Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hlo doctor my s.billurubin test level is 1.1 and typhoid test is also positive...what precaution do i follow now...bcz i have to travel daily to go on my job 120 km up down (warm weather)...can i travel or not???also suggest the diet fot billurubin high levels( jaundice).. And last in how many days i recover.... ### REPLY: HelloThanks for asking query on . As I understand you are suffering from enteric fever (typhoid) and mild jaundice, which could be related to enteric fever itself. You have not given complete details of your Liver function test. I assume you would be on antibiotics. Diet for you would be soft diet with less of spice and lots of liquids. I would some rest especially if you feel fatigued, having fever or pain in abdomen. Usually it takes about 10-14 days for 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: Hi, may I answer your health queries right now ? Please type Hi my daughter is 8 months old and my husband says her urine smells like bacon at times it smells acidic but not bacon what s wrong and lately not drinking as much as she should not eating much but for the most of the time she s happy ### REPLY: Hello, If the babies growth and development are normal, and she is attending all developmental milestones normally then I do not think that you should be worried about her. But abnormal urine smell is suggestive of inborn error of metabolism sometimes. I suggest that you get a urine IEM screen done and then if everything is negative you can be rest assured. 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, Im 21 years old girl. Im 178 cm tall and 62 kg. I have a psychic proble, I have no self confidence. The person I love has this problem too and he is always lost and out of feelings. I feel lost, confused and less confident. please i need a help ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. How can you say that you have psychic problems? The low self-confidence, confusion etc. are never psychic problems but simple life moods. You need to assess why? You are 21. The problems you face in your life could be the main causes. Please find out, and please do not carry the notion that you have psychic problems. Talk to a psycho-logic counselor if you cannot find out yourself. 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: Hi Doctor I am a 29 yrs old guy working as a software Engineer. Recently i received my Blood and Urine Test reports. In That Report Results are as follows:TOTAL BILIRUBIN : 1.6 mg/dlTOTAL BILIRUBIN : 0.48 mg/dlTOTAL BILIRUBIN : 1.12BILE SALTS  : ABSENTBILE PIGMENTS : NEGATIVEDid i get Jaundice ? If Yes pls advise me about the remedies ### REPLY: Hello, I can understand your concern for liver function test. Your blood reports are almost normal. Total bilirubin is slightly high but within acceptable range. To do not have jaundice. Only in jaundice with total bilirubin >5 mg/DL, bile salt (which make bilirubin in liver) get excreted from urine and can be detected by biochemical test. Presence of bile salt in urine is indirect confirmation of jaundice. Absence of bile salt in urine is normal. Hope I answered your query. If you have any further question, I would be happy to help you. 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: i m female 31 years old. I have been having tight chest pains in sternum area and center of back and neck as well as left shoulder blade. Ibuprofen and heat helps pain go away for a couple of hours. when working i sometimes get shortness of breath and and sometimes sweat, it s very hard for me to sweat. i also have been dealing with plantars fasciitis. In past i have had hiatal hernia and inflammation in chest. As well as kidney stone. Where when i m on my cycle my kidneys hurt and have had a ovarian cyst. Family history of females having gallbladder taken out. ### REPLY: Hello Thanks for writing to us, I have studied your case with diligence. As per your history there is possibility of rib contusion or Costco . Rib contusion is visible on X-ray. I will advise consulting to orthopedic surgeon. Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt. You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case. There can be associated inflammatory disease which lead to multi system problem. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Ive done the blood test and my platelet count is low. 109,000. Doctor told me I need to speak with the specialist and do some other test to know the reason. Is this count very bad? What could it be? I know one of the reasons can be Iron deficiency. Where can you see the level of iron in a blood test? He told me all the rest is fine though.. Thank you very much ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your platelets count is slightly low. Nothing to worry much about that. Subclinical viral infection or many other infections can lead to low platelets count. Low iron level does not cause low platelets count. Just repeat your platelets count after 3 days. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir m 23 male..i am having a small wart on my penis top i consuled a local doctor and he advised for VDRL and HIV tests VDRL is negative and HIV is non reactive so am a bit relaxed then he applied podowart lotion on that wart for the same day that wart was going down as i noticed but the second morning it reappeared as it was... so what should i do please help me ### REPLY: Hi, You should consult a Dermatologist as warts can be burnt or ablated by them. If it's not a wart then the Doctor can suggest what to do with it. With your description and without seeing the problem it is difficult for me to comment upon how to treat it. These growths are usually on the penile skin and not on the tip as you mention. Therefore, that makes it more difficult. If you do not want to visit a Doctor then you can ask us a Specialist or a Direct question to me on the site, but please do upload a photo of the wart, so we can advise you accordingly. 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: how can I ease stomac pain quickly to be ready for my work presentation -Can one be sick from 1 energy drink? I didnt sleep all night, threw up once, I feel starved yet naucious,  Can those things poison you? 23 female 160 pounds -have had ulcer before ### REPLY: Hi. Thanks for your query and an elucidated history. Certainly yes, the Energy .  Well since you have to get ready for the presentation with all the symptoms you have suggested, I would advise you the following. Take a tablet of Sanitizing 150 and Risperidone 10 mg, an antacid get. This will act within half an hour, Then you can take a light breakfast and start your presentation. IF the above medicines do not show a positive effect, I would ask you to visit a Doctor at once to get a clinical examination and investigations and treatment as per the findings. Tell the Doctor what you have taken so that the doses are not repeated. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, My son aged 4 and half years has got a Right Renal Inter Polar Small thin walled cortical Cyst Size 13x9mm (Reveled after taking a scan). Request you to give me the reason for the same and suggestive further medication. Also suggest are there any methods so to prevent from reoccurring. ### REPLY: Hi...this seems to congenital. But I would be in better position to guide you after you upload the images and report of the ultrasound or any other imaging you have done to find it out. These cysts can sometimes be multiple and can recur too. It may run in the family too. There is no specific measure to stop them. Kindly get back to me with the reports. You can approach me at the following link. Please find the link below - www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.. My father is diagnosed with Hepatitis B.. He is now taking Baraclude medicine.. Recently his LFT showed that he has high SGPT & SGOT (72 & 83 respectively).. But his bilirubin is normal... Does this mean that medicine (Baraclude) for HBV is not working? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your father has hepatitis B. His GOT and SGPT is slightly raised only.  In hepatitis these enzymes level increased very high.  If your previous GOT and SGPT level as very high then its comes normal level now and nothing to worry.  Continue your .  Avoid fatty food and alcohol. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am still having pain in my right bottom calf leg. I have had land therapy, three cortisone shots, and am now in water therapy. I am slightly better but am still plagued by not being able to stand for more than ten minutes in a shoping line nor walking for more than fifteen minutes before pain in calf returns. I have been seeing my regular orthopedic surgeon who does not recommend surgery due to two discs, L4 and 5 protruding and my stenosis condition. Will continuation of cortisone shots repeated this September compromise the tissues or muscles in my spine do harm? Should I get second opion from neurosurgeon? ### REPLY: Yes you vocal visit a euro surgeon and take secondary opinion about surgery.  If the problem is too much then need to take a chance and euro surgeon is the best doctor to take opinion in your case.  Apart from this you can also have omega 3 and vitamin C and do tablets to support the bone as well as circulation in body.  Omega 3will help to support the spinal cord too. Hope you got your answer.  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 doctor goodday my son right now had allergy on dash or something i dont know we used cetaphil for his body wash but is still there but not so...and now we decided together with my partner to change the milk he taken maybe it needed because its a cow s milk we used that milk for about 1 year and 6 months until the present his skin allergy was started just a 4 months ago ... ### REPLY: Hi... I sympathize with the kid and understand your concern. As a matter of fact even my kid had this when young. The trick of the management is keeping the skin moist and never allowing it to be .  For this oil massage and lotions like Detail will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses, they become better. But there is no way of predicting when it will get better and when it will start improving. If you know this, then you can wait peacefully as you surely know it will get better. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have a 7 month old infant born 4 weeks premature, recently began symptoms of a cold, is on amoxicilin. She is under weight at 13.5 lbs, a few days ago her fontanale became somewhat bulged and firm, and her pulse couldnt be felt there. CT scan at hospital showed nothing specific. She also has reflux and has changed formula. Today her soft spot once aqgain became enlarged and somewhat hard, for well over an hour it stayed that way and you couldnt feel her pulse. Her temp was 100.2 nd she was not lethargic. She has been sleeping much more than usual and doesn t have much appetite. By the time we got to Dr, it was once again nearly normal. Dr is reluctant to do further testing at this time, ie MRI or Spinal Tap. Her stools became very frequent an watery this afternoon also, but probably a result of the antibiotic. Of course now we have to watch for dehydration. We are concerned if we continue to just watch and wait there may be an underlying neurological disorder not yet detected, which could become worse with time. We would like to have a second opinion, however, any attempts to get her in another Pediatric office in the next day or so have been futile. What would you advise? Thank you from a concerned Mom and Grandma ### REPLY: Hi.... if I were your pediatrician I would not waste another minute in doing a spinal tap. I feel that you a kid is having probable meningitis. This can be accurately diagnosed only by spinal tap and analysis of the spinal fluid. The kid might have shown some initial improvement because of the antibiotics administered without doing proper culture or spinal tap. I suggest that you get her to the nearest Emergency Room of a pediatric Specialty Hospital. 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: stomach pain I have been having severe abdominal pain mainly after I eat. I mean it can be anything and Im in horrible pain it feels like someone stabbed me.  right side under my rib cage. and goes to my back. but I also have it in my diafram area and goes up into my chest on the left side. that one doesnt happen as often. please help. IV been to a doc about it and all he said was cut fat and spicy foods out of my diet. I can exactly cut out fat because Im breast feeding. ### REPLY: Hi. It is utmost importance to get a proper diagnosis. I would advise such a patient to undergo Upper GI Endoscopy and minimum ultrasonography of abdomen to come to a conclusion. This is most probably due to an ulcer in the stomach or duodenum. The other possibilities will be diagnosed or ruled out with the investigations. You have to have: Soft bland distant on Sanitizing or Antacid gels till you see a Doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 noticed a lump on the upper back part of my right shoulder, about 3-4 inches away from my neck. I ve monitored it for about the last six months and if there has been any growth it has been very minimal. Recently, I noticed that extreme pressure on the lump causes a sharp pain that may stay for a couple of seconds before fading. Should I be overly concerned about it? ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You may have some soft tissue tumor like lipoma, neurofibroma or dermatofibroma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear DoctorI am 37 years woman and undergone c-section(caesarean) operation with sterilization (14th June 2007) and after these operations i get pain on my lower abdomen right side often. When I took scan, it said there is a tenderness on the right iliac fosa. Can I have Naturopathy treatment for this issue. ### REPLY: Hello, Pain in right Iliad ghost can be a symptom of various disease conditions like chronic appendicitis, ovarian neuralgia etc... please provide the following information:Whether the pain is extending to any other parts on palpation? Is there any recurrent attack of fever or vomiting? Is there any burning sensation or pain before, during and after urination? Homoepathy can give a good treatment for this condition after arriving at the proper diagnosis, so please revert me with above questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, i have a swollen rib on the left side which is very sore when I walk and can t sleep at night. the last few days it got worst as I have exterme migraine aroud the eyes. I had fever and chill the last 2 nights 2 too. I am also extermely tired. i also have now shooting pains in the legs. ### REPLY: Hello, You may be suffering from acute viral infection along with migraine, or it may be sinus headache with fever or other causes like meningismi or malaria etc. You have to get it done a complete blood count, neurological examination. Use tablet paracetamol thrice a day for five days. If symptoms not improved or developed an allergy to above .  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day, i had chicken pox about three weeks ago and in one week, it was clear for me to start my duty at my place of work as directed by my doctor. but this week am surprise that i have itching, headache and body pain. does it mean i have chicken pox again, or is it shingle? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, it can't be chicken pox. It can be shingles. Chickenpox never recurs in a week period. I think it is some different thing that is causing itching. Shingles occurs with blister and burning pain as it is absent in your case it is not shingling also. You can take the visit to the dermatologist as skin disease can't be diagnosed by description only. You can take the cetirizine for itching and paracetamol for fever. Please take the above medication under your doctors' guidance. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 2 days ago i went to walk about a 20 minute walk to the store and out of nowhere i got extrem pain in the middle of my chest then i noticed my right arm was weak and heavy from the shoulr down my arm the right side of my jaw was also extremly painful.. I was wondering if i should go to the hospitale but its a little after the fact or should i just follow up with my family doctor? ### REPLY: HelloExertional chest pain need proper evaluation. It is important to know your age. Cardiopulmonary and musculoskeletal causes of pain should be excluded. You need clinical correlation and investigations like routine hologram, random blood sugar, liver function test, renal function test, lipid profile, urine RE/ME, Chest X-ray (PA view), ultrasound of abdomen, ECG in all leads, TMT,ECHO. Proper treatment depend upon findings. Get well soon. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is manic bipolar. just got out of peachford. working with our doctor to get him back on his correct meds. he woke up couldnt sleep so gave him the small dose of klonopin for anxiety so he would get a good night sleep.however i  have noticed for the second time it is causing to jerk more panic like. almost seems like slight manic acting. i also have buspar. should I give him one or a bendryl? ### REPLY: Hi sir, welcome to , I could certainly understand your concern about the symptoms that your son facing. It is advisable to start him on Klonopin for sleep and anxiety. Please provide some more details about jerky movements and panic attacks whether he has breathlessness symptoms or hyperventilation attacks associated with chest discomfort ? Fear of having another attack? Etc. Buspirone is definitely helpful to treat his anxiety and panic attacks instead of Ben . It definitely works well for his anxiety, so I can prescribe your son to take in the morning time, as it may have some sleep disturbances. Consult your psychiatrist regarding  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 fiance was told that he has low sperm count and that his chances of having a child are slim so if he gets off more than once can that help our chances of having a child ### REPLY: There are many known causes for male infertility.  The initial diagnostic test is a semen analysis. Studies suggest that normal fertility is associated with sperm counts of > 48 million/mL with a motility of > 63%, with > 12% having normal morphology.  Subfertility is seen when sperm counts are There is a genetic component, usually, with azoospermia (absence of sperm) or oligospermia (low sperm count).  However, there may be other reasons such as low testosterone levels.  Other disorders of the testes are often associated with impaired spermatogenesis (low sperm production). In any case of impaired fertility, consultation with a fertility specialist to determine the exact cause of infertility.  Increased frequency of ejaculation does not increase your chances of becoming pregnant. Be well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 essentioal tremors for about 20 years and the last 2-3 years have gotten worse. I am at the max on medication (primodine, propanaol) and the tremors still continue. What would you suggest be my next step? This has really taken a toll on my daily living. Thank you, Sue ### REPLY: Essential tremors have limited management strategy in the form of medical treatment. You are on both propranolol and pyrimidine. If you are still disabled then probably you should consult a movement disorder specialist and think about going for the surgery with the options of thalamotomy and Deep Brain stimulation. Both the procedures have high success rates and a movement disorder specialist might explain more about them. Please do not lose hope. You can get better. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi im a 16 year old boy. Sometimes i experience sharp pricking pain in my chest. Nothing too serious just a slight discomfort. I am a mild asthmatic and use an inhaler sparingly. The pain is occurs suddenly and usually at night before bed. It is not a regular thing though ### REPLY: Hi thanks for asking question. Noted you have asthma ... So periodic chest pain might be from bronchospasm induce by allergen... So at that time of chest pain auscultation done for rhonchi..... If pain severe enough nebulization by levosalbutamol and budesonide res pule may need...SOS when needed albuterol inhaler pump taken. Avoid contact with allergens.... Wear mask if you . If still repeated chest pain occurs after consulting doc and LFT done, regular long acting forecourt like MDI inhaler may be started..... Take care. Hope your concern solved.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ill since the end of December, firstly with sinusitis, which did not clear, then a chest infection, which still have. I have taken three courses of antibiotics. My tongue has a very thick coating, in spite of brushing it and most food and drink taste awful. What can I do about it? ### REPLY: Hello, Welcome to , The symptoms and your treatment history suggests me that you may be having some remote infection which is causing all these symptoms. As your symptoms are persisting even after taking three courses of antibiotics, I would suggest you to undergo chest X-ray, complete blood picture and the blood culture and sputum culture. The aforementioned investigations help us find out the reason for your symptoms, and then we can proceed with the treatment. 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 there, Im 23 years old in good shape work out 6 days a week. I quit drinking alcohol about a month ago, where I would usually drink and pass out on the weekends. I did however drink a bit last night (relapsed) and did a pretty tough cardiovascular workout today, and now my heart feels sore. Am I ok? I have an irregular heartbeat I should add that I got checked out, but it seemed to check out fine. Thanks for the help! ### REPLY: HIT hank for asking to ChatDoctorYour query really appreciated, as long as heart disease are concern it is less likely in this age unless it is the congenital kind of disease and for that I would advise getting done the cardiac evaluation that includes EKG, ECHO and with that the doubt of irregular heart beat and others, in your case dizziness could be due to hypoglycemia, or anxiety, else it may not be due to any illness, if such symptoms of pass out goes on happening on and often then better to get done the CT of brain, hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I feel at least 4 months ago. I hit my Lower mouth ,  under the gumline . five teeth back from the middle, right under I have a huge lump. You cant tell just by looking at me. It dose not hurt. My tounge does not recognize the difference. But when I push on my jaw I feel it. Like the size of a marble from the outside. But from the inside, it feels like half of a quarter size oval marble.how can I get rid of this. ### REPLY: HI. Any swelling remaining after 4 months may need excision, I suppose, if the medical management fails to resolve this. I would advise you to visit an Oral Surgeon or an ENT surgeon to get this examined and decide the course of action. Just follow his advice. This is important as this lump can give complications later. If it has to resolve on its own, would have been done within 3 weeks of injury-now it is 4 months, you say. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 64 YRS OLD WAS TOLD IN SEPT 2010 THAT HE HAS PANCRESTIC CANCER OF THE HEAD HE DID 9 WEEKS OF CHEMO AND WONT DO THE RADATION PART HE SAID THE LORD TOLD HIM NOT TO DO IT . HE IS NOT FEELING GOOD NOW HE IS TAKING A LITTLE OF A HALF OF A PAIN PILL LATE AT NIGHT WHEN I;M SLEEPING I SEE THE NEXT MORNING WERE HE CUT IT IN HALF TO TAKE IT. I THINK HE IS GOING DOWN SOME HE HAS 4TH STAGE A SPOT ON HIS LUNG TOO HE HAS WHAT CAN HE DO NEXT IF YOU CAN HELP ME? ### REPLY: Hi, Thanks for writing in. Your husband seems to be having a cancer of the pancreas that should be treated with chemotherapy and radiation therapy to extend his survival. He might be having an unresectable tumor and that is the reason surgery has not been considered as part of his treatment. It is true that we respect patient interest in treatment, but then we are left with limited option in fighting the disease. Since he has a spot in the lung and is in stage 4 cancer therefore survival for longer than 2 years is difficult. Please provide him nutritional support and pain relief to keep him comfortable. Pancreas cancer is an aggressive tumor and survival for more than 6 months to a year becomes difficult in advanced stage. Please give him emotional support and care. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Could a rough looking red bump on the side of my clitorious be cancer ? I have been on my period for about 2 days and I noticed it popped up about 3 days ago. It has some throbbing pain and I can literally grab it as if there was a ball under my skin. Thank you ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. By your description, I don't think it is due to cancer. Swelling on the side of clitoris can be due to1. Benign cyst (Catholics cyst) 2. Infection. So better to consult gynecologist and get done clinical examination. Possibility of Catholics cyst is more.  It is benign swelling, commonly seen in young females. No treatment is required if it is asymptomatic. Since you are having pain, possibility of infection is high and thus surgical removal is needed. So consult gynecologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 did not go to oral surgeon. I went to the dentist to get my upper wisdom teeth out they got the right side out easily . then they tried to get the left one out but it was too big they said and also said it was coming in sideway they broke a tiny piece off and was trying to pry it out for a really long time. she then decided to stitch it back up and give up because she didnt want me to stress out anymore.  its been 7 days since that happened and my mouth is tense it hurts i cant open it that far and there is a hard lump right under the tooth they stitched next to my jaw bone in my mouth and it hurts. idk what it is. is it normal that my mouth feels like this and is it normal for this bumb should i worry? ### REPLY: Hiii.  Welcome to ChatDoctorI have gone through your query, and it suggests that you have undergone an impaction surgery which went of well for your right wisdom tooth but unfortunately not for your left tooth. First of all avoid hot food and warm rinses which will aggravate the swelling. Also visit an oral surgeon as soon as possible and get your remaining wisdom tooth extracted.  Take care...get 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: We have been trying for a baby for the last two years and not yet got success. My semen analysis report as follows: Rapid Progressive  0%Forward Progressive 10% Slow Progressive 76% Non Progressive 14% --------------------------------------- Sperm Morphology--------------------------------------Normal Forms 5% Head Defects 88% Neck Mid- Pieces 4% Tail Defects 3% Immature Cell 0%  What should I do now? I am a non-smoker and non-alcoholic person. Moreover, I do cycling and regular exercise. ### REPLY: HAI, Your semen analysis report says some abnormalities towards infertility. Total sperm count and parameters also to be considered. Regarding your report: rapid and forward progressive forms should be more 50%(10% in your report).your slow progressive should be less than 20 to 30%(76% in your report)and sperm morphology also seems to be abnormal. More than 50 % normal sperm cells should be there and considered for fertilization. As your lifestyle is okay as you do exercise. Advise taking protein and antioxidant nourished natural food. Better to consult an infertility specialist for further management and treatment.thank you, Hope I answered your query stay healthy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 for quiet some time now had problems with my blood. They say I am anemic. But they do not tell me what is causing it. There are symptoms I am having and need some answers. I have shortness of breath, I feel like I just can t get enough sleep and this may seem odd but I have the little blisters coming up all over my legs. They pop and do not leave sores. Its like something is trying to out through my pores. ### REPLY: Hello, I understand your concern and would explain that the shortness of breath and insomnia could be related to anemia.  Anyway, considering your blisters in the leg, they could be related to skin infection or any other skin disorders.  For this reason, I recommend consulting with a dermatologist for a careful physical exam. In the meantime, it is important starting iron supplements and other vitamins to help treat anemia.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my Name is Dharti Jani, 17 years of age, 5ft5 i weigh 40kg and have no medical history. recently have overdosed myself but have survived this trauma, I cant seem to forget the past and move on and would like some tips in order to be a more happier person ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the description, I understood that you tried to commit suicide. Am I right? Happiness is something you cannot purchase from anybody or borrow. You have to find it. I am sorry if I sound like a sadhu. But that is right. To find happiness know you. Past is. Forget it. Future is uncertain. Forget it. What is certain is NOW. Enjoy the NOW. 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: The clinic has changed my pill frm oralcon (5mnths) , to nordette( 2) month this, im angry al da tym, weepy, light pain on lower abdominal side( ryt). Spotting,could this b a side effect, on oralcon i did have sum problems but they stoped aftr my 3rd cycle. ### REPLY: Degree understand your concerns went through your details. Most side effects of Corvette are not serious. The most common such effects are nausea, vomiting, bleeding between menstrual periods, weight gain, breast tenderness, and difficulty wearing contact lenses. These side effects, especially nausea and vomiting, may subside within the first three months of use. Anger and irritation are not commonly seen as side effects. You could be facing these problems because of your anxiety towards this .  Consult your doctor. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have gingivites since my childhood.Since few days I have a severe tooth ache and my tooth is moving.I already had 2 teeth extractions few years back.I dont want to go to the dentist because he will say I need scaling and extraction of my tooth. Which is very painful so its out of question.I am just 26 I cant have my teeth extracted on and off.Please tell me what should i do? Thank you. ### REPLY: Hi, At the age of just 26 you got your two teeth extracted that is awful. Let me tell you my friend that in case of gingivitis only, there is no need of dental extraction. It is your internal fear only because of which you are not taking your proper treatment. You had already assumed that dentist will say you to get this tooth removed that's why you are not going for the treatment. Nowadays even your tooth is mobile there are options available, by doing gum surgeries, root planning and reattachment procedures your teeth can be saved. But this depend on only after proper diagnosing the case. My suggestion is to visit to your dentist as soon as possible so that it won't spread ahead.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: well it all startedin 2009 when i fallen pregnant and had an arbotion where i ddint go back to get cleaned up. then after that i went on a three month contraceptive injection for about two to three years until i decided not to use it agian in 2012. i then got my period that went on for almost seen days in three weeks times and i finaly decided to go back and get another contraceptive of two months . now im not seeing my period at all and i think im not able to concieve ### REPLY: Hi, Thank you for choosing . Injectable contraceptives can cause your endometrial layer thinning, which eventually leads to not getting periods. I suggest you to stop all medicines now, get a scan pelvis to see the endometrial lining and serum FSH level to rule out pre-mature ovarian failure. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it. Thank you, Wish you good health. .  .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I believe I have tonsillitis having symptoms of sore throat , sore neck glands, swollen tonsils with the puss, difficulty and painful swallowing and body ache. I am aware I will need antibiotics for this but unfortunately I am allergic to almost all antibiotics except sulphur ones. I have veeb using natural antibiotics such as lemon, salt and honey . I have been doing some reading about how strep bacteria can spread and cause rheumatic disease. About a week and half prior to having this sore throat, I have felt my heart palpitating and beats at abnormal rate everyday. I queried if it was my asthma but it s definitely not my lungs but my chest/heart that felt odd. Five days on and the sore throat feels worse, and also I started feeling something stuck down the trachea everytime I swallow. I woke up the next day and it feels it has gone down again to mid chest as I find it tight and painful to swallow and bring my food down. Because it is the Christmas/New Year Holiday I am hesitatant to go to the hospital Emergency Depatment kowing I will be there all day. I was thinking of waiting until the endof the week when my regular general practitioner s clinic will be open. But with the chest tightness symptom, I am getting a bit worried. Is this normal with tonsillitis? Regards. ### REPLY: Hello, Sorry to note that you are having a rough time. It is most likely oxidative tonsillitis (on examination, there is white pus covering the tonsils) and streptococcal bacteria, diphtheria are main causes. Penicillin V, erythromycin, azithromycin (for penicillin allergy) are first line treatment options and also noted that you are allergic to almost all antibiotics except sulfur ones. The secretions (or exudates) from the infected tonsils go down the throat (causing sore throat) and then to the chest causing feeling of tightness. If you have asthma, then you feel this coming on quicker. Epiglottis is an indication for hospitalization. Conservative treatment involves: staying at home to prevent social contact, and you may catch other organisms; throat gargles may help; ibuprofen or paracetamol syrup to lower the pain and temperature. Usually symptoms subside in 3-5 days. I hope that was useful. Best Wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been plagued recently by nosebleeds which have been annoying and scary at times. I have received allergy shots for many years and do have prescriptive nasal sprays , over the counter nasal medication , etc,, so do realize that sinus problems and allergies do overlap. I have done the usual drill of trying not to blow my nose for a long while after an episode even though my nose is full and it gives me a headache, keep area moist, etc.. only to experience another nosebleed several days later, Could a spray tan even with a nose plug inserted in nostrils from a few weeks ago be an aggravating factor? I have had nosebleeds occur a few times in winter season but not in the summer. Recently moved to downtown Chicago from Michigan so do not have my usual doctors to help me with this issue. Should I see an ENT, an allergist, or both as I do want to continue my regimen of monthly shots. Thank you for your time and help. ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make following suggestions to you:1. Allergy shots usually need treatment for long duration. So if you are changing your place, personally I would suggest you to consult an allergist for need of continuation.2. Some intranasal sprays can aggravate nasal bleeds, and there can be local factors in nose also which can also cause nose bleeds. So I would also suggest you to consult an ENT to rule out any local cause.3.  . 4. Please make sure that your blood pressure is normal as high blood pressure can cause nose bleeds. Hope above suggestions will be helpful to you. Wish you the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, I am 14years old.i am suffering from fever for about 8 days.I take medicines from doctor which gives me relief from fever.but still then i cant digest anything,if i eat anything it starts vomitting.even the smell of eatable things disturbed me.Yesterday  my blood was tested and i have come to know that i am suffering from jaundice.my bilirubin[t] is 5.79 . i want to ask you that what should i eat and what should be avoided. ### REPLY: Hi I can understand your concern... You probably here having hepatitis infection. So omitting is common symptom as constitutional symptom.... Viral marker done... Here is advised regarding diet..... Take low fat diet to rest liver. Soft and bland diet taken... Frequent sips of fruit juice taken... Apple, pear, mango, papaya like fruit can be taken... In lunch include green leafy salad. In dinner apple, carrot juice and vegetable soup helpful.... Sugar Cain juice good to take.... Boiled vegetables taken more rather than fried.... Take crushed one tsp carom and cumin seed with water daily early in morning... Non veg and junk food totally avoided for few days... Take care .... You can be helped further if you need still more advise. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my two big toes have been fungal for two or three years. i have used no oral treatment so far , but i am going to begin today. MY BIG TOES ARE THICK AND BLACKISH WITH MY RIGHT BIG TOE HAVING A BLAKISH STREAK FROM TOP TO BOTTOM. i noticed it about two years ago appearing and disappearing when i used vinager on it. the streak is now there without my having used any vinager for two or three weeks. A dermatologist was suspected of melanoma last night, but did not recommend biopsy. my left big toe looks to have less colorful,slimmer sreaks,too. what is your view on this? I appreciate your answering the question ### REPLY: Hello,First I would like to tell that the streak you explained is unlikely to be a melanoma. Melanomas to explain in general terms would be a mole growing without no control. You might monitor closely for growing size of the lesion progressively and irregular margins. If the lesion is constant then the chances of melanoma are low.Moreover, you mentioned that the streak goes away when you use vinegar, a melanoma doesn't go away. Secondly, if you are prone to fungal infections then there are chances the lesion a result of that. I would advise you to start with oral antifungals alongside topical. Maintain feet hygiene. If your nails appear broken then it can be a sign of iron deficiency as well. Follow up with your doctor if the lesion grows or if additional signs like fever develops. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc, I have a bulging and swollen vein on my forehead (starts from eyelid and above). I had it for almost one week now, it has shrunk a bit but not to a normal condition. I felt tightness and I went to emergency dept and they brushed me off as a simple burst vein there and does not pose a danger. They also told me to wait until it heals by itself.I can t do my day job and it really bothers me. Do I need to get a second opinion and have it checked? Or this is really not a dangerous condition? Thanks. ### REPLY: Hi, thank-you for providing the brief history of you. A thorough clinical Neurological examination is advised. As you have a bulging vein on the forehead, it might not lead to any major trouble. Many a time it is just an adaptation to vascular system. Also, if you are facing any symptoms or signs like vision issues, headaches, etc. you can get it examine by a neurologist in person which can help us understand what can cause this. Besides, the feeling of tightness will be just more of a psychological as you are getting worried. In my clinical practice such bulging of vein is not at all harmful and is just a simple adaptation of the vascular system for which nothing to be worried. RegardsJay 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: hya my father is 78 last month diognosed with prostate cancer had mri scan and bone scan cancer hadnt spread anywhere else hasnt ate since eight days ago admitted to hospital yesterday been on drip to rehydrate him stomach swollen with bron fluid getting drained from it had a ct scan done this morning they say there s a blockage somewere they want to operate to have look tommorow ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Treatment of prostate cancer depends on type and grade.  Gleason score is very important in treatment. If score is less than 7 then it has good prognosis.  If score is more than 7 it has bad prognosis.  Treatment also varies depending on score.  In general chemotherapy and radiotherapy is the treatment of choice for high grade tumor.  Surgery is helpful in early stage. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr. Rynne, Male, 62 years old, white, great shape.  I have had this happen 2-3 times in the past 4 months.  Temporary numbness inside on my lip.  It might be a spot the size of a quarter, or it has been, say, an inch across.  Numbness last from 30 minutes to I think early this morning was 2 hours (I was groggy at 3:30am).  I am thinking that potentially it might be from green pecans?  I purchased a bag of pecans from Costco and from time to time would munch on a few.  I noticed numbness maybe 30 minutes later when walking.  I had leftover stuffing last night that did have pecans in it but my wife had toasted those pecans.  That symptom showed up 7 hours later.  I will typically have 6-7 pecans mixed up in a shake that I have in the morning but have not noticed issues from that. ### REPLY: Hi. Thanks for the query. The symptoms can be due to allergy while can be due to cause like nerve damage or injury, or other neurological causes. Nuts can cause allergic reaction as it is one of the common allergen and can be related to many other allergens. As it is recurring, so my suggestion is to consult an Oral Physician and get evaluated. It should be done especially when the numbness is present. Further investigations and management can be done once the cause is confirmed. 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 having severe pins and needles all over my body constantly. My doctors say it s all anxiety as I suffer from Depression and anxiety. I also was I. Benzos and came off of them. And I have a history of psychological trauma and intense stress for the last twenty years. How do I tell what is causing this quicky. I am at the end of my rope ### REPLY: Degree understand your concerns went through your details. I can understand. I say, you are suffering from anxiety and stress for the last 20 years. Still you refuse to learn. Learn the stress and trauma as part of your life and never try to get rid of it. This could be the correct approach to it. The more you try to get rid of it, the more it comes and troubles you. Understand, be aware and learn about anxiety, stress and mental trauma. Accept it as part of your life. Always. Such a change in thought style should provide you with immense inner peace. I am sure about it. My whole of the treatment methodology is revolving around acceptance of them. I have definite results and cure to justify the procedure. Try this methodology as you have already run out of options. Take care. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i recently have had a loose tooth for about 2 months now and its been really wiggly lately and now i have been wiggling it to get out ansd now its sore and its right on the corner of ccomming out and its sore and hurts now if i wiggle it. what to do? ### REPLY: Thanks for your query, I have gone through your query. The mobile teeth can be removed if it is grade 3 mobility and if it does not have any bone support. Consult a dental surgeon and get it evaluated. If the mobility is grade 1 or 2, then get the teeth cleaned and can try for grafting and splinting. Meanwhile I would suggest you to take antibiotics like doxycycline 100 twice daily on first day and once daily for next four days(if you are not allergic) which is very effective in gum infection. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a resting pulse rate of 129 along with shortness of breath. All test have all come back negative for heart disease. I have taken a EKG, stress test and cat scan of the heart. All normal and I am considered low risk for a cardiac event. My diabetes is well controlled. blood pressure well controlled. Cholesterol under 190. I am thinking about having the test to check my arteries. any suggestions. Test for thyroid, lungs and everything are negative. I have been put on a beta blocker to lower the heart rate. The shortness of breath and fatigue is still present and seems to be getting worse. ### REPLY: Thanks for your question on . I can understand your concern. Since you are diabetic, we should definitely rule out pulmonary embolism and coronary artery disease (CAD) in your case. So get done coronary angiography and CT pulmonary angiography. If both these are normal then no need to worry much. Sometimes, undiagnosed 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 .  Don't worry, you will be alright. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: thanks Dr. i have chronic back trouble, also had two fusions on my neck I am in chronic pain. Sometime it makes my right nut hurt, depending on the pain it will go into above my privates and sometimes the pain goes though my penis. I have very little sex drive. I have not had sex with my parter for over 6 months and I have not cum either. I am 52, can you give me some advice? Thanks ### REPLY: There is a strong possibility that you have developed some vertebral problem in your lower back. The tests of MRI LS spine will help us diagnose the problem more accurately. In fact, I would recommend this test if not already done. The diagnosis, if confirmed may be helped by the physiotherapy division. You see a good physiotherapist can teach you exercises that will tone your back enough to allow the pressure off your nerves. A course of steroids may help in short duration Best of luck .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How come whenever I get an erection from watching porn precum flows out. I can t watch it for five minutes without it coming out. Is there something wrong with me. Is it because I have the ability to produce more and needs to come out or there is something wrong with me. Also is losing too much precum bad. ### REPLY: Hi, Thank you for asking . I have gone through your query. It is usual to have pre-cum when you get stimulated. Some will get that more and some less. It is normal. You don't need to worry about that. If it is simply flowing without any stimulation then you should get checked by a urologist. It is also not harmful if you loose it. Hope this may help you. Let me know if you have any further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 31 years old. this is is the 2nd time i got kidney stone after 2 years. previously i got 7mm stone in left kidney, by giving lathatopsy treatment it has removed. Now again i got the kidney stone having 5 to 6mm size in both the kidneys. please advise whether if i drink plenty of watr the stones can be removed or any other treatement i need ot take.Past one month i am gettin pain in left side as well as since 2 days i am having pain in whole stomach, it it becasue of kidney stone. ### REPLY: Hai, recurring kidney stones should be fixed by assessing the content of stones and avoiding those food sources. As normally uric acid crystals, oxalate crystals phosphate with calcium will develop kidney stone. Avoiding high uric acid containing foods, reduce intake of oxalate containing food like tomato with increase water intake will keep you away from.forming kidney stones. Ayurvedic medication like Chan . Stomach pain may be a referred pain of kidney stone. Thank you hope I answered your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am female 40 years old, I have some problem since 9 years, tried to have pregnant for 7 times and I had a baby girl, now my fsh examination ELCIA assays is 12 and my lh is 2.9 Ca any one explain to me if I can try again, if there a chance for me??? ### REPLY: Hello, You check your AMH and astral follicle count on day 2 of period for ovarian reserve. If the results are normal you can get pregnant. Do serum TSH and serum prolactin then do HSG on day 8th, then do follicular study after taking Camphene from day 2 under gynecologist till follicle size increases to 18 mm and ruptures then GUI for early results. 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 swelling/a bump on the upper left side of my hard palate, above #14-15.  It is painful to the touch and hurts when I swallow.  Radiographs show no signs of infection.  It started 2 days ago and has not changed, It is just as big and just as painful, if not more. ### REPLY: Hi Dear, welcome to . Understanding your concern. As per your query you have swollen bump on upper left side of palate which is painful and causing difficulty in swallowing is nothing just an irregular shaping of the hard palate bone. It is a palatal torus, which is a normal overgrowth of bone on the roof of mouth. Sometimes food or toothbrush can scrap the tender tissue stretching over the torus causing pain. If it is very near to tooth and gingival recession is there then it could be due to calculus deposits in and around tooth of that area. Need not worry. It is a self-correcting pathology if it is a palatal torus and will attain normal shape soon. If it is really troubling you then removal is the best treatment option in that case. Upper denture is also made to cover this torus area to prevent irritation and ulceration on it again and again. Visit dentist once and get it examined properly. If it is calculus related proper cleaning and scaling is required in that area. Antimicrobial mouth wash is required on daily basis. Once that area will be clean swelling will subside and your symptoms will resolve immediately. Hope your concern has been resolved. Get Well Soon. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am Christopher and in the past I have had paranoid feelings that people are watching me or that they can listen to me by a bug or cameras etc. I have had a couple of times of my life when I thought that I was being poisoned by toxins or radiation or something in my car or at my desk when I used to work as a computer programmer. I really feel the sensations and feel weak and disoriented with loss of immediate memory. Recently I have this delusional thought and I was on zyprexa in the past for maintenance. I noticed that one time when I had the delusional episode I was prescribed risperdal and the feelings went away but I developed anxiety disorders and panic attack. I still think that maybe the people that are trying to harm me might have just taken away the toxins or devices that were trying to harm me after they knew that I was on medication. I tried to take zyprexa 7.5 mg for a couple of days but the sensations are still there. Do you think if I took risperdal like I did in the past is the right thing to do since the zyprexa does not work, I also have stuffy nose from the risperdal but it is tolerable. I am afraid that I might have the panic attacks again and the  zyprexa controls that well. ### REPLY: Hi, Thanks for using . Zprexa is good anti-psychotic medicine as like Risperdal. Before starting any medication yourself on the basis of experience, you must consult your psychiatrist. Your doctor will decide the best medicine suitable to your current episode. Zyprexa takes time to have action on your delusional thoughts so better you should wait on single medicine before switching to Risperdal. 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, for many years I have been diagnosed with MS until recently. The neurologists says it s not ms, but some other kind of connective tissue disease. My c4 levels are low 19, my thyroperoxidaise level is 843, I have a small amount of immature granulocytes .07. I am extremely fatigued, hands arms, legs are very weak. I take levothyroxine and high cholesterol. My bad cholesterol is 196, my weight fluctuates 20 lbs up and down. I am having difficulty sleeping but yet extremely tired. Any suggestions? ### REPLY: Hello! Welcome on  ! I would like to review your brain MRI findings for a more professional opinion. You should know that MS is an autoimmune disorder, which may coexist with other autoimmune disorders like thyroid dysfunction and connective tissue disorders. Have you performed a spinal tap to check for the presence of oligoclonal bands? This would be another step in the diagnosis of MS. From the other hand, I would also recommend performing a cervical and thoracic spine MRI study to be sure of MS diagnosis. Steroid treatment may be needed considering your connective tissue disorder. A follow-up with brain MRI to study the progression of those lesions is necessary too, before starting treatment for MS. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello....my son is currently taking 800 mg of Tegretol daily to treat his seizure disorder. He also has symptoms of ODD and ADHD (no diagnosis). My husband and I have discussed various medications to help withi his cognition, implusivenss and comprehension. Our doctor recently gave us samples of Intuniv. What should I be conncered about? What s your opinion of this drug? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The details you gave here is not enough to provide a proper diagnosis. You have mentioned seizure disorder, OCD, ADD (no diagnosis). I request you to consult a clinical psychologist who shall be able to make your son undergo psychometric tests to diagnose these problems. Once diagnosed, medicine as well as psychotherapy should be started. You should work with your psychiatrist / psychologist for better result. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a semen Volume of 10 motility of 35 and quantitty of 7 Can I get my gf pregnant naturally I have a semen Volume of 10 motility of 35 and quantitty of 7 Can I get my gf pregnant naturally? i am 31 yearss old and my soon to be wife is 23... ### REPLY: Hello welcome to  your sperm count should be a minimum of 20 million with at least 30% of fast motile sperms. Your count in your report is 10 million right? What you can do is get a repeat semen analysis after 4th 5 days of abstinence. Sometimes one report is not correct to do inadequate abstinence or infection. If your repeat analysis also shows a low count then get a semen culture done and see a male infertility specialist. Do not worry you will have a baby. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my doctor recently said I have stomach ulcers,but I keep having pain towards my back in the stomach region and when I walk. I know its not a kidney infection. Today i just have not felt right and tested my blood sugar and it was 150 and hour after my meal. I am not a diabetic. Could i be having problems with my pancreas? Should i go to the doctor tomorrow? ### REPLY: Hi, After going through your question I want to clear certain facts-1) Blood sugar level of 150 1 hour after meal can be considered as normal.2) Pain in stomach radiating to back may be due to pancreatic problem.Hence, I would like to advise you to consult your doctor. There is a need for clinical examination depending on it there may be need for ultrasound of abdomen and pelvis which help in evaluation of pancreas and kidneys, blood investigations like complete blood count, serum amylase and lipase (pancreatic enzymes), liver and kidney function test or CT scan of abdomen. With your mentioned blood sugar level you cannot be labeled as diabetic, I will advise you to do OG TT (oral glucose tolerance test) to confirm your diabetic status. Hope I have answered your query. If so do vote the answer. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my mum has advanced ovarian cancer. It has spread to the tubes leading to her kidneys, her liver, it is coated on her bowel and in her stomach. Her kidneys started failing last week and they put a stent in one of her kidneys however the other was too blocked to insert a stent. Every day I see her she is up and down. She has not eaten proprerly for at least 2 weeks and the hospital is now considering chemo. depending on how her one kidney operates. Do you think she will be able to go through chemo? ### REPLY: Hi, Thanks for writing in. Your mother might be having cancer ovary with peritoneal metastasis. This is a fat covering in the abdomen and ovary cancer spreads to it which again causes the disease to reach stomach, kidneys and liver. However, the spread to liver and kidneys might also happen by blood route. For the kidneys, it is important to treat obstruction to urinary passage. This requires stent placement and if the other kidney is also blocked then stent should be put. Chemotherapy is a necessity in cancer patients. Loss of appetite is seen in many patients and this puts them at risk for chemotherapy complications. There is less choice for treatment because surgery cannot be done. Please give your mother proteins and food that she will eat. Her kidney requires attention. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m 19 and have been dealing with chest pains since I was in 7th grade. They started off light and slowly over the years but now they are so bad and more frequent. I have a pressure pain on the left kinda center of my chest. The pain comes on anytime no matter what I am doing. I have woke up in the middle of the night with them. My doctor put me on Propanall a beta-blocker and I have had to up the med ever month to a stronger dose. My heart races very fast even when I m not moving It has been recorded at 170-180 when I m resting the med. My hands and feet go cold all the time, Some time is short of breath and I feel like i can t get enough oxygen . I m no tired all the time... I m a teenage and i never got to be one because of this I missed out on a lot and it s taking over my life. I have been having headaches and small nose bleeds. I m so weak from this. I feel like my heart is bruised after these episodes. The only thing I have came up with to ease the pain is Baby aspirin i chew them a lot and i know that s not good but, it the only thing that help, but they are starting to not work any more. I ve tried everything. THE DOCTORS have ruled out stress, thyroid, mummers, anemia, and arithmetic( like they way my heart moves ) and that I m not crazy :) (They tried to tel me i was until they found proof) I have had so many ekgs, I ve had running stress test, echo, breathing, so many blood test, I did a head up tilt test and i was only up 2 min and them i threw up and almost went into a full seizure and i passed out. I have tires all i can i can t take the pain and the pressure i feel when i have these i begin to start to throw up and i have bad jaw and neck pain The doctor can t figure out what wrong they seem like they don t care (I m ON my 4TH doctor) but my blood pressure is ok sometimes a little low because of the meds. I need someone to help me PLEASE PLEASE I need someone to help me give me hope and help me figure out a way to live a normal life. ANYMORE QUESTIONS MESSAGE ME ON HERE OR ON YYYY@YYYY PLEASE God let a Doctor see this I ve been to 2 cardiologist, done a ct scan and they have also ruled out asthma also.may I answer your health queries right now ? Please type y ### REPLY: Hi, After going through your medical query I understand your concern and would like to tell you that as you are already been told about your diagnosis I would like to add in that do some yoga to relieve from stress which is a triggering pint of many other disorders.  It's recommended for you to get a Holder (ambulatory ECG) for 48 hours and consult a physician with reports for further treatment. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is tammy.  I have multiple gallstones, hep c chorrosis of liver, enlarged spleen, enlarged veins.  no one here where i live wants to touch me they want to send me to a bigger town better drs....also want me on a liver doner list, which is very hared to get isnt it? ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. This is serious disease and quitting alcohol is the most important thing that should be done. Also, medications which are hematologic should be avoided. This is necessary to prevent disease progression which is lethal in most cases. At early stages it can be treated with these measures but in case of progression, only liver transplantation may help. Diet should be balanced and healthy and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: equal-sized lumps under jaw; examined by ENT, Endocrinologist, (I m diabetic), Dentist, and hematologist. Maybe a bit larger than a quarter in size. No pain or sensitivity there. While no medical professionals have said these are normal, they don t seem concerned. Michael ### REPLY: Hi! Good evening. I am  answering your query. Even though you have already shown to most of the specialists, if I were your doctor, I would go for a general clinical examination of yours in detail followed by a FNAC (fine needle aspiration cytology) of the lump to have a cytological diagnosis. Further management would depend on its report. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with a wandering pacemaker..... i am 44 years old just recently quit smoking actually 8 days ago... i exercise regularly but still am concerned about fullness in the chest and sometimes chest pains... i also tested positive for Hplioria Bacteria..... and I have low blood pressure, my doctor says not worried about heart problems.... I still am not sure... What do you think? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, your chest fullness is mostly due to HERD (gastroesophageal reflux disease) because you are smoker and tested positive for H. Pylori. 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 chest tightness, fullness, heaviness etc. So better to take treatment for H. Pylori. 14-21 days of course of amoxicillin, Clarithomycin and pantoprazole is needed. Along with this, you need to follow these lifestyle modifications for better symptomatic relief. Avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Keep 2 - 3 pillows under head in the bed to prevent reflux. Don't worry, with all these you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im scared i have herpes. I havnt had sex in 6 months nearly seven but the past 3and a half weeks i have noticed 2 red itchy spots on my scrotum which are a short distance apart and 2 red spots on the head of my penis which again are seperated. for the past year and  half i have had an itchy pimply heat rash like spread across my buttocks and thighs which has been on and off every 2 days or so. I have had tar based creams which help but never cure it. Could the 4 spots in my genital region be herpes.  Or could it be a reaction from something. Once again i havnt had sex in 6 months and i did use protection the last time i did. i dont know anyone with herpes and i wash everyday. What could it be and when will it go away? ### REPLY: Hello, It is unlikely be a herpes. Can you attach a photo in the followup query to make a clinical diagnosis?  Fungal infection will be a possible cause, and you can try over the counter available antifungal-steroid combination like clotrimazole-betamethasone for symptomatic relief. If symptoms persists better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END