Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, aged 90, suffers angina.  He has been able to control it through taking medications and not walking far, etc.  However over the past month he has suffered a couple of attacks during night.  I know he is on the maximum medication available.  Does this mean his heart is getting worse?  He says the pain from last attacked last 2 hours., and then just disappeared.  Im worried he may be risking heart attack?  Any advice here would be good thanks.. ### REPLY: Hello thanks for posting here. Going by you description it looks like he has got unstable angina or critical coronary artery disease. Also since he is on maximum medications for the same. So next step would be ideally an intervention like angiogram followed by angioplasty or surgery. But going by his age I would advise you not to go for any intervention as it will be more of a discomfort to him. Yes, he is at the risk of having a heart attack, which you have to accept. If he was my patient I would keep hi non medical management and would adjust his doses/increase doses if necessary. Wishing him good health thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have a little lump on my penis under the skin it seems to be on the edge of the sperm shaft and can only be felt when flacid. i also have a red lump on the side of my sack. the lumps are not similar. The lump on my sack is rd and sore. what could these lumps be? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some sexual transmitted disease or some other infection.  You should go for examination and take course of antibiotics according to diagnosis. 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: Father-in-law- 65 years.My Father-in-law was diagonosed Gastric Cancer- stage 3A- a D2 radical gastrectomy was performed- after surgery the staging was Stage 3B- after the pathological final report- it is stage 4. The pathologists report : diagnosis is moderately differentiated adenocarcinoma-stomach, infiltrating the serosa. proximal resected margin and distal resected margin - free.Omentum metastatic deposit. 17/20 lymphnodes show metastatic deposits- pathological stage- T3 N3-stage 4.The doctors are planning chemotherapy wednesday/thursday this week- Me and wife far away from home (foreign country)- please could you give us a prognosis on his survival rate at this staging of the cancer.He is 65 years old and is diabetic, had a MI 2 years ago is fine now (but continues medication) and has an enlarged prostrate. the gastrectomy was done 2 weeks ago. Mr Samuel. ### REPLY: Hi, Thanks for writing in. Cancer is a challenging diagnosis and the course of disease is directed by treatment. With stage 3A stomach cancer about a third of people (38%) live at least 5 years. With stage 3B about 1 in 6 people (15%) live for more than 5 years. Survival for 5 years after first detection of cancer is a milestone and with the best treatments patients can survive 5 years or more with stage 3 stomach cancer.However, the staging has changed after 17 of 20 lymph nodes show metastasis, and presently it is in stage 4. Unfortunately, about 8 out of 10 (80%) people diagnosed with stomach cancer are stage four, meaning the cancer has already spread when they are diagnosed and this is the case with your father-in-law. Therefore, the survival statistics are lower than for stage 3 stomach cancers. Fewer than 1 in 20 people (5%) live for at least 5 years if they have stage 4 stomach cancer when they are diagnosed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In an neck xray for an accident, the Dr. informed me that I have thickened bones and referred to me a few other Drs. to check out the possibility of prostate cancer. What is the relation and is this a huge concern? I am uninsured and cant afford the costly tests involved. Do you have any suggestions for me? Thank you ### REPLY: Hi, Thanks for writing in. Prostate cancer is a condition that spreads to bones. Cancers can affect bones in two ways, either there is breakdown or there is excessive calcium deposition. In breakdown the process is called lysis and in deposition of calcium it is called sclerosis. In prostate cancer, there can be sclerosis seen in the bones of the spine usually in the lower back region. However, bones of upper spine can also have sclerosis. I would suggest you to first get a low-cost insurance and then take tests for prostate cancer like ultrasound scan, serum PSA and free PSA values. If there is probability of cancer then further detailed tests are required. Please talk to your doctor to arrange for the tests keeping in mind your ability to pay upfront for the various tests. The tests must be completed within a month, and you can also try and find out healthcare support groups or from your employer if your tests and any treatment can be funded by external resources. 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: I have been have lower back pain and sharp stabbing pain in my lower abdomen. I have have the mirena for a little over a year and this is the first time that it has happened too severely. I went to see mt gyno last week and he said I was very sensitive and tender and put me on an antibiotic but didn t explain anything further. Could this be because of the mirena? ### REPLY: Hi, Well it could be due to infection, PID (Pelvic inflammatory disease), other gynecological pathology(fibroid, ), renal pathology (renal, ureteric, cystic calculus etc.) GIT pathology (polyp, appendicitis, diverticulitis, Inflammatory bowel disease, colitis, etc.). It could also be due to IUD (IRENA) but with regular use the symptoms decreases only increases with infection or PID.  As your gynecologist has clinically reviewed it and diagnosed due to some infection then complete course of antibiotic prescribed. If symptoms persists after treatment or aggravates during treatment then revisit your doctor or take second opinion with X-rays abdomen standing app view, USG whole abdomen (CT scan if required). Hope this will helpful free to ask for any query Thanks n regards . Com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Past 4 years my AST,ALT AS+bilirubin have been elevated. Lives scan showed mild diffuse fatty changes. Weight, cholesterol, etc otherwise normal. No treatment was suggested. But every time i do an LFT, the Dr ( go to different clinics/Dr each time), the Dr wants to investigate and its a waste of time because we end up not doing anything at the end of it. ### REPLY: Hello and welcome to , Fatty liver is a reversible condition in which liver cells are replaced by adipose tissue. This fatty change is caused by various causes, some of them are as follows:1. Alcoholism2. Starvation3. Malnutrition4. Diabetes Mellitus These are just few causes. If you have any of these risk factor, you can avoid it/ or treat it (in case of Diabetes Mellitus). There is no treatment for fatty liver disease but only prevention of the risk factors. Thanks and 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: Hello I believe I have recently developed a chest cold still early stages yet started having a hard time breathing just tonight. accompanying the pressure and congestion in my chest are chills, and a small fever 99.7 degrees. I was wondering if there were any home remedies to relieve the chest pain and congestion I do have vicks NyQuil and mucinex I am wondering if I should use either of those two over the counter meds or if there was a better remedy for chest pain/congestion/cold thanks in advance ### REPLY: Cellophane You for contacting . I would suggest you following things:> Take acetaminophen thrice a day for 5 days.> Take hot water in a cup, add 1 tablespoon salt in it. Perform gargles (mouth wash) with it three times a day for at least 3 days. It will give soothing effect.> Take boiling water in a pot, put your head over the steam and cover whole with a sheet. Take deep breaths in it.(Avoid getting closer else it might cause burn). Do this twice a day.AVOID:> Chilled water> . Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I had an ultrasound scan as my GP thought that I had kidney stones. The radiologist told me that i had bilateral duplex kidneys. I experience pains around the kidney regions sporadically, and especially in the past few months. Calcium oxalate crystals were found in a urine sample hence why kidney stones were thought to be a possibility. Are the two conditions linked? What are the implications of bilateral duplex kidneys? Thanks, Jennifer ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have bilateral duplex kidney. It means you have duplication of kidney on each side, and you have 4 separate kidneys. They .  However, if you don't have any other problems then no treatment is required. If you have infection of vesicouereteral reflux then treatment is required. Calcium oxalate crystals can be seen normally or associated with kidney stones. So if you have stone on USG then only treatment is required. Consult your doctor and take treatment accordingly. 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: I woke up yesterday with a painless lump behind my right ear. This cane a few days after dizziness and a cold.  Now the day after. I took my normal.anxiety meds and experienced extreme dizziness and the lump is still there. Could these be related and would a dermatologist be able to determine about the lump? ### REPLY: Hi ! Good morning. I am  answering your query. No ! Possibly these two are not related. The lump could be an inflamed lymph node secondary to the cold you had. I would also suggest you to see your dermatologist to physically examine it your scalp, infection of which could give rise to such lymphadenitis. Till that you can go for an anti-inflammatory .  I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I used Neutrogena face wash and moisturizer for the first time and now my eyes and face are swollen. they have been swollen for over 24 hours. my face feels dry, tight and quite itchy. I have never had a reaction like this to any products. I have mild allergies to perfumes and dyes but have never experienced anything this severe. ### REPLY: Hello, As you mentioned that you are using this product for the first time and have developed swelling of face and eyes with itch, it is quite clear that you are having a reaction to these products. You should quickly wash you face to clear off any leftover material and consult a physician who would like to start you on some anti histamines. Allergies can be sometimes bad and you shouldn't wait for long. You're having not experienced anything this severe doesn't make you immune to allergies. In fact sometimes the body can react to the products which you have been using for long. It's very unpredictable. Once you are better, never ever use the same product which you reacted to. Hope I am able to solve your concerns. 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: I ended my period two weeks ago, and started spotting about a week ago. After a day or two, the spotting turned into what a normal period would be for me, and seems to be ending now, two weeks after I finished my normal period. I m on the pill , and my periods have been consistent until now. Also, I ve been having pretty bad tension-like (I think) headaches that begin in the afternoon around 4-6 and get worse as the night progresses. I m wondering if these are related, as I am going through a very stressful time right now, or if it could be something else. ### REPLY: Hi, Thanks for the query. Stress and strain can alter the hormones by affecting hypothalamo-pituitary-ovarian axis. Which can cause menstrual irregularity like inter-menstrual spotting, bleeding etc. Contraceptive pills can also lead to menstrual irregularities. So now you continue your pills as usual and try to be tension-free. If the same problem repeats in future better to consult doctor once. 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 your query here... I think I have a candida problem, I have seen a nutrionist and had an allergy test, he is sure its candida, Im on a programme now of killing the yeast but occasionly have this awful smell of smoke up my nose when there is not any smoke around is this candida symptom ? ### REPLY: Hi thanks for asking question i . There are not any evidence regarding its smoke like symptom feeling. Because you are infected and got panic you might just feel it. But it doesn't cause smoke like smelling. Rather foul smell can present. It is better to complete therapy with antifungal . So keep your aim to clear fungal infection. Although you have not asked I want to give you suggestion regarding diet for your benefit. In candida coconut oil, garlic,onion, ginger,olive oil, lemon fount to be helpful. The fruit, honey,smoke meat, soya product, alcohol,mushroom is to be avoided. Take proper bath and clean every area of body. I hope my suggestion will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have been having pains under my arm but it feels like its bruised i think it feels swollen but it moves down. sometimes my whole arm goes numb and tingles only done this few times I have had it for few week now still not going what would it be !? ### REPLY: Hi, this type of pain occurs in two or three types of problems 1. Cervical spondylitis involving lower part of the neck bones. 2. pressure on the nerves at the junction of shoulder and neck 3. If you have had an injury to your hand or arm any time before. If there is any change in color/temperature around the area where it pains it will come under third option. If you have sort of giddiness or vertigo along with pain and numbness feeling it comes under first heading and if this pain or discomfort along with arm goes to the outer side of your chest or breast, then it is likely the second one. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28 weeks pregnant and I woke up last night with sharp pains in the lower left side of my chest. The pain comes when I breathe, especially deeper breaths and also when I try to bend forward. I m pretty sure it is not the baby as he has been moving and he sits really low and the pain is still there today. Should I take a trip to the er since it is the weekend or wait it out? I m not really sure what is causing this and at times can be excruciating. Thank you. ### REPLY: Thanks for your question on . In my opinion you are having pleural effusion.  As pregnancy can be a risk factor for this. And pleural effusion causes pleurisy (inflammation of pleura), this is the reason for pain during coughing, sneezing and deep breathing. So possibility of pleurisy is high. Since you are pregnant, chest x-ray is not recommended.  So get done ultrasound examination of thorax to rule out pleural effusion.  Ultrasound is safe in pregnancy so no harm in it. If ultrasound is normal than you mostly have musculoskeletal pain. So take good painkiller and muscle relaxant. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor, i am so nervous, my girlfriend and my never had sex, but on friday, we do some adults things, so i put my pennis on her ass, and some presimenial liquid go out, well she takes dixi 35 because she is an irregular , my question is, that if she could be mother or not. ### REPLY: I understand your concern and will do my best to answer your question. From what you are describing it is unlikely that she conceived but possible.  Taking birth control pills like Dixie 35 offers excellent protection against unintended pregnancy.  Using the pill correctly (perfect use) results in only a 1% chance of pregnancy each year.  Using condoms if your partner is on the pill is a great idea to avoid infections and adds some degree of added protection against pregnancy. You bring up a good question: women DO get pregnant from pronominal fluid: "pulling out" (as family planning) is far more likely to lead to pregnancy than faithful use of condoms.  Women DO get pregnant from having sperm deposited outside the vagina as well.  You should always use condoms from the start to the finish of any sexual activity until you are in a stable long-term monogamous relationship with a partner on reliable birth control. I hope that helped and best of luck to 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: end stage renal failure, dyalisis 3xs a week, female 76yrs old.....2nd day of loose bowls, potent smell, just started vomiting, appears to be bile....bp was taken this morning and bsugar...levels normal....concerned that she might dehydrate....what can be given for loose bowls..... ### REPLY: Hello, Thanks for posting in . Loose stools with potent odor points toward gastrointestinal infection. Probably amoebic type which produces the strong odor. It will be highly advisable to get a stool routine and microscopic study done to find out the exact causative agent. Because she will need antibiotics and anti protozoa agents to get treated. And do not give lots of fluids for fear of deny .  Kindly consult your nephrologist about both the queries. Hope it helps. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i got a lexiscan a month ago and where they put the iv in my wrist area the vein is hard and raised there was burning pain and it traveled up my arm where the elbow is tender and swollen arm and hand couldn t close hand without pain now the doctor gave me an antibiotic and said I have a blood clot that s not deep and poisoning from lexiscan. it still hasn t gone away so now he gave me a shot dex something with a steroid in it my sugar high and he put me on insulin it has been a week the palm of my hand is still swollen the vein is still popped and there is still burning and now the elbow on the side is sore again have pain and burning. ### REPLY: Dear patient you have a condition called superficial phlebitis which is a rare complication of an IV line placement. Steroid injection is generally not recommended in such cases. The treatment is1) Aspirin 75 mg once a day to prevent further and deep clot formation2) Ibuprofen 800 mg twice a day for the pain and swelling3) Heparin gel at the area4) Arista injection to break the clot# Please be advised that point 1 cannot be taken with points 3 or 4 as it can lead to internal bleedingGenerally Arista is given followed by Aspirin after 2 weeks5) Hot fomentation and/ or compression bandages hope it helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dearm dr my dughter harir losted, her doctor prescribed minoxin and her hair growing and she is 12 years old, what is exatly dosage can i give and how long she will take just about 3 months and hair become well. so i need your advice abdulqadir abdinur barre  from somalia ### REPLY: Howell come to ChatDoctorI really appreciate your concern, let me tell you something that "Minoxidil" may not be use in this age group of 12 years, but underlying cause of hair fall need to be found out and in my opinion this could be pedicurists or fungal infection so rule out this and if found something like this then try to treat this but "Monoxide is questionable, hope this information helps, take care and have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I live with my sister who is 59 and mentally handicapped. She has lived alone for a longtime and will not go to a doctor. I m noticing she has an occasional hacking cough and her skin looks yellow. Her eating habits are terrible but she will only eat what she feels like eating. She s about 4 10 and maybe 90lbs. Got any ideas? I can t force her to go to either a doctor or a dentist. ### REPLY: Thanks for your question on . I can understand your situation and problem. Yellow discoloration of skin can be due to jaundice.  It is because of high bilirubin (pigment), which accumulate in skin and gives yellow tinge to it. Bilirubin is raised mostly in liver diseases. So get done liver function test to rule out jaundice. Hacking cough can be due to lung infection, so chest x-ray is needed to rule out this. So for diagnosis ABD treatment you have to take her to the 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 am a 33 yr old male and have suffered from back pain for 2 yrs. MRI shows I have a ruptured disc L4-L5 with the disc membrane in the spinal canal. I started developing spasms in both calves. What happens if I do not have surgery? Will the disc eventually dissolve and I can be pain free? I am 6 ft tall and weigh 160 and injured back doing mixed martial arts.Thank you ### REPLY: Hello, Spasm is not due to disc but due to lack of salt and calcium. You need to take vitamin D 60000 unit on weekly basis. For disc, it does not dissolve, but pain may decrease. If you can manage that then there is no need of surgery. In case you want complete pain relief then surgery is only option. In that we remove disc from that are with the help of endoscope. It is very small surgery and there is no bed rest. You can walk from second day of surgery, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was wondering what type of seizures i have.  My neuro has never told me.  It starts pulling in my right foot then travels up my right arm.  I am confused and scared about the way my arm and foot feel.  I am conscious the whole time.  It lasts anywhere from 5-7 min. What are they called.Also I have taken so many seizure meds and cannot stop breakthrough seizures.  I have been on generic Keppra, Lamictal, carbatro, Oxitol, Lyrica, and cant remember the others.  I would recognize them if I saw them.  What do you think about Klonopin? ### REPLY: HIT hank for asking to ChatDoctorI can understand your problem, this could not be seizure but more it seems panic attack and the episode is entirely depending upon the functional condition, if you can well control your anxiety depression stress then this can be best avoided, the Klonopin is mainly given for panic episode or to control the functional seizures, take care and try to control your self you will be fine soon bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have these weird spots on my hands. They are small and starting to form like small clear heads. They itch a bit. At first it was only 3 or 4 bumps on one hand but now theres like 10 and its on both hands. tops and bottom.Theyre tender to the touch as well. I have been sick with a fever, nothing more than post nasal drip and sore throught. What could they be? ### REPLY: Hi, Welcome to . Based on the description you have mentioned I am suspecting either an allergic reaction to some chemical or could be a condition called herpetic whit low. Try to correlate any incidences where you have come in contact with any particular chemical or . If you have, you can take Tab Benzine 10 mg twice daily for three days. Herpetic whit low occurs due to exposure to a virus called herpes simplex 1 which usually causes oral lesions during fever. These are also called fever blisters. If you have had fever recently and if you have had fever blisters, then there is a chance of you getting herpes lesions on your hands due to direct contact. I suggest you get a confirmation of diagnosis by a skin specialist. If he confirms herpes you can take Tab Ocular 200 mg four times daily for a week. The lesions will heal within a week to 10 days. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, I have a 22 month old that I believe caught head lice at her daycare. The center has mostly African American children there and the providers strongly claim that African Americans do not catch or spread lice, which I am not too sure about as to we do not go anywhere else. But anyway... can you give me some inexpensive home remedy treatments to treat my daughter. Also, is this something that here doctor can help with a prescription? ### REPLY: Dear this is not really to be worried about, school going child .  Simple and effective home remedy as you are asking is applied coconut oil mixed with lemon juice and leave it for 1 hr and after washing properly with shampoo use a thin brusChatDoctorb. There is a different comb for lice extraction you have to buy that, it has crowded bristles to entangle the lice when you comb hair. This is how you can to some extant remove head lice but for complete removal you need to apply antilice shampoo as well as oil. If you don't remove all the lice, after a week or so nits will grow to become lice and cycle goes on. As eggs are not killed by anti-louse treatment and eggs hatch, so you need to repeat treatment after 7 days. Moniker or any other anti-louse preparation can be used............TC 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 your query here... HI, I m 29 years of Age, weighing 75 Kgs and 5 4 height. Recently i started to work out at a fitness centre. My heart rate during work outs has been going higher to 187. A message had appeared on the machine saying, your heart beat rate is higher . Please slow down. Is this normal. MJ ### REPLY: Hello, These heart rate values are quite normal during straining physical activity, especially when you are not used to training regularly.  For this reason, it is important to start gradually physical activity and increase the exercise load day by day as your heart and body gets used to it gradually and tolerate physical activity better.  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: Can herbal supplements help  control Diabetes instead of dangerous drugs?  I read that Fenugreek, Banaba leaf from Prickly pear cactus and Cinnuling from Cinnammon can help.  What is your take?  Also can type two Diabetes be reversed using Diet,Exercise and nutritional supplements? ### REPLY: Hi thanks for using  .... First we should understand the pathophysiology of type2 DM. In T2DM the sugar values are elevated due to the insulin resistance, the insulin in the body is not able to act properly. The resistance is like a wall and the insulin cannot act on the insulin receptors. As a result the sugar values become more. If we can destroy the resistance then we will be able to reduce the sugar values. Exercise, diet and weight reduction is the key to reduce the insulin resistance.Hence, with diet and exercise we will be able to reverse T2DM initially. But after sometime only lifestyle modification can't help the situation, Metformin will be required at that point. But as time progresses the insulin production will be reduced, and we require some external helps. That external helps are either . 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: Why does my body feel wierd one day Im dizzy headache the next day Im tired and feel discomfort in my upper chest area and other days feels like my body wants to give up. I just feel wierd and dont know what to think. I get worried alot and stress out so I really dont know if that maybe the cause. I always think I feel like its my heart but I was checked before and its not that. I know when I did some cardio workout for a lil while couple days of the week my body felt so much better. So what could it be?? ### REPLY: Thanks for your question on . By your history and description, possibility of stress and anxiety related symptoms is more. Your symptoms are improving with Cardio workout. Heart and lung diseases actually precipitate after Cardio workout. So possibility of major heart and lung diseases is very less. Stress and anxiety can cause similar symptoms. So better to consult psychiatrist and get done counseling 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. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just rinsed with chlorhexanate gluconate prior to oral surgery tomorrow.Now I must swallow a pill.  Should I rinse out the dregs of the chlorhexanate or may I swallow thecoating and rinse it down with water and the pill?  That is, should the germicidal rinse remain in my mouth a while and not be rinsed away?  Is it dangerous to swallow?Ione ### REPLY: Hello, Thanks for your query. Chlorhexidine gluconate oral rinse provides antimicrobial activity during oral rinsing. Patients should be instructed to not rinse with water, or other mouthwashes, brush teeth, or eat immediately after using Chlorhexidine gluconate oral rinse. Chlorhexidine gluconate oral rinse is not intended for ingestion and should be expectorated after rinsing. Chlorhexidine gluconate oral rinse is indicated for use between dental visits as part of professional program for the treatment of gingivitis as characterized by redness and swelling of the gingival, including gingival bleeding upon probing. Some patients may experience an alteration in taste perception while undergoing treatment with Chlorhexidine gluconate oral rinse. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, i really need your help!! :( on the 25th i had unproteced sex 5 times, and i was then scared after that i would end up pregnant, but then on the 27thi came on which is 1 day early, and i didnt think anythng of it. but now its the 9th, and im still on, and thats not normall for me, im only ever on for 5-6 days, its not heavy though just a light brownish colour. my friend is 8 mounths pregnant and and she said she had the same thing!!!! please help im only 16!!!!!! ### REPLY: Hello dear, I.understand your concern. In my opinion if the period has come on 27th the 25 tChatDoctores under safe period. That means even the unprotected sex might not result in pregnancy. So relax. Avoid stress. Stress regarding the thought of pregnancy also might make the cycle irregular. Any symptoms of pregnancy start 3-4 weeks after intercourse. And it is too early to feel pregnancy symptoms on 27th with intercourse on 25th. So relax. The chances of pregnancy are very, very rare. If bleeding is continuing consult doctor. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell on my left knee roller skating and again a few days later after running over a train table the ortho said it was a bone bruise but it was vry painful yet numb feeling to touch. Now 6mos later there is like a swollen knot that feels like it has fluid in it and can t stand to touch it. It s about the size of an egg. What might this fluid filled. pocket be? ### REPLY: Dear patient You have got prepatellar bursitis. Its fluid collection that is lying anterior to knee joint and formed due to recitative trauma.  This needs to be investigated with ultrasound of knee joint to confirm diagnosis.  If ultrasound is showing prepatellar fluid collection it needs to be removed surgically. Please consult expert orthopedic surgeon nearby you and get yourself examined.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ive been taking Norg-Ethin Estra an i havent been taking it for 6 months an ive been having pains on my left side alot an ive took 2 home pregnacy test an they said negative but im still having pains on my left side an the smell of food makes me want to vomit every time i smell it....can you tell me why this is going on ### REPLY: Hi, welcome to the forum. With this presentation in my clinic, I would first rule out an ectopic pregnancy. It is possible to have a negative urine pregnancy test in ectopic pregnancy because serum levels of beta  (hormone that is detected in urine during pregnancy) do not rise quickly as in normal pregnancy. To arrive at the diagnosis in early ectopic pregnancies, a test has to be carried out on blood complimented with a pelvic ultrasound. In my opinion, I think you should rush to an emergency department for proper assessment. I hope I have answered your querying you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. im not sure why my stomach all the sudden started to hurt.. but i woke up with the worst stomach pain right in my stomach. at first i thought it was gas, so i went to the bathroom... only to find that my stool was completly black... i have not felt like this before... i feel like i have to throw up, but my body wont.. please help ### REPLY: HiT hanks for posting query on  Your symptoms indicate possibility of acid peptic disease that may result in to peptic ulcer. That could be causing pain. Sometime blood vessel this ulcer erodes nearby blood vessels and causes bleeding in stomach or duodenum give black color to stool. Consult doctor he will give you medication (pantoprazole or omeprazole) investigate (Hemoglobin, CBC, Stool for occult blood) and if necessary endoscopy. 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. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 42 yr old female and healthy. i just had a physical and blood work and everything came out good. ive been having a very dull pain in my left lower back that seems to travel. it sometimes feels like it is going through the front. its more annoying than painful. could it be a nerve? when i get a massage it feels better but seems to come and go. ### REPLY: Hello, Your symptoms of dull aching pain in left lower back region, radiating to front consistent with L)lumbar radiculopathy (Involvement of nerve root which arises from spinal cord) This usually is more common in females with obesity and calcium depletion. This makes bones and ligament softer and chances of mild disc protrusion and compressing roots. Since you does not have any weakness. You need not worry. You need neuralgic medicine which has to be started after assessing you clinically by neurologist and imaging after assessment ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was told that he has vertigo but now having issues with his left side dragging his left leg and left arm weak and going num if he lays on it back in the hosptial and blood pressure is 143/104 while standing but sitting 133/92 help we don t understand and sometimes he talks as if he is drunk and he has forgot things that he shouldn t not have ### REPLY: Hello, I would explain that his symptoms (numbness in the left leg and arm) could be related to a stroke. For this reason, I would recommend consulting with a neurologist for a careful physical exam and a brain MRI. Regarding the .  A head Up Tilt test would help investigate on this issue. Hope I have answered your query. Let me know if I can assist you further. Take care. All the best.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI my 3 years old son seems infection in stomech i got roution stool test but no puss sells are there and i seen mucus in stool ,after eating meal he pass motion .he is taking  water can i give him normet if yes pls recomend doses also ,......motin frequency 4 or 5 times a day. ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics (LIKE NOR MET) unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a sore throat and sore ear for couple weeks also im dizzy alot and alway have heart burn . doc gave me a steroid shot and amox tr-k clv 500-125 mg . i took it all and i still have one sore like a blister on back of my throat on right side and still dizzy and sore under my jaw on right side. although ive win feeling my glands so could have been y gland iz sore. im 35 and i do smoke and scared cuz sore wont heal and ear pain and dizziness still there. is is throat cancer? ### REPLY: Hi, If sore throat are not responding to antibiotics for long time, then this condition should be evaluated in detail. Careful otorhinolaryngological examination is mandatory to find out any suspicious lesion. In case of gland enlargement it should be carefully examined whether it is tender or not. Anyway in case of suspicion your ENT specialist can order a issue diagnosis. Follow your ENT specialists opinion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am 59, weight 159 lbs, moderately active.  I have a very low pulse rate (around 45).  I getdiscomforting pain (not overly sharp or stabbing, but still more than a mild discomfort) on my left side and upper back.  I get it only when I lie down and only when I breatheout.  It goes away if I breathe in and hold my breath.  It eventually subsides. ### REPLY: Hello, I have gone through your query. Thanks for using . Your low heart rate may not be related to your chest pain. You must get one Resting ECG to determine type of rhythm you have. Depending upon on your baseline ECG you may need exercise stress testing to rule our blocks in heart arteries causing chest pain. If your heart check up turns to be normal you should consult a physician to evaluate you for acid reflux and any other cause of your pain, My best wishes .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 30 year old male. I do have some drinks at night before bedtime. I know i cutta cut that in half. Anyway i just had a liver function test done. Heres resultsAlkaline Phosphatese 65    Range 40-150Ast  42     Range 10-50Alt 51   range 2-50Bilirubin total 7.5  range 6.0-8.5Protein Total 7.5  range 6.0-8.5Albumin 4.7  range 3.9Uric Acid 8.1   range 3.9-8.3What are your thoughts on these #s? For the past 9 years i would have 4-5 cups of wine a day. I know i need to cut it in half, my dr said as well. But how do these #s look overall??  And im not sure what total protein and Uric Acid means? ### REPLY: 1) alcohol consumption affect liver function and liver enzymes are predictors for that.2) considering normal liver enzymes, this test looks fine3) total protein means, level of protein in blood which is indirect indicator of liver function as protein formation occur in liver.4) uric acid level is for renal function and purine metabolism without any correlation with liver function. But there is possibility if liver function damage due to high level of uric acid. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mom has complained of a sore throat for 8 days, tightness for 5. A rapid strep test done today was negative but she was put on azithromycin. Tonight shes complaining of abdominal pains/tenderness and fever. She has taken Ibuprofen 600mg and Tylenol 650mg for the fever, but is still 101.3. Im a nurse and trying to triage her over the phone, but not sure what to do. Any advice? Thanks ### REPLY: Hi. Thanks for your query and an elucidated history. Since you are a nurse and the query is related to your Mother, I would advise you the following:To stop Azithromycin and Ibuprofen as both may cause more problems than the benefits they can have. Better to start with Definite as this helps in both the infections of the abdomen and the throat. Plain paracetamol in appropriate dosage and may be with antispasmodic can help symptomatically. Get the blood, urine and stool tests done. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dr. Grief My daughter has had some type of allergic reaction recently.  She has a rash that started on her arm and has since spread over her body.  She went to the emergency room two nights in a row and the doctors have said that it could possibly be insects maybe dust mites or bed bugs. They treated her with antibiotics and a topical cream.  Her apartment manager called Terminix and they could not find anything.  What do you suggest we do? ### REPLY: HI, it can be due to some allergy or some systemic causes also, first get it examined by a dermatologist and then to rule out allergic reaction you should go for differential count and total count of white blood cells, platelets count, prothrombin time and closing time, D dimer estimation, immunoglobulin estimation to rule out any autoimmune pathology going inside the body, can go for complete panel allergen test to rule out allergic reaction, serum Egg should be estimated. Respiratory tract involvement should be ruled out, internal gastrointestinal tract bleeding should be ruled out, routine examination urine should be done, and you should go to a higher center for its diagnosis and should not be neglected. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I gained over 30 pounds and have now lost about 15.. I am noticing a indent in my lower abdomen in the center that won t go away. I has been having abdomen pain and gotten many test but nothing came back and I didn t know if this could be the reason. I have never had children. ### REPLY: You have not given details of your test reports and age that will be valuable in accessing your conditions. Any if ultrasound has not revealed anything you should go for ct abdomen. At the same time total hormonal study like thyroid and LH; FSH; prolactin; Progesterone seven testosterone. At same time Renal and gastrointestinal pathology should also be investigated d. Meanwhile start pantoprazole and comparison empty stomach. Take bland and fibrous diet. Mild laxatives if constipated. Get in touch with good medical institution. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there , I recently had dinner and ran downstairs to the kitchen and on my way back up I had a sharp pain in the middle of my chest. It was scary but lasted a second. I also suffer from fibromyalgia and always fear it is my heart. I am only 20. What can this be? ### REPLY: Thanks for question on . In my opinion you should first get done ECG to rule out cardiac cause. If it is normal than I think HERD is the cause. It is Castro Esophageal Reflux Disease. It is due to laxity of gastroesophageal sphincter. Due to this the acid of the stomach tends to come and cause the symptom of central chest pain. So try to follow these FOF better control of HERD.1. Avoid hot and spicy food. Avoid large meals. Take frequent small meals. Avoid stress and anxiety.2. Avoid routine use of painkillers. Take it only when required. 3. Take protein pump inhibitors. 4. Go for walk after means.5. Avoid smoking and alcohol if you are taking. Lose weight if you are obese.6. Keep 2-3 pillows under head in bed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 want to know whether can we go for an iui method because its been 5 years and i have not been able to do proper intercourse with my wife due to premature ejaculation and one more reason is that my foreskin does not pull back due to which i feel very pain during intercourse. we have decided to go for iui method. i want to know, is iui method is applicable for us or not.please reply soon. we both r 35 years of age and staying in delhi sanjeev ### REPLY: Hello dear, I understand your concern. In my opinion intrauterine insemination(GUI) might be helpful in your case.GUI is indicated for those with low sperm counts, ejaculatory problems, unexplained infertility etc. It is a simple procedure with fairly good results. So you can go on with it. It can be tried up to 4-6 cycles before going for advanced techniques. Avoid stress. Relax. Abstain from smoking or alcohol to improve the semen quality. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My gf and i had protected sex, but it was not even a complete one. I mean my penis did not even entered her vagina completely & she didnt even had bleeding at that time. But next morning she had bleddng and now she told me that her period duration is getting delayed, also shes saying tht shes feeling a bit weak these days. What does this means?? pls rpy asap. Urgent, m in TENSION. Pls Help Dr. ### REPLY: Hello, You are unnecessarily getting tensed as there is no chance of pregnancy, because of two reasons. Any intercourse just before the periods is totally safe and once you get periods, then it itself is an indication that there is no pregnancy. As far as feeling weak is concerned, it could be because of various other physical causes and may be even psychological. If your weakness persists, you may consult your doctor for that but as far as pregnancy is concerned, it is not there. I hope it eases you. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have had an abcess tooth before that was pulled. I have another broken tooth that has been giving me trouble for quite some time, but i dont have insurance, so i have not been to the dentist. There is no swelling around the tooth, but it is painful a lot of the time. Lately my head has felt pressure. My ears are clogged and the left side of my nose is runny all the time, which is the side that the tooth is on. could this be a spreading abcess? ### REPLY: Hi and thanks for the query, Its very appropriate for you get consulted by a dentist. It is very possible for a poorly treated tooth infection to spread, especially in case of an abscess. Nearby structures like the sinuses and the bones around can easily be attained. Osteomyelitis of nearby bones is a common complication of poorly treated tooth infections. Consulting dentist at this point in time is of utmost importance for an appropriate evaluation and treatment. Adequate . Thanks for the query and hope this helps, Best regards, Luchuo, MD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when i have intercourse at the peak stage my penis shrinks.i dont know what happens..a sudden spark through my body and penis shrinks which i am not able to explain..not always..this has happened about 5 times..i have been married since april 6 2014. but when i masturbate there is no problem. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  You have not given your age. Most of the sexual erection and shrinkage problems are mainly due to undue anxiety about sexual intercourse. For you this happened about 5 times. Married for almost 4 months. How many times this did not happen? That is what you should count on. Count positive aspects and remove anxiety about it. You will succeed. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. 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: In the last year I have taken in combination and separately Deanxit, Zoloft and Atacand. But I have stopped all now since two months. can these be a cause for lasting ejaculation problems? I cannot easily orgasm during sex...usually only through masturbation after my partner has climaxed. I can acheive acceptable and long lasting erections but seem to lack feeling. Either tactile on my penis or sensuelle sexuelle emotion mit my partner. What do you think? ### REPLY: Degree understand your concerns went through your details. There are many potential causes of DE, including psychological hang-ups, chronic health conditions, and reactions to medications. Relationship stress, poor communication, and anger can make DE worse. Disappointment in sexual realities with a partner compared to sexual fantasies can also result in DE. Often, men with this problem can ejaculate during masturbation, but not during stimulation with a partner. Medications such as antidepressants, antipsychotics, high blood pressure medications, diuretics, and alcohol can all cause DE. In that sense, Zoloft could be a cause. But you should talk to your psychiatrist. 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 am a 39 year old female, previous history of WPW but I had an ablation in 2003. I have been experiencing chest pain, PVCs and palpitations. Went to the the cardiologist and the EKG said consider left ail enlargement. My resting heart rate is 105 and I also have a heart murmur which gets louder when I stand. What does this all mean, should I be worried? the Dr ordered an echo which hasnt been approved yet by insurance and a holter monitor which I have not got yet either. Thanks ### REPLY: DEAR USER, THANKS FOR CONSULTING WITH ChatDoctorI UNDERSTAND YOUR CONCERN. YOUR PAST HISTORY OF WPA POINTS TOWARD YOU MIGHT HAVE AN ADDITIONAL ARRHYTHMIA ASSOC TD AND AFTER ABLATIVE THERAPY HAS NOT RELIEVED COMPLETELYHENCE YOU HAVE PCs AND PALPITATION INTERMITTENTLYREGARDING YOUR ECG SHOWING LEFT ATRIAL ENLARGEMENT WITH MURMUR MIGHT INDICATE A VALVULAR PATHOLOGY BUT CAN ALSO BE FUNCTIONAL AS YOUR HEART RATE IS 105 THAT HAS CAUSED THE FUNCTIONAL MURMUR. BUT WITHOUT EXAMINING OR DOING A ECHO THE EXACT CAUSE CANNOT BE COMMENTED SUGGEST TO TALK TO YOUR CARDIOLOGIST SO THAT HE CAN HELP YOU. IF YOU MESSAGE ME THE ECG I MAY ALSO HELP MORE BetterHelp I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dr. my name is vinod and i m from punjab i have problem of hair fall last 8 or 9 years last 4 months i talk a treatment and dr.said u take these medicines(Biotee plus and androanagen tablet) but now i feel its effect on sex my sex power week pls tell me these medicines effected on sex i m unmarried person ### REPLY: Hi, These medicines are not known to cause any problem in sex. Biotee-plus is a B complex vitamin commonly used as a nutritional supplementation for dietary shortage or imbalance which may cause hair loss or total alopecia. Its common side effects include stomach upset, heartburn or allergic reactions. An .  Its common side effects include nausea, vomiting, stomach upset or allergic reactions, although not everybody gets them. These medicines are not associated with any sexual problems. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, my wife has a bad rash around her lips & mouth and has been to see 3 doctors and tried several different prescribed creams, but none of them seem to work. she has this problem for...Hi doctor, my wife has a bad rash around her lips & mouth and has been to see 3 doctors and tried several different prescribed creams, but none of them seem to work. she has this problem for... ### REPLY: Hello, Thank you for posting on . I can understand your concern regarding the skin lesions around mouth and lips but It's difficult to point specific diagnosis in absence of clinical examination. Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way. You can reach me directly through the below-mentioned link.https://urldefense.com/v3/__http://doctor. ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My best friend has been diagnosed with pancreatic cancer which seems to have metastisied to his lungs and other organs.  He is having chemotherapy and has been prescribed liquid morphine.   Is there anything ese we can do to ease his pain?  He has deteriorated very fast in the last two weeks from being totaly mobile to us having to hold him up when he walks.   He seems to have accepted the inevitable but Iw ould dearly love to see him more comfortable.At what stage do we get him to a hospice? ### REPLY: Hello, I feel sorry for the plight of your friend. Basically there are two main treatments for severe pain resulting from pancreatic cancer with metastasis. First is narcotic analgesics which you are already giving in form of liquid morphine.2nd is celiac plexus block by 50-100 alcohol solution or phenol and gives very good pain relief for 3-4 months time. As far as going to the hospital is concerned, only supportive treatment can be given. You should discuss both (pain management and admission in hospital) with his treating doctor. Best of luckThanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 33 years of age and had bloods taken liver count was high but not real high I also had a ultrasound done report came back with a ? When asking my local doctor what this meant the only answer I received was the word emporium and colorful ??? I am unsure of what this means they also found a palp on my gallbladder ? Will I have to have surgery to remove it? ### REPLY: Hi, thanks for the query to H. C.M. Forum. Why you get in blood examination ? Why you get in a U/S? What are the complaints for which you are asking about surgery?Anyhow the meaning emporium and colorful as far as concerned about U/S is nothing. If there are stones in gall bladder than surgery is the only option. If enlargement of liver is there than you have to take treatment accordingly. Have a nice day. Good luck  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had mould in my room caused from a leaking pipe 3 years ago and i got a really bad chest infection and was close to being sent to hospital and ever sinceI constantly get sick with chest infections and bhronchitis and I am wondering why I keep getting sick and can it damage my lungs? Regards Danielle, 15 ### REPLY: Thanks for your question on . I can understand your concern. You had chronic mold exposure. This can cause COPD (chronic obstructive Pulmonary disease). So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is must for the diagnosis of COPD. It will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My grown daughter just spent an overnight in the hospital......had symptoms of gastroenteritis , diaherrea, and at night was awakened with horrible pain radiating up shoulder and to the back of the neck....thought she might be having a heart attack and went to the ER....found cysts on liver as result of CAT Scan...did not actually find anything. ### REPLY: Hello Carolyn, Thanks for posting on , If the symptoms of your daughters' gastroenteritis were abrupt and with no fever then there is the likely possibility that she suffered or is suffering from food poisoning (intoxication from eating a contaminated food). The liver cyst was surely discovered by chance from the CAT scan and is will rarely be accused as the cause of her gastroenteritis. Rarely, liver cysts may indicate a serious, underlying condition such as:- Polycystic liver disease, an inherited disorder- Echinococcus infection, a parasitic infection-Liver cancer too worried biopsy might be required. I suggest her stools get analyzed for possible bacterial or fungal cause of the gastroenteritis. If that be the case, treatment with antibiotics will be required and oral rely .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY SISTER WHO IS 45 YEARS OLD HAS BEEN DIAGONISED AS HAVING EMPYEMA AND IS NOW IN APOLLO HOSP IN BANGALORE UNDERGOING TREATMENT FOR THE LAST22DAYS. THE PLEURAL FLUID HAS ALMOST BEEN DRAINED BUT NOW THE DOCTOR  SAYS THERE IS AIR BUBBLES IN THE LUNGS WHICH IS CAUSE FOR CONCERN .KINDLY LET ME KNOW THE SERIOUNESS OF THE PROBLEM ### REPLY: Hi thanks for contacting ... Your sister is having lung infection in form of emphysema.... So for that antibiotic given.... And if needed ICD inserted which has been done in your sister case.... Now this air bubble can be from starting pneumothorax.... In this condition patient suffer from chest pain and breathlessness also.... It can be life-threatening ... So constant observation needed.... If dyspnea more and blood oxygen level falls then oxygen supplementation needed...... If needed chest tube . . You are in good hospital ... So condition is serious and follow doctors advise.... 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: Hello,i have a lump on my inner thigh area near my right scrotom mayb 3 days before it appeared I trimmed my pubic area with scissors could this b the cause my gf said I shouldnt have used scissors I just dont know but this bump does hurt only when I take a seat tho ### REPLY: HI, Dear,Thanks for the query regarding your daughter. I studied your query and understood your health concerns. Remedy-You seem to Scrotal Boil/folliculitis due to public shave with scissors. Consult your ER Surgeon, who would check and do what is necessary treatment after investigations. So Don't worry and act fast as suggested. Welcome for any query to  and me in this regard. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes I am having trouble with my asthma now im having trouble eating a little food I fill up so fast , im also ache when I walk im tried of feeling like this my stomach is sore and when I cough I wet myself , do u have any ideas that might help me think u ### REPLY: Hi, Welcome to  forum.  As you describe it appears to be the gastric irritation due to the .  The other reason may be the cor pulmonale, the heart failure due to the asthma, where the liver enlarges, and causes the lack of appetite, dyspnea, on exertion. The first sign seen is the edema of the feet.  I advise you to consult a physician for diagnosis and treatment. You may need to have X-ray chest, E.C.G. and other tests for confirmation.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a infection in bladder 4times in the past year, never before. Painful. Was given nitrofurantoin,, ciprmofloxacin,sulfamethoxazole/trimethoprim. I wondered what was causing them and why so painfuL and why they are not clearing up. Many antibiotics I have reaction to so it is double trouble ### REPLY: Hello For chronic urinary bladder infection, you need clinical examination and investigations. Investigations include routine hologram, renal function test, Urine culture and sensitivity and Ultrasound of abdomen. Ultrasound of abdomen can exclude many possibilities. You may need further evaluation like cystoscopy(for direct visualization of urinary bladder)or CT scan depending upon findings. 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: Hello Dr.Andrew, I received a root canal today on my lower right side tooth. I am in extreme pain and very swollen. Is this normal? I am taking pain pills and ibuprofen and they only seem to reduce minimal pain for only two hours. I am also taking an antibiotic. I have never experienced this type of pain before with a root canal. Should I ice or heat the knot on my jaw or what would you recommend ### REPLY: Hello and welcome. Thanks for sharing your concern. Pain post root canal treatment is normal. But extreme pain is not expected. It requires revisit to your dentist. There could be one or more unexplored canal, this could be one of the causes. Please continue with your antibiotics but at the same time visit your dentist for an x-ray or RVG. Also do warm saline rinses thrice daily. You can apply ice externally on the affected area, but please avoid heat. Heat can aggravate the symptoms. This should help. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What does it mean when you have decreased basal tracer distributionto the, bilateral parieto-occipital, bilateral patchy parietal , bilateral mesial temporal, bilateral orbitofrontal, patchycerebellar and periventricular with Cortical Metabolic index (CMi) 61.26%, within. alues (48.0-66.1)%, noted in 43 near normal patients, consistent with traumatic brain injury and mild cognitive impairment . Decreased perfusion-simulated tracer distribution, overall similar to the basal study with background corrected Cortical Perfusion index (CPi) 66.14%, within values (56.3-77.2)% noted in 43 near normal patients, and consistent with normal cerebral flow reserve index, FRi = 4.88%, vs values + (3.7-15.7)% for 43 near normal patients. ### REPLY: Hi, Thank you for posting your query. These findings refer to findings of a metabolic scan of brain, most likely SPENT scan. You have only given a part of study here. This looks like a comparison of metabolic activity of brain of head injury patients, with that of normal brain. The study has shown that metabolic activity is reduced in brains of head injured patients, when compared to that of normal brains. 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 recently been tested for a S.T.D but have yet to get my results back. At this point most of the symptoms have gone away. The symptoms were 1. My penis head was raw and very painful from contact with my undershorts. 2. A small amount of white discharge. 3. A pain deep inside of my penis. Now the only symptom seems to be that my penis foreskin is swollen and sagging with a slight itching. Does this mean my body is healing itself or am i experiencing a transition to some other stage of my condition? What does sagging and or swollen penis foreskin indicated? ### REPLY: HelloThanks for query. You have not mentioned sexual history in your query The redness, swelling of foreskin and glans with other symptoms that to had strongly suggested infection of glans penis and foreskin (Ba llano Prostatitis), The white discharge that you have is suggestive of Sexually Transmitted Infection and needs to be investigated. Please consult qualified Urologist or Dermatologist and get following basic test done to confirm the diagnosis .1) Swab test of urethral discharge 2) Blood test for STI .3) Urine routine and culture. Continue taking antibiotic like Erythromycin twice daily along with topical antibiotic ointment Newsprint for local application. Ensure to wash your genitals with warm water twice daily. Ensure to avoid sexual encounters till it heals up completely. Further treatment will depend upon result of these tests and final diagnosis. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is having a very high risk surgery to remove clots.from lungs and around heart. They have to open his chest. He has been suffering.for 10 years..this past year his health declined so quickly he could.not even.walk to the bathroom without fits of coughing...is surgery really as.risky as they say...he is only 46...and.seems like 70.. ### REPLY: Thanks for your question on . By your description I think your husband is having large, chronic pulmonary embolism in major pulmonary arteries. And if it is large enough to occlude blood flow than surgery is the only option. And yes, surgery is very risky. Because already lungs and heart are weakened due to clots. So it is considered as major surgery with very, very high risk intraoperatively as well as post operative. So need to discuss outcomes in depth with your treating surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 need help. I was diagnosed with depression, anxiety and OCD about seven months ago. I was first given citalopram but I got 100 times worse and tried to take my own life. I was then switched to dosulepin and seem to have improved. I now feel totally alienated from reality. I get these extreme, almost physical waves of confusion and alienation from people and my old life. I look at old photos and cant seem to identify with them. I feel really awful. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Anxiety, depression and OCD are almost always hand in hand. Best method of treatment is lifestyle change. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Lifestyle changes, change in thinking pattern, relaxation etc. are as essential as medicines. Psychotherapy can help you to change your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. 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: Cardiac arythmia symptoms.  Hi I am recovering from an aortic valve replacement, mechanical (Nov 22 2000).  I have recently developed arythmia and I am now  unable to lie flat on my back without the arythmia becoming more severe.  During the day the arythmia is presesnt but goes away when I exercise (walking)  I take previscon and beta blockers.  Should I return to my consultant for a check up. ### REPLY: Hellothanks for posting here. Previscan is a blood thinner to prevent blood clots from forming on the mechanical valve. It has no role in arrhythmias. Beta blockers are effective in controlling arrhythmias. They also keep the heart rate in control. You must do well on beta blockers. If their arrhythmias interfere with your day-to-day activities, or you are having symptoms like dizziness or syncope, you must consider increasing the dose or changing to another arrhythmia controlling medication. Wishing you good health thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is almost 3 yrs old and just passesd some greenish clay looking stools. There was also a red line looking thing. He has been drinking this v8 drink mixed with fruit punch gatorade, so I can t tell if it s that, or blood. I m freaking out and very worried. I don t know if I should take him to the ER? ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on Crestor 10 mg ..daily and i just received my liver function test where by theSerum Billirubin 39 Umol/L...Serum alkaline phosephatase 116 U/l..i do went heart surgery operation in year 1994..four by pass were needed..i do also take metfomine 1 twice daily and also aspirin 75mg daily.how can i decrease the bilirubin .. ### REPLY: Hi and welcome to . It may indicate certain liver damage caused mostly by fatty liver or viral hepatitis so rule out these 2 first. The most common liver disorders are fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didn't find anything and viral markers are negative then you have no reason to be concerned. You should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated .  Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest going step by step. If you don't have any symptoms then this is just slight and reversible liver damage. Wish you good health. Regards ### END