Instruction: NAD, Im a 911 dispatcher. The fact that EMS was able to get a pulse back means you and your neighbor did the right things and did your absolute best to give him a fighting chance. Unfortunately, sometimes no matter what you do, its not enough and its too late. So many times, cardiac arrest calls we take end with EMS doing CPR until getting to the hospital, and the hospital calling it shortly after. Perhaps your quick action gave his family time to see him a last time and say goodbye. I hope you find peace and comfort... and even just a few sessions of therapy can provide such a huge benefit toward professing things like this.

Output: Echoing all that was said here.First off, thank you for trying to help. These kind acts keep society alive despite political posturing and divisiveness in social media.As hard as it is to imagine and as difficult it is to go about your routine, inaction would be far more paralyzing. You did everything that you could in his time of need. I have had similar instances in my career in the ED and this same message was relayed to me early in my career: We can only do everything we can do and nothing more. At the end of the day, you gave him a chance. If no one did anything, he would have died. You gave him a chance.I cant speak to exactly what happened, but respiratory arrest is essentially saying that he stopped breathing. That could imply severe asthma, anaphylaxis/allergic reaction or even cardiac arrest (eg, I had a 42 yo MI in a patient just today). Or pulmonary hypertension.I wouldnt rule out overdose. Narcotic addiction has almost never been higher and is one of the leading cause of death of young people. I pulled someone out of their car unresponsive, cyanotic last week for the exact same reason.I trained in one of the most severe areas of narcotics in the US, Kensington in Philly. Its everywhere and a daily occurance. An opioid addicts life has been replaced with daily struggle to obtain narcotics or suffer debilitating withdrawal that few ever want to experience in their lives ever again. Its said that alcohol withdrawal can kill you; narcotic withdrawal makes you wish you were dead.Fortunately, there is help. Suboxone and other treatments can help to replace their addiction with an extremely safe and effective alternative. Its unfortunate that this happened and likely could have been well known by the family. I have had this converation far too often in my career. Parents who performed CPR on their child as they were holding their grandchild in their lap on christmas morning, the daughter who could no longer struggle and overdosed on every pill in the house and the 15 year old who is going to gift of life after found in the rear of the bus. Family are expecting that someday that they will get a phonecall - they just dont know when.The carfentanyl that is used in place of heroin is deadly for anyone who cant fight their addiction and relapse, only to find that the ford taurus of narcotics was replaced with a tractor-trailer. And its often too late. Methadone can be used, and maybe used by some on the street or for pain control, but its hallmark is that your breathing is stopped often before pain control. And it has some of these cardiac effects that were mentioned regarding hydroxychloroquine.Narcan is a medication that is widely utilized. It reverses their apnea (lack of breathing/respiratory arrest). But its temporary. Sometimes ingestions can rebound and the effects can wear offI trust that you did everything you can.If this continues to haunt you, in addition to asking your family doctor for a referral to someone to speak to regarding your experience, ask for a prescription for narcan. Even our local libraries carry some. Keep some in your bag. Speak out, see if there are groups in your area that you can support financially or otherwise. Reach out to the family that was involved. Addiction is often a genetic process. Finally, if you have your own kids, be aware that opioid addiction can happen...especially those with addiction tendencies. It can happen with as few as 12 pills.Best of luck. And again - thank you for all that you do!

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: NAD, Im a 911 dispatcher. The fact that EMS was able to get a pulse back means you and your neighbor did the right things and did your absolute best to give him a fighting chance. Unfortunately, sometimes no matter what you do, its not enough and its too late. So many times, cardiac arrest calls we take end with EMS doing CPR until getting to the hospital, and the hospital calling it shortly after. Perhaps your quick action gave his family time to see him a last time and say goodbye. I hope you find peace and comfort... and even just a few sessions of therapy can provide such a huge benefit toward professing things like this.. ### Response: Echoing all that was said here.First off, thank you for trying to help. These kind acts keep society alive despite political posturing and divisiveness in social media.As hard as it is to imagine and as difficult it is to go about your routine, inaction would be far more paralyzing. You did everything that you could in his time of need. I have had similar instances in my career in the ED and this same message was relayed to me early in my career: We can only do everything we can do and nothing more. At the end of the day, you gave him a chance. If no one did anything, he would have died. You gave him a chance.I cant speak to exactly what happened, but respiratory arrest is essentially saying that he stopped breathing. That could imply severe asthma, anaphylaxis/allergic reaction or even cardiac arrest (eg, I had a 42 yo MI in a patient just today). Or pulmonary hypertension.I wouldnt rule out overdose. Narcotic addiction has almost never been higher and is one of the leading cause of death of young people. I pulled someone out of their car unresponsive, cyanotic last week for the exact same reason.I trained in one of the most severe areas of narcotics in the US, Kensington in Philly. Its everywhere and a daily occurance. An opioid addicts life has been replaced with daily struggle to obtain narcotics or suffer debilitating withdrawal that few ever want to experience in their lives ever again. Its said that alcohol withdrawal can kill you; narcotic withdrawal makes you wish you were dead.Fortunately, there is help. Suboxone and other treatments can help to replace their addiction with an extremely safe and effective alternative. Its unfortunate that this happened and likely could have been well known by the family. I have had this converation far too often in my career. Parents who performed CPR on their child as they were holding their grandchild in their lap on christmas morning, the daughter who could no longer struggle and overdosed on every pill in the house and the 15 year old who is going to gift of life after found in the rear of the bus. Family are expecting that someday that they will get a phonecall - they just dont know when.The carfentanyl that is used in place of heroin is deadly for anyone who cant fight their addiction and relapse, only to find that the ford taurus of narcotics was replaced with a tractor-trailer. And its often too late. Methadone can be used, and maybe used by some on the street or for pain control, but its hallmark is that your breathing is stopped often before pain control. And it has some of these cardiac effects that were mentioned regarding hydroxychloroquine.Narcan is a medication that is widely utilized. It reverses their apnea (lack of breathing/respiratory arrest). But its temporary. Sometimes ingestions can rebound and the effects can wear offI trust that you did everything you can.If this continues to haunt you, in addition to asking your family doctor for a referral to someone to speak to regarding your experience, ask for a prescription for narcan. Even our local libraries carry some. Keep some in your bag. Speak out, see if there are groups in your area that you can support financially or otherwise. Reach out to the family that was involved. Addiction is often a genetic process. Finally, if you have your own kids, be aware that opioid addiction can happen...especially those with addiction tendencies. It can happen with as few as 12 pills.Best of luck. And again - thank you for all that you do!.


Instruction: Its said that alcohol withdrawal can kill youHow can it kill you? That's insane!It can happen with as few as 12 pills.It's seriously that addictive? I was on codeine cough syrup for three months and I had no problem putting the bottle away when my cough was gone. Maybe it helped that I genuinely hated every single thing about it except for the cough relief.

Output: How can it kill you? That's insane!Since you don't appear to have gotten an answer. Two main ways. Alcohol withdrawal can cause seizures, which can be deadly, and alcohol withdrawal can cause something called delirium tremens. Delirium tremens is more of a form of withdrawal characterized by quick and varying changes in someones heart rate and blood pressure in such a way that it can kill (through irregular heart rate called arrhythmias) or a person can become unable to "protect their airway" so to speak and choke.Alcohol withdrawal isn't a pretty thing. BUT the good and bad news is that it varies a lot from person to person.https://emedicine.medscape.com/article/166032-overview

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Its said that alcohol withdrawal can kill youHow can it kill you? That's insane!It can happen with as few as 12 pills.It's seriously that addictive? I was on codeine cough syrup for three months and I had no problem putting the bottle away when my cough was gone. Maybe it helped that I genuinely hated every single thing about it except for the cough relief.. ### Response: How can it kill you? That's insane!Since you don't appear to have gotten an answer. Two main ways. Alcohol withdrawal can cause seizures, which can be deadly, and alcohol withdrawal can cause something called delirium tremens. Delirium tremens is more of a form of withdrawal characterized by quick and varying changes in someones heart rate and blood pressure in such a way that it can kill (through irregular heart rate called arrhythmias) or a person can become unable to "protect their airway" so to speak and choke.Alcohol withdrawal isn't a pretty thing. BUT the good and bad news is that it varies a lot from person to person.https://emedicine.medscape.com/article/166032-overview.


Instruction: I'm not a doctor so I can't say much on what happened but I went through something similar.An elderly man that walked past my house every day to go to church collapsed in front of my house. I have no idea how long he was there. But I heard a woman screaming for help so I went outside to look. He had no pulse. I gave him chest compressions until ambulance arrived but i knew he was already gone. I could hear air going in and out of his lungs from the chest compressions. I'll never forget that sound and how sad I felt doing it to him when I knew he was gone and feeling his ribs crack. This was 5+ years ago and I still remember it like it was yesterday. I still wonder if i had looked out my window sooner if he would have survived and wonder how long he was there before the woman saw him. I also remember how the fire fighters arrived first and stood around me and told me to keep going rather than take over. It was definitely traumatic.I feel so sorry for your neighbors family. So young and so much life ahead to live.Life really sucks sometimes.I will always remember the experience and it was hard to process at the time but it did get better as time went on.

Output: This probably doesnt really add anything, but I just want to reiterate, THANK YOU. You did something that is incredibly hard both physically and emotionally. You kept your cool and did what needed to be done, and what each of us hope that someone would do for us or our loved ones. The causes of suddenly death make a long list, and include things like congenital or acquired arrhythmias, vascular issues including aneurysm rupture or clot in the brain or lungs, and among many many others drug overdose which is sadly probably the leading cause in this age group these days. Im sorry that we cant really give you an answer here. As others have said, please seek help if you need it to process this event. Its a trauma and not something that many people have experienced. Remember that you did everything right, there is likely little that would have changed the outcome, and that you helped give his family a week to say goodbye.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I'm not a doctor so I can't say much on what happened but I went through something similar.An elderly man that walked past my house every day to go to church collapsed in front of my house. I have no idea how long he was there. But I heard a woman screaming for help so I went outside to look. He had no pulse. I gave him chest compressions until ambulance arrived but i knew he was already gone. I could hear air going in and out of his lungs from the chest compressions. I'll never forget that sound and how sad I felt doing it to him when I knew he was gone and feeling his ribs crack. This was 5+ years ago and I still remember it like it was yesterday. I still wonder if i had looked out my window sooner if he would have survived and wonder how long he was there before the woman saw him. I also remember how the fire fighters arrived first and stood around me and told me to keep going rather than take over. It was definitely traumatic.I feel so sorry for your neighbors family. So young and so much life ahead to live.Life really sucks sometimes.I will always remember the experience and it was hard to process at the time but it did get better as time went on.. ### Response: This probably doesnt really add anything, but I just want to reiterate, THANK YOU. You did something that is incredibly hard both physically and emotionally. You kept your cool and did what needed to be done, and what each of us hope that someone would do for us or our loved ones. The causes of suddenly death make a long list, and include things like congenital or acquired arrhythmias, vascular issues including aneurysm rupture or clot in the brain or lungs, and among many many others drug overdose which is sadly probably the leading cause in this age group these days. Im sorry that we cant really give you an answer here. As others have said, please seek help if you need it to process this event. Its a trauma and not something that many people have experienced. Remember that you did everything right, there is likely little that would have changed the outcome, and that you helped give his family a week to say goodbye..


Instruction: To respiratory physicians: is length of time of holding breath an indication of lung capacity?Im a 24M, light smoker, on no meds, weighing 71kg at 175cm.For a smoker who is hypersensitive to the effects of smoking on his body, I am often testing my lungs, usually while exercising (swimming), to see how long I am able to hold my breath. Am I making a false conclusion when I see that my ability to hold a longer/shorter breath correlates to better/worse lung health?Side note: Ive heard that lung capacity can only deteriorate, and is rather stubborn in improving, or all together impossible.. so what gives?Ps: if there is a better sub to ask this question, please do suggest it!

Output: The other comments here are correct that breath holding time is not an accurate reflection of total lung capacity (TLC).But to unpack your question a little further, TLC is just one of many variables important in lung health. Chronic lung disease from smoking is predominantly obstructive (COPD), which is measured by a decrease in the forced expiratory volume in 1 second (FEV1), often also expressed as a ratio to the forced vital capacity (FVC), or the total amount of air you can blow out at once.If anything, smokers tend to increase their total lung capacity as their disease progresses because they are trapping air, unable to blow it out.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: To respiratory physicians: is length of time of holding breath an indication of lung capacity?Im a 24M, light smoker, on no meds, weighing 71kg at 175cm.For a smoker who is hypersensitive to the effects of smoking on his body, I am often testing my lungs, usually while exercising (swimming), to see how long I am able to hold my breath. Am I making a false conclusion when I see that my ability to hold a longer/shorter breath correlates to better/worse lung health?Side note: Ive heard that lung capacity can only deteriorate, and is rather stubborn in improving, or all together impossible.. so what gives?Ps: if there is a better sub to ask this question, please do suggest it!. ### Response: The other comments here are correct that breath holding time is not an accurate reflection of total lung capacity (TLC).But to unpack your question a little further, TLC is just one of many variables important in lung health. Chronic lung disease from smoking is predominantly obstructive (COPD), which is measured by a decrease in the forced expiratory volume in 1 second (FEV1), often also expressed as a ratio to the forced vital capacity (FVC), or the total amount of air you can blow out at once.If anything, smokers tend to increase their total lung capacity as their disease progresses because they are trapping air, unable to blow it out..


Instruction: Respiratory sinus arrhythmia or sinus pause ?? EKG (sorta) included20M, 52, 150lbs, hypothyroidism, anxiety disorder, depression, .5mg Xanax, 25mgc levothyroxine, 12.5mg metoprolol 2x dailyHi again !! So I have one of those at home 1-lead ekgs and whenever I do one and take a deep breath I notice my heart rate slows down and it looks like it skips a beat...... can anyone tell me what this is ?? I have a lot of anxiety around my heart and bought the ekg to monitor my heart rate and I know these things arent 100% accurate but this is worrying me. Sorry if this is asking a lot but im not seeing my cardiologist for a couple weeks so could someone tell me what this looks like ? https://imgur.com/gallery/wjuAjvy

Output: 100% normal - this is respiratory sinus arrhythmia. Stop checking.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Respiratory sinus arrhythmia or sinus pause ?? EKG (sorta) included20M, 52, 150lbs, hypothyroidism, anxiety disorder, depression, .5mg Xanax, 25mgc levothyroxine, 12.5mg metoprolol 2x dailyHi again !! So I have one of those at home 1-lead ekgs and whenever I do one and take a deep breath I notice my heart rate slows down and it looks like it skips a beat...... can anyone tell me what this is ?? I have a lot of anxiety around my heart and bought the ekg to monitor my heart rate and I know these things arent 100% accurate but this is worrying me. Sorry if this is asking a lot but im not seeing my cardiologist for a couple weeks so could someone tell me what this looks like ? https://imgur.com/gallery/wjuAjvy. ### Response: 100% normal - this is respiratory sinus arrhythmia. Stop checking..


Instruction: Update to Previous Post Regarding Cough Up Blood After Workout. Results Were SurprisingAge: 31Sex: MHeight: 6'6"Weight: 250 AthleticRace: White/CaucasianDuration: 4 1/2 MonthsLocation: Lungs/Upper Respiratory, Upper G/ICurrent Diagnosis: Stage 4 Aggressive Gastro-Intestinal CancerCurrent Meds: Pain Killers, DiureticsAs needed Meds: Lidocaine Patches, Anti-Nausea, Melatonin sleep aidOriginal: https://www.reddit.com/r/AskDocs/comments/c2ls61/chronic_cough_and_now_coughing_up_blood_after/?utm_medium=android_app&utm_source=shareSo after spending some time at an Urgent Care, getting some scans lined up and trying to be patient, I woke up one morning to pain and compression over my chest. Urgent Care Docs had advised me that any escalation of symptoms should mean I go to the Emergency Room. Once there they almost immediately checked me into the ICU for observation and began running every test you could name. For the next 4/5 days I did just an unreal number of scans, 2 biopsies, and they drew enough blood to fill a small pool. Pain escalated daily while there so finding a solution was a running theme. So after a lot of trails here's what they found:Current: Stage 4 Aggressive Metastatic Gastrointestinal Cancer ( Adenocarcinoma )Previous: Disseminated Intravascular CoagulationAfter doing a Lymph Node & Bone Marrow Biopsy they found my marrow filled to capacity with dead cancer cells. This pointed them in the right direction. My platelets were crashing daily (20,000 at admission) and I've got inflamed lymph nodes throughout my chest cavity which is one source of my (significant and at time escalating) pain. Its infiltrated my lungs and several vertebrae along my spine (causing vertebrae to show signs of Osteopenia) . Weirdly enough there's no noticeable tumor/mass/lump they can trace it back to. It's kind of just spread throughout (described as Adenocarcinoma) , though they were finally able to locate a small ulcer in my stomach that allowed them to finally be able to classify it. I've currently just completed my 3rd (now weekly) round of chemo (we started asap when other options such as clinical trials were deemed a non-option) and we've been able to stabilize a number of things (blood factors such as platelets, hemoglobin and the like) along the way. Many of my blood counts are still in the trash so clinical trails are not currently an option. In early stages of my 3 weeks hospital visit I was in a state called **DIC (**Disseminated Intravascular Coagulation) which caused me to act like something akin to a blood squirt gun if i bled. Essentialy it screws with you clotting factors and any bleeding event is an issue. Any procedure became an issue and many my numbers were artifically raised in order to attempt anything that would cause me to bleed. Fortunately after a week of treatments and what felt like several wheel barrows of infusions we kicked my body out of D.I.C and am more or less clotting normally. Fun story: early one morning after the vampires took their daily does of my blood a CNA came in to do a routine vitals check. This particular morning they took 2 unique sets of blood samples plus a rather large sample for testing against infectious disease. This was also kind of at the height of my "he's not clotting" phase. During the blood pressure check it popped open all the fresh holes in my arm, causing them to bleed and freaked/surprised the CNA. Made me laugh. (end of story). Immunotherapy is what my Oncologist are banking on right now so crossing my fingers. Chemo is causing reasonable progress (numbers are low but stable) so we're staying the course for now. My personal mid->long term goal is to find an alternative to opiates for pain management (who the hell knows why a person tolerates opiates for a buzz cause constipation sucks!!!) so looking at alternatives (THC pills potentially or preferably resolving the issue that's causing me pain) I've been discharged from the hospital after 3 weeks so now I'm working to find a routine that works. Losing weight so a short term goal is stopping that (I'm rather tall and (was) muscular so my bodies nuking whatever calories I put in and I'm not putting in a lot due to general nausea, but smoothies have been my friend. Please let me know if you have any questions or advice.. I'll answer what I can and absorb what reasonable advice I read.

Output: Man, that was not high on my list of possibilities after your original description. Sorry to hear. Give it hell.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Update to Previous Post Regarding Cough Up Blood After Workout. Results Were SurprisingAge: 31Sex: MHeight: 6'6"Weight: 250 AthleticRace: White/CaucasianDuration: 4 1/2 MonthsLocation: Lungs/Upper Respiratory, Upper G/ICurrent Diagnosis: Stage 4 Aggressive Gastro-Intestinal CancerCurrent Meds: Pain Killers, DiureticsAs needed Meds: Lidocaine Patches, Anti-Nausea, Melatonin sleep aidOriginal: https://www.reddit.com/r/AskDocs/comments/c2ls61/chronic_cough_and_now_coughing_up_blood_after/?utm_medium=android_app&utm_source=shareSo after spending some time at an Urgent Care, getting some scans lined up and trying to be patient, I woke up one morning to pain and compression over my chest. Urgent Care Docs had advised me that any escalation of symptoms should mean I go to the Emergency Room. Once there they almost immediately checked me into the ICU for observation and began running every test you could name. For the next 4/5 days I did just an unreal number of scans, 2 biopsies, and they drew enough blood to fill a small pool. Pain escalated daily while there so finding a solution was a running theme. So after a lot of trails here's what they found:Current: Stage 4 Aggressive Metastatic Gastrointestinal Cancer ( Adenocarcinoma )Previous: Disseminated Intravascular CoagulationAfter doing a Lymph Node & Bone Marrow Biopsy they found my marrow filled to capacity with dead cancer cells. This pointed them in the right direction. My platelets were crashing daily (20,000 at admission) and I've got inflamed lymph nodes throughout my chest cavity which is one source of my (significant and at time escalating) pain. Its infiltrated my lungs and several vertebrae along my spine (causing vertebrae to show signs of Osteopenia) . Weirdly enough there's no noticeable tumor/mass/lump they can trace it back to. It's kind of just spread throughout (described as Adenocarcinoma) , though they were finally able to locate a small ulcer in my stomach that allowed them to finally be able to classify it. I've currently just completed my 3rd (now weekly) round of chemo (we started asap when other options such as clinical trials were deemed a non-option) and we've been able to stabilize a number of things (blood factors such as platelets, hemoglobin and the like) along the way. Many of my blood counts are still in the trash so clinical trails are not currently an option. In early stages of my 3 weeks hospital visit I was in a state called **DIC (**Disseminated Intravascular Coagulation) which caused me to act like something akin to a blood squirt gun if i bled. Essentialy it screws with you clotting factors and any bleeding event is an issue. Any procedure became an issue and many my numbers were artifically raised in order to attempt anything that would cause me to bleed. Fortunately after a week of treatments and what felt like several wheel barrows of infusions we kicked my body out of D.I.C and am more or less clotting normally. Fun story: early one morning after the vampires took their daily does of my blood a CNA came in to do a routine vitals check. This particular morning they took 2 unique sets of blood samples plus a rather large sample for testing against infectious disease. This was also kind of at the height of my "he's not clotting" phase. During the blood pressure check it popped open all the fresh holes in my arm, causing them to bleed and freaked/surprised the CNA. Made me laugh. (end of story). Immunotherapy is what my Oncologist are banking on right now so crossing my fingers. Chemo is causing reasonable progress (numbers are low but stable) so we're staying the course for now. My personal mid->long term goal is to find an alternative to opiates for pain management (who the hell knows why a person tolerates opiates for a buzz cause constipation sucks!!!) so looking at alternatives (THC pills potentially or preferably resolving the issue that's causing me pain) I've been discharged from the hospital after 3 weeks so now I'm working to find a routine that works. Losing weight so a short term goal is stopping that (I'm rather tall and (was) muscular so my bodies nuking whatever calories I put in and I'm not putting in a lot due to general nausea, but smoothies have been my friend. Please let me know if you have any questions or advice.. I'll answer what I can and absorb what reasonable advice I read.. ### Response: Man, that was not high on my list of possibilities after your original description. Sorry to hear. Give it hell..


Instruction: Fortunately I do, and they've been a tremendous help. Would have been very difficult without their aid. However , things have mellowed out enough, now that I've been discharged, that most everyone has been able to return to their routines, which is nice. Their support was invaluable but I was eager to get everyone back to their normal lives as well for their own sakes and health.

Output: Thanks for the update, OP, though I wish it were better news.I will leave this up for now as OP has a specific follow up question regarding pain and symptom management. However, if this thread becomes off topic (including an excess of well wishing in relation to actual advice being given), we will lock it.We all want OP to do well. Stay on topic so we don't bury good advice that may come forward.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Fortunately I do, and they've been a tremendous help. Would have been very difficult without their aid. However , things have mellowed out enough, now that I've been discharged, that most everyone has been able to return to their routines, which is nice. Their support was invaluable but I was eager to get everyone back to their normal lives as well for their own sakes and health.. ### Response: Thanks for the update, OP, though I wish it were better news.I will leave this up for now as OP has a specific follow up question regarding pain and symptom management. However, if this thread becomes off topic (including an excess of well wishing in relation to actual advice being given), we will lock it.We all want OP to do well. Stay on topic so we don't bury good advice that may come forward..


Instruction: My significant other's health has sharply deteriorated and after months we have no idea what it is.Hello. My (24F) boyfriend, Paul (29M), and I are fairly active. We go on road trips every year with our main stops being prime hiking spots. Paul is 5'7'' and 230 pounds. Due to his southeast asian/pacific genetics, his entire family is on the heavier side, but Paul is just as active as I am and eats well.Recently, we have gone long distance. Paul returned to live with his parents due to the pandemic while I stayed where I was. I visited him in June 2021. At this point, Paul had few symptoms, but some new minor health issues. We went hiking around Lake Tahoe and Paul was a little more out of breath than usual. He hasn't needed to use his inhaler since he was a kid, and he had to use it on this trip. We attributed this to recent wildfires in the area and poor air quality.However, Paul's health continued to sharply deteriorate. We went to Edinburgh, Scotland, in July. While hiking Arthur's Seat, Paul had to use his inhaler so many times he emptied it out. He could not get it refilled as we were out of the country. Until the end of the trip, Paul's breathing became more and more labored and he developed a persistent cough.I did not visit Paul August-November 2021. We spoke on the phone and Skyped regularly. During this time, Paul would sometimes leave the call or mute for a few minutes. He'd come back and apologize, saying he'd had to cough pretty violently and didn't want me to hear. I was concerned. I overheard one wracking, moaning coughing session and knew it was not just asthma or an irritated throat. By October 2021, the air quality in his area had greatly improved.I persuaded Paul to visit his general practitioner. His GP dismissed all of his concerns and cited Paul's being fat and asthmatic as the source of his issues, and that the issues would disappear with rest and exercise. I had to fight doctors for years to get them to take my chronic pelvic pain seriously, and was finally diagnosed with an ovarian cyst that was 8mm long and about to burst, so I have experience with self advocacy in the medical space. I helped Paul see new doctors.In mid-October 2021, Paul developed abdominal edema. Paul's feet, legs, and lower stomach were swelling up like crazy. He gained 40 pounds. He could barely move at all, even to go to the bathroom. He couldn't sleep lying down without suffocating, which only worsened his exhaustion. He went to the doctor again and was prescribed diuretics. The diuretics helped with the swelling and extra weight and within 2 weeks he was back to his regular weight, but the coughing and weakness persisted.About a month after regularly taking diuretics (November), Paul started feeling intense nausea on a weekly basis. This nausea would prompt coughing fits. Paul couldn't eat or focus while nauseated. Our calls became more and more infrequent as Paul's nausea and headaches grew. He told me sometimes the nausea would get so bad that he would vomit. There were no patterns to the vomiting--it didn't happen at a certain time of day or after meals. Sometimes it was foamy. He got a CT scan to look at his gall bladder and all results were within normal ranges. Blood tests, including labs for liver function, all came back normal. His doctor referred him to a gastroenterologist for more testing, but due to increases in COVID-19 cases, they haven't even processed his file, let alone scheduled appointments, which would be months out. A nurse anticipated he wouldn't be able to go in until February 2022, but at his rate of decline, this has me concerned for his mental wellbeing and life quality.This week, in late December 2021, I visited him and his family for Christmas. I had heard from Paul about his issues and was following closely with his medical updates, but seeing it firsthand was another thing altogether. I have never seen human suffering and sickness like this up close or cared for another human being in such an intimate way.Every single day, he has intense coughing fits and bouts of nausea where he makes vocalizations and gags, usually every few hours. At least once a day, these coughing fits are so bad that he spends 5-30 minutes vomiting in the sink. The vomiting has increased drastically. After this, the nausea alleviates, but Paul feels exhausted and has migraines. He barely eats. He barely sleeps.Today, he had three different nausea/coughing bouts that induced vomiting. One developed rapidly and he threw up in a restaurant bathroom. The last one, which just happened this evening as of writing this post, also caught him by surprise, and he vomited in the kitchen sink. The vomiting was so physically taxing that his nose bled profusely and he lost control of his bowels and peed himself. He was not strong enough to make it down the hall to the bathroom. Eventually, I assisted him into the shower. I am writing this before bed, and he is still coughing, and has a migraine. He hasn't gotten up from where he sat after taking the shower.I would appreciate any medical advice about what might be causing what Paul is going through, as well as tips for how to navigate the medical system to ensure this gets treated in the best way possible. I would like to reiterate that while neither of us are marathon running body builders, Paul (before all of this) was physically active and monitored his eating habits. He was also mentally active and had returned to school to pursue a degree in a new field. We both have families that are reasonably well off and are good support systems.Paul is one tough puppy, and reassures me that it "isn't so bad," but after seeing it firsthand, I know this is not something that can continue the way it is. I am extremely worried, and caring for him is beginning to wear on me mentally. Sometimes I feel sympathy nausea when I hear the noises he makes in the bathroom.Please help in any way possible. I appreciate any and every tip, and can provide additional information if needed. Thank you very much.UPDATE 12/26:We went to the ER at 4 AM right after Christmas. Luckily, it was almost completely empty. I was not allowed to go back with him, so for the entire five hours I was sitting in the waiting room, I was only ever accompanied by one or two other people at a time.Paul's shortness of breath, fatigue, and wracking coughs got him seen quickly. He texted me updates as things progressed. He got every test I wrote down from these comments--BNP test, pulmonary work, chest x rays, GI work. An echocardigram is scheduled for next week.They found out right away that Paul's BNP results were seven times higher than usual. They said this was indicative of heart failure. They also tested Paul for COVID 19. He tested negative, but did test indicating he had some kind of viral illness.Paul's doctor concluded that he was suffering from chronic RSV that was made worse by poor genetics, asthma, and obesity. Paul did confirm he had what felt like a respiratory illness in Scotland in June, then after going to a wedding in October, then this week when he got severely ill and we found out his mother had a cold.There is no cure for RSV, but a vaccine has reached human trials. The only things Paul can do to alleviate his own suffering and avoid a heart attack is to make significant lifestyle changes and live like an immunocompromised person. I believe in his ability to achieve the former, but the latter is more difficult because of his emotionally overattached mother who brings the entire extended family out for lunches, movie nights, shopping, etc. several times a week. I'm concerned she won't take it seriously or will be in denial to avoid feeling responsible and will therefore continue to expose Paul to colds that could kill him.Paul is currently resting. He was given medication for his nausea and a new inhaler. He is doing better but still coughing. We have already started on his new food regimen. I am hoping for the best, but the pandemic has proved that people rarely take precautions for others' goodwill. Thank you for all your support. Paul might never have gone to the ER if I hadn't visited and reached out to this community.

Output: He needs to go to the emergency department. It sounds like he has some sort of heart failure causing the shortness of breath and swelling. The nausea and vomiting could be anything, though Id be concerned about electrolyte abnormalities or increased intracranial pressure. Heart failure can cause it too but not this severe Id imagineDont have a great answer tying them together thoughThis was pretty much exactly my thought process as well. Hard to tie all of these symptoms together until we start a work up, which should definitely include an Echocardiogram. Go to the emergency department to get started, then will probably need to stay in the hospital until a diagnosis and care plan is made, as well as symptomatic improvement.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My significant other's health has sharply deteriorated and after months we have no idea what it is.Hello. My (24F) boyfriend, Paul (29M), and I are fairly active. We go on road trips every year with our main stops being prime hiking spots. Paul is 5'7'' and 230 pounds. Due to his southeast asian/pacific genetics, his entire family is on the heavier side, but Paul is just as active as I am and eats well.Recently, we have gone long distance. Paul returned to live with his parents due to the pandemic while I stayed where I was. I visited him in June 2021. At this point, Paul had few symptoms, but some new minor health issues. We went hiking around Lake Tahoe and Paul was a little more out of breath than usual. He hasn't needed to use his inhaler since he was a kid, and he had to use it on this trip. We attributed this to recent wildfires in the area and poor air quality.However, Paul's health continued to sharply deteriorate. We went to Edinburgh, Scotland, in July. While hiking Arthur's Seat, Paul had to use his inhaler so many times he emptied it out. He could not get it refilled as we were out of the country. Until the end of the trip, Paul's breathing became more and more labored and he developed a persistent cough.I did not visit Paul August-November 2021. We spoke on the phone and Skyped regularly. During this time, Paul would sometimes leave the call or mute for a few minutes. He'd come back and apologize, saying he'd had to cough pretty violently and didn't want me to hear. I was concerned. I overheard one wracking, moaning coughing session and knew it was not just asthma or an irritated throat. By October 2021, the air quality in his area had greatly improved.I persuaded Paul to visit his general practitioner. His GP dismissed all of his concerns and cited Paul's being fat and asthmatic as the source of his issues, and that the issues would disappear with rest and exercise. I had to fight doctors for years to get them to take my chronic pelvic pain seriously, and was finally diagnosed with an ovarian cyst that was 8mm long and about to burst, so I have experience with self advocacy in the medical space. I helped Paul see new doctors.In mid-October 2021, Paul developed abdominal edema. Paul's feet, legs, and lower stomach were swelling up like crazy. He gained 40 pounds. He could barely move at all, even to go to the bathroom. He couldn't sleep lying down without suffocating, which only worsened his exhaustion. He went to the doctor again and was prescribed diuretics. The diuretics helped with the swelling and extra weight and within 2 weeks he was back to his regular weight, but the coughing and weakness persisted.About a month after regularly taking diuretics (November), Paul started feeling intense nausea on a weekly basis. This nausea would prompt coughing fits. Paul couldn't eat or focus while nauseated. Our calls became more and more infrequent as Paul's nausea and headaches grew. He told me sometimes the nausea would get so bad that he would vomit. There were no patterns to the vomiting--it didn't happen at a certain time of day or after meals. Sometimes it was foamy. He got a CT scan to look at his gall bladder and all results were within normal ranges. Blood tests, including labs for liver function, all came back normal. His doctor referred him to a gastroenterologist for more testing, but due to increases in COVID-19 cases, they haven't even processed his file, let alone scheduled appointments, which would be months out. A nurse anticipated he wouldn't be able to go in until February 2022, but at his rate of decline, this has me concerned for his mental wellbeing and life quality.This week, in late December 2021, I visited him and his family for Christmas. I had heard from Paul about his issues and was following closely with his medical updates, but seeing it firsthand was another thing altogether. I have never seen human suffering and sickness like this up close or cared for another human being in such an intimate way.Every single day, he has intense coughing fits and bouts of nausea where he makes vocalizations and gags, usually every few hours. At least once a day, these coughing fits are so bad that he spends 5-30 minutes vomiting in the sink. The vomiting has increased drastically. After this, the nausea alleviates, but Paul feels exhausted and has migraines. He barely eats. He barely sleeps.Today, he had three different nausea/coughing bouts that induced vomiting. One developed rapidly and he threw up in a restaurant bathroom. The last one, which just happened this evening as of writing this post, also caught him by surprise, and he vomited in the kitchen sink. The vomiting was so physically taxing that his nose bled profusely and he lost control of his bowels and peed himself. He was not strong enough to make it down the hall to the bathroom. Eventually, I assisted him into the shower. I am writing this before bed, and he is still coughing, and has a migraine. He hasn't gotten up from where he sat after taking the shower.I would appreciate any medical advice about what might be causing what Paul is going through, as well as tips for how to navigate the medical system to ensure this gets treated in the best way possible. I would like to reiterate that while neither of us are marathon running body builders, Paul (before all of this) was physically active and monitored his eating habits. He was also mentally active and had returned to school to pursue a degree in a new field. We both have families that are reasonably well off and are good support systems.Paul is one tough puppy, and reassures me that it "isn't so bad," but after seeing it firsthand, I know this is not something that can continue the way it is. I am extremely worried, and caring for him is beginning to wear on me mentally. Sometimes I feel sympathy nausea when I hear the noises he makes in the bathroom.Please help in any way possible. I appreciate any and every tip, and can provide additional information if needed. Thank you very much.UPDATE 12/26:We went to the ER at 4 AM right after Christmas. Luckily, it was almost completely empty. I was not allowed to go back with him, so for the entire five hours I was sitting in the waiting room, I was only ever accompanied by one or two other people at a time.Paul's shortness of breath, fatigue, and wracking coughs got him seen quickly. He texted me updates as things progressed. He got every test I wrote down from these comments--BNP test, pulmonary work, chest x rays, GI work. An echocardigram is scheduled for next week.They found out right away that Paul's BNP results were seven times higher than usual. They said this was indicative of heart failure. They also tested Paul for COVID 19. He tested negative, but did test indicating he had some kind of viral illness.Paul's doctor concluded that he was suffering from chronic RSV that was made worse by poor genetics, asthma, and obesity. Paul did confirm he had what felt like a respiratory illness in Scotland in June, then after going to a wedding in October, then this week when he got severely ill and we found out his mother had a cold.There is no cure for RSV, but a vaccine has reached human trials. The only things Paul can do to alleviate his own suffering and avoid a heart attack is to make significant lifestyle changes and live like an immunocompromised person. I believe in his ability to achieve the former, but the latter is more difficult because of his emotionally overattached mother who brings the entire extended family out for lunches, movie nights, shopping, etc. several times a week. I'm concerned she won't take it seriously or will be in denial to avoid feeling responsible and will therefore continue to expose Paul to colds that could kill him.Paul is currently resting. He was given medication for his nausea and a new inhaler. He is doing better but still coughing. We have already started on his new food regimen. I am hoping for the best, but the pandemic has proved that people rarely take precautions for others' goodwill. Thank you for all your support. Paul might never have gone to the ER if I hadn't visited and reached out to this community.. ### Response: He needs to go to the emergency department. It sounds like he has some sort of heart failure causing the shortness of breath and swelling. The nausea and vomiting could be anything, though Id be concerned about electrolyte abnormalities or increased intracranial pressure. Heart failure can cause it too but not this severe Id imagineDont have a great answer tying them together thoughThis was pretty much exactly my thought process as well. Hard to tie all of these symptoms together until we start a work up, which should definitely include an Echocardiogram. Go to the emergency department to get started, then will probably need to stay in the hospital until a diagnosis and care plan is made, as well as symptomatic improvement..


Instruction: What about ruling out lung cancer? You dont have to be a smoker or old to get lung cancer and unfortunately Asian/Pacific islanders are at higher risk?

Output: Lung cancer is almost unheard of in your 20s. Also none of the symptoms other than cough fit

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: What about ruling out lung cancer? You dont have to be a smoker or old to get lung cancer and unfortunately Asian/Pacific islanders are at higher risk?. ### Response: Lung cancer is almost unheard of in your 20s. Also none of the symptoms other than cough fit.


Instruction: Disclaimer: Not a doctor.With Paul's history of being active outdoors(I also wonder if he has any pets?), I also wonder if the hospital should be checking for Lyme Disease? Depending on his other symptoms not sure how high up it would be on the differential?I know that coughing is pretty rare in it, but from the sounds of it whatever he's had has been going on for a prolonged period of time, and it kind of sounds similar to this patients story, but also maybe not entirely?I guess it could be something for the OP to ask the doctor about that they're talking with.

Output: It is something I thought about though I dont know Lyme prevalence in the UK and more importantly Lyme is more associated with heart block than with heart failure. Something worth thinking about though

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Disclaimer: Not a doctor.With Paul's history of being active outdoors(I also wonder if he has any pets?), I also wonder if the hospital should be checking for Lyme Disease? Depending on his other symptoms not sure how high up it would be on the differential?I know that coughing is pretty rare in it, but from the sounds of it whatever he's had has been going on for a prolonged period of time, and it kind of sounds similar to this patients story, but also maybe not entirely?I guess it could be something for the OP to ask the doctor about that they're talking with.. ### Response: It is something I thought about though I dont know Lyme prevalence in the UK and more importantly Lyme is more associated with heart block than with heart failure. Something worth thinking about though.


Instruction: When you look at intracranial pressure, how does that affect how someone breathes?I know it makes you work harder to breathe but not why.

Output: Theres the Cushing reflex which makes you breathe shallower but Im not 100% sure the nausea/vomiting and breathing troubles are relatedGood lord this is a hospital visit.As a physician these symptoms would spark a large battery of tests in my primary care office, but it sounds late for that. He needs to try a hospital. Make sure he tells them exactly what you wrote here.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: When you look at intracranial pressure, how does that affect how someone breathes?I know it makes you work harder to breathe but not why.. ### Response: Theres the Cushing reflex which makes you breathe shallower but Im not 100% sure the nausea/vomiting and breathing troubles are relatedGood lord this is a hospital visit.As a physician these symptoms would spark a large battery of tests in my primary care office, but it sounds late for that. He needs to try a hospital. Make sure he tells them exactly what you wrote here..


Instruction: I dont mean to be rude with this question but I know as someone with chronic illnesses I am generally reluctant to go to the ED when they flare up because of the whole history of being told theres nothing doctors can do for me, or its just because Im fat, anxious, whatever. If hes been dismissed by doctors before what should he say now to make sure he actually gets the care he needs?

Output: Its always hard to say what another doctor saw or thought when someone got care. Miscommunication between providers and patients are extremely common with chronic illness. With flares of chronic illnesses there is often not much that can be done outside of the norm, and brief emergency care is frequently not enough to solve the flare but hospital care is frequently not indicated, which can make one feel very much dismissed.In this case, OPs BF has several huge red flags that suggest he should go to the emergency room for evaluation.Severe worsening nausea and headachesLoss of bowel/bladder controlProgressive coughing and shortness of breathFluid buildup requiring diuretics (this is VERY unusual and requires a significant evaluation that I dont see written about here)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I dont mean to be rude with this question but I know as someone with chronic illnesses I am generally reluctant to go to the ED when they flare up because of the whole history of being told theres nothing doctors can do for me, or its just because Im fat, anxious, whatever. If hes been dismissed by doctors before what should he say now to make sure he actually gets the care he needs?. ### Response: Its always hard to say what another doctor saw or thought when someone got care. Miscommunication between providers and patients are extremely common with chronic illness. With flares of chronic illnesses there is often not much that can be done outside of the norm, and brief emergency care is frequently not enough to solve the flare but hospital care is frequently not indicated, which can make one feel very much dismissed.In this case, OPs BF has several huge red flags that suggest he should go to the emergency room for evaluation.Severe worsening nausea and headachesLoss of bowel/bladder controlProgressive coughing and shortness of breathFluid buildup requiring diuretics (this is VERY unusual and requires a significant evaluation that I dont see written about here).


Instruction: How can we determine which ER around us is the best/most advanced? Paul's insurance is considered good (Kaiser Permanente) but his doctors barely listen to him, infrequently order tests, and weren't overly concerned/in emergency mode over the fluid buildup.

Output: If he is a Kaiser insured patient he will only be able to seek care at Kaiser facilities. This is a situation of the squeaky wheel getting the grease. He needs to go to the biggest Kaiser in the area and be on his doctors ass every single day until he gets help.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: How can we determine which ER around us is the best/most advanced? Paul's insurance is considered good (Kaiser Permanente) but his doctors barely listen to him, infrequently order tests, and weren't overly concerned/in emergency mode over the fluid buildup.. ### Response: If he is a Kaiser insured patient he will only be able to seek care at Kaiser facilities. This is a situation of the squeaky wheel getting the grease. He needs to go to the biggest Kaiser in the area and be on his doctors ass every single day until he gets help..


Instruction: There is a Kaiser ER near us. Hopefully they listen.

Output: Kaiser is generally a good system, but weird things can be harder to diagnose in the system because they are much more conservative in general with testing

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: There is a Kaiser ER near us. Hopefully they listen.. ### Response: Kaiser is generally a good system, but weird things can be harder to diagnose in the system because they are much more conservative in general with testing.


Instruction: Ideally it should be an academic / teaching hospital. They're more used to seeing unusual cases and thinking outside of the box.

Output: This will not be possible with Kaiser insurance, they will simply send him to a Kaiser hospital from the academic hospital ER, and he will get a large bill for it

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ideally it should be an academic / teaching hospital. They're more used to seeing unusual cases and thinking outside of the box.. ### Response: This will not be possible with Kaiser insurance, they will simply send him to a Kaiser hospital from the academic hospital ER, and he will get a large bill for it.


Instruction: Im with Kaiser and Ive gone directly to the ER for an emergency by ambulance. I just paid my co pay.

Output: It can happen, but you cannot be admitted to a non-Kaiser hospital unless you are too unstable for transfer or the Kaiser is on diversion for some reason.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Im with Kaiser and Ive gone directly to the ER for an emergency by ambulance. I just paid my co pay.. ### Response: It can happen, but you cannot be admitted to a non-Kaiser hospital unless you are too unstable for transfer or the Kaiser is on diversion for some reason..


Instruction: I agree. He should go straight to the most advanced ER/hospital local to him. A lot of things are probably going on.Once the more acute and scary things are sorted out I'd look into a sleep study to find out if he has sleep apnea since it can cause a cascade of serious problems.Also I do not mean to sound insensitive (and of course doing this is a very personal decision) but if obesity is a big problem for him he may want to consider weight loss surgery after he recovers from whatever is going on now. I was obese my entire life, once my health started failing I had gastric bypass surgery and I can't tell you how much it has helped me and probably saved my life.

Output: I agree he needs urgent evaluation with his worsening symptoms. The differential is broad for his various symptoms and will likely need cardiac, pulmonary and GI workup.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I agree. He should go straight to the most advanced ER/hospital local to him. A lot of things are probably going on.Once the more acute and scary things are sorted out I'd look into a sleep study to find out if he has sleep apnea since it can cause a cascade of serious problems.Also I do not mean to sound insensitive (and of course doing this is a very personal decision) but if obesity is a big problem for him he may want to consider weight loss surgery after he recovers from whatever is going on now. I was obese my entire life, once my health started failing I had gastric bypass surgery and I can't tell you how much it has helped me and probably saved my life.. ### Response: I agree he needs urgent evaluation with his worsening symptoms. The differential is broad for his various symptoms and will likely need cardiac, pulmonary and GI workup..


Instruction: The most important part is that - while you may have a list and such, an ER visit isnt going to find the exact diagnosis right there and perform all those tests at your request. The goal of this visit is going to be to assess for any acute abnormalities OR to get him admitted to an internal medicine team that can take the time to work these things out.

Output: Posts by unflaired users that claim or strongly imply legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: The most important part is that - while you may have a list and such, an ER visit isnt going to find the exact diagnosis right there and perform all those tests at your request. The goal of this visit is going to be to assess for any acute abnormalities OR to get him admitted to an internal medicine team that can take the time to work these things out.. ### Response: Posts by unflaired users that claim or strongly imply legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification..


Instruction: As the physicians here have responded, go to ERnow. And please update! Very curious to hear his outcomes. Best of luck to you

Output: Does he use drugs, specifically marijuana?Food allergies? It would be a bit drastic, and may not explain the swelling, but you can develop them at any time.A bit young for cancers, but maybe he is genetically predisposed, getting at least a CT scan with contrast of his abdomen would be good.This is concerning for his heart too, as mentioned.He needs quick workup, as mentioned. Worrisome is not eating and what his electrolytes are like.Not that being obese is the sole cause of his symptoms, but he should lose weight. Almost every physician you will run into will say this as it is important for his health, just as they would tell him to stop smoking if he was smoking.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: As the physicians here have responded, go to ERnow. And please update! Very curious to hear his outcomes. Best of luck to you. ### Response: Does he use drugs, specifically marijuana?Food allergies? It would be a bit drastic, and may not explain the swelling, but you can develop them at any time.A bit young for cancers, but maybe he is genetically predisposed, getting at least a CT scan with contrast of his abdomen would be good.This is concerning for his heart too, as mentioned.He needs quick workup, as mentioned. Worrisome is not eating and what his electrolytes are like.Not that being obese is the sole cause of his symptoms, but he should lose weight. Almost every physician you will run into will say this as it is important for his health, just as they would tell him to stop smoking if he was smoking..


Instruction: He doesn't use drugs and has no known food allergies. He was able to eat breakfast today, and so far it hasn't come back up, though he is coughing. I feel overwhelmed by these responses but appreciative. I'm worried about going to the ER because our area is having a huge COVID surge and hospitals are at capacity. Is it safe to wait? Where is best to go?

Output: As tough as it is right now, you might have to take him for emergency care. If he is coughing/vomiting so much that he loses control of bodily functions and is unable to eat and generally take care of himself, he should be seen sooner rather than later.Are the headaches coming before or just after the other symptoms? Bad migraines can present with nausea and vomiting, and sometimes neurological complaints, as well.It's hard to tell more without seeing full labs and imaging, again, pointing to getting some answers quicker by going to an ER.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: He doesn't use drugs and has no known food allergies. He was able to eat breakfast today, and so far it hasn't come back up, though he is coughing. I feel overwhelmed by these responses but appreciative. I'm worried about going to the ER because our area is having a huge COVID surge and hospitals are at capacity. Is it safe to wait? Where is best to go?. ### Response: As tough as it is right now, you might have to take him for emergency care. If he is coughing/vomiting so much that he loses control of bodily functions and is unable to eat and generally take care of himself, he should be seen sooner rather than later.Are the headaches coming before or just after the other symptoms? Bad migraines can present with nausea and vomiting, and sometimes neurological complaints, as well.It's hard to tell more without seeing full labs and imaging, again, pointing to getting some answers quicker by going to an ER..


Instruction: They were probably wondering if cannabis hypermesis syndrome could be contributing to ten vomiting

Output: Yes, cannabis hyperemesis syndrome, or cyclical vomiting syndrome, as mentioned. Usually people who have been smoking daily for while, 10-15 years, but can happen with less.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: They were probably wondering if cannabis hypermesis syndrome could be contributing to ten vomiting. ### Response: Yes, cannabis hyperemesis syndrome, or cyclical vomiting syndrome, as mentioned. Usually people who have been smoking daily for while, 10-15 years, but can happen with less..


Instruction: [25m 175lb 61] Post-Concussion Respiratory IssueI suffered a mild to severe concussion on Dec 10th after flipping my car. Jan 13th I began to get sick. I mention this because I know it affects the immune system.So, 1/13; It started with a sore throat & a lump by my adams apple. For the first week It progressed to wheezing, headaches, extreme fatigue and as much mucus and snot that the body can produce. By Jan 22nd I felt better, but the mucus and sinus pressure was still there. Today is Jan 28th. The past 4 days Ive had mucus that began as lime green color the first two days, and the past 2 days (including today) has been the color of an egg yolk. I also coughed up blood a little while ago today. I have never had a sickness last me this long. Not even covid. Im concerned. What should I do?

Output: It sounds like you have an upper respiratory tract infection.It could be that your symptoms resolved and you got a second infection.It could be that you've got a bit of congestion or post nasal drip. You can treat this with a mucolytic agent that can help the body break down and clear the mucous.It could be that you've developed a bacterial infection that is taking longer to clear and may require some antibiotics.It is likely that these symptoms have nothing to do with your car accident.Given how long your symptoms have been going for, I'd suggest seeing your GP or PCP for further treatment options.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: [25m 175lb 61] Post-Concussion Respiratory IssueI suffered a mild to severe concussion on Dec 10th after flipping my car. Jan 13th I began to get sick. I mention this because I know it affects the immune system.So, 1/13; It started with a sore throat & a lump by my adams apple. For the first week It progressed to wheezing, headaches, extreme fatigue and as much mucus and snot that the body can produce. By Jan 22nd I felt better, but the mucus and sinus pressure was still there. Today is Jan 28th. The past 4 days Ive had mucus that began as lime green color the first two days, and the past 2 days (including today) has been the color of an egg yolk. I also coughed up blood a little while ago today. I have never had a sickness last me this long. Not even covid. Im concerned. What should I do?. ### Response: It sounds like you have an upper respiratory tract infection.It could be that your symptoms resolved and you got a second infection.It could be that you've got a bit of congestion or post nasal drip. You can treat this with a mucolytic agent that can help the body break down and clear the mucous.It could be that you've developed a bacterial infection that is taking longer to clear and may require some antibiotics.It is likely that these symptoms have nothing to do with your car accident.Given how long your symptoms have been going for, I'd suggest seeing your GP or PCP for further treatment options..


Instruction: Undiagnosed respiratory illness.32M177cm77kgEuropean whiteI've had an ongoing illness with no diagnosis for 2 years. Main symptoms are respiratory; sore chest, flu-like symptoms, no energy, coughing up blood and mucous, shortness of breath, exhaustion at the slightest of exertion. Numb nose, inflammation all in nose.I've had a CT scan abdominal and there was nothing too abnormal. One thing stated was large lung volume, but no signs of COPD, fibrosis. I also did genetic test with Ancestry which stated I have a significantly increased risk (although stated it could be a mistake) for lung diseases. I would like to know is there any clinical significance to increased lung volumes with no other symptoms? It's just something I am curious of but can't find answers online, like is it a precursor to getting COPD or something. Can someone explain if it means anything?At this stage due to the CT abdo scan coming back mostly normal, I am beginning to suspect some sort of nasal infection, but I would like someone explain to me what increased lung volume could mean, so I can move forward and narrow down my illness and eliminate all other possibilities whilst also understanding what it means.

Output: There's honestly no real clinical significance to just noting large lung volumes.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Undiagnosed respiratory illness.32M177cm77kgEuropean whiteI've had an ongoing illness with no diagnosis for 2 years. Main symptoms are respiratory; sore chest, flu-like symptoms, no energy, coughing up blood and mucous, shortness of breath, exhaustion at the slightest of exertion. Numb nose, inflammation all in nose.I've had a CT scan abdominal and there was nothing too abnormal. One thing stated was large lung volume, but no signs of COPD, fibrosis. I also did genetic test with Ancestry which stated I have a significantly increased risk (although stated it could be a mistake) for lung diseases. I would like to know is there any clinical significance to increased lung volumes with no other symptoms? It's just something I am curious of but can't find answers online, like is it a precursor to getting COPD or something. Can someone explain if it means anything?At this stage due to the CT abdo scan coming back mostly normal, I am beginning to suspect some sort of nasal infection, but I would like someone explain to me what increased lung volume could mean, so I can move forward and narrow down my illness and eliminate all other possibilities whilst also understanding what it means.. ### Response: There's honestly no real clinical significance to just noting large lung volumes..


Instruction: For 19 days, My wife has had fever and muscle soreness to where I have to help her stand up and get out of bed. She is convinced she is dying. Please help.We have been to the clinic twice since this started but since she has no respiratory problems they did not test for covid. She had a chest x-rayMe and our 1 year old are fine. Wife did not get the flu shot this year so we think it might be related but for 19 days seems outrageous.She has been prescribed antibiotics and tamiflu which she finished two days ago.She gets fevers around 2pm and closer to bed time around 9pm. They've been around 102 on average and peaking at 102.9 a few days ago.We're scared because this hasn't let up for 19 days. Are there side effects if your body stays at fever temperature for long periods of time?Is 19 days unheard of for the flu?? Is it likely something else?31 F 5'9 188 lbs. Caucasian.Taking Tylenol regularly to fight fever and achesUpdate: Wife is in hospital. Thank you for the help.I can't be with her yet. All of our normal sitters and family are either out of town, unavailable or also sick.They would not let us bring the baby in so I'm just home waiting for info. She is at least in good hands.

Output: She'd almost certainly have a headache though and I see no mention of that.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: For 19 days, My wife has had fever and muscle soreness to where I have to help her stand up and get out of bed. She is convinced she is dying. Please help.We have been to the clinic twice since this started but since she has no respiratory problems they did not test for covid. She had a chest x-rayMe and our 1 year old are fine. Wife did not get the flu shot this year so we think it might be related but for 19 days seems outrageous.She has been prescribed antibiotics and tamiflu which she finished two days ago.She gets fevers around 2pm and closer to bed time around 9pm. They've been around 102 on average and peaking at 102.9 a few days ago.We're scared because this hasn't let up for 19 days. Are there side effects if your body stays at fever temperature for long periods of time?Is 19 days unheard of for the flu?? Is it likely something else?31 F 5'9 188 lbs. Caucasian.Taking Tylenol regularly to fight fever and achesUpdate: Wife is in hospital. Thank you for the help.I can't be with her yet. All of our normal sitters and family are either out of town, unavailable or also sick.They would not let us bring the baby in so I'm just home waiting for info. She is at least in good hands.. ### Response: She'd almost certainly have a headache though and I see no mention of that..


Instruction: Headache can sometimes manifest as neck pain if its referred pain, I just wouldnt rule out.

Output: Right, but I've never heard of neck pain without headache. It's referred from the meninges so it'd be very strange to present like that. It's always possible but the likelihood is maybe < 1%? Additionally, symptoms typically start improving within 7-10 days.Any answer on the mono testing? If shes never had mono it can be pretty brutal. Comes with neck pain and fevers for sure.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Headache can sometimes manifest as neck pain if its referred pain, I just wouldnt rule out.. ### Response: Right, but I've never heard of neck pain without headache. It's referred from the meninges so it'd be very strange to present like that. It's always possible but the likelihood is maybe < 1%? Additionally, symptoms typically start improving within 7-10 days.Any answer on the mono testing? If shes never had mono it can be pretty brutal. Comes with neck pain and fevers for sure..


Instruction: How severe is the neck pain? Look up Kernigs sign. Its a maneuver you can do to test for meningitis. Meningitis is the inflammation of the lining of the spinal cord and meninges in the brain. It can be caused by both virus or bacteria. Shed be positive if she has extreme pain and cant extend past 90. If thats positive, you need to call the doctor/ED. Also, meningitis can cause a pinpoint rash. If shes darker skinned, you could see it more easily on the palms and soles of the feet. Rashes May also appear with prolonged fever. You can do the tumbler test where you take a clear glass and press it against the rash. If redness goes away when pressed, then its negative. If you can see the rash still through the glass, then its positive. Its sounding more like Mono. If possible, see if the doctor can test. Mono needs to run its course, but it can have some complications. One of them in enlarged spleen, so no sports and if she has sudden upper left abdominal pain go straight to the ER. It also can cause liver issues, so watch out for jaundice which is yellowing if the skin. I hope she starts feeling better soon OP!

Output: I'd be careful about posting medical advice like you are without fact checking.Kernig's is actually a pretty bad test for meningitis. It has a sensitivity of only 5% and a PPV of 27%. That's pretty awful. I also wouldn't recommend for untrained people to test it on themselves or their loved ones.Not all types of meningitis causes a rash. I believe you're referring to meningococcemia. I think this diagnosis is extremely unlikely as she has been having symptoms for 19 days. She would be dead by now. Symptoms of meningococcemia progress very rapidly. Also, the tumbler test is also a pretty bad test and all it does it to be able to differentiate petechiae from other blanchable rashes. It's not specific to meningococcemia and can also just be done with a finger."Prolonged fever" do not cause rash. I am not sure what you are referring to here. Yes, a lot of diseases that can cause fever are also associated with rashes but it's not the fever itself that leads to a rash.I don't think Mono is likely here. While some of the symptoms would match, it would be unlikely to have persistent fevers for 19 days with simple mono.OP, I believe that at this point a visit to the hospital is warranted if your wife is as impaired as you are describing it.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: How severe is the neck pain? Look up Kernigs sign. Its a maneuver you can do to test for meningitis. Meningitis is the inflammation of the lining of the spinal cord and meninges in the brain. It can be caused by both virus or bacteria. Shed be positive if she has extreme pain and cant extend past 90. If thats positive, you need to call the doctor/ED. Also, meningitis can cause a pinpoint rash. If shes darker skinned, you could see it more easily on the palms and soles of the feet. Rashes May also appear with prolonged fever. You can do the tumbler test where you take a clear glass and press it against the rash. If redness goes away when pressed, then its negative. If you can see the rash still through the glass, then its positive. Its sounding more like Mono. If possible, see if the doctor can test. Mono needs to run its course, but it can have some complications. One of them in enlarged spleen, so no sports and if she has sudden upper left abdominal pain go straight to the ER. It also can cause liver issues, so watch out for jaundice which is yellowing if the skin. I hope she starts feeling better soon OP!. ### Response: I'd be careful about posting medical advice like you are without fact checking.Kernig's is actually a pretty bad test for meningitis. It has a sensitivity of only 5% and a PPV of 27%. That's pretty awful. I also wouldn't recommend for untrained people to test it on themselves or their loved ones.Not all types of meningitis causes a rash. I believe you're referring to meningococcemia. I think this diagnosis is extremely unlikely as she has been having symptoms for 19 days. She would be dead by now. Symptoms of meningococcemia progress very rapidly. Also, the tumbler test is also a pretty bad test and all it does it to be able to differentiate petechiae from other blanchable rashes. It's not specific to meningococcemia and can also just be done with a finger."Prolonged fever" do not cause rash. I am not sure what you are referring to here. Yes, a lot of diseases that can cause fever are also associated with rashes but it's not the fever itself that leads to a rash.I don't think Mono is likely here. While some of the symptoms would match, it would be unlikely to have persistent fevers for 19 days with simple mono.OP, I believe that at this point a visit to the hospital is warranted if your wife is as impaired as you are describing it..


Instruction: THIS. NAD but same symptoms I had and it was sepsis. I was also sent home from doctor/ER twice before they realized it. Need to have blood taken for dx (in my case anyway).

Output: Please read our rule on claiming credentials

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: THIS. NAD but same symptoms I had and it was sepsis. I was also sent home from doctor/ER twice before they realized it. Need to have blood taken for dx (in my case anyway).. ### Response: Please read our rule on claiming credentials.


Instruction: I wouldnt worry about COVID right now. As your wife is probably septic and requires urgent care to live and prevent death.Spesis KillsSorry to sound blunt please update us

Output: This is your final warning on claiming credentials without verification.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I wouldnt worry about COVID right now. As your wife is probably septic and requires urgent care to live and prevent death.Spesis KillsSorry to sound blunt please update us. ### Response: This is your final warning on claiming credentials without verification..


Instruction: Ok. Can you please send me the information so I can send through my information. Kind regards Rachelle. Sorry I have never done this before.

Output: Posts by unflaired users that claim legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ok. Can you please send me the information so I can send through my information. Kind regards Rachelle. Sorry I have never done this before.. ### Response: Posts by unflaired users that claim legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification..


Instruction: Exactly. Ive seen a couple cases like this. Id still recommend for OP to have her checked in the ED. Would rather not miss another explanation such as underlying infection and like others have mentioned possibly sepsis. Id suspect an infectious source will need to be ruled out first as it can then be treated with antibiotics and is more lethal. If nothing is identified from labs/imaging maybe further pursue labs to rule out rheumatoid arthritis.

Output: This sounds like it could be mono. It's possible she's septic from various sources but I'd think they would have been ruled out by the clinic you went to.Has she been getting worse or does it seem like she was bad at first and has stayed at that level?What does she doe for work? Has she had any sick contacts?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Exactly. Ive seen a couple cases like this. Id still recommend for OP to have her checked in the ED. Would rather not miss another explanation such as underlying infection and like others have mentioned possibly sepsis. Id suspect an infectious source will need to be ruled out first as it can then be treated with antibiotics and is more lethal. If nothing is identified from labs/imaging maybe further pursue labs to rule out rheumatoid arthritis.. ### Response: This sounds like it could be mono. It's possible she's septic from various sources but I'd think they would have been ruled out by the clinic you went to.Has she been getting worse or does it seem like she was bad at first and has stayed at that level?What does she doe for work? Has she had any sick contacts?.


Instruction: Can the flu be misdiagnosed as an upper respiratory infection?M14Height: 5'3"Weight: 145 lbsRace: WhiteComplaint: Very flu like symptoms; fever, aching body, being hot cold hot cold, chills, dry cough, the whole nine yards. Doctor did 15 minute flu test (nose swab) that came back negative and prescribed an inhaler and cough syrup for an upper respiratory infection.Existing medical issues: None to my knowledgeCurrent medicine and doses: Prescribed Fluticasone nasal spray; 2 sprays in each nostril and Poly-tussin liquidSmoke? No but secondhand smoke from parentsDrink? NoRecreational Drugs? NoAny help is greatly appreciated. I am happy to answer any questions.tl;dr Flu symtoms, got diagnosed with upper respiratory infection. Doesn't sound right.

Output: Flu technically is an upper respiratory infection (in general, though it can cause lower respiratory infections). The false negative rates of the rapid flu swab are pretty low, so while it is theoretically possible, I would just assume that it's true that you do not have the flu. The flu is just one of many, many related illnesses that all act similarly. Our rapid nasal swabs only test for that one specific virus (influenza), but there are tons of other viruses that we cannot rapidly test for and which could cause similar symptoms. You could have parainfluenza, human metapneumovirus, RSV, etc.The treatment is the same for all of them, inhaler, cough syrup, Tylenol/ibuprofen/naproxen and time.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can the flu be misdiagnosed as an upper respiratory infection?M14Height: 5'3"Weight: 145 lbsRace: WhiteComplaint: Very flu like symptoms; fever, aching body, being hot cold hot cold, chills, dry cough, the whole nine yards. Doctor did 15 minute flu test (nose swab) that came back negative and prescribed an inhaler and cough syrup for an upper respiratory infection.Existing medical issues: None to my knowledgeCurrent medicine and doses: Prescribed Fluticasone nasal spray; 2 sprays in each nostril and Poly-tussin liquidSmoke? No but secondhand smoke from parentsDrink? NoRecreational Drugs? NoAny help is greatly appreciated. I am happy to answer any questions.tl;dr Flu symtoms, got diagnosed with upper respiratory infection. Doesn't sound right.. ### Response: Flu technically is an upper respiratory infection (in general, though it can cause lower respiratory infections). The false negative rates of the rapid flu swab are pretty low, so while it is theoretically possible, I would just assume that it's true that you do not have the flu. The flu is just one of many, many related illnesses that all act similarly. Our rapid nasal swabs only test for that one specific virus (influenza), but there are tons of other viruses that we cannot rapidly test for and which could cause similar symptoms. You could have parainfluenza, human metapneumovirus, RSV, etc.The treatment is the same for all of them, inhaler, cough syrup, Tylenol/ibuprofen/naproxen and time..


Instruction: Ok. Thank you for answering! I do have a question though. How long should I stay out of school? I was planning to not go tomorrow, and have a doctors excuse to go back on the 5th. Is that good or should I stay out longer. A lot of kids have influenza but go anyway and the school won't shut down to prevent infections. On a sort of related note, I had RSV as a baby and have had bad lung function ever since I can remember.

Output: Just stay out of school until you're feeling better. The 5th sounds reasonable to return. Ideally people would not be in school when they're sick, but the reality is if you're in school you're going to get sick in the winter. Lots of babies have RSV, I don't know that it predisposes you to having it more as a teenager.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ok. Thank you for answering! I do have a question though. How long should I stay out of school? I was planning to not go tomorrow, and have a doctors excuse to go back on the 5th. Is that good or should I stay out longer. A lot of kids have influenza but go anyway and the school won't shut down to prevent infections. On a sort of related note, I had RSV as a baby and have had bad lung function ever since I can remember.. ### Response: Just stay out of school until you're feeling better. The 5th sounds reasonable to return. Ideally people would not be in school when they're sick, but the reality is if you're in school you're going to get sick in the winter. Lots of babies have RSV, I don't know that it predisposes you to having it more as a teenager..


Instruction: My dad had an upper respiratory infection and now I am nervous from being around him.Age: 44Sex: MHeight: 6'3Weight: 202lbsRace: WhiteDuration of complaint: NALocation: TennesseeAny existing relevant medical issues: NoCurrent medications: NAMy dad and sister went on a vacation trip to Peru roughly two weeks ago. About a week after returning from the trip he developed runny nose, chest congestion, probably a fever (never took his temp), and a bad cough. He is in his late 60s and already has a weakened immune system from a bone marrow transplant he had a few years ago, so he just chalked it up to the common rhinovirus cold that he seems to get every year. I went to visit him this past weekend (about a week after his symptoms started). He didn't have a fever or anything, but had a pretty bad cough the entire time I was there. All in all, he was healthy and out doing stuff the entire weekend. However, with so much coronavirus in the news, now I find myself contemplating whether or not its POSSIBLE he had it (I havent seen Peru in the news, but ya never know) and if I now possibly have it (I am currently observing no symptoms and was at his house from Friday to Sunday morning). He was not observing very good hygiene protocol with his coughs, and I had to chastise him numerous times for coughing into his hands or not covering up at all. Again, he had zero symptoms at time of visit other than a lingering cough. I guess my question is, should I be dedicating any real estate in my mind right now to worrying about this corona virus? It should be noted that my sister was in close proximity with my dad the entirety of the trip as well as a week after the trip when he started getting symptoms, and she has shown zero signs of anything. With all this panic in the news, I just find myself silently listening or observing my body for the onset of symptoms and its interfering with my daily life.

Output: You do not need to worry about 2019-nCov at all. There have only been 2 imported cases in Brazil and 1 imported case in Ecuador in all of Latin America. Even if there had been cases in Peru, the odds of him coming into contact with it would be very slim, and the Futher odds of you being at any sort of risk would be neglegible.Stop panicking about this, and get your flu shot every year.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My dad had an upper respiratory infection and now I am nervous from being around him.Age: 44Sex: MHeight: 6'3Weight: 202lbsRace: WhiteDuration of complaint: NALocation: TennesseeAny existing relevant medical issues: NoCurrent medications: NAMy dad and sister went on a vacation trip to Peru roughly two weeks ago. About a week after returning from the trip he developed runny nose, chest congestion, probably a fever (never took his temp), and a bad cough. He is in his late 60s and already has a weakened immune system from a bone marrow transplant he had a few years ago, so he just chalked it up to the common rhinovirus cold that he seems to get every year. I went to visit him this past weekend (about a week after his symptoms started). He didn't have a fever or anything, but had a pretty bad cough the entire time I was there. All in all, he was healthy and out doing stuff the entire weekend. However, with so much coronavirus in the news, now I find myself contemplating whether or not its POSSIBLE he had it (I havent seen Peru in the news, but ya never know) and if I now possibly have it (I am currently observing no symptoms and was at his house from Friday to Sunday morning). He was not observing very good hygiene protocol with his coughs, and I had to chastise him numerous times for coughing into his hands or not covering up at all. Again, he had zero symptoms at time of visit other than a lingering cough. I guess my question is, should I be dedicating any real estate in my mind right now to worrying about this corona virus? It should be noted that my sister was in close proximity with my dad the entirety of the trip as well as a week after the trip when he started getting symptoms, and she has shown zero signs of anything. With all this panic in the news, I just find myself silently listening or observing my body for the onset of symptoms and its interfering with my daily life.. ### Response: You do not need to worry about 2019-nCov at all. There have only been 2 imported cases in Brazil and 1 imported case in Ecuador in all of Latin America. Even if there had been cases in Peru, the odds of him coming into contact with it would be very slim, and the Futher odds of you being at any sort of risk would be neglegible.Stop panicking about this, and get your flu shot every year..


Instruction: 81 y/o female- respiratory distressMy grandmother got pneumonia this time last year. Currently she is achy, having trouble speaking, her throat hurts very bad. We went to the Doctor a few days ago, they took an X-ray of her lungs and said there was one area with fluid they wanted to keep an eye on but werent too worrisome. Today I call her and she can barely speak and is wheezing while breathing. Do we need to go to the emergency room?

Output: Yup

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 81 y/o female- respiratory distressMy grandmother got pneumonia this time last year. Currently she is achy, having trouble speaking, her throat hurts very bad. We went to the Doctor a few days ago, they took an X-ray of her lungs and said there was one area with fluid they wanted to keep an eye on but werent too worrisome. Today I call her and she can barely speak and is wheezing while breathing. Do we need to go to the emergency room?. ### Response: Yup.


Instruction: Post-Respiratory Illness - Cardio -- persistent elevated heart rateI have been sick with a respiratory illness for several weeks. I tested negative for the flu, the doc didn't think it was COVID-19 and would not test me. I have been on several antibiotics and I take the last dose tomorrow. It was mostly chest tightness and inflammation. I felt better today so I went for a run. I shortened the distance and intensity by half.About an hour after my run, my heart rate spiked to 99 bpm and my hands began trembling . It's varied this evening between 80-120 bpm all night at rest. My baseline is around 66 bpm. I have tested my temperature several times - no fever.Could this be something serious? It has me a bit concerned. Thank you41M5"10180 lbsSmoke (occasionally)Duration - 6 hours

Output: No way for us on here to tell you wholeheartedly whether this is serious or not. If it is bothering you then it is serious. Does this typically happen when you run? Cause I know for a fact when I run my heart rate shoots up as well. Very normal for this during physical activity. I would recommend stopping smoking if you are worried of respiratory illness.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Post-Respiratory Illness - Cardio -- persistent elevated heart rateI have been sick with a respiratory illness for several weeks. I tested negative for the flu, the doc didn't think it was COVID-19 and would not test me. I have been on several antibiotics and I take the last dose tomorrow. It was mostly chest tightness and inflammation. I felt better today so I went for a run. I shortened the distance and intensity by half.About an hour after my run, my heart rate spiked to 99 bpm and my hands began trembling . It's varied this evening between 80-120 bpm all night at rest. My baseline is around 66 bpm. I have tested my temperature several times - no fever.Could this be something serious? It has me a bit concerned. Thank you41M5"10180 lbsSmoke (occasionally)Duration - 6 hours. ### Response: No way for us on here to tell you wholeheartedly whether this is serious or not. If it is bothering you then it is serious. Does this typically happen when you run? Cause I know for a fact when I run my heart rate shoots up as well. Very normal for this during physical activity. I would recommend stopping smoking if you are worried of respiratory illness..