### REPLY: HelloYour findings suggests mildly enlarged fatty liver with coarse echo texture. Coarse echo texture may indicate liver parenchymal disease. You may need clinical correlation and few investigations like routine hologram, random blood sugar, liver function test, renal function test, lipid profile, urine RE/ME. Ultrasound findings also suggest adenomyomatosis of gall bladder. It is a benign condition characterized by hyperplastic overgrowth of mucosa of gall bladder, thickening of the muscular wall and formation of diverticulum or intramural sinus tracts(Rokitansky-Aschoff sinuses). Echogenic loci with posterior of artifacts seen in fungal region may be due to deposition of cholesterol in gall bladder wall. It may be an incidental asymptomatic finding and may not require any treatment. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,Now I am 11 days late of my period. Its 6 weeks 3 days almost. Last week I did HTP but came out negative. My cycle is 33-35 days. My last period was on 2nd sept. After 2 weeks of my period I got slight bleeding and then spotting for almost 2 weeks on and off. My breasts are sore. And now after 6 week, yesterday I got to see little brown discharge on and off. But now its not there. Could I pregnant? ### REPLY: Hi, You have a 35 days cycle. So the ovulation should be around 21st day of cycle.  As per your history, this time you had spotting, which lasted for one more week. So ovulation could not take place & so no chance of pregnancy in the month.  The sore breast brown discharge off & on suggest Either missed abortion(previous month pregnancy) OR hormonal imbalance.  To pinpoint the condition you should be physically examined by a Gynecologist & investigated (USG abdomen) The treatment can be decided after that only. Please don't worry, it can be easily managed by proper approach.  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 team, I have got my semen analysis done yesterday and following is the result: Sperm Count: 45 million/mL Motility: 50% (I) 20% (II) 20% (III) 10% (IV) Morphology: Normal: 70%, Abnormal: 30% Viscosity: normal Sperm aggregation: present Please explain the summary of my above result. There are gelly substance present in my semen which is a primary concern for me. I see these substance since 8 years now. Will that create any problem to father a child? Thank you in advance. Chakradhar ### REPLY: HelloThanks for your query, based on the facts and report of your semen analysis that you have posted it appears that your semen parameters are within normal range of WHO standards, However the agglutination of sperm is suggestive of either due to infection or presence of Anti Sperm antibodies. Which could be the cause of infertility. Please get your blood tests for presence of anti sperm antibodies and semen culture done to rule out presence of infection done. Further treatment will depend upon findings of these tests. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 henna tattoo on my skin. Hennas are supposed to be gone in about 2 weeks but its been a month and my henna is still stained on my skin. 1 week after Ive had a henna, I experienced itching. The part of my skin, which has the henna, soared and when I touched that part it felt hot. I dont really know what happened. I just know that its still on my arm and it doesnt go away. Can you please give me some advice on what product to use or just simply how to remove this from my skin. ### REPLY: Hello. Thanks for writing to us at  You seem to have developed Post-Inflammatory Hyperpigmentation (PIN) at the site of Henna application. Henna is a common allergen. PIN seems to be the result of Allergic contact dermatitis, which you probably developed to henna as exemplified by symptoms such as itching, swelling and warmth. If I was the treating doctor I would have asked you to use a moderately potent topical steroid e.g. fluticasone propionate 0.05% Or Mometasone furnace 0.1% cream, twice daily at the site. These are prescription products and I would suggest that you visit a dermatologist for a confirmatory diagnosis as well as appropriate prescription. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was diagnosed with valley fever on January 6, at that point I had lost about 10 pounds, I was in the hospital for two weeks, now I am not, I will be taking meds for a year, I want to know when will my weight start coming back and should u be concerned if I have lost a little more weight since I was discharged? ### REPLY: Hello, It is often the case that you lose weight when you have a serious illness. You need to make sure that you are getting adequate nutrition and especially that you are getting some extra calories. Taking a multivitamin daily may also be helpful. Make sure you are also .  It is not a big concern if you lost a bit more weight after discharge as long as you start gaining your weight back soon. Make sure you get plenty of protein and fats in your diet. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey, I m AAAAA, and 21years old. I have received my MRI scan after many months of back discomfort and the report says its all normal except at the last observation which says: Lumbar spondylosis with small posterior central bulge L5/S1 disc mildly indenting the Thecal sac and nerve roots. It gets very uncomfortable when I sit in the same position for over 10 minutes or so, Sometimes when I sit on hard surfaces I tend to feel some numbness in my legs or pins and needles which takes a few minutes to go away after I stretch ... Also last time I was doing my training ( boxing ) I noticed that when I was doing jumping exercises after a few minutes I started not being able to lift my legs in the jump with much agility, almost like I didn t have total control of them and my balance was clearly disminished on the landing of each jump.. What could this be and what can I do? Thank you for your attention ### REPLY: Hi, It sounds like your symptoms are out of proportion to the MRI findings. The MRI indicates that there is mild indenting of the thecal sac and nerve roots. This is subjective, but does not sound very significant.  Bottom line, your ordering physician must correlate these findings with your symptoms. Some docs consider a nerve conduction study or spinal injections for localization of symptoms.  My concern is that you should also look elsewhere given the striking symptoms versus the mild disease on MRI. 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: calcium oxalate seen in crystals of urine report in my 3.5 years old daughter. Is this any serious matter? In her first urine report ketones were trace with ++++ (160mh/DL) also protein & octtul bold traced and crystal was nil, in her second report ketones found with 1(+), proteinfound 1(+), octtul blood traced & crystal was nil but in her 3rd report ketones & proteins found abcent, blood found moderate (NH), also appearance found first time in her 3rd report Turbid (moderate) and Calcium Oxalate seen in crystals. What it means and is it very serious matter? Pls guide me ### REPLY: Thanks for following up. It is clearly seen from analysis that your daughter has metabolic nephropathy, hyperoxaluria. Treatment required next diet:1. Avoid:chocolate, spinach,peas, beens, rajma and other kind of DAL or passes, beet roots, sour fruits, lots of meat, markets juices, avoid mixed subdue -panir and tomato, because in food we will receive Calcium oxalate2. You may give to her-potato-cabbage diet, carrot, soup, Dali, panir, milk, cheese green tea with lemon.  3. She should . She should  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 took clomid from day 3 of my periods for 5 days. After which i ovoluted on day 14 (i had got a follicular study done).....from day 14 i started duphaston dose for next 10 days. Its 32 day today and i have still not received my periods. i did the pregnancy test today but it was negative. today i also noticed a pinkish trace in my cervical mucous. I have ahistory of irregular periods. can u tell me the role of duphaston in my case and my chances of pregnancy? ### REPLY: Hello dear, I understand your concern. In my opinion the cause for irregular periods in your case might be POD where the problem is absence of ovulation. The Comics an ovulation induction . So it is effective. It can be tried up to 4-6 cycles. There will be progesterone insufficiency in case of irregular periods so the phaeton which is a progesterone is supplemented from 14th day onwards. I suggest you to repeat the urine pregnancy test after a week as it gives accurate results a week after missed period. Avoid stress. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was just at the dentist and they discovered a black area on the left lower jaw area below my teeth and they called me back and said I should go get a CT scan. I am 23 years old and otherwise healthy, is cancer the only thing this could be? I had a root canal re done last year on that same side but this black area isnt underneath that tooth it is along the other ones next to it. ### REPLY: Hi and welcome to . Thank you for your quarry. Cancer is the less common thing that could be. Tooth tumors are rare especially in your age, but it must be ruled out of course. It can be any benign mass, abscess, tooth tissue, neuroma, or calcification. CT would show exact size and signs of infiltration but i don't think it would be serious. Even if this is, it can be surgical managed. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, I have fungal infection on my thighs that leads to rashes & the whole area gets black in color. I have been having this problem on & off for quite sometime now. I used to use Tinaderm solution and it used to give me temporary relief. But now it s not available. I went to a dermatologist who has given me Citrezol...have been taking it for 3 weeks now but it s just slightly reduced..not fully gone. Is there a substitute for Tinaderm? Is there a permanent cure for this fungal rash?? Please help I am so fed up of this problem. Also I get this only when I am in India. Never had this in UK...and I find I get this rash when I use synthetic clothes :( ### REPLY: Hi, I can understand your concern for fungal infection on thighs leading severe rashes. You have not told us your relevant details like your age, sex and occupation. After reading your query it appears to be due to Fungal infection of the thigh area which is quite common due to heat and humidity. Fungal infection of the skin is quite common due to infection and hygiene as well as most commonly due to diabetes. Go for your blood sugar check up to rule out diabetes and raised blood sugar if you are more than 40 years of age. To prevent the further spread maintain good hygiene wash it two times properly. Stay away from hot and humid climate. You can use clotrimazole cream or terminating cream over the affected areas under medical supervision. I suggest you to take antifungal tablet by mouth such as fluconazole 150 mg alternate days for 15 days. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a lot of gas, sharp pain in my lower abdomen and lower back. I have endometriosis and pcos. I have lost a lot of hair and gained about 30 pounds in the last year and cant seem to lose it. I also seem to have frequent urination and an average of one bowel movement a day. Im a 24 year old female. I also suffer from ptsd because of being raped by 15+ men in the last 3 years. Ive had 20+ sexual partners. I dont know if any of these relate at all but I figured I should give you any information that may be helpful. Any idea what would cause this pain and tons of gas? ### REPLY: Hi, You are 24 year, female, You have a lot of gas, sharp pain in lower abdomen and back, You have endometriosis and P.C.O.S, hair loss, weight gain, frequent urination.  You have 2 issues, one is pelvic infection, second is gastric irritation. I advise you to consult a gynecologist for treatment. UN less the infection is completely treated you can't be relieved of the backache.  I usually advise my patients' omeprazole, risperidone combination once daily in empty stomach, for gas problem.  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 fell two months ago and my right hand was scraped on the top so I bend it down pretty far... A week later I had it xray but they said it wasn t broken... They gave me a splint to wear... I really wasn t religious wearing it... But it hasn t got better... It hurts when I twist it to the left or inward and can t twist with ... I am wearing the splint religiously but still hurts .... Any suggestions? ### REPLY: Hi, Thanks for your query. From description, it seems you might develop muscular or ligamentous injury as on X-ray there is no bony injury. Now after 8 weeks if pain is severe, I would suggest getting this evaluated by an orthopedic for an accurate diagnosis and appropriate management. You may get the MRI of the area affected under his/her guidance. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 33 years now . I am married for the last 11 years got a kid after 5yrs with treatment in 2006 ..No IUI and No IVF . after that got ecotopic pregenency in 2007 and left tube removed. Now for the last one year i am trying for second kid.All my blood reports ,AMH, HSG reports are normal.Still i am not seeing the positive result. We decided to go for IUI from now onwards.Can somebody suggest this would help or not and what could be my problem. ### REPLY: Hello, I would be happy to help you with your question. I think that you should still be concerned about the remaining tube.  For the same reasons that you had the ectopic in 2007, your other tube might be diseased as well in a way that was not detectable on HSG.  There should be consideration of a laparoscopy to look at the other tube, and to assess for adhesions.  I only suggest this because GUI is expensive, and if the remaining tube is not functional or there are adhesions, then it will likely not work, or you will be at risk for a recurrent ectopic pregnancy. I hope that this helps and good luck!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old has recently had some bowel movements that smell like bleach. She doesn t have any discomfort or symptoms of and illness and he bowel movement appears normal. She has been in antibiotics every month for the past 4 months, but finished the last one 3 weeks ago. She also takes miralax daily for constipation. What could cause this smell? ### REPLY: Welcome to the ChatDoctorI understand your concerns. It seems that the use of antibiotics and MiraLax for long duration has lead to the change in gut flora of your daughter. Don't worry. I would recommend you to start her on probiotics such as enterogermina to replenish her flora. Constipation in kids of this age is most likely due to lack of fibers and deny .  So, enrich your children diet with fibers and give her plenty of fluids to avoid deny ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir..my dad is sufferinf from urinary tract infection from 1 yr..after getting antibiotic traetment  still 4-5 pus cells come..recently septicemia diagnosed with urine infection...after 5 day of hospitalisation still feel weakness and fatigue but tlc report is normal(10,600)...what should we do? ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that weak less after septicemia is common. Nothing to worry about it in any way. 4 to 5 pus cells in urine is normal. I advise your father should take gluon D powder for energy purpose. Nothing much is required. Every thing will be fine in a week or two. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: do I need to see a doctor?I often feel really low and depressed , im angry and irritated by small things. I often feel sucidial and that theres nothing to live for. but after a few weeks or sometimes days I no longer feel like this. sometimes my head is filled with thoughts and I feel like my head will explode if I dont stop thinking and then I just get a headache. im 18 , female. I just want to know if this is anything I should show a psychiatrist? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I assure you that you do not have any mental issues. You do not have to see any psychiatrist if you keep yourself busy. Sometimes young people have these kind mood problems mainly because of disappointment. Mind you, this is not clinical depression but disappointment. At teenage, human brain is so vibrant and creative, that finding a suitable task becomes very difficult. The tasks at hand are so boring and slow. They become lazy, irritated, angry and disappointed. Coupled may be the affairs and boy / girlfriends. Every disappointment contributes to the laziness anger and irritation. Eventually lethargy overwhelms. Thinking and talking about suicide at this juncture is normal, but you should make sure that the behavior is not sustained. You have to find some tasks which keeps you active. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a hard red raised bump with a white center on the inside of my arm, where my elbow bends. It has been there for about 2 weeks. It started as a red bump and has, within the past 2 days, formed a white center. It does not hurt or itch. Any ideas as to what this may be and how I should treat it? ### REPLY: Thank you for your query. Your description points an abscess/ an infected hair follicle. I would examine the site to look for signs of infection, redness in the surrounding areas (skin, subcutaneous tissue), warmth over the area, tenderness, any possible bite/sting marks, hair follicle in the center. I would do a complete blood count to check for levels of white blood cells in comparison with others. A folliculitis will be about 2-5 mm in size. An abscess, in most cases is larger (1-5 CMS). If there is adjacent skin involvement (redness, pain, warmth, fever) cellulitis could be present (unlikely based on your description). I would advise to keep area, clear & .  Since it has been two weeks and seems to have pus (white center), I suggest a topical antibiotic cream twice a day for 1 well or till it resolves. Do not pop it or squeeze it. If the antibiotic cream does show improvement in 3 days, or is signs of cellulitis develop, I suggest you show it to a physician. Hope this helps. Please get back to us for further clarification. Hope this resolves quickly. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 23yrs and have lump with pus in my armpits and outside labia since few months.Have not consulted the Dr. till yet.Lump surpress after the periods and occurs again on next cycle. Please suggest what might be the reason?Whom should i consult? ### REPLY: Welcome to . 1. The painful lumps with collection of pus within possible cause is a hair follicle infection, next possible cause could be subcutaneous abscess due to infective causes.2. Lumps outside the labia, possible cause could be ductal dilatation- Bartholdi cyst - does not need any treatment unless causing any discomfort.3. The lumps under arm can be treated with a course of antibiotics or a small incision and . 4. As a remedy do not squeeze the lumps, it will only complicate, (clean the arm pit area with antiseptic liquid to clear infections)5. Suggest to see your GP get them examined and treated accordingly. Good luck. Hope I have answered your query.Anything to ask do not hesitatehttp://doctor. ChatDoctor .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...hi, doctor i am 23 yrs of age and have got white heads pimples on my face from past 6 yrs.i think it is caused due to masturbation.i am not masturbating now  but having nightfall and dayfall.please suggest some medicine ### REPLY: Hello, Thank you for posting on . Whiteheads are basically a type of acne. Any cosmetics or medication can block the pores and cause acne. Especially sunscreen are notorious to cause acne because they are oil based most of the time. Try using water-based sunscreen like Sun mate sunscreen gel-lotion.Also, on daily basis use a retinoid like retinoid in lower percentage like 0.12 or 0.25 at nighttime over full face to prevent new eruption of acne and for healthy glowing skin. Use a gentle cleanser for oily skin like detail OS on regular basis. .  Also note there is no connection between masturbation and acne so don't worry. Hope this will take care of your issue. Wish you best of health. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes, yesterday I started having cramp like feeling close to my heart and under it just on the left side. I am experiencing shortness of breath, and when I walk it hurts more than when I am laying still. This just came on yesterday after I had a cigarette. I havent been smoking long at all, and I dont smoke often. ### REPLY: Hello, I have gone through your query. Thanks for using . Any pain which increases or is aggravated by walking and relieved by rest is likely heart pain, I.e. Angina.Besides, this you have shortness of breath too, so I suggest you to get a resting ECG. If it is normal you must get exercise treadmill test done. This will rule out or confirm heart disease. Depending upon its result you may need further work up for heart or evaluation for other cause of your symptoms. Please give up smoking my 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: My almost two month old son just had a bm and it was a grey color and thick. He filled his diaper up and another one soon after I changed him. He does has gas problems and I have noticed that he has went from having multiple bm s a day to only going 1 or 2 times a day or he will skip a day. Should I be concerned and take him in? Thanks in advance ### REPLY: Hi welcome to ChatDoctorI understand your concern but 4-6 formed stools or a stool in 2-3 days (unless it is very hard) is normal for a two months baby. Colour of stool does not matter unless it is blood stained or contains blood. If your baby is active, accepting feed well, passing urine every 3-4 hourly, not febrile, you not worry. Passing stool with gas is normal. Hope I answered your queryFeel free to ask any other query thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a hard immovable lump under the skin of my left ear.  It is located on the helix and as said is under the skin.  I just recently noticed it and have had it for at least two weeks now.  It is painless and since I have recognized it, there has been no change in size. ### REPLY: HI. Thanks for good information. This is most probably a Serbia, meaning a collection of blood or serum under the skin. This is so because it is present only for 2 weeks. The treatment is repeated aspiration and to get a compression bandage. Consult only an ENT Surgeon, He only knows the proper treatment. If it fails to resolve, button therapy can be done for a permanent cure wherein a button is stitched to keep this in a compressed position. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So I have had some ear pressure and sensitivity that comes and goes along with headaches, mild pressure in back of throat when swallowing achy feeling. I also had some teeth aching on my left side that lasted 2 weeks. I know I have a clenching problem and have tried to focus on not doing it during the day. So are these related to each other? etc? ### REPLY: Hi... Welcome to . You have problem of clenching of tooth called Brunssum. Bruxisum can lead to headache problem and muscle pain.... Bruxisum may be because of stress or irregularities in occlusion or other reasons. Consult an orthodontist for clinical examination and treatment plan. Southward is helpful in Brunssum habits. Longtime Brunssum habit can lead to wearing off tooth. Treat underling cause. I hope this will help you. Take care. Thank you. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 30 years old and Im about to get married in next 6 months. I have a tight fore skin and I want to get circumcision. I live in Bangalore and want to know the best doctor and hospital to get it done.I Also want to know how much time will it take to fully recover. Also is there any laser surgery available for circumcision? ### REPLY: Hello, Circumcision is a simple surgical procedure, and it can be performed by any surgeon and even in primary health centers it can be performed.  I am sure there are many surgeons near your apartment in Bangalore. The circumcision surgical wound should be healing within 15 days.  Your surgeon should be able to provide more accurate data and time frame. Therefore, I suggest consulting a surgeon for physical examination, and treatment. 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 a 30 yr old female and when I first wake up in the morning my heart rate is 84, but during the day it stays around 96bpm. I suffer from bad panic attacks and lately have been obsessing over my pulse. Today I got anxious after I ate and my pulse went to 120. Should I be worried or is it just anxiety causing the increase in my heart rate? After I calmed down it has went back down to 96bpm. I do not suffer from dizziness or shortness of breath. But, I do suffer from many panic attack symptoms while suffering an attack. Is there any advice on how to quit obsessing over my pulse? Should the 120bpm while having an attack alarm me and should I see a doctor over it? Thanks ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. There are certain things you should know. Fear is fearing something which is present. Apprehension is imagination. Anxiety is creating the symptoms of fear with the help of apprehension, means anxiety is fear without the presence of the reason. Obsession is repeated unnecessary behavior. Now, in your case, pulse and heart rate is a bit high because of your apprehension and anxiety. Checking pulse is not a bad option, because you have the problem here. What you have to change is, the anxiety and apprehension. You should tell me what are the causes of your anxiety? For how many days it is present etc. For now start with .  Keeping yourself busy helps in overcoming thoughts. Thoughts are there to come and that is the duty of the brain. Let the thoughts come. You need to divert the thoughts to more priority ones. Means be busy and divert thoughts. 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: I had surgery for a hernia last Nov. Ever since then, I have had pain, swelling in the area of the surgery of the hernia repair. I havs ask, 3 different Drs to check this, explain why. I think I may have an abscess, all Im hereing is I need a groin block injection. I disagree. Still have swelling and pain after 9 months, feeling run down. What should I do ne t? ### REPLY: Hi, thank you for your query. Chronic pain is the most frequent long-term complication of treating inguinal hernia. Onset of post-hernia repair pain usually occurs immediately after surgery. There are two predominant types of post-hernia repair pain: nociceptive pain, due predominantly to inflammation, and neuropathic pain, due to nerve injury. The most common type of postoperative pain is nociceptive which occurs due to tissue damage or mesh placement. The most common treatment for alleviating such pain is the groin block. Based on pain distribution, the patient is given ultrasonography-guided local anesthetic (lidocaine) injections in the ilioinguinal nerve and lateral femoral cutaneous nerves. There is considerable pain reduction and mobility is also increased. The swelling in your groin maybe a Serbia or collection of fluid in the groin region. If you have additional pain and fever then it can be an abscess.I would advise you to get the groin block and then get an aspiration of the fluid done to get a clear picture about the swelling. Depending upon that we can start antibiotics and other tablets. Thank you wishing you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 38 year old woman with one kidney. I just got a call from my family doctors telling me that I need to come back in to the office because I have a uti and the culture showed it to be citrobacter koseri. I took 2 days of color, but stopped taking it after I had a rocephin shot. I guess my question is, is this something people are hospitalized with? ### REPLY: Hi, Thanks for writing in. A single kidney urinary tract infection has always been difficult to treat because of its particular clinical, therapeutic and evolution aspects. There is no specific pathology related to single kidney, but an increase in the incidence of the ordinary pathology is obvious. It is generally accepted that the urinary tract infection (UTI) is the most frequent morbid association in a person with single.  In conclusion, the latest medical literature says that we can note that UTI is frequently associated to single kidney and accelerates its evolution toward chronic renal failure. For this reason treatment under close supervision after admission to the hospital is essential. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 married woman , after 6 years mu husband and I are trying to have a baby. I usually have a regular period , last month we had 3 times unprotected sex , I expected to be pregnant but my period was started 8 weeks earlier. Would you please tell me what is the reason? It was a normal flow bleeding as previous periods. And this unusuall period will affect on my this month ovulation?Thanks ### REPLY: HelloThanks for your query. An irregular cycle does mean erratic ovulation, so your ovulation date would be unpredictable this month.Your question is not clear. Are you trying to conceive for 6 years ? If so then please consult an infertility specialist for a complete evaluation - including hormonal profile, documentation of ovulation status, assessment of fallopian tube patency and semen analysis of male partner. Also, I fail to understand how your period could be 8 weeks early ? Please write back with correct and further details. Take care. Have regular folic acid supplements and maintain a healthy BMI. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 51 year old woman with low income. I believe I need remaining teeth pulled to get dentures , or implants. I am suffering with broken impacted teeth and decay. I can t afford a dentist . What should I do? I believe I would be a good candidate for dental students to be able to perform real dental procedures. Can I do that?? Jamie ### REPLY: Hello Jamie, since you say that you can not afford a dentist so approaching dental students or free dental camps organized by various hospitals can definitely help you. I would suggest that before deciding to go for a denture just get your full mouth check up done and I think that should be affordable. avoid going for implants as the procedure requires blood tests and all. Any tooth that can not be saved can be extracted and the others with good prognosis can be conserved. Yes definitely you can be a good candidate for dental students and don't worry they perform their treatments under supervision of highly qualified doctors.....take care. Hope this may help you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , 35yo male Military, full run up of bloodwork, 24hr bp, holter, and Ultrasound of everything, but ongoing over a year strange thumps in chest and abdomin, thay go nicely with the constant pulse sensation felt throughout the body, almost daily and around the clock now. Low/ no stress kinda guy, all results normal, excellant physical condition. Stumped? ### REPLY: Thanks for your question on . I can understand your concern. No need to worry about major heart or lung related diseases for your symptoms as your extensive reports are normal. Sometimes, undiagnosed, uncontrolled stress and anxiety can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Counselling plays very important role along with anxiolytic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 total knee replacement 9 weeks ago. This was my second replacement and it took forever (4 months) to get off the pain meds with the first knee. I was hoping for a better result this time. I do, however, have a different problem with this procedure. All around the incision, I feel tight, very tight. The skin surrounding the skin is very tender. There does not appear to be any infection, just warmness from time to time. I am wondering if this is a scar tissue problem and what can be done about it? I finished therapy a month ago. ### REPLY: Hello, I have studied your case. As pre your history suture site infection is likely diagnosis DO NOT IGNORE INFECTION IN POST TAR. You may need to investigate like CRP, CBC, ESRPCR culture is very useful to find culprit organism. If infection is confirmed then debridement is required. Persistent infection revision operation is required. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: both my sons age 17mos and 4yrs developed impetigo from school about a month ago..it has since healed..however, the places where they had it on their skin started peeling..now I have noticed some of their fingernails have turned yellowish and are very weak...is this normal? ### REPLY: Hi dear, I understand your concern. With such presentation in my clinic I will exclude anemia, because lack of iron can cause impetigo and weak nails, also I will consult dermatologist to exclude fungal infection. I suggest you-apply iodine or beta din to affected fingernails, it will helpful in case of fungal infection. Don't worry skin of child heals very well, because they have good blood circulation. Hope it is answered to your query. Wishing your baby good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been taking Adderall for several months and it is just recently that my pulse has gone up. I just changed the dosage around a bit from taking 20mg XR in the morning and 15mg IR in the afternoon, to taking 25mg XR in the morning and 10mg IR in the afternoon. I have also increased my exercise regime from 4 days to 5 days. Normally, my pulse has been between 76-80 on or off the adderall. Now, it is between 85 and 95. Do you think I just need to adjust to my new medication switch? I m not taking any more than I was before, just at different times. ### REPLY: Hello knflesheAdderall is a stimulant .  It increases heart rate and over all cardiac output. So the increase in heart rate in you is due to increase in dose in morning as previously you were taking 20 mg extended release which is long acting and now its 25 mg, so due to this dose adjustment HR has increased. As immediate release dose has nothing to do much because its short-acting only and its decrease just will not affect much. Hope I solved your query. Thanks 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 boil on my upper tummy and im 8months pregnant... is it a cause of alarm? I have been putting triderm ointment on the reddened area.. is it safe... its painful... i covered it up with gauze so it would not rub on my shirt...it s a relief but is it ok to cover it up? ### REPLY: Hi, Triderm is a steroid cream, and it could increase the size boil if it is infectious, so I would advise you to discontinue it. If the boil is present for a longtime and is causing pain and itching please see a gynecologist, and she will examine you and decide the nature of it. Certain skin conditions are more common in pregnancy and these need to be identified by a doctor before treatment. Triderm is not contraindicated in pregnancy, but should be used with caution and the skin where it is applied should not be covered by anything as this can increase the absorption the . Do not use it without a doctor advise. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am going in for a MRI for a 1.4 x 1.0 sclerotic focus on the posterior thoracic vertebra I should add I was am a ovarian cancer survivor 2013 and kidney cancer clear cell 2014 Curious what this could be Lung X-ray was clear I have horrible back. 71 years old female ### REPLY: Hello, Sclerosis in medicine is term applied to the structure that is changing the tissue with normal one or replaces with abnormal tissue which makes the organ or structure stiff, (Sclerotic is the adjective of sclerosis) in your case it is the vertebra that is being changed with abnormal tissue which might have made the vertebra structure stiff. (Sclerosis mostly happening due to the inflammatory process)Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just been told I have Reverse-Hill Sachs lesion and a chronic reverse Bankart lesion with denuded cystic degeneration of the posterior glenoid rim, both of the labrum and the osseous glenoid with mild posterior glenohumeral subluxation and patulous ventral aspect to the glenohumeral space(all in keeping with prior dislocation). Subscapularis strain and partial tearing. I was originally referred to our local orthopedic surgeon because of progressing bone spurs in my lower back along with chondrosis in my hips and knees. I started lifting weights when I was 12 . I have been on hydrocodone 10 mg with 325 mg of Tylenol for almost a decade. What would you suggest for a narcotic pain medication that might work for me because of my opiate tolerance. My normal Dr. put me on oxycodone 10 mg every 4-6 hour. That was before they knew all of the damage. I have to take two of these at once to get the main edge off the pain. I have had 3 children without any help from drugs so my idea of a 1 - 10 pain scale equals how many centimeters my cervix would be during labor. ### REPLY: Hi, Good scale for pain. The location and movement of a pain gives clues as to what is going on. But the key point here, is that the pain often has some either inflammatory or nerve components. These are better treated by non-narcotic medications. Tolerance can be overcome by time off from narcotics and/or on a narcotic blocker. Otherwise, you're just stuck going with just higher doses. As these things go, 50 mg a day is the border between doses that are not going to cause problems to doses that might get progressively more of a problem. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a tooth that was worked on 6 months ago.. they took my grey cavity out and filled it w a white one and also protected it w something.... they spent awhile on it. months later it was infected, so I took anti biotic... only bothered me a few times after minimal compared to b4 antibiotic... Now say 4 months I have a pimple like bubble on the side of my tooth... Is this conhhenry1978cerns to me suggestion I need a root canal?? ### REPLY: Hi, Welcome to  forum, Your tooth which was filled earlier has got infection due to any residual caries or secondary caries. Due to caries, infection has reached the pulp and periapical abscess has formed. This pimple like bubble is due to abscess formed because pus needs a way to extrude itself. Consult a dentist for radio graphical examination done. Root canal treatment has to be done in this tooth. 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 type 2 diabettes and taking metformin for several years.  I am presently suffering from right shoulder pain that sometimes the pain goes down through my hand.  I find difficulty in rotating my arms due to the pain in my shoulder.  Can this be the result of vitamin b 12 defficiency? ### REPLY: Hi, I read your problem. Actually frozen shoulder or adhesive capsule. It is common in diabetes, but cause is not known. It may be due to high glucose level. Frozen shoulder occurs when the shoulder joint capsules are Inflamed or stick with the head of humerus bone. The frozen shoulder causes pain and stiffness which leads to limitation of shoulder joint. Frozen shoulder has some causes like Diabetes, shoulder injury or stroke, heart disease, lung disease, Dupuytrens contracture. It does not seem to me that there is any it 12 deficiencies in this case because there is looking no symptoms of numbness or tingling on whole over arm. But pain can radiate to whole arm due to frozen shoulder or shoulder pain due to gravity or other reason. To rule out the cause of your shoulder pain get the x-ray of shoulder joint. 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: hello madam .iam trying for pregnancy from two years .my medical reports are very clear and i have regular periods and every month egg is raptured.my husband sperm count is 70% and motility is 70%.please tell me what are the reasons for not getting pregnancy. ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern looking to your query I could say that as I always say that pregnancy is more natural phenomenon than the physiological certain condition are there and that should be fulfilled and that is presence of ovum and sperm at the time of coitus, beside this even after every thing is normal still conception does not happen, take care and have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: blocks in back i have arthritis in my lower back.i was going to a pain clinic and they were giving me 12 shots at a time in my lower back along my spine..now another dr says i need both hips replaced..can the blocks do that damage to my hips? and now i have nerve damage in both legs. ### REPLY: Hi, If you have severe enough arthritic degeneration to affect the lower spinal column then, there is a good chance that the hips will also be involved by the same process. The shots will not have caused your hips to deteriorate rather the same arthritic process. The nerve damage you perceive to be in your legs most likely is due to the same arthritis affecting the lower spine which is compressing lumbar nerve roots L4 and possibly L5.  That's where the problem likely resides. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a pinprick blistering rash on the top of both my feet.  I thought at first it was a spider bite, the first noticible one was in a set of two, but now they are all over my feet and itch like crazy...no one else in my home has them, including my partner who sleeps in my bed... ### REPLY: Hello, Thank you for posting on . Insect bites are usually pretty easy to treat unless secondary infection sets in. I would suggest you consult a dermatologist, who would suggest you short course of oral antibiotics and analgesics. Oral corticosteroids may be added as required. Apply a cream containing mupirocin for 3 days followed by a cream containing clobetasol and juridic acid twice a day over affected areas for at least 5 days. Take antihistamines for itching as required. Hope your queries are resolved and wish you best of health. Kindly spare some time to rate my answer and . Com/v3/__http://doctor. ChatDoctor .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Five days ago the upper back of my neck became very stiff and sore. it makes it difficult to rise fro a prone position and even from chairs, particularly if I am down for more than 15 or 20 minutes. I don t know of any injury that caused this. What is it and what steps should I do to correct this? ### REPLY: Hello, As what I can understand is this could be leading due to some Factors like - inflammation of the trapezius muscle, interscapular muscle spasm or a nerve root entrapment. I would ask you to try taking hot water fermentation and do simple scapular and trapezius gentle massage by someone's help. Also, some exercise will be good. I will even recommend you to not ignore your cervical spine as at most times there some abnormalities which are present and due to which there is inflammation in the trapezius muscle. Having an MRI done for the neck should help understand the curvature of the cervical spine and also the soft tissue injuries. In my 12 years of experience, I have seen many cases with similar problems. And most respond well with physical therapy and exercises. 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: My mom has Alzheimer s. She has had several seizures and have had no diagnosis until last one over weekend. Doctor thinks has low blood pressure 100-106/60 was what he is looking at. Pressure in ER was 131/60. He thinks she is having seizures due to low blood pressure. She has only been taking HCT 12.5 every other day. Had triple bypass in 2008. EEG only test done other than CT whicChatDoctores back ok. EEG showed slow brain activity and was same as last one done in 2012. Very confused. Took her off HCT ans to let pressure increase. What happens when this seizure comes on is her body goes stiff and her head jolts back with some shake and goes unresponsive. Latest episode she didn t come to for at least 20 minutes. She just stayed sleepy and groggy. In hospital for 3 days. She has been having a lot of jerking as well and has increased over past few months with heavy tiredness. Overall she is healthy and vibrant other than Alzheimer s issue. Only meds taking are levothyroxine and simvastatin. Aspirin and vitamin as well as potassium. HCT out since 1/9/15. ### REPLY: Hello, Judging from that description those episodes do indeed seem to be seizures. EEG may not necessarily show epileptiform activity between seizures. It is important that a CT has been done to exclude causes like stroke or tumors. So, at this point there is not a clear cause for seizures, but that is not uncommon especially in the elderly. The low blood pressure may be a possible cause, but not at those values. If doctor thinks that to be the cause a prolonged monitoring through a portable device called Holder should be done to check if there are episodes of very low blood pressure and if confirmed the cause should be searched. If no lower values are found though then treatment to prevent seizures should be started, at that age Aborigine or levetiracetem are the most common medications. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 16 month old baby. For the last 4 days, he seems to have stomach aches/pains. A few times an hour, he will suddenly start crying, stamp his feet very hard and hold on to me very tight (that it actually hurts me). It is not a tantrum. And after a few minutes, he stops as if it didn t happen. Is this stomach pain, teething or something else?? His back teeth are coming through. ### REPLY: Hello, I can understand your concern. During teething, the gums become sore and itchy and the child constantly wants to bite or scratch on something with the teeth. This makes child .  This habit sometimes cause stomach infection and food poisoning. In addition, because the child himself is annoyed with the teething process, he screams and acts irritated and annoyed. Holding on to you very tight is a symptom not associated with the teething process. You can discuss this issue with the pediatrician. If he develops food poisoning, pediatrician should be consulted for the antibiotic course. For the sore gums, you can apply Travel on the gums of the child to make teething little easier for him. I hope this information helps you. Thank you for choosing . Take care. Best, ### END