Instruction: 31F, ~125 lbs in NYC (a hard-hit neighborhood in Brooklyn). Pre-existing conditions: classical EDS (with ID'd genetic mutation) and mild dysautonomia. In 2018 I had a very bad case of mono and by early 2020 was just getting over the fatigue from it.I've been sick with suspected covid-19 for almost a month now and just can't seem to get 100% over it. Week 2 was the worst, couldn't eat and lost almost 10 pounds (was originally at 130 lbs and now starting to gain a little of it back) and had chest pain. I had ordered a pulse oximeter, which arrived halfway through Week 3. Readings are mostly normal, it once dipped to 94 briefly. Have had persistent low-grade 100-degree fever (99.5-100.3) that lessens a little at night and worsens in the afternoon, comes with chills and sweats. Pretty fatigued and get winded doing normal things in my apartment like cooking (I live alone.) I have swollen lymph nodes (two that have bugged me since the mono that swell with any infection since then, one on the back of my head and one in my thigh [?!], other lymph nodes affected through this were the ones in my armpits and groin).After 4 weeks of fever, my PCP asked me to come in for a physical and bloodwork. Lungs sounded fine, temp measured 99.4 in the office (morning), throat was red, lymph nodes in armpits were felt by her but didn't seem unusually large. Metabolic panel and CBC came back normal -- not even elevated white blood cell count. Dr was a little concerned about the buggy lymph node in my thigh and said it should be imaged when the pandemic is over....but that will probably be months from now. I was diagnosed with "fever of unknown origin." Tylenol and Aleve relieve some discomfort, but don't bring the low-grade fever down. It just likes to stay put at about 100. (I normally run in the 97s-98s.)I am starting to worry about lymphoma because of that lymph node. It was imaged (ultrasound) when it first appeared in 2018 and was deemed large but noncancerous. Since then I've caught some more bugs than usual but attributed that to recovering from mono and a particularly bad cold/flu season in the city.My PCP is getting harder and harder to reach since she is now working in the ER to help those that are in dire need of help, and I don't want to bother her too much since I'm not dying...I'm just mildly ill and not getting better.Are there cases of mild covid19 that just seem to linger on and on and on like this? I had some friends who had mild cases around the same time as me and recovered in 2 weeks and are completely better now. I'm nearing 5 weeks and still sick. Is this just how covid19 is in some people, or do I need to be worried about cancer? I'm sorry, just really scared and won't be able to get regular/thorough medical help for the time being.

Output: Most likely prolonged recovery. Lymphoma very very unlikely, but review with your primary doctor when theyre back open.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 31F, ~125 lbs in NYC (a hard-hit neighborhood in Brooklyn). Pre-existing conditions: classical EDS (with ID'd genetic mutation) and mild dysautonomia. In 2018 I had a very bad case of mono and by early 2020 was just getting over the fatigue from it.I've been sick with suspected covid-19 for almost a month now and just can't seem to get 100% over it. Week 2 was the worst, couldn't eat and lost almost 10 pounds (was originally at 130 lbs and now starting to gain a little of it back) and had chest pain. I had ordered a pulse oximeter, which arrived halfway through Week 3. Readings are mostly normal, it once dipped to 94 briefly. Have had persistent low-grade 100-degree fever (99.5-100.3) that lessens a little at night and worsens in the afternoon, comes with chills and sweats. Pretty fatigued and get winded doing normal things in my apartment like cooking (I live alone.) I have swollen lymph nodes (two that have bugged me since the mono that swell with any infection since then, one on the back of my head and one in my thigh [?!], other lymph nodes affected through this were the ones in my armpits and groin).After 4 weeks of fever, my PCP asked me to come in for a physical and bloodwork. Lungs sounded fine, temp measured 99.4 in the office (morning), throat was red, lymph nodes in armpits were felt by her but didn't seem unusually large. Metabolic panel and CBC came back normal -- not even elevated white blood cell count. Dr was a little concerned about the buggy lymph node in my thigh and said it should be imaged when the pandemic is over....but that will probably be months from now. I was diagnosed with "fever of unknown origin." Tylenol and Aleve relieve some discomfort, but don't bring the low-grade fever down. It just likes to stay put at about 100. (I normally run in the 97s-98s.)I am starting to worry about lymphoma because of that lymph node. It was imaged (ultrasound) when it first appeared in 2018 and was deemed large but noncancerous. Since then I've caught some more bugs than usual but attributed that to recovering from mono and a particularly bad cold/flu season in the city.My PCP is getting harder and harder to reach since she is now working in the ER to help those that are in dire need of help, and I don't want to bother her too much since I'm not dying...I'm just mildly ill and not getting better.Are there cases of mild covid19 that just seem to linger on and on and on like this? I had some friends who had mild cases around the same time as me and recovered in 2 weeks and are completely better now. I'm nearing 5 weeks and still sick. Is this just how covid19 is in some people, or do I need to be worried about cancer? I'm sorry, just really scared and won't be able to get regular/thorough medical help for the time being.. ### Response: Most likely prolonged recovery. Lymphoma very very unlikely, but review with your primary doctor when theyre back open..


Instruction: Does anyone know if taking antibiotics for a bacterial infection while potentially being infected with coronavirus is dangerous?Ive had a fever the last couple days with sever headaches, however I dont fit the criteria for testing where I live. This morning I noticed what seems to be a times flare up on my left foot. A couple hours later and my toe has swollen and there is a redness spreading slowly up my foot. I spoke to a doctor over the phone and mentioned the fever, and gave my other symptoms. The doctor prescribed me with some antibiotics for my foot and said theyll fax to the pharmacy for me.Im just worried that the antibiotics would be detrimental to my immune system if I do have covid-19.

Output: No benefit but doesnt seem to worsen things either. Current agreement is to give antibiotics if any suggestion of a bacterial infection instead of/in addition to COVID.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Does anyone know if taking antibiotics for a bacterial infection while potentially being infected with coronavirus is dangerous?Ive had a fever the last couple days with sever headaches, however I dont fit the criteria for testing where I live. This morning I noticed what seems to be a times flare up on my left foot. A couple hours later and my toe has swollen and there is a redness spreading slowly up my foot. I spoke to a doctor over the phone and mentioned the fever, and gave my other symptoms. The doctor prescribed me with some antibiotics for my foot and said theyll fax to the pharmacy for me.Im just worried that the antibiotics would be detrimental to my immune system if I do have covid-19.. ### Response: No benefit but doesnt seem to worsen things either. Current agreement is to give antibiotics if any suggestion of a bacterial infection instead of/in addition to COVID..


Instruction: I and my mother just came back from England 10 days ago (flew to Romania). We're in self-isolation, haven't gone out even for shopping. When we were at the border the doctor told us to call our GP or 112 (emergency number) if we get symptoms. I have just heard Mom properly cough, very loudly and persistently, and it lasted a while. The airport and plane were very crowded so I wouldn't be surprised if we have it. Mom doesn't want to call our GP because she is afraid of a hospital quarantine. 112 seems a bit drastic for some coughing. There's a national covid19 information hotline. Should I call them? Should I just talk to her and we agree to continue self-isolating for a month beyond the government enforced period? If I am honest, I'm kind of scared of a hospital quarantine too because I feel like it might make her (and maybe me) worse. I'd much rather just self-isolate at home, but I feel like if we don't know she/I are positive she'll really want to go out grocery shopping and stuff. She's also probably going to want to meet with my Dad (who is 64, has diabetes, hypertension, liver problems, is overweight and has had a benging tumor in his intestine for which he's been operated). She's 49 and I'm 17. Should I not call anybody and just talk to her? Call the hotline? Call 112?

Output: I dont know what measures Romainia is taking but I would encourage you to follow all local guidance. If the cough lasts more than an hour then call.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I and my mother just came back from England 10 days ago (flew to Romania). We're in self-isolation, haven't gone out even for shopping. When we were at the border the doctor told us to call our GP or 112 (emergency number) if we get symptoms. I have just heard Mom properly cough, very loudly and persistently, and it lasted a while. The airport and plane were very crowded so I wouldn't be surprised if we have it. Mom doesn't want to call our GP because she is afraid of a hospital quarantine. 112 seems a bit drastic for some coughing. There's a national covid19 information hotline. Should I call them? Should I just talk to her and we agree to continue self-isolating for a month beyond the government enforced period? If I am honest, I'm kind of scared of a hospital quarantine too because I feel like it might make her (and maybe me) worse. I'd much rather just self-isolate at home, but I feel like if we don't know she/I are positive she'll really want to go out grocery shopping and stuff. She's also probably going to want to meet with my Dad (who is 64, has diabetes, hypertension, liver problems, is overweight and has had a benging tumor in his intestine for which he's been operated). She's 49 and I'm 17. Should I not call anybody and just talk to her? Call the hotline? Call 112?. ### Response: I dont know what measures Romainia is taking but I would encourage you to follow all local guidance. If the cough lasts more than an hour then call..


Instruction: I heard her, she had breaks but it was very very loud and it was about an hour, she was trying to silence it and go to sleep. Im not sure how seriously they mean call 112 though. Ill call the information hotline in the morning and see what they say.

Output: There is a strong chance she has covid. Follow all local guidelines

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I heard her, she had breaks but it was very very loud and it was about an hour, she was trying to silence it and go to sleep. Im not sure how seriously they mean call 112 though. Ill call the information hotline in the morning and see what they say.. ### Response: There is a strong chance she has covid. Follow all local guidelines.


Instruction: I'm trying to find an answer to this because the CDC released conflicting information.How much benefit is there to cloth/homemade masks? My understanding is they don't help much, they don't block coronavirus, and if anything they increase risk because people are constantly touching/removing/adjusting them.Surely there isn't much benefit in wearing a homemade mask at work if I have to remove it for lunch and then put it back on. I'm just touching my face more.

Output: The benefit of the public wearing masks is really going to be in prevention of transmission from folks that are asymptomatic but spreading the virus. You could be spreading it right now. Please wear a mask so that you don't get others sick. We don't know exactly how much benefit this will have, but it's a simple enough thing to ask people to do.You shouldn't be touching your face at all when removing a cloth mask.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I'm trying to find an answer to this because the CDC released conflicting information.How much benefit is there to cloth/homemade masks? My understanding is they don't help much, they don't block coronavirus, and if anything they increase risk because people are constantly touching/removing/adjusting them.Surely there isn't much benefit in wearing a homemade mask at work if I have to remove it for lunch and then put it back on. I'm just touching my face more.. ### Response: The benefit of the public wearing masks is really going to be in prevention of transmission from folks that are asymptomatic but spreading the virus. You could be spreading it right now. Please wear a mask so that you don't get others sick. We don't know exactly how much benefit this will have, but it's a simple enough thing to ask people to do.You shouldn't be touching your face at all when removing a cloth mask..


Instruction: An article mentioned that hypertension is a significant risk factor.Does this refer to untreated hypertension or treated, or both?If someone had hypertension that has been successfully treated for years or decades, is it still a risk factor?

Output: Hypertension seems to be a risk factor. Whether that is because of the hypertension itself or because of the associated micro and macrovascular damage cause by untreated hypertension we do not know.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: An article mentioned that hypertension is a significant risk factor.Does this refer to untreated hypertension or treated, or both?If someone had hypertension that has been successfully treated for years or decades, is it still a risk factor?. ### Response: Hypertension seems to be a risk factor. Whether that is because of the hypertension itself or because of the associated micro and macrovascular damage cause by untreated hypertension we do not know..


Instruction: Allergy season is coming up, which means sneezes and sniffles. Currently I take a steroidal nose spray to cope, I also have access to non-steroidals if needed. Will a steroid nose spray have any negative affects vis-a-vis covid19? I do not have it, but dont want to make things more difficult than it needs to be.

Output: Nasal steroids safe to continue

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Allergy season is coming up, which means sneezes and sniffles. Currently I take a steroidal nose spray to cope, I also have access to non-steroidals if needed. Will a steroid nose spray have any negative affects vis-a-vis covid19? I do not have it, but dont want to make things more difficult than it needs to be.. ### Response: Nasal steroids safe to continue.


Instruction: I keep hearing "I had the virus back in November!"In November of 2019, there wasn't a surge of deaths and hospitals becoming inundated with ill people.The virus didn't just decide to start becoming highly contagious in March 2020.I find it hard to believe these people actually did have it already months ago.

Output: Unless these people were living in Wuhan then it is phenomenally unlikely they had covid in November.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I keep hearing "I had the virus back in November!"In November of 2019, there wasn't a surge of deaths and hospitals becoming inundated with ill people.The virus didn't just decide to start becoming highly contagious in March 2020.I find it hard to believe these people actually did have it already months ago.. ### Response: Unless these people were living in Wuhan then it is phenomenally unlikely they had covid in November..


Instruction: Someone told me it was a matter of controversy that COVID-19 is transmitted via breath.Is that controversial like it is controversial to say that smoking causing lung cancer? :-).

Output: Theyre talking nonsense

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Someone told me it was a matter of controversy that COVID-19 is transmitted via breath.Is that controversial like it is controversial to say that smoking causing lung cancer? :-).. ### Response: Theyre talking nonsense.


Instruction: What is a good source of news about the progress of the pandemic?I tried MedCram on youtube, but it goes off on tangents.People keep recommending web sites teenagers built.I would like a news source that would tell me the numbers, the trends, what has been learned, and what the recommendations are.

Output: In terms of hard stats on numbers of cases/deaths etc http://worldometers.infoIn terms of everything else the ebook listed at the top of the FAQ

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: What is a good source of news about the progress of the pandemic?I tried MedCram on youtube, but it goes off on tangents.People keep recommending web sites teenagers built.I would like a news source that would tell me the numbers, the trends, what has been learned, and what the recommendations are.. ### Response: In terms of hard stats on numbers of cases/deaths etc http://worldometers.infoIn terms of everything else the ebook listed at the top of the FAQ.


Instruction: Can someone who was sick in Feb with what they thought was the flu, now test positive for Covid-19?Or in other words, is the virus similar to Hep-C where you can still test positive weeks after recovery because of antibodies?

Output: There is no reliable antibody test yet available.Once one exists it should be able to confirm exposure within the last year, perhaps longer. The immune response still not fully understood.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can someone who was sick in Feb with what they thought was the flu, now test positive for Covid-19?Or in other words, is the virus similar to Hep-C where you can still test positive weeks after recovery because of antibodies?. ### Response: There is no reliable antibody test yet available.Once one exists it should be able to confirm exposure within the last year, perhaps longer. The immune response still not fully understood..


Instruction: Age 23. Female. North Colorado. 55. Maybe 105 pounds. I have Ehlers Danlos Syndrome with Vascular Complications, Gastroparesis, and an AVM in my dueduom that bleeds periodically ( started bleeding again yesterday) (currently anemic because of this). My father recently told my family that he tested for antibodies of covid. I lived with him from Feb 29- April 3. He was sick from March 23- April 1. I developed a low grade fever last night as well as a headache, and have been very lethargic. Would I be able to be tested without proof that he has antibodies? He and I arent on good terms and I am very concerned. I am also concerned as I lost health insurance April 1st and havent secured a new plan yet.

Output: Current antibody tests (particularly the home testing kits) are not accurate and of no diagnostic use.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Age 23. Female. North Colorado. 55. Maybe 105 pounds. I have Ehlers Danlos Syndrome with Vascular Complications, Gastroparesis, and an AVM in my dueduom that bleeds periodically ( started bleeding again yesterday) (currently anemic because of this). My father recently told my family that he tested for antibodies of covid. I lived with him from Feb 29- April 3. He was sick from March 23- April 1. I developed a low grade fever last night as well as a headache, and have been very lethargic. Would I be able to be tested without proof that he has antibodies? He and I arent on good terms and I am very concerned. I am also concerned as I lost health insurance April 1st and havent secured a new plan yet.. ### Response: Current antibody tests (particularly the home testing kits) are not accurate and of no diagnostic use..


Instruction: Is it safe to go outside for walks? I'm obese and therefore more likely at risk due to my condition, so I'm trying to lose weight. I would get a mask obviously.

Output: Yes walks alone in open spaces should be fine. That said follow local guidelines - some countries forbid anything but trips out to collect food.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Is it safe to go outside for walks? I'm obese and therefore more likely at risk due to my condition, so I'm trying to lose weight. I would get a mask obviously.. ### Response: Yes walks alone in open spaces should be fine. That said follow local guidelines - some countries forbid anything but trips out to collect food..


Instruction: Many sources earlier this year kept stressing that the flu was worse than covid19. The flu has been around for a long time. covid19 was new and no one knew much about it yet people kept saying the flu was worse. Now we're where we are now. Why didn't people take it more seriously?

Output: Those sources were probably not scientists or doctors. This was never not worse than the flu. This is what bad journalism does to our society

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Many sources earlier this year kept stressing that the flu was worse than covid19. The flu has been around for a long time. covid19 was new and no one knew much about it yet people kept saying the flu was worse. Now we're where we are now. Why didn't people take it more seriously?. ### Response: Those sources were probably not scientists or doctors. This was never not worse than the flu. This is what bad journalism does to our society.


Instruction: Hi guys, this might be a bit of a stupid question, but four weeks ago my ear temperature hit 38 degrees, naturally it scared me so I self isolated, I tried to go on my PC again after 10 days and the same thing happened again. Skip forward another 20 days to today, and it's happened again (37.8 this time)... Can headsets make your temperature rise by like a whole degree? My temp was 37.1 when I went on my PC. I've felt fine for almost three weeks until today. Also can anxiety cause this? cos I am very anxious/stressed basically constantly atm and do suffer from diagnosed severe anxiety.

Output: I would certainly suggest taking off your headset for an hour then rechecking.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Hi guys, this might be a bit of a stupid question, but four weeks ago my ear temperature hit 38 degrees, naturally it scared me so I self isolated, I tried to go on my PC again after 10 days and the same thing happened again. Skip forward another 20 days to today, and it's happened again (37.8 this time)... Can headsets make your temperature rise by like a whole degree? My temp was 37.1 when I went on my PC. I've felt fine for almost three weeks until today. Also can anxiety cause this? cos I am very anxious/stressed basically constantly atm and do suffer from diagnosed severe anxiety.. ### Response: I would certainly suggest taking off your headset for an hour then rechecking..


Instruction: Whats the deal with NSAIDs? Are we able to take them? I dont have covid, just being cautious. Specifically looking to use topical voltaren gel for chronic neck pain. Any advice is appreciated!

Output: Recent review found no evidence that NSAIDs worsen covid. Youre definitely okay to use NSAID gel such as voltarol.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Whats the deal with NSAIDs? Are we able to take them? I dont have covid, just being cautious. Specifically looking to use topical voltaren gel for chronic neck pain. Any advice is appreciated!. ### Response: Recent review found no evidence that NSAIDs worsen covid. Youre definitely okay to use NSAID gel such as voltarol..


Instruction: Why cant blood and organ UV radiation be a treatment for Coronavirus?Okay, I know how stupid that sounds, but I didnt want to jump on the bandwagon so I did a couple of minutes of research and I just want to hear from people who know better why this thinking is wrong.I know external UV radiation would not do anything, however:Uv radiation and high humidity has been found to be very effective at killing the coronavirus :https://www.google.com/amp/s/www.aljazeera.com/amp/news/2020/04/sunlight-humidity-kill-coronavirus-fastest-scientists-200424065853466.htmlUltraviolet irradiation of the blood used to be used to treat diseases like pneumonia before antibiotics in the 1950s :https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122858/Ultraviolet radiation has been used or suggested before as a way to sterilize organs during organ transplants:https://www.jhltonline.org/article/S1053-2498(18)30378-4/abstracthttps://www.efe.com/efe/english/technology/brazil-develops-technology-for-sterilizing-organ-transplants/50000267-3933369So what is stopping doctors from, in the worst case scenarios, treating critically ill coronavirus patients by irradiating their blood and/or a lung?

Output: Beware quackery.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Why cant blood and organ UV radiation be a treatment for Coronavirus?Okay, I know how stupid that sounds, but I didnt want to jump on the bandwagon so I did a couple of minutes of research and I just want to hear from people who know better why this thinking is wrong.I know external UV radiation would not do anything, however:Uv radiation and high humidity has been found to be very effective at killing the coronavirus :https://www.google.com/amp/s/www.aljazeera.com/amp/news/2020/04/sunlight-humidity-kill-coronavirus-fastest-scientists-200424065853466.htmlUltraviolet irradiation of the blood used to be used to treat diseases like pneumonia before antibiotics in the 1950s :https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122858/Ultraviolet radiation has been used or suggested before as a way to sterilize organs during organ transplants:https://www.jhltonline.org/article/S1053-2498(18)30378-4/abstracthttps://www.efe.com/efe/english/technology/brazil-develops-technology-for-sterilizing-organ-transplants/50000267-3933369So what is stopping doctors from, in the worst case scenarios, treating critically ill coronavirus patients by irradiating their blood and/or a lung?. ### Response: Beware quackery..


Instruction: F23 Respiratory Sinus ArrhythmiaHi, I was recently diagnosed with Respiratory Sinus Arrhythmia and prescribed an inhaler. I was only told to use "as needed" but I have been having trouble figuring out when "as needed" applies. Do I only use it when I feel like I'm having an onset attack? Or at night when I lay down to sleep and my symptoms seem more noticeable? Are both situations applicable? Also any advice on lifestyle changes to ease my symptoms? Thank you in advance.

Output: A "respiratory sinus arrhythmia" is an absolutely normal phenomenon and doesn't need to be treated, as it's normal. What was the inhaler prescribed for?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: F23 Respiratory Sinus ArrhythmiaHi, I was recently diagnosed with Respiratory Sinus Arrhythmia and prescribed an inhaler. I was only told to use "as needed" but I have been having trouble figuring out when "as needed" applies. Do I only use it when I feel like I'm having an onset attack? Or at night when I lay down to sleep and my symptoms seem more noticeable? Are both situations applicable? Also any advice on lifestyle changes to ease my symptoms? Thank you in advance.. ### Response: A "respiratory sinus arrhythmia" is an absolutely normal phenomenon and doesn't need to be treated, as it's normal. What was the inhaler prescribed for?.


Instruction: I was also confused when the physician said she was prescribing an inhaler, the main things I complained about was a feeling of pressure in my chest and my heart feeling as if it was beating faster, but too softly, then skipping a beat and beating harder as if to compensate for the lost beat. I also mentioned how a little over 2 weeks ago I had a severe attack that was causing my muscles to twitch and spasm and i was sweating. The papers from my discharge say asthma but asthma was never mentioned during the visit.

Output: Agree with above post. Your doc may have prescribed as a diagnostic/therapeutic trial for some symptoms, but ran out of time to explain it all to you. I'd get in touch with the person who prescribed it to you and ask them, as inhalers aren't typically used in this situation.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I was also confused when the physician said she was prescribing an inhaler, the main things I complained about was a feeling of pressure in my chest and my heart feeling as if it was beating faster, but too softly, then skipping a beat and beating harder as if to compensate for the lost beat. I also mentioned how a little over 2 weeks ago I had a severe attack that was causing my muscles to twitch and spasm and i was sweating. The papers from my discharge say asthma but asthma was never mentioned during the visit.. ### Response: Agree with above post. Your doc may have prescribed as a diagnostic/therapeutic trial for some symptoms, but ran out of time to explain it all to you. I'd get in touch with the person who prescribed it to you and ask them, as inhalers aren't typically used in this situation..


Instruction: 30 F Not feeling fully recovered 1 month after a Myasthenic Crisis and Acute Respiratory failure30 Female, medical conditions: Myasthenia Gravis, Chronic MigraineMeds: Mestonin 60mg every 4 hours, Cellcept 2x day ( 1st month on medicine)It's been a little over a month since I had a Myasthenic Crisis and was hospitalized in the ICU. I had three days of high-dose steroids and plasmapheresis for 5 days. I was feeling better respiratory-wise but still felt very tired and not back to 100% of where I was before the crisis. I was put on Cellcept by my neuro immediately after release and so far it has made me have less droopy eyes and mouth but I haven't noticed much difference.( Note: I have been diagnosed since late 2019 and on Mestonin, they did not put me on other meds since I responded well at the time. It has since been suggested that the mestonin alone was no longer able to handle the disease and that is why I went into a myasthenic crisis)The past week I have felt the shortness of breath from the Myasthenia come back, and at times I have gone on my CPAP to help reduce the strain and it has made me feel better. I'm starting to feel fatigued again, but not at myasthenic crisis level, so I'm pretty sure the benefits of plasmapheresis wore off. My main concerns are:Is it normal to take a while to recover from a Myasthenic Crisis?Is the reemergence of shortness of breath a troubling symptom?Should I ask my neuro for another treatment or medication? ( I was warned it could take 2-6 months for CellCept to fully work)I do see my neuro early next week, but I'm not sure if these symptoms are troubling enough I should seek medical care sooner or if there are other suggestions I should bring up to my doctor when I see her.

Output: Yes you really need to contact your neuro doc. You are at risk for another crisis because you had one already. You may need ongoing weekly plasma exchange until you are on stable immunosuppressants. Your docs are the best ones to advise you, you aren't bothering them.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 30 F Not feeling fully recovered 1 month after a Myasthenic Crisis and Acute Respiratory failure30 Female, medical conditions: Myasthenia Gravis, Chronic MigraineMeds: Mestonin 60mg every 4 hours, Cellcept 2x day ( 1st month on medicine)It's been a little over a month since I had a Myasthenic Crisis and was hospitalized in the ICU. I had three days of high-dose steroids and plasmapheresis for 5 days. I was feeling better respiratory-wise but still felt very tired and not back to 100% of where I was before the crisis. I was put on Cellcept by my neuro immediately after release and so far it has made me have less droopy eyes and mouth but I haven't noticed much difference.( Note: I have been diagnosed since late 2019 and on Mestonin, they did not put me on other meds since I responded well at the time. It has since been suggested that the mestonin alone was no longer able to handle the disease and that is why I went into a myasthenic crisis)The past week I have felt the shortness of breath from the Myasthenia come back, and at times I have gone on my CPAP to help reduce the strain and it has made me feel better. I'm starting to feel fatigued again, but not at myasthenic crisis level, so I'm pretty sure the benefits of plasmapheresis wore off. My main concerns are:Is it normal to take a while to recover from a Myasthenic Crisis?Is the reemergence of shortness of breath a troubling symptom?Should I ask my neuro for another treatment or medication? ( I was warned it could take 2-6 months for CellCept to fully work)I do see my neuro early next week, but I'm not sure if these symptoms are troubling enough I should seek medical care sooner or if there are other suggestions I should bring up to my doctor when I see her.. ### Response: Yes you really need to contact your neuro doc. You are at risk for another crisis because you had one already. You may need ongoing weekly plasma exchange until you are on stable immunosuppressants. Your docs are the best ones to advise you, you aren't bothering them..


Instruction: Found out I have convex chest at 40 after years of respiratory issues, now what?I am a 40 year old white male. Recently I had some issues with what I believe to be acid reflux (possibly aided by too much coffee) and it made me vomit several times. After telling my doctor this he decided to do a chest x ray and so far has only told me I have a convex chest.As an aside, I have been trying to find answers to joint issues I've had since puberty. My knees feel like they pop off and back in, even when that hasn't happened they swell up and hurt severely if I'm on them too long.Tgis applies to other joints to a lesser degree, I also have scoliosis and severe back pain.What should I ask my doctor to do? What to test for? Sometimes I feel like I have to ask for things with him and I'm worried about my future health.Anyway, thank you for reading and kind regards.

Output: Chronic dyspnea and chest wall deformities make me think it might be worthwhile to be assessed by a pulmonologist. These lung doctors have a series of tests that can evaluate how much the chest wall deformity may be affecting your overall breathing, and if substantial have different ways of treating it.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Found out I have convex chest at 40 after years of respiratory issues, now what?I am a 40 year old white male. Recently I had some issues with what I believe to be acid reflux (possibly aided by too much coffee) and it made me vomit several times. After telling my doctor this he decided to do a chest x ray and so far has only told me I have a convex chest.As an aside, I have been trying to find answers to joint issues I've had since puberty. My knees feel like they pop off and back in, even when that hasn't happened they swell up and hurt severely if I'm on them too long.Tgis applies to other joints to a lesser degree, I also have scoliosis and severe back pain.What should I ask my doctor to do? What to test for? Sometimes I feel like I have to ask for things with him and I'm worried about my future health.Anyway, thank you for reading and kind regards.. ### Response: Chronic dyspnea and chest wall deformities make me think it might be worthwhile to be assessed by a pulmonologist. These lung doctors have a series of tests that can evaluate how much the chest wall deformity may be affecting your overall breathing, and if substantial have different ways of treating it..


Instruction: Need ideas from as many medical minds as possible please! Chronic respiratory failure - hypoxia. Worsening. Low BMI. Ruled out pulmonary and cardiac causes, whats in your differential?51F, 59, thin, white, USA. never-smoker, non-drinker; no prescriptions; unintended weight loss of now 28lbs since January, oxygen desats started in January w/ exertion, suddenly worsening in the past few days and now on continuous oxygen. Exhausted and weak. X-post for visibility. (This is for my mom)ETA see bottom of this, someone mentioned cervical spine issues, my mom has those, found in MRI in 2020!Ive posted about this a couple of times but need as many ideas as possible, and casting as wide a net as possible as weve hit a dead end and its looking bad.All pulmonary and cardiac testing done. Normal. (Only abnormal test so far has been an elevated 5-HIAA ordered bc hours-long intense hot facial flushing episodes began at the same time as the oxygen desats). Follow up with GI in 2 weeks.Over the past several days oxygen desats started coming on faster and going lower so after respiratory therapist consult now on continuous oxygen. Follow up with the pulmonary doc tomorrow but after 6 months of pulm/cardiac testing - and now sudden worsening of symptoms over the past few days - it seems like its time to look for other causes.What other specialist besides pulmonology or cardiology would you recommend? What would be in/on your differential list at this point?ETA: someone mentioned cervical spine issues causing this - here's her MRI of cervical spine and brain brief notes from neurologist about this from 2020:Her MRI of the C spine shows degenerative changes but most notable for disc protrusion at C6-C7 narrows the spinal canal to 5 mm. She is nearly asymptomatic at this point, but still encouraged her to discuss with neurosurgery for opinion given the findings.MRI of the brain shows multiple punctate foci, estimated at 30.

Output: I've been thinking about your mom since you posted last week about her worsening symptoms.The typical differential diagnosis for hypoxia is pretty simple to workup -- decreased partial pressure of oxygen (altitude), hypoventilation, decreased diffusion, VQ mismatch, and shunt). I would expect any reasonable pulmonologist could pretty easily work through that differential diagnosis, and I suspect if your mom got a shunt study that has gotten a thorough workup.There are some additional, rare causes of hypoxia/dyspnea that do exist. They are things that we predominantly see in the ICU, as they are typically acute causes. I categorize them as histocytotoxic and competitive. It's a bit complicated:Histocytotoxic causes do not exactly cause hypoxia. An example is cyanide. It uncouples the electron transport chain (ETC), which is the process of how cells utilize oxygen to make energy molecules). When the ETC is uncoupled/blocked you can not process oxygen, so physiologically it's like your body experiences extreme hypoxia. It's an immediately fatal process, so I can pretty much assure you your mom isn't dealing with cyanide toxicity. Perhaps you could bring up the idea of histocytoxic hypoxia to your mom's pulmonologist, though. She may have a chronic exposure to a substance that is causing hemoglobin dysfunction.Competetive hypoxia/hypoxemia is related to something that either outcompetes oxygen for hemoglobin binding or changes the hemoglobin conformation so that it no longer binds oxygen as well. There is something called methemoglobinemia (pronounced "met-hemoglobinemia", not meth-hemoglobinemia). It's also something we see on an acute setting in the hospital. There is a congenital/hereditary form, but it usually presents pretty immediately after birth. I wouldn't expect it to arise later in life like with your mother. There are plenty of acquired forms, but these usually happen acutely. It could also be worthwhile to bring up the idea of methemoglobin or other competitive forms of hypoxia/hypoxemia to your mom's pulmonologist.These are super rare and unlikely things, but it sure sounds like your mom doesn't have a common or simple problem. Hope this helps!

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Need ideas from as many medical minds as possible please! Chronic respiratory failure - hypoxia. Worsening. Low BMI. Ruled out pulmonary and cardiac causes, whats in your differential?51F, 59, thin, white, USA. never-smoker, non-drinker; no prescriptions; unintended weight loss of now 28lbs since January, oxygen desats started in January w/ exertion, suddenly worsening in the past few days and now on continuous oxygen. Exhausted and weak. X-post for visibility. (This is for my mom)ETA see bottom of this, someone mentioned cervical spine issues, my mom has those, found in MRI in 2020!Ive posted about this a couple of times but need as many ideas as possible, and casting as wide a net as possible as weve hit a dead end and its looking bad.All pulmonary and cardiac testing done. Normal. (Only abnormal test so far has been an elevated 5-HIAA ordered bc hours-long intense hot facial flushing episodes began at the same time as the oxygen desats). Follow up with GI in 2 weeks.Over the past several days oxygen desats started coming on faster and going lower so after respiratory therapist consult now on continuous oxygen. Follow up with the pulmonary doc tomorrow but after 6 months of pulm/cardiac testing - and now sudden worsening of symptoms over the past few days - it seems like its time to look for other causes.What other specialist besides pulmonology or cardiology would you recommend? What would be in/on your differential list at this point?ETA: someone mentioned cervical spine issues causing this - here's her MRI of cervical spine and brain brief notes from neurologist about this from 2020:Her MRI of the C spine shows degenerative changes but most notable for disc protrusion at C6-C7 narrows the spinal canal to 5 mm. She is nearly asymptomatic at this point, but still encouraged her to discuss with neurosurgery for opinion given the findings.MRI of the brain shows multiple punctate foci, estimated at 30.. ### Response: I've been thinking about your mom since you posted last week about her worsening symptoms.The typical differential diagnosis for hypoxia is pretty simple to workup -- decreased partial pressure of oxygen (altitude), hypoventilation, decreased diffusion, VQ mismatch, and shunt). I would expect any reasonable pulmonologist could pretty easily work through that differential diagnosis, and I suspect if your mom got a shunt study that has gotten a thorough workup.There are some additional, rare causes of hypoxia/dyspnea that do exist. They are things that we predominantly see in the ICU, as they are typically acute causes. I categorize them as histocytotoxic and competitive. It's a bit complicated:Histocytotoxic causes do not exactly cause hypoxia. An example is cyanide. It uncouples the electron transport chain (ETC), which is the process of how cells utilize oxygen to make energy molecules). When the ETC is uncoupled/blocked you can not process oxygen, so physiologically it's like your body experiences extreme hypoxia. It's an immediately fatal process, so I can pretty much assure you your mom isn't dealing with cyanide toxicity. Perhaps you could bring up the idea of histocytoxic hypoxia to your mom's pulmonologist, though. She may have a chronic exposure to a substance that is causing hemoglobin dysfunction.Competetive hypoxia/hypoxemia is related to something that either outcompetes oxygen for hemoglobin binding or changes the hemoglobin conformation so that it no longer binds oxygen as well. There is something called methemoglobinemia (pronounced "met-hemoglobinemia", not meth-hemoglobinemia). It's also something we see on an acute setting in the hospital. There is a congenital/hereditary form, but it usually presents pretty immediately after birth. I wouldn't expect it to arise later in life like with your mother. There are plenty of acquired forms, but these usually happen acutely. It could also be worthwhile to bring up the idea of methemoglobin or other competitive forms of hypoxia/hypoxemia to your mom's pulmonologist.These are super rare and unlikely things, but it sure sounds like your mom doesn't have a common or simple problem. Hope this helps!.


Instruction: Can coronavirus present as a cough and shortness of breath without other severe symptoms?I know you guys get a stupid amount of these posts, but I'm trying to figure out if I should go to a doctor to get tested, and I figured you guys might be able to tell me if my mild symptoms have any chance of being caused by the coronavirus.Me: female, age 20 (21 in a few days), 5'10", 160 lbs., no comorbidities, mentally and physically healthy and fit, no drugs/alcohol, no medications. Possibly came into contact with someone sick.A few of my distant coworkers have tested positive for coronavirus. Two days ago, someone I share a desk with (who works the opposite night shift as me) went home sick with severe symptoms - it really sounds like he has the disease.Now, four days ago, before hearing about these cases, I had a headache, some body aches, a very mild sore throat. I'd explain it as, like, the most mild cold you can have. I popped an ibuprofen and went to work.For the next two days, I continued to have the same very mild symptoms. No fever, no runny nose. I thought it was allergies. But I started developing a cough. At first, it felt like when you exercise too much and can't breathe properly, but with a little chest pain to boot. But these symptoms have gotten progressively worse, to the point where I can't take a deep breath without coughing. My chest burns like someone rubbed some mild capsaicin cream on the inside of my lungs. My heart rate is higher than normal, and I have some mild body aches/fatigue. When I move around, I get short of breath way too fast. Additionally, today I think I may have developed the mildest of fevers (though I have no thermometer on hand).The feeling in my chest really reminds me of that one time I accidentally mixed bleach and ammonia and breathed in some of the fumes, but a little worse. It's not comfortable, but it's not bad. I am NOT coughing nonstop. I can speak, breathe, and sleep normally. But I undeniably HAVE a cough, and I'm tired. However, the other symptoms are so mild that if it wasn't for the cough, I'd think it was allergies/psychosomatic symptoms.I did call out of work and am keeping myself at home. I feel HORRIBLE about it because my symptoms are so blasted mild, but it's not worth the chance. I will go to the doctor and get tested if it doesn't go away, but I just figured I'd ask here beforehand - just in case my symptoms in no way match the coronavirus. I've read about people's symptoms, and most people talk about severe upper respiratory symptoms, which I do not have. Everything in me is screaming "you're being dramatic," so I thought I might be able to get an opinion here on whether I am, indeed, just being dramatic.Thank you so much for reading through. I appreciate your time.Edit: I called and asked for a test. They don't want me to be tested because my symptoms are pretty mild, so I will just be staying home for a bit (5 days) to see if my symptoms get worse at all. That's how much ATO I have. If they go away, back to work. If not, I'll talk to HR and risk my job rather than other people's lives :( Thanks for the help.Edit 2: reports of positive tests in my area have been rolling in today, including in my boyfriend's workplace. Yikes.E3: I guess my birthday present is probably going to be unemployment because I'll be doing a full quarantine.E4: happy news! I talked to my employer and I won't be fired if I quarantine! Woot woot! 14 days of bored coughing, here I come.E5 03/20/2020: yeah it's getting worse. Chest is on fire. Hopefully this really isn't the coronavirus, because that would suck. Stay safe guys. This shit fucking hurts :)E6 03/22/2020: bedridden now and they won't test me. Breathing is hard. I hate this.E7: 03/26/2020: finally getting better. I am still extremely short of breath and can't do much or walk far. My lungs still ache, and going out in the cold is the worst. I can't taste or smell very well. However, I am extremely grateful that the worst of the sickness is through. That was probably the sickest I've ever been in my life, and it sure wasn't fun. I'm so glad my employer granted me paid leave; I spent four days in bed and will be self-quarantined for a while yet. Yeah, this was probably the coronavirus. Thanks for your help guysE8: 04/04/2020: I am much recovered. However, I am still very out of breath. I ended up calling the covid hotline again (long story involving my now sick roommate) and NOW they want me to get tested - AFTER I HAVE RECOVERED - because I am still very short of breath. The test was this morning (very uncomfortable). Let's watch this test come back negative now XD

Output: Yes

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can coronavirus present as a cough and shortness of breath without other severe symptoms?I know you guys get a stupid amount of these posts, but I'm trying to figure out if I should go to a doctor to get tested, and I figured you guys might be able to tell me if my mild symptoms have any chance of being caused by the coronavirus.Me: female, age 20 (21 in a few days), 5'10", 160 lbs., no comorbidities, mentally and physically healthy and fit, no drugs/alcohol, no medications. Possibly came into contact with someone sick.A few of my distant coworkers have tested positive for coronavirus. Two days ago, someone I share a desk with (who works the opposite night shift as me) went home sick with severe symptoms - it really sounds like he has the disease.Now, four days ago, before hearing about these cases, I had a headache, some body aches, a very mild sore throat. I'd explain it as, like, the most mild cold you can have. I popped an ibuprofen and went to work.For the next two days, I continued to have the same very mild symptoms. No fever, no runny nose. I thought it was allergies. But I started developing a cough. At first, it felt like when you exercise too much and can't breathe properly, but with a little chest pain to boot. But these symptoms have gotten progressively worse, to the point where I can't take a deep breath without coughing. My chest burns like someone rubbed some mild capsaicin cream on the inside of my lungs. My heart rate is higher than normal, and I have some mild body aches/fatigue. When I move around, I get short of breath way too fast. Additionally, today I think I may have developed the mildest of fevers (though I have no thermometer on hand).The feeling in my chest really reminds me of that one time I accidentally mixed bleach and ammonia and breathed in some of the fumes, but a little worse. It's not comfortable, but it's not bad. I am NOT coughing nonstop. I can speak, breathe, and sleep normally. But I undeniably HAVE a cough, and I'm tired. However, the other symptoms are so mild that if it wasn't for the cough, I'd think it was allergies/psychosomatic symptoms.I did call out of work and am keeping myself at home. I feel HORRIBLE about it because my symptoms are so blasted mild, but it's not worth the chance. I will go to the doctor and get tested if it doesn't go away, but I just figured I'd ask here beforehand - just in case my symptoms in no way match the coronavirus. I've read about people's symptoms, and most people talk about severe upper respiratory symptoms, which I do not have. Everything in me is screaming "you're being dramatic," so I thought I might be able to get an opinion here on whether I am, indeed, just being dramatic.Thank you so much for reading through. I appreciate your time.Edit: I called and asked for a test. They don't want me to be tested because my symptoms are pretty mild, so I will just be staying home for a bit (5 days) to see if my symptoms get worse at all. That's how much ATO I have. If they go away, back to work. If not, I'll talk to HR and risk my job rather than other people's lives :( Thanks for the help.Edit 2: reports of positive tests in my area have been rolling in today, including in my boyfriend's workplace. Yikes.E3: I guess my birthday present is probably going to be unemployment because I'll be doing a full quarantine.E4: happy news! I talked to my employer and I won't be fired if I quarantine! Woot woot! 14 days of bored coughing, here I come.E5 03/20/2020: yeah it's getting worse. Chest is on fire. Hopefully this really isn't the coronavirus, because that would suck. Stay safe guys. This shit fucking hurts :)E6 03/22/2020: bedridden now and they won't test me. Breathing is hard. I hate this.E7: 03/26/2020: finally getting better. I am still extremely short of breath and can't do much or walk far. My lungs still ache, and going out in the cold is the worst. I can't taste or smell very well. However, I am extremely grateful that the worst of the sickness is through. That was probably the sickest I've ever been in my life, and it sure wasn't fun. I'm so glad my employer granted me paid leave; I spent four days in bed and will be self-quarantined for a while yet. Yeah, this was probably the coronavirus. Thanks for your help guysE8: 04/04/2020: I am much recovered. However, I am still very out of breath. I ended up calling the covid hotline again (long story involving my now sick roommate) and NOW they want me to get tested - AFTER I HAVE RECOVERED - because I am still very short of breath. The test was this morning (very uncomfortable). Let's watch this test come back negative now XD. ### Response: Yes.


Instruction: Thanks. Appreciate it. I will get tested.

Output: You may not be able to get tested, given the limited supplies in most of the US right now. Please assume you have it and STAY HOME and away from family members who are at risk.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thanks. Appreciate it. I will get tested.. ### Response: You may not be able to get tested, given the limited supplies in most of the US right now. Please assume you have it and STAY HOME and away from family members who are at risk..


Instruction: Same here i have cough and burning throat and can be hard to breath. I do also have random fevers and the first time it went away but now its returned. And my job flat out refuses to pay unless we are confurmed to have it.

Output: Don't take ibuprofen!

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Same here i have cough and burning throat and can be hard to breath. I do also have random fevers and the first time it went away but now its returned. And my job flat out refuses to pay unless we are confurmed to have it.. ### Response: Don't take ibuprofen!.


Instruction: Not so sure about that. Heard a doc on on of the networks today saying there's no evidence to back this up. Hard to know with a lot of unconfirmed advice going around. Best wishes to those feeling unwell.

Output: Yeah I'm not sure either, but it's better to be safe at this point. I'd go for Tylenol.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Not so sure about that. Heard a doc on on of the networks today saying there's no evidence to back this up. Hard to know with a lot of unconfirmed advice going around. Best wishes to those feeling unwell.. ### Response: Yeah I'm not sure either, but it's better to be safe at this point. I'd go for Tylenol..


Instruction: Overnight the cases doubled in New York where I GREW UP and my father still lives. ( Mind you he is late 60s something he's as stubborn a mule and won't go inside ugh) It may not have hit us yet but It will. I don't give two shots if he's from Kiribati or Myanmar or even Jupiter. I'm concerned with folks taking it seriously.As for you if you reread my message I clearly state that this guy didn't offend me, to which I'm not making a snarky remark I'm stating " oh man that fucking sucks what's happening in Italy that shots for real over there, it's gotta be difficult. In which I then go on to wish him well. At NO point in my reply did I ever curse him or put Ill will upon him just the opposite.I APOLOGISE if it came across another way that was not my intent.As for you maybe in the future you might stop and consider the gravity of what's going on. I may personally live in the Midwest for now but I'm shipping out in a week and I have family all over the East coast. Lastly good luck hopefully we can do this again some time, this nothing quite like a decent discourse

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: Overnight the cases doubled in New York where I GREW UP and my father still lives. ( Mind you he is late 60s something he's as stubborn a mule and won't go inside ugh) It may not have hit us yet but It will. I don't give two shots if he's from Kiribati or Myanmar or even Jupiter. I'm concerned with folks taking it seriously.As for you if you reread my message I clearly state that this guy didn't offend me, to which I'm not making a snarky remark I'm stating " oh man that fucking sucks what's happening in Italy that shots for real over there, it's gotta be difficult. In which I then go on to wish him well. At NO point in my reply did I ever curse him or put Ill will upon him just the opposite.I APOLOGISE if it came across another way that was not my intent.As for you maybe in the future you might stop and consider the gravity of what's going on. I may personally live in the Midwest for now but I'm shipping out in a week and I have family all over the East coast. Lastly good luck hopefully we can do this again some time, this nothing quite like a decent discourse . ### Response: Please read our rule on claiming credentials.


Instruction: 23M I was prescribed Prednisone after getting symptoms of upper respiratory infectionI went to an urgent care yesterday after having a sore throat the night before, I took the prednisone yesterday as well. Now my sore throat has turned into horrible nasal and chest congestion and an even more sore throat. My sister is just finishing up a bout with bronchitis(thats what she was diagnosed with). Is this the right medication for me? My body is telling me its not based on my infection getting worse it seems.

Output: These things are likely unrelated. Despite the prednisone you would likely have gotten worse anyway. It just seems like cause and effect because of the timeline. You also likely have the same viral infection as your sibling. You really dont need the prednisone unless youre wheezing. You dont really need any medications specifically but can take things for the symptoms such as Tylenol/Motrin for aches, pains, or fever, OTC cough suppressants, etc. drink plenty of fluids. I assume the urgent care swabbed for flu/covid? If not that would be something that could direct treatment plan more.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 23M I was prescribed Prednisone after getting symptoms of upper respiratory infectionI went to an urgent care yesterday after having a sore throat the night before, I took the prednisone yesterday as well. Now my sore throat has turned into horrible nasal and chest congestion and an even more sore throat. My sister is just finishing up a bout with bronchitis(thats what she was diagnosed with). Is this the right medication for me? My body is telling me its not based on my infection getting worse it seems.. ### Response: These things are likely unrelated. Despite the prednisone you would likely have gotten worse anyway. It just seems like cause and effect because of the timeline. You also likely have the same viral infection as your sibling. You really dont need the prednisone unless youre wheezing. You dont really need any medications specifically but can take things for the symptoms such as Tylenol/Motrin for aches, pains, or fever, OTC cough suppressants, etc. drink plenty of fluids. I assume the urgent care swabbed for flu/covid? If not that would be something that could direct treatment plan more..


Instruction: Do I have some sort of respiratory infection22M, 5 ft 20, 235lbs. 2 weekends ago went to a family party and we were all drinking and started sharing a bottle that was passed around between like 5 people. The next morning I had a sore throat and just thought it was nothing. It continued for a few more days and after the sore throat went away I got really congested and got a really bad cough that I still have to this day almost 10 days later. My mom also had the same symptoms plus her sinuses were bothering her so she got a covid test that came back negative. I just assumed I wouldnt have covid if my mom didnt if we were both sick. The doctor at the clinic she went to said she had a sinus infection. I havent seen a doc yet but my sinuses havent been bothering me at all just my chest snd a cough. The cough is the worst in the morning then kind of slows down a little then picks up again around the time I want to go to bed. I get in nasty coughing fits to the point where I can barely even breathe and I cough up a ton of green phlegm. Ive had an upper respiratory infection before but it was never this bad. Ive barely been getting any sleep because of this cough. Ive taken mucinex dm, robutussin, and dozens of cough drops but nothing is working.

Output: Sounds like either COVID or an enormously long list of alternative upper respiratory viral infections. Just because your mom tested negative doesn't mean you don't have COVID as well.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Do I have some sort of respiratory infection22M, 5 ft 20, 235lbs. 2 weekends ago went to a family party and we were all drinking and started sharing a bottle that was passed around between like 5 people. The next morning I had a sore throat and just thought it was nothing. It continued for a few more days and after the sore throat went away I got really congested and got a really bad cough that I still have to this day almost 10 days later. My mom also had the same symptoms plus her sinuses were bothering her so she got a covid test that came back negative. I just assumed I wouldnt have covid if my mom didnt if we were both sick. The doctor at the clinic she went to said she had a sinus infection. I havent seen a doc yet but my sinuses havent been bothering me at all just my chest snd a cough. The cough is the worst in the morning then kind of slows down a little then picks up again around the time I want to go to bed. I get in nasty coughing fits to the point where I can barely even breathe and I cough up a ton of green phlegm. Ive had an upper respiratory infection before but it was never this bad. Ive barely been getting any sleep because of this cough. Ive taken mucinex dm, robutussin, and dozens of cough drops but nothing is working.. ### Response: Sounds like either COVID or an enormously long list of alternative upper respiratory viral infections. Just because your mom tested negative doesn't mean you don't have COVID as well..


Instruction: Why did urgent care send me home to fight an upper respiratory infection that has put my husbands coworker in the hospital?Age: 28, race: Caucasian, sex:FIve been dealing with an upper respiratory infection these last few days. went to urgent care Wednesday, no fever, sore throat. Negative for Covid, strep, flu. Doc told me to take time off work, could not due to previous attendance issues so Ive been doing half days. Sore throat went away and it feels like my chest is chock full of mucus. I already have mold in my house, so yay. Ive done a nasal spray and taken a decongestant but Im so nervous. I dont want to wait for this to get as bad as Hs coworker did. Urgent care doc struck me as one of those its not a big deal people and denies my illness could get worse

Output: I mean... we didn't put everyone with covid into the ICU or even admit them all.Illnesses hit different people differently, we base treatment recommendations on your illness severity, not based on what happened to an acquaintance.If you decided to go to work afterwards, it sounds like the urgent care doc 100% made the right call.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Why did urgent care send me home to fight an upper respiratory infection that has put my husbands coworker in the hospital?Age: 28, race: Caucasian, sex:FIve been dealing with an upper respiratory infection these last few days. went to urgent care Wednesday, no fever, sore throat. Negative for Covid, strep, flu. Doc told me to take time off work, could not due to previous attendance issues so Ive been doing half days. Sore throat went away and it feels like my chest is chock full of mucus. I already have mold in my house, so yay. Ive done a nasal spray and taken a decongestant but Im so nervous. I dont want to wait for this to get as bad as Hs coworker did. Urgent care doc struck me as one of those its not a big deal people and denies my illness could get worse. ### Response: I mean... we didn't put everyone with covid into the ICU or even admit them all.Illnesses hit different people differently, we base treatment recommendations on your illness severity, not based on what happened to an acquaintance.If you decided to go to work afterwards, it sounds like the urgent care doc 100% made the right call..


Instruction: Contracted respiratory symptoms from my childMy son (10 months old, male) was fussy, with runny nose and coughing between Friday and Sunday last week. Now he's not longer fussy, the runny nose decreased to less than a half and he caughs once or twice a day. He's very active and with good mood.As of Tuesday I started having an itchy throat that led to a sore throat and a runny nose the next day. On Thursday I had elevated temperature (37.8 C) and cough. Friday the cough went on, but temperature was normal. Today the cough feels coming from deeper in my chest, but no fever. I've taken two sars-cov2 antigen test (Thursday and today), both negative.Tomorrow I have an appointment with the family doctor. My partner (41yo female) and her daughter (13 yo female) are starting to develop similar symptoms as I did.Since apparently my son caught an infection and then passed onto us, plus the covid antigen tests came negative for all three (partner, daughter,me) I'm not sure if covid could be ruled out.Could you please share your thoughts? I'm not really sure what to ask specifically, just want to get some opinions and maybe suggestions.Cheers!

Output: Sounds like the easier solution would've been to get your son tested first, instead of everyone else.Remember that there are plenty of viruses besides COVID that cause similar symptoms. More likely that you have one of those given the negative tests.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Contracted respiratory symptoms from my childMy son (10 months old, male) was fussy, with runny nose and coughing between Friday and Sunday last week. Now he's not longer fussy, the runny nose decreased to less than a half and he caughs once or twice a day. He's very active and with good mood.As of Tuesday I started having an itchy throat that led to a sore throat and a runny nose the next day. On Thursday I had elevated temperature (37.8 C) and cough. Friday the cough went on, but temperature was normal. Today the cough feels coming from deeper in my chest, but no fever. I've taken two sars-cov2 antigen test (Thursday and today), both negative.Tomorrow I have an appointment with the family doctor. My partner (41yo female) and her daughter (13 yo female) are starting to develop similar symptoms as I did.Since apparently my son caught an infection and then passed onto us, plus the covid antigen tests came negative for all three (partner, daughter,me) I'm not sure if covid could be ruled out.Could you please share your thoughts? I'm not really sure what to ask specifically, just want to get some opinions and maybe suggestions.Cheers!. ### Response: Sounds like the easier solution would've been to get your son tested first, instead of everyone else.Remember that there are plenty of viruses besides COVID that cause similar symptoms. More likely that you have one of those given the negative tests..


Instruction: My best friend died suddenly, and Im trying to figure out what happenedIm sorry if this isnt an appropriate question for this sub - if you have any other relevant sub recommendations, please let me know.29 year old white female, 58/315lbs, frequent drinker, non smoker, no medications other then OTCs, no known health problems.On December 13, my best friend (we work together) went to her sisters company Christmas party. Towards the end of the night, they got into a fight, which continued until they got home (they lived together). During this fight a shard of glass or mirror punctured her trachea (still dont know the truth as to how this happened, but thats a different story).They had her in the ICU for two days. While in the ER, her lungs stopped working and they put her on a ventilator while in the ICU. Her kidneys started to act up, so they kept her for a full week. I visited her and gave her a care package, we walked around the ward a bit, and she was in pretty good spirits although she got winded easily. Externally, it looked like her injury was healing well.On December 23, she came back to work for a half day. She had subcutaneous emphysema and was retaining water weight for some reason. We took a walk and she got very lightheaded at one point. She was supposed to leave at 2, but she got lightheaded again and said she was going to wait a few minutes before driving, I gave her some water and pretzels. About 10 minutes later, I heard strange gurgling noises coming from her desk (we sat across from each other with a divider in between) so I ran over. She was bent over her desk shaking and barely breathing, her pupils were dilated and she was unresponsive. She also lost bladder control at one point. She fell out of her chair as I was calling 911, and when on the ground she was only breathing 1-2 breaths per minute (agonal breathing?), her face and tongue turned blue and then grey, and she was clenching her jaw. I stayed on the phone with 911 while two of my coworkers started chest compressions. Once the paramedics arrived, they took over, started manually breathing for her, and hooked up an AED (I think), and the first time they stopped CPR she flatlined and wasnt in a shockable rhythm. It took them forever to find a vein that worked, but they finally got one and gave her epinephrine 3 times that I noticed along with sodium bicarbonate. They also intubated her. I dont know if this is standard, it seemed strange to me, but they worked on her for over an hour, maybe even an hour and a half - every time they stopped compressions she would flatline, but after the first time her heart was in a shockable rhythm so they shocked her several times. They were unable to resuscitate her, and told us that she died of kidney and respiratory failure.If any additional information is required, Ill do my best - not sure if I covered everything. I requested a copy of the autopsy report from the county ME but they said the case was referred to a justice of the peace, so I have to contact her directly (and if theres an active investigation she may not release the report). If anyone has any ideas as to what happened here, I would really appreciate it. Thanks in advance.

Output: Wow, those are quite some tragic events to happen to everyone involved. My condolences.At this stage I guess you will have to wait for the autopsy.My first guess would be a large pulmonary embolism (immobilized in the ICU).A primary cardiac cause seems unlikely. A respiratory or airway cause (suffocation or serious bleeding in the upper airway) I'm not so sure about either, because it wouldn't have such an extremely acute onset and your friend would typically run over in case she was suffocating for instance. A very serious and sudden arterial bleeding (ruptured aortic aneurysm) doesn't make sense either considering her age and history.A major intracranial (subarachnoid) hemorrhage is a second possibility.Again, pure speculation. You would have to wait for the autopsy report.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My best friend died suddenly, and Im trying to figure out what happenedIm sorry if this isnt an appropriate question for this sub - if you have any other relevant sub recommendations, please let me know.29 year old white female, 58/315lbs, frequent drinker, non smoker, no medications other then OTCs, no known health problems.On December 13, my best friend (we work together) went to her sisters company Christmas party. Towards the end of the night, they got into a fight, which continued until they got home (they lived together). During this fight a shard of glass or mirror punctured her trachea (still dont know the truth as to how this happened, but thats a different story).They had her in the ICU for two days. While in the ER, her lungs stopped working and they put her on a ventilator while in the ICU. Her kidneys started to act up, so they kept her for a full week. I visited her and gave her a care package, we walked around the ward a bit, and she was in pretty good spirits although she got winded easily. Externally, it looked like her injury was healing well.On December 23, she came back to work for a half day. She had subcutaneous emphysema and was retaining water weight for some reason. We took a walk and she got very lightheaded at one point. She was supposed to leave at 2, but she got lightheaded again and said she was going to wait a few minutes before driving, I gave her some water and pretzels. About 10 minutes later, I heard strange gurgling noises coming from her desk (we sat across from each other with a divider in between) so I ran over. She was bent over her desk shaking and barely breathing, her pupils were dilated and she was unresponsive. She also lost bladder control at one point. She fell out of her chair as I was calling 911, and when on the ground she was only breathing 1-2 breaths per minute (agonal breathing?), her face and tongue turned blue and then grey, and she was clenching her jaw. I stayed on the phone with 911 while two of my coworkers started chest compressions. Once the paramedics arrived, they took over, started manually breathing for her, and hooked up an AED (I think), and the first time they stopped CPR she flatlined and wasnt in a shockable rhythm. It took them forever to find a vein that worked, but they finally got one and gave her epinephrine 3 times that I noticed along with sodium bicarbonate. They also intubated her. I dont know if this is standard, it seemed strange to me, but they worked on her for over an hour, maybe even an hour and a half - every time they stopped compressions she would flatline, but after the first time her heart was in a shockable rhythm so they shocked her several times. They were unable to resuscitate her, and told us that she died of kidney and respiratory failure.If any additional information is required, Ill do my best - not sure if I covered everything. I requested a copy of the autopsy report from the county ME but they said the case was referred to a justice of the peace, so I have to contact her directly (and if theres an active investigation she may not release the report). If anyone has any ideas as to what happened here, I would really appreciate it. Thanks in advance.. ### Response: Wow, those are quite some tragic events to happen to everyone involved. My condolences.At this stage I guess you will have to wait for the autopsy.My first guess would be a large pulmonary embolism (immobilized in the ICU).A primary cardiac cause seems unlikely. A respiratory or airway cause (suffocation or serious bleeding in the upper airway) I'm not so sure about either, because it wouldn't have such an extremely acute onset and your friend would typically run over in case she was suffocating for instance. A very serious and sudden arterial bleeding (ruptured aortic aneurysm) doesn't make sense either considering her age and history.A major intracranial (subarachnoid) hemorrhage is a second possibility.Again, pure speculation. You would have to wait for the autopsy report..


Instruction: Yea I watched my son die of a PE we knew it was eventually going to happen and the gurgling made me immediately think of that. Sorry for your loss. Please consider some counseling as it can really help work through dealing with unexpected deaths.

Output: Sorry for your loss. If she actually had SQ emphysema when you saw her that day, I would be concerned that she may have had an air leak and may have developed a tension pneumothorax. A tension pneumothorax can potentially lead to progressive shortness of breath and cardiac tamponade which would drop her blood pressure. In that situation, I would have expected her to be having some chest pain prior to the event and for symptoms to build up. If this happened very suddenly, then I agree that a pulmonary embolus is more likely.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Yea I watched my son die of a PE we knew it was eventually going to happen and the gurgling made me immediately think of that. Sorry for your loss. Please consider some counseling as it can really help work through dealing with unexpected deaths.. ### Response: Sorry for your loss. If she actually had SQ emphysema when you saw her that day, I would be concerned that she may have had an air leak and may have developed a tension pneumothorax. A tension pneumothorax can potentially lead to progressive shortness of breath and cardiac tamponade which would drop her blood pressure. In that situation, I would have expected her to be having some chest pain prior to the event and for symptoms to build up. If this happened very suddenly, then I agree that a pulmonary embolus is more likely..


Instruction: Do you think there will be charges brought against her sister? I could see an Involuntary Manslaughter charge for someone where I live happening.

Output: Sorry to ask, but did the ems people work on her for an hour and half or did they transport her and the docs worked on her for an hour and half?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Do you think there will be charges brought against her sister? I could see an Involuntary Manslaughter charge for someone where I live happening.. ### Response: Sorry to ask, but did the ems people work on her for an hour and half or did they transport her and the docs worked on her for an hour and half?.


Instruction: Ems from op

Output: Why on earth would EMS work on someone in the field for 1.5 hours instead of transporting?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ems from op. ### Response: Why on earth would EMS work on someone in the field for 1.5 hours instead of transporting?.


Instruction: Depending on the area, sometimes med command directs EMS to stay on scene with an unstable patient. Ive heard them be instructed to stay up to 2 hours before med command calls it, but its so unusual Ive only ever encountered it once. Does seem very very strange, but it also very much depends on rural vs urban settings. A lot of different possibilities.

Output: Ive heard them be instructed to stay up to 2 hours before med command calls it, but its so unusual Ive only ever encountered it once. Does seem very very strange, but it also very mMakes no sense honestly, intubate, start acls, go.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Depending on the area, sometimes med command directs EMS to stay on scene with an unstable patient. Ive heard them be instructed to stay up to 2 hours before med command calls it, but its so unusual Ive only ever encountered it once. Does seem very very strange, but it also very much depends on rural vs urban settings. A lot of different possibilities.. ### Response: Ive heard them be instructed to stay up to 2 hours before med command calls it, but its so unusual Ive only ever encountered it once. Does seem very very strange, but it also very mMakes no sense honestly, intubate, start acls, go..


Instruction: Depends on your area and protocols. Study's have shown improvement in survivability and neuro out come of obtaining ROSC in the field prior to transport. Field terminations are becoming more common in EMS on medical arrests. Mainly in part you're unable to properly work an arrest in a moving ambulance.Requirements in my area for field term are 30 minutes of basic ACLS. Epi, fluids, ET/ laryngeal airway, bicarb/ calcium on renal pts. If the patient remains in asystole med controls is contacted for any additional orders, with no change we terminate.

Output: Yes, improved survivability if ROSC within a certain time frame, 1.5 hrs?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Depends on your area and protocols. Study's have shown improvement in survivability and neuro out come of obtaining ROSC in the field prior to transport. Field terminations are becoming more common in EMS on medical arrests. Mainly in part you're unable to properly work an arrest in a moving ambulance.Requirements in my area for field term are 30 minutes of basic ACLS. Epi, fluids, ET/ laryngeal airway, bicarb/ calcium on renal pts. If the patient remains in asystole med controls is contacted for any additional orders, with no change we terminate.. ### Response: Yes, improved survivability if ROSC within a certain time frame, 1.5 hrs?.


Instruction: This varies a lot with the culture of EMS agencies, transport distance, etc. I work with some agencies that work it on scene and only transport if they get ROSC or if theres something obvious the hospital can do that they cant. To be fair, unless its a known STEMi that can be cathed, or a cold water drowning, or trauma were just going to do to ACLS too.

Output: Define what "we're" means, you are ems or em?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: This varies a lot with the culture of EMS agencies, transport distance, etc. I work with some agencies that work it on scene and only transport if they get ROSC or if theres something obvious the hospital can do that they cant. To be fair, unless its a known STEMi that can be cathed, or a cold water drowning, or trauma were just going to do to ACLS too.. ### Response: Define what "we're" means, you are ems or em?.


Instruction: My particular Emergency department. Things might be different elsewhere

Output: Your ER Doctors do not use ACLS, nor should any board certified EM physician. It is a backburner protocol that can be implemented while thinking but is ultimately a protocol created for non resuscitationists. Your ED should not be doing "ACLS too." There is also a significant difference in the number of available hands for CPR, med pushing, and ultrasound machine, a pharmacist, a respiratory therapist, etc etc. I know I don't know all the details, but a young person who arrests in the field should be brought into the ER ASAP.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My particular Emergency department. Things might be different elsewhere. ### Response: Your ER Doctors do not use ACLS, nor should any board certified EM physician. It is a backburner protocol that can be implemented while thinking but is ultimately a protocol created for non resuscitationists. Your ED should not be doing "ACLS too." There is also a significant difference in the number of available hands for CPR, med pushing, and ultrasound machine, a pharmacist, a respiratory therapist, etc etc. I know I don't know all the details, but a young person who arrests in the field should be brought into the ER ASAP..


Instruction: If critical care paramedics use thrombylitic agents on scene it requires an additional 90 minutes of CPR, at least in UK guidelines.

Output: Those don't really exist here. And if they do, they are in remote academic areas where transport should have been quick.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: If critical care paramedics use thrombylitic agents on scene it requires an additional 90 minutes of CPR, at least in UK guidelines.. ### Response: Those don't really exist here. And if they do, they are in remote academic areas where transport should have been quick..


Instruction: Where do you work? A lot of EMS protocols around the world are "No ROSC = no transport" except maybe in some extreme cases that can't be treated in the field (ie. PE in some places, or intrapartum cardiac arrest).

Output: I am so sorry for your loss, it seems you got into a very tough situation but did all you could to help her and gave her and the EMTs the best chances; you're a good friend and person. I would agree with the colle ague that a PE or another clot of some sort (intracranial bleed/occlusion) comes to mind as a plausible possibility, and that waiting on the autopsy results is the best step. A serious underlying reason would also explain why the resuscitation was unsuccessful.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Where do you work? A lot of EMS protocols around the world are "No ROSC = no transport" except maybe in some extreme cases that can't be treated in the field (ie. PE in some places, or intrapartum cardiac arrest).. ### Response: I am so sorry for your loss, it seems you got into a very tough situation but did all you could to help her and gave her and the EMTs the best chances; you're a good friend and person. I would agree with the colle ague that a PE or another clot of some sort (intracranial bleed/occlusion) comes to mind as a plausible possibility, and that waiting on the autopsy results is the best step. A serious underlying reason would also explain why the resuscitation was unsuccessful..


Instruction: UPDATE ABOUT MY MOM: Chronic respiratory failure - hypoxia w/o pulmonary or cardiac explanation.51F, 59, thin, white, USA. never-smoker, non-drinker; no prescriptions; unintended weight loss of now 28lbs since January, oxygen desats started in January w/ exertion, suddenly worsening in the past few days and now on continuous oxygen. Exhausted and weaker every day. X-post.This is just an update for anyone interested. Ive posted about this several times on the various medical subs here out of desperation and have been blown away at the helpful advice and input. I wanted to post an update in case anyone remembers spitballing about this and might be curious about new developments.Today mom had her follow up with her pulmonologist following the normal shunt study. He spent a solid hour with us going over everything shes been experiencing the last six months with a fine tooth comb, reviewing prior records in the hospital system from the past year before the oxygen issue, and doing a thorough physical exam - we knew something crucial might be in those clues.Very long story short - its not a happy update but it unfortunately makes sense given a lot of other problems mom has been having during this same timeframe that just seemed insignificant or unimportant compared to the chronic respiratory failure. Things she thought could sit on the back burner til that was solved, but have been accelerating in just the past 2-ish weeks along with the worsening oxygen desats.Basically, there are several observable, objective signs and symptoms that seem to point to some kind of neurological/neurodegenerative process/disorder.He ordered a lot of tests that will be happening next week, and she will be seeing a neurologist for further evaluation on Tuesday.The more we read, the more huge lightbulbs are going off on this kind of process being a possibility. Not going to assume anything, and not trying to be negative, it is just undeniable that a lot of the puzzle pieces fit and we want to prepare for the worst mentally/emotionally. It's a long way from here to final answers (if we ever get any, we are well aware we might not ever get this figured out, that there are limits to medicine), but I just thought Id update since my moms situation is such a very odd, even bizarre, case. Thanks so much to all of you who have pitched in.

Output: Glad to hear you've found yourself a solid pulmonologist. Might I ask what institution he/she is working at? I like to know where there are good folks if I ever need to reach out.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: UPDATE ABOUT MY MOM: Chronic respiratory failure - hypoxia w/o pulmonary or cardiac explanation.51F, 59, thin, white, USA. never-smoker, non-drinker; no prescriptions; unintended weight loss of now 28lbs since January, oxygen desats started in January w/ exertion, suddenly worsening in the past few days and now on continuous oxygen. Exhausted and weaker every day. X-post.This is just an update for anyone interested. Ive posted about this several times on the various medical subs here out of desperation and have been blown away at the helpful advice and input. I wanted to post an update in case anyone remembers spitballing about this and might be curious about new developments.Today mom had her follow up with her pulmonologist following the normal shunt study. He spent a solid hour with us going over everything shes been experiencing the last six months with a fine tooth comb, reviewing prior records in the hospital system from the past year before the oxygen issue, and doing a thorough physical exam - we knew something crucial might be in those clues.Very long story short - its not a happy update but it unfortunately makes sense given a lot of other problems mom has been having during this same timeframe that just seemed insignificant or unimportant compared to the chronic respiratory failure. Things she thought could sit on the back burner til that was solved, but have been accelerating in just the past 2-ish weeks along with the worsening oxygen desats.Basically, there are several observable, objective signs and symptoms that seem to point to some kind of neurological/neurodegenerative process/disorder.He ordered a lot of tests that will be happening next week, and she will be seeing a neurologist for further evaluation on Tuesday.The more we read, the more huge lightbulbs are going off on this kind of process being a possibility. Not going to assume anything, and not trying to be negative, it is just undeniable that a lot of the puzzle pieces fit and we want to prepare for the worst mentally/emotionally. It's a long way from here to final answers (if we ever get any, we are well aware we might not ever get this figured out, that there are limits to medicine), but I just thought Id update since my moms situation is such a very odd, even bizarre, case. Thanks so much to all of you who have pitched in.. ### Response: Glad to hear you've found yourself a solid pulmonologist. Might I ask what institution he/she is working at? I like to know where there are good folks if I ever need to reach out..


Instruction: I (27F, 65in, 125lbs) was recently prescribed propranolol (20mg twice a day) for migraine prophylaxis. As I was reading through the information, I saw that multiple occurrences of past bronchitis are a significant contraindication. I have had pneumonia several times, and am not sure about bronchitis because the several pneumonia cases I had, I put off going to the doctor until I had to go to urgent care (less than ideal, I know. poverty can really be a bitch.) The last time I had pneumonia I ended up with cracked ribs from coughing so hard.Is it safe for me to be taking propranolol, and are there early warning signs I can look out for if my respiratory system is being negatively impacted? Would I develop a cough?I would call the prescribing PA but not only was it the first time I had an appointment with them, it was also their last week at that job, and they also were a little bit dismissive when i asked if there could be any interactions with my psychiatric medications (bupropion xl 300mg & concerta xr 27mg.)Thanks for your help!

Output: Previous infections shouldn't affect you today, I wouldn't worry about it too much but yes you are correct, they would be signs. The main sign would be an asthmatic sensation, in which case you should not take any more propranolol and seek help.It's very hard to give good medical advice you seem to have shared lots of pertinent information, I can only suppose, but I suppose there's no problem taking this beta blocker at this moment.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I (27F, 65in, 125lbs) was recently prescribed propranolol (20mg twice a day) for migraine prophylaxis. As I was reading through the information, I saw that multiple occurrences of past bronchitis are a significant contraindication. I have had pneumonia several times, and am not sure about bronchitis because the several pneumonia cases I had, I put off going to the doctor until I had to go to urgent care (less than ideal, I know. poverty can really be a bitch.) The last time I had pneumonia I ended up with cracked ribs from coughing so hard.Is it safe for me to be taking propranolol, and are there early warning signs I can look out for if my respiratory system is being negatively impacted? Would I develop a cough?I would call the prescribing PA but not only was it the first time I had an appointment with them, it was also their last week at that job, and they also were a little bit dismissive when i asked if there could be any interactions with my psychiatric medications (bupropion xl 300mg & concerta xr 27mg.)Thanks for your help!. ### Response: Previous infections shouldn't affect you today, I wouldn't worry about it too much but yes you are correct, they would be signs. The main sign would be an asthmatic sensation, in which case you should not take any more propranolol and seek help.It's very hard to give good medical advice you seem to have shared lots of pertinent information, I can only suppose, but I suppose there's no problem taking this beta blocker at this moment..


Instruction: Thank you! Would asthmatic sensation feel much different than respiratory symptoms from sickness? I noticed today that drinking very cold things makes me cough and feel like i have an itchy throat/need to clear my throat. This isnt completely unusual for me, but its been more extreme than normal.

Output: Not really, shortness of breath, is shortness of breath.Allow me to advise you not to drink very cold things.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you! Would asthmatic sensation feel much different than respiratory symptoms from sickness? I noticed today that drinking very cold things makes me cough and feel like i have an itchy throat/need to clear my throat. This isnt completely unusual for me, but its been more extreme than normal.. ### Response: Not really, shortness of breath, is shortness of breath.Allow me to advise you not to drink very cold things..