Datasets:

GGYIMAH1031

/

ChatDoctor-10k

like 0

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My 61 year old husband was diagnosed with hypetrophic cardiomyopathy a few years ago. He has been seeing a Cardiologist ever since and a pacemaker/difibrilator was placed to reduce his risk of sudden death. In March his legs started swelling and he was very short of breath and was taken to the ER where he was diagnosed with CHF. He was hospitalized for one day while the fluid was removed and was sent home with strict diet instructions. He s on several medicines to which they ve now added a low dose diuretic. He s done very well sticking with the low sodium diet, exercising, and following all of the lifestyle chances. He has maintained his weight and feels better than he has in a year or more. I m very confused as to his prognosis. When I asked his cardiologist about a prognosis I was told that he has the good kind of heart failure and that the main issue to worry about is sudden death which is why the device was implanted, but when I talk to our family doctor he doesn t seem to think he ll live very long. The ER cardiologist mentioned that he didn t think the ChatDoctor was being managed well enough and changed several dosages of his medicines. He also mentioned that there are two surgeries that are options if his condition worsens. One is an alcohol ablation and the other is septal myectomy. My question is two-fold: Realistically does he fall into the dreaded 50% chance of dying in 5 years, or since the heart failure seems to be caused by the ChatDoctor can either of these two surgeries turn the heart failure around? What is the good kind of heart failure? I ve never heard of such a thing. I m younger than he is and we have a young child together the stress of constantly worrying about his life expectancy is overwhelming. ### output:

Hi, Lets start from the surgery. Your doctor may have explained to you that in hypertrophic cardiomyopathy the heart muscle gets very thickened. Such thickened muscle may produce life-threatening arrhythmias, that's why defibrillator was implanted, which is the most efficient way to prolong the life of patients with hypertrophic cardiomyopathy. Also, in some cases, the thickened muscle obstructs a part of the heart from where blood flows from the heart to the aorta. Two types of surgeries, who mentioned are done in this case. They are meant to reduce the thickness of the muscle in the heart septum, thus, give a chance to blood flow to the aorta. Heart failure in patients with hypertrophic cardiomyopathy have two causes 1. The obstruction I have mentioned above 2. When heart thickened heart muscle starts work weak, and heart can't pump enough blood to the body. You can talk to your doctor to find out which one is the case of your husband. In the first case, the surgery may help. In the second case, only medications are indicated. The life expectancy of heart failure patients depends on many factors, one of them is how weak is heart muscle. But usually if you can achieve good results with medications, his 5-year life expectancy may be quite high, especially if he has a defibrillator. Hope I have answered your query. Let me know if I can assist you further.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I m a 55 yr old chinese female. 153cm ht and 49.5kg wt.On 15/4/11 my medical report shows : 1)Eosinophils 7%, ESR 47 mm/hr, 2)triglycerides 1.7 mmol/L, LDL -Cholesterol 3.1 mmol/L, 3) Gamma GT 192 U/L (last year was 195), AST (SGOT) 35, 4) Positive Helicobacter Pylori, 5) Noted Hematuria, mild UTI, 6) Mammogram axillary region appears normal bilaterally, category 2, benign finding, 7) Gall bladder calculi, g.bladder wall not thickened (got this afew years ago), 8) ultrasound bone densitometry - osteopenic changes of the left ankle with increased risk of fracture. I dont smoke nor drink. My sleeping time is after 12.45am - 2am. I dont drink alot of water. I like to eat tit bits and junk foods and my meal time is irregular.I am taking glucosamine caps, calcium tab, sometimes spirulina tabs once a day. I took EPO previously but stopped a year ago. Please help and give advise as what I should do. Thank you very much. ### output:

Hello Thanks for posting at Chat Doctor. I have gone through your description. let's proceed one by one with your complaints.1) ESR 47 which is high. ESR levels are usually high when there is any inflammation or infection in the body. Total WBC counts are not mentioned. Can be rue to UTI. Other reason can be H pylori infection Of stomach. 2) Triglycerides and LDL within normal ranges. No need to worry about them. 3) GGTP and GOT no need to worry. 4) H pylori infection can case gastritis and gastric ulcers. Should be started on antibiotics for H pylori and antacids. Since you mentioned that you don't eat properly, diet modifications should be done. Eat small quantities in short intervals for 5-6 times a day. Avoid oily, smoked, spicy, very hot food. 5) Blood in urine with UTI. Again should be on antibiotics. Some antibiotics can treat both UTI and h pylori. End ciprofloxacin, ampicillin. If despite antibiotics urine symptoms persist, do a urine culture. 6)Mammography findings being. Repeat scan every year. 7) Gall bladder stones not to be treated until they cause infection. 8) report suggest osteopenia. Please check it D levels and serum calcium. Continue supplements which you are taking.additional correction of vitamin D and calcium if found low. Since you were taking EPO I guess you have anemia and possible kidney disease. Please take iron supplements if hemoglobin is low. EPO once a week for hemoglobin less than 8 should also be considered. I hope I have solved all your queries. Wishing you good health. Regards

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have started having panic attacks and when I have them, it s hard to breathe. I have always been a constant worrier and have always been stressed. I get knots in my stomach that make me miserable and nauseated badly. sometimes I throw up. I can t eat like this and I lay awake most nights when this happens until 3:00 to 4:00 am. I do this at least once a week and this whole mess of problems may last up to 4 days and sometimes longer. I have gone to several physicians asking for help because I make the mistake of asking for Xanax. I took that medicine for several years and it took the problem away, then the doctor who prescribed them retired. I don t know where to turn. I had it so bad the other day, that the knots in my stomach were real high up in my stomach (right where I hurt when I had a gallbladder), but when my stomach was like that it felt like my throat was swelling shut or it had a big knot in it one. My mom gave me a Xanax and after it started working, my stomach settled down and my throat wasn t swollen any more. that was the only relief I had for 3 days of living with my stomach and throat like it was. I am 60 years old, and I m not trying to get a buzz like I have heard some younger people do, I just need one for my nerves, not to abuse, just for relief. When I had them prescribed before, the doctor gave me too many, I thought because he gave me enough to take 6 per day. I can truthfully say, if I took one it was usually one about mid-day and one at bed time. If my stomach wasn t bothering me, I took one only when I was nervous and got the shakes real bad, or at bedtime if I couldn t sleep. Why is it so hard for someone to get a prescription when they need one, that s what they are manufactured for. ### output:

Hi.thanks for your query and an elucidated history. After reading and re-reading your history I could get is that you need Xanax. You should consult another Doctor For a second opinion and any good Doctor would certainly after going through your history would prescribe you this. As a precaution due to your age of 60, you should get yourself investigated at least once, and I would advise you the following:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen, *Colonoscopy All these investigations should be within normal limits for one to say you have IBS. Treatment:STRESS = stress is the most important cause of IBS. Please remember, and you must have observed that when you do not have stress your problem with IBS is reducedChange of lifestyle. I think maybe you are not coping with something. Vacation outside your area, mobiles phones to be off. You must have noticed already that these changes help a lot. Try to avoid anything which you are / have to do against your will and wish. Get into the hobbies which make you forget the world around you. Life comes only once,

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: About 6 years ago I started taking roaccutane for Acne vulgaris. It treated the Acne vulgaris problem well but it gave me other issues to deal with. Such as a pain in the top of the stomach and a pain in the lower back of the head & it feels like in the center of the head too. These two pains come together with the feeling of something moving up through the area where the pain of the back of the head takes place and when this thing moves up it feels like it is dealing with the pain where it makes it go less intense for a moment. Roaccutane also made my depression and fear overcome me which lead me to some kind of Obsessive-Compulsive Disorder . I went to see a doctor about the stomach pain and he took tests..(a lot of them) and he told me that my test results have shown no problems but he pointed me to a psychiatrist. all psychiatrists I met have agreed on that I have a depression problem anyway and they decided to treat me for it. the medicine the gave me for it was Seroxat and it has made the case of depression much better. I had it for about about 8 months. Seroxat made both pain in the top of the stomach and the lower back of the head pain less appearing by about 77% because me fearing these two pains has got less power and once they appear this thing that move up in the back of my head which got even stronger after Seroxat makes them go away. (these two pains usually appear when I m stressed out, didn t eat for a while, didn t sleep for a while, change sleeping or eating time habits, After physical exercise). I stopped taking seroxat because it made me fat from about 75 Kgs after roaccutane to 100 Kgs and the tests have show my cholesterol level as 200 & I also lost more hair than I did while on Roaccutane.. when I stopped taking seroxat about a year and two months ago pain in the top of the stomach and a pain in the lower back of the head started to come back and also fear & depression took over again. My questions are that, what is happening to me ? if I leave my case to time..is everything going to be ok and everything will come back to my normal state before taking these medications and when could it be?, is my weight coming back to normal, are these pains, fear and depression going away? IF NOT what do you think I should do ? *I did (Thyroid Stimulating Hormone test ) and it showed no problem. I also did (helicobacter Pylori Antigen Stool test) and also showed no problem)!! -about 19 years ago I ve had Tonsillectomy! ### output:

Hi, Thank you for posting your query. I appreciate the detailed description you have provided, it was helpful. It is clear that you have depression and the pain is part of depression. Medication has helped you, however has resulted in side effects, most notably weight gain. You have stopped the antidepressant and symptoms are coming back. I would urge you to meet your psychiatrist and discuss with him these issues, so that the antidepressant can be started. Also, if needed, a new Chat Doctor. Regarding weight gain, if you take care of your diet, and do regular exercises, you should be able to control it. Best wishes,

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I m just in need of some moral support, as I am not in a situation to get it elsewhere. My mental health isn t good and I am feeling completely depressed and very irritable, I m also being anti social. I am visiting family right now. For 9 years my father has been remarried and has another child, and has raised 4 other step children. I ve had to watch my mother struggle to raise me on her own with no financial support from him, and he s had little part of my life apart from random visits, I ve suffered childhood anxiety that carried on into adulthood because of my absent father. Now at 20 I still feel obliged to travel 2 hours by plane + 2 hours by car to get here to see them and act like family and keep a connection, I don t want to have this responsibility. I am struggling to maintain my composure this time around as I have gone through illness and injury last year, and had a very hard year overall and am just starting to get back into a good frame of mind to continue my studies in 2 weeks time. I am feeling extremely trapped in this environment, witnessing my step siblings hugging my father and watching him behave fatherly towards them, fathering his 4 year old daughter, and dealing with his wife who is a demanding and silently judgemental woman is hard on its own. She has been the brick wall between myself and my father, and continues to disallow any quality time for us. I want to go home, but will need to be here for another week, taking time from my own life and giving it to people who are undeserving and will put me back in the back seat once I leave, and I ll hardly enter their thoughts. After a very hard year, I don t have enough of myself to give to these people, and I just don t feel like I can continue to act friendly and polite to them with so much pain and hurtful history in the back of my mind, It just feels very unfair, and I m feeling very hurt. I can t afford to be slipping back into a depression because I need to be mentally strong to handle a full time work load. Is it wrong of me to be keeping so distanced in how I interact while I am here? And how should I go about keeping my mental health good and not becoming more and more depressed? Thank you for your time. ### output:

Hi, No, your feelings are not wrong. You need to be happy and mentally sound. You have a bright future ahead of you for which you need to be focused, and you also need to work for it. This should be your goal in life. You need not try to act good with people who don't seem to bother or worry about you and your mother. Politeness is good but not at the cost of our own happiness. Try to develop good friends and lead a happy and productive life. Evade all depressing times with your father and his family. It is time to realize that you do not really need them. No father is better than a bad father. There are many people in this world who grow up as confident and good citizens without any love or care from father. Yes, it will be better if one has a good father. But it needs not be bad if one does not have such father. Believe in yourself. Take care and live your lives with happiness for you and your mother. Above all, stop expecting anything like financial help or love from your father. It will only lead to depression. Detach your mind from them and start afresh. Best wishes!

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello, my name is Trent and i am a 34-year-old, slightly overweight (around 50lbs over BMI scale for my height) male police officer. for the last 2 years, ive been dealing with ventricular bigeminy/trigeminy as well as extremely frequent PVC s, tachycardia and the occassionally supraventricular tachycardia. at times the chest pains have been so bad i have passed out and hit the floor. i have not been able to work since january 2010. i have been hospitalized for these symptoms 6 times in the last year and half. i have been through 2 cardiac ablations and have been tried on metoprolol, soltalol, amiodarone, dronedarone, and 3 other antiarrythmics that i cannot remember the names of. neither ablation worked, and the second one caused more damage then good. prior to the second ablation (march 2011), my ejection fraction was 45% and there was mild diffuse hypokinesia in the left ventricle. after the second, ejection fraction dropped to 38% and there was moderate global hypokinesia of the left ventricular segments. structural disease was ruled out in 2010 by angiography and echocardiograms as well as a cardiac MRI. so far, none of the 5 cardiologists i have seen have been able to isolate the cause of all of my symptoms. my biological father had a pacemaker implanted at age 35 after he suffered an MI. i believe he was diagnosed with sick sinus syndrome. i have inquired into the possibilty of having SSS myself, but again, no one has confirmed or disproved this. since the failure of the ablations as well as the failure of antiarrythmics, the cardiologists that i have seen have told me there are no further treatment optins other then a 3rd ablation. having been through 2 already, i am definetly not eager to go for a 3rd. am i candidate for a pacemaker or ICD type device? and what is causing all of this? i shoud mention that cardiomyopathy was originally suspected, but again, not ruled out or confirmed. i was drinking alcohol on a regular basis up until november, and have not touched a drop since. any advice you could give me would greatly appreciated! i am extremely eager to have my condition treated and get back to work!! thank you for your time, trent a c wright. ### output:

Hello thanks for posting harbor seem to have refractory arrhythmias which despite medical and repeated ablations are not regressing. I think you must go ahead with a CRT -D implantation. I will resynchronize your heart contractions, and will correct your rhythm when required. It also has a back-up pacemaker activity which will pace the heart of rhythm is too low. It so gives you a small shock when the heart rate becomes irregular and life-threatening events can be avoided. You will only feel a small jerk during the episode. Sometime a notification will go to your cardiologist regarding the event so that he can get a tab on your health.Also, it is a very safe procedure and will not lead to decrease in your ejection fraction. Regards.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My mother had a massive stroke on 4/6. Our family is devastated. Long story short, she is 66, diabetic. We believe she had the stroke, then went to bed afterwards. We found her unable to wake up the next morning (about 12 hours later). Called an ambulance, she went into cardiac arrest at the hospital, she developed septic shock, which she miraculously recovered from. This all left her with brain damage to the frontal lobes. Doctors completely gave up to her, told us that she will never get better and to put her in hospice. Hospice told us that she was NOT eligible, because she was and is NOT on any type of life support. We bought some baby food and took her home, where she is now receiving in home hospice care. It has been 4 months and she is still alive, her vitals are good. She eats a soft diet everyday and we just started her on cereals and soups. She swallows and drinks perfectly and definitely WANTS the food. She is bed bound, we change her diapers and bathe her. She does not respond to commands, but it seems like she tries to touch her nose when asked, but she is TOO weak to do it. So, we are cautious about giving her the Glasgow scale assessment, because maybe she really is just too weak to lift her arm (we want to be fair to her). She has trouble speaking, but inconsistently will say yes , no and small phrases like Stop it Kim or Oh sure or That s good or Shut up or she will nod her head when asked a question. At times, she will say things that we cannot understand, but we can see that she is trying to communicate something...The problem and reason for for me reaching out to you today is that sometimes she looks spaced out, not fully there, like she s looking off into space. Her eyes will be looking up to the right direction and she is not saying anything. She looks like she is not fully there . We know it is the brain damage she suffered, but we are wondering IF she will pass through this stage or is this the best she will be? And what state of consciousness would you say she is in? Again, it has been 4 months since the initial stroke and she is 66. ### output:

Hello, It would be useful to have the imaging reports understanding the extent of the damage, but however by your account on what the doctors said it is clear it was a case of massive damage. Frontal damage is commonly associated with apathy and depression so those episodes where she doesn't seem to be there may be in that setting. Epileptic seizures would be another possibility, so you should watch her for abnormal, even subtle, movements in her face and limbs. As for her level of consciousness since it seems she is able to obey some commands, pronounce some phrases and alert I would tell her consciousness is intact, inability to communicate is probably related to damage to the language areas, not due to a diminished level of consciousness. As for expected improvement. Improvement is expected in the first 6 months, afterwards very little can be expected. However, most improvement takes place during the first 3 months, so while there may be some advanced in the next 2-3 months it should be a minor one, she will probably remain bed bound I am afraid. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: From August of 2011 to December of 2011, I lost 20 lbs, going from 125 to 105. In December of 2011 I started noticing extreme bloating and severe fullness after eating as if my food was not digesting, which would last the entire day and get worse as I ate more food throughout the day, only feeling better with long fasting(15+ hours). This has lasted until now. The past couple months, I ve had an endoscopy , a gastric emptying test, a small bowel barium x-ray , a upper right quadrant ultrasound, and a HIDA scan with CCK. All were normal except the HIDA scan. My gallbladder never appeared after 4 hours and they never injected the CCK. My GI doctor told me this may be what is causing at least some of my symptoms. I went to see a surgeon, who told me that my symptoms appear to be inconsistent with what he said were the only 2 reasons for results like mine, inflammation, and a gall stone blocking the duct(I asked about sludge and he said sludge usually shows up on an ultrasound). He said if that were the case, I would be in severe pain where my gallbladder is located. I am really looking for answers. All of my tests have come back normal except for the HIDA, and the surgeon doesn t seem to believe it. I am really worried and am looking for any information I can find. Although I am not a doctor, I ve read that gallbladder problems can FEEL as if your food is not digesting(although clinically I KNOW mine is digesting), and bloating and an unusual feeling of fullness can occur. I have also read that rapid weight loss can contribute to gallbladder issues. I guess what I m asking is, out of all these tests one comes back abnormal and the surgeon is not willing to accept it as abnormal, so MUST you feel severe pain as the doctor said for a test to come back the way mine did? And do my other symptoms(fullness, bloating) fit at all with my abnormal HIDA scan result? ### output:

Hello! Thank you for the query. You have the right to insist that this is gallbladder only if you do suffer from symptoms like: upper right abdomen pain radiating to the back, nausea and vomiting, pain after a meal especially when it is fatty or spicy food. Otherwise, there is no reason for gallbladder removing. Looking into the tests you have had performed, I cannot see colonoscopy and abdominal CT. Weight lost and bloating can be a symptom of colon cancer. Colonoscopy is very important in ruling it out. Abdominal CT with oral contrast is another test which should be done to visualize pancreas. Regular ultrasound won't tell anything about its condition. You should also have some blood tests: amylase, lipase, urine amylase, CEA, CA 19.9, CA-125. Stool tests should be also performed. Only if really all other reasons of your pain will be ruled out, and you do suffer from symptoms located in the upper right abdomen, you may ask a surgeon for laparoscopic gallbladder removal. Hope this will help. Regards.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been through chemo the last year. Have finished 1 1/2 months ago. Doctors had taken me off all meds in the beginning. Reintroduced me to one high blood pressure 3 months ago. Sugar levels started rising again, so they said I needed to go back on Metformin. Did that about 20 days ago. At this time, I went yo the gym twice and worked out on machines maybe too hard, but on machine I felt were fairly safe and would t hurt me. My muscles started started tightening up on my whole body and kept tightening, like torquing, to excruciating pain with 7-9 days. I used to take 200 mg of Metformin a day before the cancer, so when I started again, I took only 1000 mg. When my body was torquing me so bad I cut it to 500 mg. I also took 10 mg of baking soda as I sensed I was acidosis, and the next day, I took no Metformin because I just was in too much pain, but I took 30 mg of baking soda to try to turn by body alkaline. I was in so much pain through my lower back, hips, all side of my legs, knees, lower calves, a little torguing in my arms and hands with elbow and knees burning. I ended up in Emergency at the hospital. They did several blood test, and no, I didn t have Lactic Acidosis. They felt that maybe the baking soda had made my ph normal. I left the hospital with all the pain. Suffering one week until I see a doctor, they also did test, everything came up normal including Vit. D. So I at a loss, I take Actaminophen 325 mg. Either two of these or one of these and one Advil, but I also have to take one Oxyecotden? (I take 3/4 of one pill) to finally cut into the pain to make it bearable. Doctors have no answers. They say do I want to make an appt with them or not. Their suggestion is to up my Gabapenton ( nueropathy in my feet and ankles from the chemo). That is their answer to my overall pain going on in my body. I also want to mention I was only a lot of homeopathic tablets which I went of when my muscles were torquing so bad and have no been on them for over a week. I also tested the one high blood pressure med, Lozartan. I went off for one day just testing that, and no all the pain was still there, so I went back on because I know I need to be on that. And so there is my problem. ### output:

Hello, Possibilities of your aches are post chemo break down of muscles. Restart of exercise usually leads to aches and pains. Metformin may aggravate acidosis caused by reintroduction of exercise. You will have to get pH when you are off the baking soda. Get CPK levels done for muscle break down and readings of blood sugars should be from 80 to 140. I think these steps will improve your aches. Meanwhile, you take help from paracetamol 1g thrice a day. Hope I have answered your query. Let me know if I can assist you further.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear Sir/Madam My son is 1 month old right now. He is having strider from the time he was born. We consulted the pediatric ENT specialist and got confirmed that this is a case of Laryngomalacia. I came to know your details online and would like to get your valuable suggestion on my son s case. Below are the details: Weight at birth: 3.55Kgs (7lb 13oz) Lowest weight observed during first week: 3.29Kgs (7lb 4oz) Gained to birth weight by 11th day. Increased the weight to 3.60Kgs (7lb 15oz) We detected UTI on his 19th day. He already lost weight by that time. 3.40Kgs (7lb 8oz) He has been hospitalized and is on IV antibiotics for 5 days. Gained a few ounces. 3.52Kgs (7lb 12oz) Got discharged from hospital and is on oral antibiotics for 5 days. Gained a few ounces. 3.62Kgs (7lb 15.5oz) His Pediatrician suggested continuing the antibiotics (1 dose a day) for another few weeks and ordered VCUG test. He is having Strider almost all the time and the sound has been increasing. He has chest and throat retractions. He is on breast feeding but is not able to feed well because of the strider and the retraction. We tried pumping the milk in bottle which helped a little but not to the desired extent. On his Pediatrician referral we consulted Pediatric ENT specialist Initially on April 26th he thought its in moderate stage but yesterday May 16th he evaluated again and mentioned that its in severe stage and mentioned that a surgery is needed for correcting the same. We are already worried with the strider and the UTI (all the antibiotics). In this situation hearing about the surgery made us even more worried. I would like to get your valuable suggestion in this case. Should we go for the surgery? What could be the details we need to consider if at all you suggest us to go for surgery? I would really appreciate if you can please reply back at your earliest possible. Thank you so much in advance for all your guidance. Thanks Suresh ### output:

Differentiating between stages of laryngomalacia is very important, because it directs us toward the management.moderate laryngomalacia symptoms and signs include : feeding difficulties, esophageal reflux, retracting chest along with the noisy breathing, usually these child Chat Doctor. While in sever laryngomalacia babies may have hypoxia (lower tissue oxygen) , sever reactions that require multiple ER visits, recurrent chest infections due to checking. If any of these symptoms occur, surgery is advisable, and it includes (supraglottoplasty) which removes the flabby tissue above vocal cords and it's done through the babies mouth, and the baby stays in the Pediatric ICU for 1-2 days before removing the breathing tube .keep in mind surgery doesn't remove the problem completely, you will hear the noise, but there is a

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have a lump under my armpit that has been there for years. As of recently it started hurting when I touch it. The lumps have been there for years but are getting bigger within the past couple of days and started hurting a couple days ago. I am about to be on my period if that means anything. I have also felt these same bumps before under my other armpit, on the crest of my arms, and on my Bikini line that are al noticeably there. I know that is where a lot of lynphnodes are but for some reason these ones under my armpit are irritated all of a sudden. What could it be? I m about to schedule an appointment with my doctor. ### output:

Hi, Dear,Thanks for your query to Chat Doctor virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns. But the query needs to be updated with more details, like-What is size/ hard or soft feel of the lumps under the armpit??is it your first period when lumps have got sore? Any associated lump in the breast? What about the lumps along the bikini line in the groin (in the lemonade area)Did you had any recent viral infection?(Infectious mono viral)As the information about these lumps is not sufficient and as I don't have any first-hand information of these lumps as told above, I would advise you to consult ER Primary care doctor(PCP) or a Surgeon, who would check it up and would rule out many other causes responsible for such lumps, and would treat accordingly. Cause pf these lumps on the armpit-Still from the data given from you, following causes need to be ruled out-- Infectious mononucleosis viral infection or any viral fever / or Acne with boils may cause such lumps. -IF your period is to be related to these underarm lumps, then whether similar sore lumps are there in the breast(like Fibroadenomas with axillary tail of the breast being affected with such a lump-a benign tumor of breast). Moslty your lumps are of infective nature and need to be confirmed by second opinion from your doctors. To confirm other causes I would hence suggest you to consult ER Surgeon or PCP doctor. Treatment-This would depend on the cause of these lumps, which would be decided by your treating doctor. If medicinal treatment is not useful from PCP, then ER Surgeon would do FNAC biopsy with HPR, /X-ray Chest/CT scan study and would fix the reasons and treat it according to its benign or malignant nature. So till the time you consult ER PCP and or ER Surgeon and get his definitive opinion, DON'T WORRY AT ALL about it being tumor, but you need to be worried as it would complicate into other problem associated with it. And act fast on the above suggestions, which helps you to plan treatment with your ER Surgeon. Hope this would resolve your query with full satisfaction. Welcome for any further query in this regard to ME by direct question at Chat Doctor. Write excellent review and hit thanks, to narrate your experience, which would improve my rating for many other visitors to Chat Doctor. Wishing you fast recovery. Have a good day. Chat Doctor. N. Senior Surgical Consultant. M.S. Genl-CVTS

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I fell yesterday while holding my 2-month-old granddaughter cradled in my right arm. Once I realized I d lost my footing, I twisted my body to keep her on the up side and I must have landed flat on my left side. I got up quickly and though the baby let out a little cry, it was from the shock of the fall and she seems to be fine. I m so thankful. Fairly quickly, my right waist band area, where I was cradling her, began to hurt. We sat in the rocker and rocked a little and the baby is fine. My right side started hurting and my daughter arrived home from work within 10 minutes or so. I left quickly and went to my chiropractors office. Once I waked to the car, I could feel something sharp on my right side hurting me. I can press on it and it s not the spine, but more soft tissue between my pelvis and my rib cage. The chiropractor massaged and adjusted me slightly then added ice and stems unit. He thought I may have bruised an area between the ribs as he says that is very painful. I was no better and when I got home, I could barely walk. Raising my left leg or using my right arm hurt the worst, so I scuffed along groaning in pain. It s definitely one spot along the waistband, but internally and not the skin or a bruised area. It s part of my core because when I lift my left leg, it hurt it or when I push with my right arm, it hurts it. Luckily, I just had surgery three weeks ago and had many hydrocodone left, so I took one and some ibuprofen and sat in my laz-y-boy for awhile and then went to bed. I slept well and when I woke up, was much better though I can tell the danger zone is still there. The pain last night was very sharp and definitely worsened by some movements. The pain today is better but I m just resting and taking it very easy. I would go to the ER, but we had 6 of snow, and there s no way I can shovel show. I ve asked my neighbor for help and he has a few houses ahead of me. I will just wait it out. Too bad... the satellite is covered in snow too and I can t get out there to brush it off. lol ### output:

Hello, As you had a fall, what I understand with the history is that there will be direct impact over the muscle which would have got swollen in the fiber region of the muscular system. Also during cold seasons, there are changes to have that area getting feeling some kind of knot at the pain region. I feel this should be just a muscle and bony hurt which will become better in 3-4 days or max by a week. You need to take a hot water fermentation and also do much rest. Avoiding movement in injuries allows tissue to heal better. I don't feel this is a major injury. But in case after a week or so the pain don't subside with hot water fermentation and rest than feel free to ask me other questions. We will be able to figure out what could have been the injury level. But for time being I don't think you need to visit an ER. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i have arachnoiditis from pantopaque dye (a petroleum base iodine contrast ) that was injected in my lumbar spine with two doses and the table was tilted upside down to reach my cervical spine I was instructed to hold my head up so the pantopaque dye dosent go into my brain unfortunately instead of removing the dye within 30 min itwas left in my spine for two and a half months and twenty doctors later, until a neuro-surgeon sent me to a second neuro-surgeon at NYU to corroborate his diagnosis and treatment plan to remove the dye. p.s. the first neuro-surgeon attempted to remove the dye and did it by feel without the aid of fluroscopy and stabbed me in my spinal chord. I screamed - he took out the needle without removing the dye. It is now thirty-five years later. I ve been diagnosed with cancer of the brain, cancer of the spine (incorrect), multiple sclerosis, spinal stenosis, three herniated discs, scoliosis. By the way, the reason I went for a mylogram thirty years ago was for a numbness in my left thigh which disappeared two weeks later. I was in excruciating pain after the procedure and I had l05 degree fever. At the present time, my pain is mainly in my feet and toes. It feels like a thousand needles stabbing and burning. I should also add I have neuropathy and find it impossible to balance and walk due to this and the pain. I was allergic to Lyrica - my tongue started to swell up and had a hard time trying Neurotin. It made me very lethargic. I also was treated with ten 80 miligrams of Oxycontin and 8 thirty miligrams of Oxycodin which I got off of because I told the doctor I lept building up a tolerance for the drug and required higher and higher doses which caused me to develop a paralytic colon or sluggish colon. I am still taking one 30 miligram tablet at night with a ten miligram valium. A neurologist at Cornell is suggesting I take Cymbalta, 30 miligrams once a day. I am trying to stop the Oxycodin and Valium which takes the edge off the pain in my feet. I looked up Cymbalta to see if there would be a problem stopping the drug if I had to. To my dismay, the doctor on the internet said that it is nearly impossible to wean off of because of the doses of 60 miligrams and 30 miligrams, resulting in horrible withdrawal symptoms. What do you suggest? Please help - desperate and broke. ### output:

Hi, Cymbalta is certainly a good option for you. It is used very commonly and there are no problems in tapering it off. It is not like opioids and even if it is stopped abruptly, there are only minor discontinuation symptoms. Furthermore, it is not habit-forming and one does not develop tolerance to it. If you are still worried and would prefer a medicine that is available in a wider range of dose strengths then you can try amitriptyline (Email), which also works well in neuropathic pain. Best wishes.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear Dentists, I had the right upper molar nr.1 extracted 3 weeks ago as the tooth was originally filled in a long time ago and the filling fell out then the tooth broke down. So there were 2 smaller pieces of tooth extracted and also the 3rd bigger piece was extracted. It was an easy extraction, took 3 mins. The dentist pulled out the tooth and she told me she might not be able to do the extraxtion as my jaw is very narrow and the tooth is close to my sinus I guess, but she did it. The place of the tooth healed very nicely though it was bleeding a lot directly after the extraction. Then the around 6 days after the extraction on the roof of my mouth close to he gum of the etxracted tooth. It felt like a tiny breadcrumb is stuck there, but it wasn`t I checked it with my tongue . Then I had clogged ear on the extraction site, sometimes a feeling of having a lump or something in my troat which sometimes makes me difficult to swallow on the right side . I My gums were and are not inflammed. The little breadrcumb thing on the gum /roof of mouth changed it`s shape. It`s hardened and the flattened or maybe moved. It gets harder like the gum and when I touch it with my tongue I feel no pain at all. Is maybe something in my gum, I remember used the gauze for 3 hours after extraction and it pulled my tooth when I changed it in every 20 mins as the dentist said. Eveyr time I changed it ( it was dry , the dentist didn`t tell me I need to make it wet as I figured it out later and every time I chnaged it I felt a pain at one point of the tooth around the area where the 3rd piece of tooth turned and twisted and extracted by the dentist. Could you please tell me what is causing the clogged ear and the difficulty of swallowing sometimes on the side of the extraction? I am 3 weeks after the extraction now. The blood clot is developing nicely I can feel it with my tongue, but it`s still softer than the gum. Is that normal? I am still doing the warm salt water rinsing since the 2nd day after the extraction. I also developed something on to top of my tongue, like red patches , it feels like I burned it but didn`t eat anything like that not even spicy. What is that? Should I worry about that or it goes away by itself? Thanks in advance for your answer Judit ### output:

Welcome to ChatDoctorI went through your history & would like to tell you that post extraction there is pain & swelling, difficulty in swallowing in some cases & It's nothing to worry about. Healing requires time & there is formation of granulation tissue that appears whitish. Later on it merges with normal gingival. Still if you feel that something is inside then you should get an IOWA done of associated region.Meanwhile, you can do warm saline rinses. You also mentioned that you are experiencing burning sensation in tongue & that might be due to side effects of antibiotic that you might be taking. I would suggest you to take some multi-vitamin therapy for that & avoid spicy food. Consult your dentist for further problem. Take Disregards Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Patient 76 years Old. Female - a Non Diabetic, non asthmatic with HIGH BP Stage II. Hypothyroidism on regular drug therapy - AMLP , ATLP and with AF with controlled VR [ On Acitrom] was admitted on 22.04.2014 with the c/o breathlessness and palpitaions. No H/O chest pain / sweating / giddiness / nausea or vomiting. PR 144/min, irregular [AF with Fast VR] BP 150/9O. Patient was conscious, oriented, afebrile. Became Stable with Torsemide and Amiodarone 300 mg over 30 min given intially. CAHD:Stable Angina: AML & PMLP: TVD. - Poor LV Functions - Tachycardiaopathy [ FS: 30 % EF: 58 %] Mild PAH with Sec TR [Estimated RVPSP: 46 MM HG] Mild MR: AF with Fast VR controlled with Injection: Amiodarone 300 mg High BP Stage II - Does not Tolerate Amlodipine [Edema ] / Hypothyroidism - TSH 7.51. At present taking Tab Thyrofit 25 mcg 1 0 1 Tab Metosarten 25 + 40 1 0 1 Tab Cardarone X 200 mg 1 0 1 Tab Dytor 5 mg 1 0 0 Tab Trizid SR 60 mg 1 0 1 Tab Korandil 10 mg 1 0 1 Tab Clopilet 75 mg 0 1 0 Tab Aztor 5 mg 0 0 1 Tab Acitrom 2 mg 1 @ 5 pm daily Tab Raliz D 1 0 1 [If needed for Acidity] Tab Ativan 1 mg 0 0 1 [ If needed for Sleep] Echocardiogram reveals Anterior Mitral and Posterior Mitral Leaflet Prolapse. Triple Vessel Disease ?? Atrial Fibrillation with Fast Ventricular Response during Study. Mild Pulmonary Arterial Hypertension with Secondary Tricuspid Regurgitation. [Estimated RVPSP :46 mmHG] Becasue of taking Acitrom skin becomes Blakish and spreads in forearm, legs, thighs. PTT 38 CONTROL 14 INR 2.7 with 3 mg Acitrom daily. Tab Acitrom reduced to 2 mg. My question is whether Acitrom can be replaced with ECOSPRIN 150 or 75 mg. ### output:

Hi dear. Given your detailed history of triple vessel disease and mitral leaflet prolapse and tricuspid regurgitation. I would suggest you to continue with the same medications. You can consult your doctor regarding dose adjustments of citron. Keep your INR under the reference range. And also ask your doctor about tab brilliant. I feel you do need citron because of your valve disease. Thank you .hope my answer helped you. Please do rate my answer

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, I am a female, 31, and 3 weeks ago I travelled to Mexico City, the first 5 days I was ok but then started feeling very dizzy with a heavy headache and difficulty to breath. (This was on June 26th) I went to the doctor and she said it was low BP (80/60) and gave me some drops to feel better, I felt slightly better but kept getting very dizzy to the point I could not even walk more than 5 min. I went to the cardiologist and the ear doctor and they both said I was ok, and gave me some Medicibe for the dizziness, which helped a little but u was still feeling I could not breath and I got insomnia as well. Then went to the ER and my blood results were ok and they sent me home. I had to take a plane back to the U.S. And even though I was very dizzy I did ok in the flight.( July 5) Doctors in Mexico though it was related to the high altitude in Mexico (8,000ft) and once I got to lower altitude it would get better. Before my trip to Mexico I participated in a triathlon (June 14) and it was really rainy and muddy, I reached Mexico on June 20th and the next day I participate in a half marathon but I could only run 8 miles and felt aweful (June 21), the next day I was ok. I have been a runner for 10 tears and t was not my first long distance run and a triathlete for 4 years. In June 5th I started getting some fever (99.2 F) and it goes away when I take paracetamol or ibuprofen but then it comes back ( usually in the evenings, around 5-6 pm), I went to the doctor and I took an urine test and a thyroid one, still waiting or results. I have had a heachae ( in the frontal part) for 2 weeks now, it occasionally goes away but comes back with the fever and have been feeling really tired, also the lights bother me a lot and can t stand the computer for more than 4 hours. I am still not sleeping 100%, keep waking up every 2-3 hours) What can it be? We had a tick problem at work and I m worried it could be related. Thanks! Monica ### output:

Hello Monica! Thank you for asking on Chat Doctor! Regarding your concern, your symptoms seem to be related to a chronic infection. The episodes of fever are very concerning about an infection. I would like to know if you have noticed any strange lesions in your skin, that may lead to a tick bite. Usually the first signs are skin lesions and then the other symptoms occur. The other symptoms (dizziness, fatigue, headache, difficulty breathing) could be related to a tick bite or any other chronic infection, affecting multiple organs. Anxiety could also be related to these episodes, but it can't cause fever. I recommend consulting with an infection disease specialist and performing some general blood tests (complete blood count, inflammation tests, blood electrolytes) and some specific tests for chronic infections (like Lyme disease). A brain MRI may be necessary to exclude possible intracranial lesions. Hope to have been of help! Best wishes,

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: So to make this short and quick Im a 33 year old male who has been disabled by a loosely or undiagnosed condition, as I see it, including symptoms ranging from chronic neck pain, eye pain, muscle spasms, body wide muscle tension, neurologic abnormalities, cervical radiculopathy, fatigue, pain in lower back/coccyx, low testosterone, low vitamin D, osteophytes mainly in my cervical spine/lumbar spine, mild stenosis in cervical, many different blood work abnormalities(IGG IBB.... antibody, ACE high, low RBC, high rheum factor, etc. Ive been seeing my pain management dr. for about 1 1/2 years+ who is a nurse practitioner. She seems to know less about pain management than I have accumulated throughout my 3 years of debilitating pain, and treats me like Im a statistic. Ive never violated my pain contract in anyway and have passed all of my drug tests. Ive also given her permission to talk to my family, friends, girlfriend, doctors. Anyways, my question is when is it time to seek the care of a new pain doctor. Ive gotten every procedure that theyve suggested, continue to see a slew of dr.s trying to get a confirmed dx so that I can work at the core of the problem and not just the symptoms. I realize I forgot to mention my problem with her care. She has me on 75mcg fentanyl patch, which has been the only long acting medication that even keeps me moderately functional though she refuses to prescribe a short acting med for breakthrough pain. Shes been putting me on a wild goose chase where she tells me to do something like see a pain psychologist then tells me not to, then told me to see him again last week. I feel that my pain is the primary symptom that is keeping me from finishing my bachelors and being a more functional person. I dont want to be on opiates all my life but I believe that keeping me as functional as possible until I find out what is causing all of this is a lot better than not. Ive tried physical therapy, yoga, meditation, ice packs, heat, hot baths w/ magnesium, distraction, etc. and nothing else seems to help. My PCP, psychiatrist, and family all believe its a logical idea but she does not. There is a Dr. in charge of the pain center and the last ditch effort is to ask him to intervene but Im afraid of getting nowhere and if I have to find a new Dr. I know that many are reluctant to take on patients whove seen pain doctors in the past. I hope you may help steer me in the right direction. Thanks in advance. Sincerely,Matthew Olsen ### output:

Hi Dear Mathew welcome to ChatDoctoryour concern regarding your health is normal, and you have got degenerative changes in your bones very early due to inflammation of joints and synovial membrane, I will advise you to visit again your orthopedic Doctor and ask him for further investigation like CRP, ANA, and HLAB27there are some immunomodulator which can retard the progress of ailment and some time reverse it, for pain management you can try Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi i am a 50 year old male. 7 years ago i had decompresive discectomy L4L5 L5s1. I have had sympthectomy & epidural injections pre & post opp. I have had vairying degrees of numbness & sciatic pain ever scince. due to back & leg pain i have led a very sedate lifestyle since back problems started. Febuary this year i felt like i had a infection in a crack in hard skin on heel & noticed a redness around my ankkle. GP checked and dismissed infection. said redness was due to lack of blood flow. my calf and foot has had varing degrees of colour and pain since opp so redness was not to much of a issue. By march this year redness was up to knee sometimes a constant colour sometimes blotchey. Mainly foot ankle & shin. was treated with oral and introveonus antibiotics. Admitted to hospital and was treated for celoulites. after 24 hours in hospital i was discharged because the redness in leg would fade if leg was elevated. I was told most likley caus was due to infection in spine after opp and had been laying doormant untill now. Given more oral antibiotics. I see gp again and was sent to see vascular surgeon and pain clinic. Vascular surgeon said i had poor circulation in foot and orderd a xray with dye. I have had this and are waiting for results now. I have got another mri scan on lower spine in near future. I seem to be baffling everybody. I wake up every morning and standing there urinating and i can see my shin foot and calf going black like a 3-4 day old bruise. After 10-20 minutes of moving about the bruising effect go and return to red. I had a 50mm deficet of left calf muscle due to muscle wastage, this has now swollen to same size as other leg. My good leg is now starting to play up, sore around ankle and lower calf. I am a smoker (25years). Trying to stop have reduced by 75-80%. I am showing all charastics of PVD. All charastics of CRPS. My leg seems to be scabbing on shin where doctors have been checking pulses in leg. This is weeping a small amount of liquid every so offten. what seems to be baffling everybody is the way my leg seems to flush out when leg is raised. Can you explain this ? My questions to you are: 1: Can i harbour a doormant infection for 6-7 years. 2: If any changes in spine could produce same symptoms. Thank you i hope you can help. ### output:

Hello, Its unlikely that you are harboring an infection for such a long time but since your blood supply to limbs is less catching infection won't be a surprise. Kudos on reducing smoking. Taking care of skin is of prime importance. Secondly, spinal problems can lead to numbness, burning sensations or feeling of heaviness or feeling cold/hot. Your symptoms are very unlikely due to spinal problems. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 51 years old female and I have been diagnosed with SVT in 2004. I ended up in A@E as I collapsed. Rapid heart beat 180 and incrased BP. Put on medication, fine till 2007, yet another collapse, changed medication, varieous test been done ECG on SO ON. I was ok till 2009 and since then the episodes have increased and the time span from 6 month to 3 month, now it happenes on a 4 weekly basis. I am on Sotalol 80 mg twice and Amlodipine 5mg at night one. Since January this year I have more symptons. I now have high blood pressure, blue hands and lips, loos of balance, co-ordination increased dizzy spells and mild pressure behind breast bone. My last episode was last week. This came out of the blue. I was driving the car and suddenly I felt a bit weired,my heart started to raice fast, felt dizzy, faint, my hands changed colour from blue to white cold hands, lips blue, pale skin, waves of pressure behind my breast bone. Which lasted for one hr. BP 195/104 P 104. After about 2 hr. BP down to 160/85 P 85. I am still not right, I have small episodes of that every day. My feet are getting numb too now at times and it comes on at anytime, not physical related. No stress, nothing. My BP is at times high than low from 160 - 110 and my P goes down to 52. My arteries are fine and my valves are working fine. I end up in A@E and they send me home when I am medical stable. My GP looking into my kidney function and I had many blood test done. Every time I have an episode either consious or lose consiouness, I take longer and longer to recover and I am so tiered after that. I need to sleep for hrs. I am not in controll of this as it can happen anytime. Can you help of what I need to do. Thank you ### output:

Hi, SVT, uncontrolled hypertension, dizzy spells, cyanosis of lips, hands and vertigo (coordination) all indicates symptoms of chronic heart failure and Ischemic hypertensive encephalopathy. First, it is very important to distinguish whether the arrhythmia (SVT) is permanent atrial fibrillation (I guess it is as you're on Stall), holder monitoring should be done to find out frequency of paroxysmal episodes and proper cardiologist consultation(with lipid profile, recent ECG, holder and echocardiogram) should be sought in case of severe interruption of day to day activity so that an ablation could be arranged if required. Hypertension can be controlled by taking combos such as Losartan+HY Chat Doctor. 5 in the morning. Amiodarone can be used during paroxysmal episodes of atrial fibrillation 200 mg (according to treating physicians advice) Also supportive therapy should be considered to avoid euro circulatory complication during hypertensive crisis such as IV Paracetamol infusion after complete evaluation.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello.this is going to sound strange but i need to know if u ever heard of this happening anywhere before. someone is in love with my husband and they want me out of the pic. they electronically put words all over my body out of revenge and on my face. on my husband, it looks like scratches. on my body it looks like very light and old tattoos (like home made tattoos but theyre extemely light in color). and on my face, it looks like its the color of my skin but when im inthe sun, it looks white. my skin is tanning now that its sunny out and it doesnt appear to be tanning. in my home, wherever it appears, the words look like the design its going onto for example - my wood floors has a design - the words blend in with any design in the apt. on glass, it looks like smudges. its very scifi and scary and i havent told anyone because theyll think im insane. its insane that the persondid this to me, but im totally sane and not at all crazy. i have a very normal life and i work at my job for almost 20 years. the person wants to make me think im nuts or make people think im nuts telling them they are words all over the place. on my white walls, the color looks like new paint color against my old white walls. it blends in the designs everywhere. the electronic words made scratches in paint, on my car paint, and scratches in my wood furniture in spots. have u ever heard of this or know what this is???? it appears to be computerized because where ever we go, it appears there. and the words are big and very small also in sizes. it says stuff like (LA) is my man. over and over. set him free. i love LA. LA and so and so. all over the place and im not making this up and its not a joke. its actually a bad joke on me. but i love him and im not letting him go. thank you for reading this. i have couple of pics of my face.its hard to see but u can see hearts and other stuff. oh and the words keep appearing like if i leave a paper in the car, the next few hours it has hearts and LA and the persons name on it. the words are hard to notice if u look at them but i can see them. i have cateracts and had my eye fixed on one eye and its a good eye. sometimes i can only see the letters on the glare. have u ever heard of this happening anywhere and can u look into this and let me knowif u ever heard of anything like this happening so ill know which way to search for whats happening to me. thank u much. i appreciate it. L ### output:

Yes, I have heard like few cases before this. You didn't mention your age and since how much time are you suffering from these! But I suggest going with your husband to see a psychiatrist. You may be suffering from some delusion that you would not believe. I know you are not going to accept the fact that there is something disturbed in your mind rather than around. But do u know that someone who is doing like this? If anyhow you can prove to others that whatever you are telling is true, it's good. But if you can not prove, Just believe me it's a problem in your mind. You can become out of this with help of a psychiatrist if you believe the treating doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Dr. Christensen, I have been having heart palpitations. Actually they feel more like skipped beats. They started about 6 months ago. However, they are becoming more frequent (happening daily for 4 days now). With the first day having an extreme attack of skipped beats in a row which threw me for a loop while I was at the supermarket. I have been diagnosed with anxiety but for some reason these seem different. It is not so much my heart racing like an anxiety attack it is a skipped beat. Also, I don t have a panic when they are happening like an anxiety attack. I also do not feel dizzy or pass out or any other symptom but complete discomfort! Also, the only other symptom is that I feel like belching when they skip a beat (I know that sounds crazy). I am 46 years old and believe that I might be in the stages of perimenopause. My menstrual cycle, although pretty regular, only lasts a day now. I also seem to have pms all the time! I think I have about 1 or 2 good days out of the month. My husband has said I have PMA (pretty much always!..lol) I did go to a physician for the skipped beats and they happened when he listened to my heart (for about not even a minute). I am on meds for BP ( atenolol ). The doctor told me to up my dose to 50 mg (I was on 25 mg). It hasn t done anything for the palps at all! Also, my blood pressure wasn t high on my normal dose that I was previously on. I am also on Xanax for anxiety. I do take the xanax when the palps are happening and it doesn t help either. The doctor did order some bloodwork and I do have to return to see him after I get the bloodwork done. However, at this time, I do not have health insurance since I started a new job and cannot afford for all sorts of expensive testing. I do have a stressful job working for a family law attorney and have been doing this type of work for over 20 years. Your input would be greatly appreciated. Thank you in advance! Regards, Laurie ### output:

Hello and welcome to Chat Doctor. Thanks for your query. It is possible that your palpitations could be anxiety related. Especially, the premenopausal period is a period where hormonal imbalances can also contribute to changes in mood or an increase in the anxiety levels. It is important to understand that anxiety can present with not only psychological symptoms but also with physical or somatic symptoms. Shakiness, dizziness, fast heart rate (palpitations), etc. are symptoms which are commonly seen in anxiety disorders. However, considering your age and since you mention that you sometimes have "skipped beats", it is also important to rule out a cardiac cause. So, I would advise you to have an ECG done to rule out the possibility of a cardiac arrhythmia. For your anxiety symptoms, in addition to the medication, I would suggest that you try relaxation therapies, like deep breathing, progressive muscle relaxation, yoga, etc. Avoiding excessive stress and adopting a healthy lifestyle with regular food and sleep habits and regular physical exercise is also essential. Wish you all the best.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had a severe toothache about seven days ago. It was around the upper left molar teeth.I have had sensitive teeth for a long time, but the impact would be only for a few seconds. And that too my teeth have been sensitive to only cold things, not hot. But now, the pain would become more severe even if drank something hot.I tried home remedy initially. I applied clove oil, but that did not help. And then I took a dose of Panadol (Paracetamol 500mg x 2 tablets), but that wasnt of much help too. The ache lasted for several hours. I couldnt sleep at all that night. The next morning I went and saw a dentist.He did cleaning and scaling. He had to local anaesthesia when working on the left side, due to the existing pain. He took an x-ray. He said the pain was caused by inflammation of gums which was due to infection in the pulp. He said two teeth were affected. He has indicated that I would need to do root canal treatment for both the affected teeth.He prescribed an antibiotic and a painkiller: Amoclan Forte 625mg (Amoxicillin and Clavulanic Acid - 1 tablet twice daily for 5 days; Dolgit 400 (Ibuprofen 400mg) - 1 tablet twice daily for 5 days, if I the pain exists). He asked me to come bad for the next visit after completing the course for five days.I have completed the five days of medication. My next visit to the dentist is due today.My questions are:(1) Do I really need root canal treatment? How can I be sure? Are there any alternative treatments?(2) I have been told that I will need to come for two visits. Does root canal treatment take multiple visits? Can it be done in one visit? What all steps does it involve?(3) Is it possible that commercial reasons may have prompted the dentist to recommend root canal treatment instead of an alternative treatment that may cost much less?(4) I was told that if I delayed the root canal treatment, the infection would get worse. Is that right? I live in the UAE, and I would be on a visit to India two months later. Medical costs are much lower in India than in the UAE. Would it be okay if I postponed the root canal treatment, so that I can do it in India.(5) How much of an emergency is root canal treatment? Does it need immediate attention? After this course of medication that I have already been through, in case the pain does not occur again, then will it be okay if I saw a dentist in India and then take action as required - whether a root canal treatment or any other treatment?Look forward to your response. Many thanks.Regards,Arun Joshi ### output:

Hello, Requirement of root canal treatment can be decided only after examining your oral cavity. If the tooth is decayed, and it has involved the pulp it should be root canal treated. Root canal treatment usually takes 3 sitting, but now there is single sitting RCT which can be done if the tooth is not infected. Since the cost of RCT is higher in the UAE you can get it done at a cheaper cost in India. You can use Colgate Prorelief toothpaste for sensitivity. It gives quick relief. Regards

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: This is about my father. Age = 65 Medical History: Diabetes, leprosy ( treatment going. started 6 months before), hypertension(taken alphrazolam for 3 months as per medication) Description: my fathers age is 68 and he is very abusive to my mom who is 58 He does not understand that his impulsive angry behavior is pain for my mom and the family. he only tries to make his point and does not follow any logical discussions. he may agree with certain logical discussions but later will forget that start with his own saying. he was really abusive to my mom 5 yrs before physical and mental. Also he was very irresponsible in his duties towards his family. when everything wat he wants is there, he is the perfect guy who talks intellectually spritiually but as soon as something happens which is not as per his wish he turns violent if he has a weak opponet or becomes a nagging dog if he has a strong opponent. he dont want to see a psychiatric. We have taken him to psychiatric 2 yrs before and he was prescribed with alprazholam. he took them multiple times a day and his health detoriated. We somehow made him stop taking that. His health went back, but the mental health remains the same. He is very extreme in nature. his anger has no control, and he jst goes restless if something does not happen according to him(specially when people do not behave the way he wants them to behave with him). he also has the fear of dying if he does not eat well or travel fast. he gets very anxious about his health for a moment if he thinks he will not get food in time. he has a mania of playing with water and applying it on his forehead. even in extreme winter he feels like he need a fan running in front of his head. He does not understand a reason which does not align with what he want to do. Even when he understand and says he will apply, during the implementation he goes his way. he has taken the family in many absurd situations. now i am getting married and my mom is near a breakdown due to this behavior. Now he can only magnify his behvior in front of my mom as we have grown up. he remains calm and quite as we are around and as we leave he starts everything with my mom. how to tackle this. i am from pune, india. does any institution handle these kind of cases. he do not want to go to a doc for this ### output:

Dear friend don't worry. After studying your case homeopathic line of treatment is most beneficial to your father. In allopathy, they only give medicines that induces sleep. Homeopathy treats person as a whole, not a single disease that means all details of your lifestyle will be asked by homeopath doctor and according to that medicine will be given which will be most suitable to you. So please consult a homeopath nearer to you.in circumstances if you can't consult a homeopath doctor, take following medicines.syphilis 6 or syphilis 30 5-6 pills twice per day for 4-5 days. Aconite nacelles 6 5 Chat Doctor. Continue your medicines for diabetes and hypertension. After one month inform me again. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i think i could be pregnant i have changed from the injection to the pill and i got told that i could get pregnant in that week , the next day me and partner had sex and the condom split, i have had signs of pregnancy like sore nipples even around my nipple have darkened , they have also fatened out they havent gone up a size but they have become move wider and heaviler, i came off my pill after 21 days for my break , i came on 6 /7 days after i had stopped takinging it which is not normal for me its usually about 2 days after. i came on with really bad cramps and slighty heavy bleeding, i still had pregnancy signs. i came off after 4 days which is unusual my cycle usually lasts 7 days are 8, my signs have got worse and i find myself having to sit down and for water and fresh air as i have been going really dizzy and going really sick and it does on and off through the days . i also keep getting strong headakes which i rearly get, i have taken for test 2 before the period and 2 after and all negative , im getting more bloated and going for my tollet breaks depending on the day, i dunno if its in my head are what but i have worked out id be 7-8 weeks pregnant if i am help ?? ### output:

Hallow Dear, Even 2 months after the missed period if your pregnancy tests are negative, I would have otherwise written off the case as no pregnancy. Soreness of the breasts can happen due to many other causes which includes rough handling also. All other symptoms like headache, bloating, fatigue are not pertinent to pregnancy. However, darkening of the nipples and areola with areolar widening makes me consider that you may be pregnant. You have two alternatives for diagnosing the condition:1. Go for Beta Chat Doctor test. This is very specific and sensitive test which gives reliable results even few days before missed period. 2. Get ultrasonography done. By this time, it will give direct visual evidence of pregnancy. Moreover, if you are not pregnant, it will help to look for any evidence of Polycystic Ovaries (PCs). PCs is known to delay menstrual cycle for considerable time. When the periods start, they are usually very heavy. If you are diagnosed non-pregnant, please undergo investigations for finding out the underlying condition. Blood examination for Prolactin, FSH & LH would be important. Since you are having headache, Prolactin values will be important. If they are raised, they lead to breast secretions. Then X-ray of the head will try to see whether you have got pituitary tumor. Usually this can be treated with Tab. Bromocryptine. Get Thyroid function also assessed. Thyroid dysfunction does alter the regularity of the menses. The symptoms like lethargy, fatigue, etc. may be attributed to low Thyroid functioning. Please have a consideration of your body-mass index. In PCs as well as Hypothyroid condition, BMI is raised. Try to maintain it between, 18.5 to 24.9. I would request you not to depend only on urine pregnancy test and undergo more investigations. Please report to you Gynecologist.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My daughter aged 5.6 yrs has got fever from last sunday(16-sept)& had high temperature till Tuesday (18-Sept). She was fine & active on Wednesday(19-sept). On 20th morning, she had sever pain on leg muscles. We consulted a doctor & as he advised, we took Blood & Urine test. Report on 20-Sept-2012 ALKALINE PHOSPHATASE. 147 U/L; SGPT 12 U/L; UREA, SERUM 23.5 mg/dL; CALCIUM 9.5 mg/dl; CPK,SERUM 353 U/L; BLOOD ROUTINE EXAMINATION: HB 14 gm% ; TC 2,800 Cells/cumm , DC P-44-58, L-37-47, M-3-7, E-1-5; Neutrophils 50%; Lymphocytes 44%; Eosinophils 2 %; Monocytes 4 %. ESR 3 mm/hr; PCV 41.8 %; PLATELET COUNT 1.5 Lakhs/Cumm URINE ROUTINE EXAMINATION PROTEIN NIL;SUGAR NIL;BILE SALT NEGATIVE;BILE PIGMENT NEGATIVE;BLOOD NEGATIVE;KETONE NEGATIVE;UROBILINOGEN NORMAL;PH 5.5;SPECIFIC GRAVITY 1.030; DEPOSIT ..... PUS CELLS OCCASIONAL; ..... RBCS NIL; ..... EPITHELIAL CELLS OCCASIONAL; ..... CRYSTALS NIL; ..... CASTS NIL; BACTERIA NIL; Report on 22-Sept-2012 CPK,SERUM 1412 U/L ; SGOT 87 U/L; SGPT 29 U/L HB, TC, DC HB 13.9 gm % ;TC 2,300 cells/ cumm ; DC P44-58,L-37-47, M-3-7,E-1-5; Neutrophils 30%; Lymphocytes 66%; Eosinophils 2%; Monocytes 2%; PCV 41.4 % ;PLATELET COUNT 1.3 Lakhs/Cumm Will you please guide us on wat to do next? Note- We live in India ### output:

Hello dear, it seems she has streptococcal infection. For differentiation, you should also give antistreptolisin -O, IGM, G to Chlamydia trachomas, uric acid, reumatoid factor, throat culture and sensitivity to antibiotics. Amoksiclav, ibuprofen should be given for 10 days. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your baby good health.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: dear sir , i got married 3 years completed. idont have baby , i went hospital a lot of medicine i will take, since now i will use sitha medicine dr say pcod , i took medicine, he will say pcod clear , this month you are try to conceive , please help me ### output:

Hello mam...the for trusting Chat Doctor doctors for your health related queries. I guess your concern is about getting pregnant. Firstly I want to tell u that. Ur main problem is irregular menses, because of this you are not getting pregnant yet. But RELAX... It's NOT A BIG DEAL...its treatable thing. Its is the most common thing in reproductive age women's (reproductive age women are 15-45 yrs in which chances of getting pregnant is high). But u didn't give information about your exact age.so i don't give any comment on this. U told that your doctor treating u with medicines these medicines are given to the patients who r having PCs.these medicines are usually given for minimum 3-6 months, secondly let u discuss PCOS (poly cystic ovarian disease). In this case patients usually having irregular menses, obesity, difficulty in getting pregnant etc. but once treatment is completed your will get pregnant...women don't get pregnant either there is problem in wife or husband or sometimes both of them...in your case it s Jun pod,once its treatment is over...u can get pregnant...but u haven't shared info about your husband,his exact age??how old is he??was it a late marriage for him???? Etc.so i canto comment exact reason y are u not becoming pregnant....even if there is problem in him,don't worry u can com pregnant...here comes the advantage of 21st century technology to com pregnant...It's called ART... Assissted Reproductive technology(It's difficult to explain in detail about it in this short message)now I would like u to focus on interfertile PERIOD,it starts from 10th-16th day of menses....here ovulation occurs,this ovum meets sperm n women gets pregnant....in this period if u do more episodes of intercourse the chances of pregnancy are more....well with this small discussion u can try out my suggestions:-1.have patience....don't put unnecessarily ourself into tension.2.complete your pod treatment....3.I insist u n your wife to have more episodes of intercourse during fertile period(scientific mean told already ABV)try this after completion of pod treatment for next 4-5months,this solves 90% of your problem3.if you're in very hurry or no results after 4-5months then visit a nearby gynecologist/infertility specialist for further help hope this WZ informative enough, helpful n useful for your query.regards: Chat Doctor. .(married for 3yr,still no baby...so u r in tension full mind...besides this u have pod,that has doubled your tension...I can understand your psychology...don't worry...have patience.I pray god u get blessed with cute baby asap,hopefully, TWINS!!!!!)

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi .. Plz help me out, I am very worried and confused also. As we dont know about the pregnancy I had chest X-ray during very early stage of pregnancy.Let me share the sequences wise details with you which were happened with me.1. My period date is 4th March2. Me & my husband stopped planning from 12th March because we need baby3. From 18th march I had fever & go to hospital for treatment. Doctor suggest for blood test , so we go for it and its detected typhoid. Doctor has given some anti-typhoid medicine. After 2 day again I had fever, so doctor suggested that I should be admit in hospital for 2-3 day for monitoring the fever.4. I was admitted on 1st of april, since last 15-20 day I had chest pain and told to doctor about the pain, he suggested we should go for chest X-ray for further medicine treatment. We told doctor about our planning so he said before X-ray we go for UPT. So we did it, but its negative. So on 2nd april in morning I had chest x-Ray.5. I discharged from hospital from 3rd of april,but from 4th of april I had strong stomach pain due to medicine, as I dont suit the allopatChatDoctoredicine. I had problem during latrine even I couldnt sit properly.6. I was waiting for my period, So on 6th april morning, we fixed the appointment with gynecologist. Again we go for UPT but its negative.7. After 2-3 day I feel relax but worried about the period, so we go for UPT at home on 12th april evening and this time we get the positive result.8. So early in the morning we fixed the appointment with the gynecologist. Share each and everything with her. Had sonography. She said nothing to worry everything will be fine because x-ray was done in very early stage of pregnancy i.e. at the time of fertilization. Doctor has stated the treatment.9. I was discussed the matter with 2-3 doctor and pathologist, they also said nothing to worry. But I want to know your expert opinion in this regards. Is there any problem of my unborn baby, on its health etcplz help me out ### output:

Thank you for trusting us with your query.I'll try to explain with numbers so that you can understand about the various magnitudes. Strength of radiation of Imaging studies like X-Ray, CTS are measure in RADS.usually an exposure of 10 rads will cause harm.1 RAD= 1000 mill rashest X-Ray is approximately 60 mill rads. As you see, It is highly unlikely that your baby will be affected. What's more is that having a. X-ray even before you know you are pregnant has lesser risk. Relax and be assured that your baby is fine. In the future, X-rays should be avoided but if your doctor d coded you absolutely need them, it is better to get it done with adequate precautions' no to minimize the risk to your baby. Hope Ive reassured you and if you have further query let us know. Congratulations.wish you both the best of health.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Im a 13 year old female. I have had pains although my body for 2 years. I would rate the pain 7/10. The pains are in my joints, but sometimes muscles. They mostly occurred in my feet and legs, but also my arms and back. The pains have slowly got worse. They occur everyday. Everything about them is random. They always change. Pains happen when walking, running, jumping etc but also sometimes when sitting down. Lately I feel like my left arm is very weak, (I m right handed) and hurts when I use they muscle. I also find that roughly where my large intestine is and under my ribs gets pain sometimes. I have glasses for things at school like reading or on my ipad or looking for desk to board because my eyes have trouble focusing, don t know if related. I sit out on most pe lessons because I just can t join in. Mostly I just try to deal with it. Sometimes I have to limp. Right now while typing this, under my wrist it hurts. I am not using it at all. The doctor has gave me supplements because I have some vitamin deficients. I also have orthotics because I have flat feet. I have been wearing them for 3 months and these is no improvement at all. I have been taking the supplements for 2 months and still no improvements. I have had blood tests, and they only show iron deficient and nothing at all for arthritis. I don t know how to discribe the sort pain but I would say aching. But the type of pain all ways changes. I was wondering if it could be something like nerve pain. Sometimes I also get tingling fingers and sometimes toes. My fingers get numb when easily. They go white then after about 10 mins they go purple then back to normal. I used to do netball and diving but have stopped because of pain. I have seen many doctors, specialists and no one knows anything. I have seen a peditrition, foot specialist, eye place for glasses, nutritionist and local doctors loads of times and nothing has helped. Please help and find an answer!! ### output:

HelloI have studied your case in detail. It seems you have iron deficiency anemia. This anemia is associated with aches and pains, pins and needles in hands, feet, fatigue,listlessness, weakness etc. cause is either loss in stools from bowels (in which case other deficiencies of calcium, vitamins co-exist) or in menses in girls or some chronic disease in body., or due to nutritional deficiency diet, since you have been to many doctors, I may suggest simple nutritional supplements with iron rich foods, green leafy vegetables, bands and pomegranate juices and oral supplements of iron pills after breakfast like ferrous fumarate spangles. Get stool examination done to identify any blood and iron loss, serum calcium and vitamin D levels, serum B12 deficiency (in pernicious anemia), consult a doctor who may get these tests done to find cause for iron and other vitamin deficiencies, rule out pernicious anemia, stomach acid qualitative and quantitative tests for chloral Chat Doctor. For aches and pains take Tylenol tabs best wishes

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello.I ve been having breathing problems for more than a month. I feel like I can t breathe as if someone is suffocating me.It especially gets worst when I lay down or am asleep. I have been to two doctors, the first doctor diagnosed me with asthma and said I need to take cortisone inhalers. After a week of using it for only once a day, it got a lot better.After I stopped using the inhaler, the breathing difficulties returned again. This time, I went to a different doctor since the old one wasn t available anymore. The other doctor said I do not have asthma at all. I made many different tests and they all said I was fine. I didn t have anemia or heart problems and my blood pressure was just fine. The doctor just gave me a multivitamin for general health and said I need to come back for the X-Ray for my chest. What could be the real reason for it? It s getting really worst lately. I don t know what to do anymore. For some reason, my parents and doctor doesn t think i m asthematic, but I was diagnosed with it as a child and one time during my teenage years, and the other doctor disagrees about me having it in the first place. I don t have coughing or weezing, just shortness of breath. How come the inhaler made me feel better if it wasn t the case? Thanks, Allison. ### output:

Hello Allison, Thank you for asking at Chat Doctor. I went through your history and can understand your concern and confusion. I would like to know more about you like your age, nose symptoms (nose congestion, running nose, nose itching, etc.), whether you are exposed to passive smoking/polluted environment, etc. However, at present, from your provided details, I would like to make suggestions for you as follows:1. To confirm whether you have asthma or not, I would suggest you a test known as spirometry with post-bronchodilator reversibility. This will help to know your lung capacity as well as status of airways, whether they are obstructed, etc.2. Inhaler made you feel better suggests possibility of asthma. However, if you have not had such problems in past years, it could be a simple episode of bronchitis or infection which lasted long. (please note that some episodes can last for 4-6 weeks until complete recovery). If you have shortness of breath in past years (even childhood), it would more favor diagnosis of asthma.3. I would like to mention here that most of the patients with asthma have normal chest X-rays. Chest X-rays are not useful to diagnose or to rule out asthma. Of course, Chest X-rays are helpful to know if you have any other lung related conditions like pneumonia, etc.4. In general, I would also suggest you regular breathing exercises and avoidance of smokes/fumes/dusts to improve your lung capacity on long term basis. If you are routinely exposed to such environment, I would suggest you personal protection measures such as using face mask, etc. Hope above suggestions will be helpful to you and will help you solve the confusions. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I have visited my Gp atleast thrice since last month, the first visit was on march 6th 2014, reason for visit was waking up every night after couple of hours of sleep and couldn t go back to sleep with fast heart beat and chest discomfort, very rapid chest pain, raising and racing heartbeat, whole body shivering, heavy sweating from all over body in sleep, feeling week and drained of energy, was passing out almost and my Bp was 120/70 heart and pulse over 90 and Gp thinks its anxiety and prescribed 10 tablets of trizolam 125mcg but that couldnt help me in any way, so after using them without any good outcome, I re-visited to my Gp s clinic, this time got checked up by another Doctor, This time my bp was 130/60 and doctor said I am mild anxiety patient and said no need for any medication but just need to go on google and look for tips to get rid of anxiety. Today visited the same doctor again and he checked my bp it was 120/86 and he was concerned with my heart beat, he didnt tell me how much but he said its quiet abnormal, so he prescribed me 15 tablets of zopiclone and 14 tablets of bosvate 2.5mg, i feel like no one is sure whats my condition as i ended up in emergency 6 times in 5 months with heavy chest pains and rapid heart beats, all this while they couldnt find any particular reason behind my issues.Sorry forgot to mention first time i ended up in emergency in november with chest pain my bp was 170/130 continuously for 7 hours and they asked my to see my GP as my blood pressure, my blood sugar levels and my cholesterol were too high, my Gp did blood test twice and results cholesterol 6.2mmol/l and HbA1c was 56mmol/mol and i was put on 500mg metformin daily two tablets with food and one Atorvastatin 20 mg daily one after dinner, 10 days back my Gp did my blood test again and my results were total cholesterol 2.5mmol/l and my HbA1c was 47 mmol/mol . my Gp not really impressed with my HbA1c as he said I should be at 41 mmol/mol by now as i have given up drinking since november and stopped smoking since over a month and have been eating healthy since 5 months and lost nearly 10kgs, so my question to the doctor over here on this site is why am I going thru so many complications with my heart and sleep and chest ### output:

Hi Sir, Welcome to Chat Doctor, I understand your concern. Your symptoms are suggestive of Ongoing Myocardial ischemia. So I advise you to get an ECG,2D Echo of your heart immediately to confirm the diagnosis. Chat Doctor. Coronary angiogram followed by angioplasty will be the procedure of choice. Avoid stress and anxiety. Consult your cardiologist for expert management. Post your further queries if any, Thank you.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 27 114lb 5 7 female ive been smoking cigarettes since i was 13, quite a heavy marijuana smoker in teens but no more, I started using crystal meth when i was 21 only snorting it for the first 6 months i started smoking it quite heavily thru a water bong often with incredibly sugary juices and candies in it for flavor. I quit for 1 year in 2008 relapsed very shortly after yr to date when i relapsed in 2009 using same bong method with juice. last year in march i went to rehab but left in july due to a relapse, my daily intake is rather excessive i can often smoke up to an eight ball (3.5 grams) a day, i started to occassionally use heroin in september of this year I am not physically addicted to it, but i do use it more than i should. around christmas of this year i noticed i was becomming very short of breath and having troubles breathing wheezing very badly. on christmas i suffered my first asthma attack my respiratory health has steadily declined unfortunalty my meth bong usage has not. i have just recently stopped smoking heroin(i was using bongs for that also) and i can only take about one puff of a cigarette without choking literally and coughing till i usually cough up blood. I have been in the hospital now about twice a month since december. my coughs are very severe and often have a sick churning gurgle sound and the mucus that comes up is very yellow and thick thick balls and large curdy thick chunks and resemble long disgusting wormy looking mucus noodles, often m with brown or bloody like color swirls. this last month has been especially bad, my wheezing is constant and walking up 5 stairs will often bring me to the point of asthma attack. im 27 and i8 sound like a 90 yr old woman. I am obviously growing very concerned about my condition and i am now trying to no longer smoke jib on a bong....or really at all. i would like to mention also that i have had more than one set of chest xrays when nothing was said to be the matter.....I guess my question is do you think this is due mainly from bong usage noting however i never encountered a problem EVER in past or is there something else to worry? thank you ### output:

YOU STILL NOT HAVE DAMAGED ANYTHING BUT MAKE SURE THAT YOU STOP ALL THE BAD THINGS NOW BECAUSE THIS IS TIME TO QUIT EVERYTHING THIS IS YOUR WILL POWER WHO CAN STOP YOU START TAKING TABLET MONTELUKAST 10 MGM THRIVE A DAY DDO IT FOR 6 WEEKSSEROFLO INHALER 125 MGMT TWICE OR THRICE A DATA ZINE TAC 150 MGM EMPTY STOMACHACHE 3 GLASSES OF HOT WATER IN THE MORNING AND 3-4 GLASSES OF WARM WATER BEFORE SLEEP

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Please help me doctor..me and my girl friend had doing sex yesterday..I insert my reproductive part in 1and half min and pulled out after few minutes I again inserted less than a minute and pulled out..same for 3 or 4 times..and sperm comes after 5min at that 5min of time I m not inserted into her vagina..this type of sex we are doing for 4times in 2 and half months.. Last month she attains a period properly...but dis month we had sex before 2days of her period..is there any chance of getting pregnancy of my girl friend...please doctor we are unmarried and young lover. My age is:22,her age is:20..please I beg u doctor...u r our only hope...I want privately to tell you doctor..please doctor help me..wen we can meet u safely and privately..please doctor reply my message...I can t sleep during nit doctor for past 5days..I dono what to do.. theriyama pannitom...please help me please I beg you doctor..please doctor...u r our only hope...we r from decent family please..doctor help me.please doctor...what to do doctor..reply please please please don t ignore this we are in serious trouble...please help us doctor.. we have decided to die..we don t know wat to do ..we are too young ..we don t have any other options....you are my last and final hope...please doctor help me...we want safe and secure help...please doctor please doctor...mudila doctor help me please...please reply to this message..u r our god..u r our last hope..please please... ..help me please ### output:

Hello.thanks for trusting the Chat Doctor doctors for your health related queries. I guess your concern is about.chances of getting pregnant without ejaculation inside the vagina.right.first I want to say that.don't beg to me.I'm here for your help n RELAX.NOTHING TO WORRY, THERE IS NO CHANCE OF GETTING PREGNANT, if ejaculation occurs outside the vagina. Please calm down. U people not at all done anything wrong. For getting pregnant following things are required-1. Penis should be inside the vagina2. Ejaculation should be inside the vagina.3. Having sex during fertile period(it is from 10th to 16th day of cycle)but in your case the above things not happen. So DON'T WORRY, nothing will happen. With the above discussion u can try out my suggestions-1. If u r still in doubt then do urinary pregnancy test, it is easily available in medical store. Do it.2. If it is negative then nothing to worry.3. If it is positive then visit nearby gynecologist. He/she can help u. I hope the above information is useful, informative and helpful for u.(DON'T WORRY.EVERY PROBLEM HAVE A SOLUTION, please do not commit suicide. U PEOPLE ARE OUT OF DANGER. UR GF WILL NOT Get PREGNANT.SO RELAX.KICK OUT THE TENSION FROM UR MIND)GOD BLESS BOTH OF U.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My mom was in the hospital for approximately 2 weeks- she had been having episodes of rapid heart rate, congestive heart failure, copd. And was put on iv antibiotics. She was diagnosed with C-diff and died a few days later from that. In her lifetime she did seem to use antibiotics alot for her chronic emphysema and probably the last six months or so complained of diarrhea. My question is could she have had c-diff before she went into the hospital? In the past two years she probably lost 30-40 lbs and lost her appetite. She did eat but got very picky about what she would eat. Her primary care doctor always did bloodwork on her and it always came back normal. She also had alot of chest xrays that came out ok. I was also wondering if she could have had some sort of cancer? I have gone on numerous websites and could not find how long you can have C-diff and live with it without treatment. She was also put on 3 liters of o2 the last 6 months of her life since her stats were in the 80s. I guess I am also wondering about her rapid decline. she was a heavy smoker all her life but she was so healthy and did alot up until about 2 years ago. She would not leave the house and seemed very depressed. She also had been diagnosed schiziophrenia in her 20s and was always on medication for that - she was on prolixim by injection every two weeks for probably the last 10 or so years and was doing very well. ### output:

Well Hello her, Reading about your mother I understand she had a lot of pre-existing problems which left her body very weak. As her age is not mentioned here, I'm assuming she must be an elderly lady. I'm really sorry for your loss and I know that there may be a thousand questions racing through your mind. Let's look at them systematically. She was a diagnosed schizophrenic from an early age and on treatment which has its own long term side effects. A necessary evil cos schizophrenia should be treated and it's a long term thing, so side effects could not be avoided. She was a heavy smoker which affected her lungs and heart leading to development of heart failure and COPD which are themselves life-threatening when present as independent entities in any patient. They were both present at the same time in your mothers case. One need not have a cancer. These two themselves are fatal problems leading to rapid decline in one's health. COPD is the condition where the lungs are damaged mostly due to smoking as was in this case and are not able to meet the needs of the body resulting in frequent infections and also cardiac failure. Smoking in itself is a major cause of heart failure as it causes degenerative changes in the heart and blood vessels. Your mother was already suffering from two life-threatening conditions and this along with the C-diff diarrhea proved fatal. Diarrhea in itself if not treated promptly proves fatal. So in this case we are seeing three independently life-threatening conditions coming together unfortunately, proving fatal in the end. So attributing your mothers death only to the C-diff diarrhea would not be appropriate. Hope you got your answers. Take care.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dr, i am suffering from muscles loss , my hand ,leg,back all area become very lean no muscles ,it append very slowly past 6 months i was in addict of doing masturbation past 20 years ,idid not had any problem in my life and normal activity and healthy life, but in 2012 i had sudden fever heavily it took 2 months to become normal there after month by month i faced new problems first low stamina , lots of fear in mind, weight loss, memory loss,nee pains,sleep less,night fall , excess body temp, acidity , dry skin, sudden hair fall , mentally confusing,not able to execute any decisions , lost my intelligent,looking very sad ,face become very unfair, then physically, low erection, low desire ,fear to marry & am little bit recovered automatically after i left masturbation but in these unconditioned body iam fear to get marry, am 37 yeras old living in coimbatore. what is the treatment how can i become normal human being ,writing this from very poor mental condition am not able to realize myself , nerves system also very weak , help me to cure is alopathy have remidy or should i go to siddha idont konw dr. ### output:

Hello, Relax down, don't be given up in your life like this. In everyone's life, there are ups & down, but one should be very sincere and honest towards ones own capabilities. Don't be that much given up in life, nature has given us a lot of opportunities.Don't go on recalling your weaknesses all the time. If something is wrong in someone the simplicity lies in coming out of the wrong track and be on the right track. See whatever you were doing was wrong, but have you ever realized the consistency and Inner strength you had in yourselves? You were so consistent and continuous in your activity that it has been for 20 years, what one needs to do is change the bad things with good one had it been If u don't have that much energy and consistency in yourself you would have perished long back from this world. Remember you have a lot of strength in yourself but all you need to do is utilize it in the right direction. I want to congratulate you on one thing, You have the honesty and desire and sense of reality that what you are doing is wrong and what is right. In most of the time, many of us will be hardly aware or familiar with our inner self with the intention to correct oneself, the extent of severity and pity you are in yourself is the brave potential that is in yourself to get you on the right Path. So you need continuous counselings and moral support, everything in yourself gets fixed as if it was nothing. What you need to do is concentrate on your career, if you don't have qualifications sufficient to start some job, then get to know about yourself in which field you are interested, and it is correct, accordingly get busy in that and try to do the things in what the best way you can, don't worry about your failures and falls repeatedly, when the baby is small just few years old its start walking, but they fell down again they try to get up, again they fell. So failing and again starting is a life process. We should always be very much clear and focussed that we should never give up or depressed. Hope I have answered your query. Let me know if I can assist you further.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Im looking for orthopedic surgeon and pain management dr. who can help me going forward,with surgeries to my knees and lumbar, Ive qualified for disability,waiting for final approval paperwork. until it goes thru would be a self pay. I have rhuemetoid arthritisis,my hands (especially thumbs and joints) are in terrible pain, I have a fusion at C5C6C7, herniation at C4,C3. The lumbar is seperated at lumbar and sacrum and herniated at L5L4L3, my knees healed wrong, and my right groin was torn and have terrible pain with my right hip, all due to a fall down a L shaped staircase, landing upside down. the Cervical spine, due to a construction truck running a stop light and stopping once he hit me. The pain I deal with on a daily basis as at a 8, that is just dressing, trying to do at least 4 meals a week, Im in the Baltimore area. Ive been through so many different regiments of medicines, therapy is impossible until my knees, hip and lumbar are addressed hopefully with the least amount of surgery possible, I found after my fusion, the scar tissue and the healing years later has its own set of problems. My goal right now is to maintain the ability to be a home maker with the least amount of pain until surgeries can be done, and even then those aren t guaranteed to take away a lot of the pain, as I learned with my cervical surgery. Fentanal patches, gave me my life back, my break through medicine was reduced to 15mg.1 to 3 a day max.My goal is to have the least amount of medicine with the most amount of quality of life, ive been dealing with this pain for over 10 years now, my last doctor whom I loved and was an amazing gift, finally was able to go into the field he longed to do, which was childrens cancer, leaving me searching for a dr. but not finding one that could address my pain and have a plan long and short term plan for surgery and pain. My pain management plan re: surgery was interuppted with a bacterial infection from an infected kidney stone, which became sepsis, and I nearly died, I had a nephrostomy tube and 3 stents until the surgery was finally performed to remove my the infected stone and it took months to get my health back. Trust is critical and Im looking for that trust and care close to my home if possible. Thank you Sandie ### output:

You have made an excellent PM HOI. It gives lots of inputs. You need to focus on your diet, sleep, exercise plans. This works in most of the RA cases. Pain and aches are disabling which is acceptable. Keep a positive attitude. Do regular yoga breathing exercise like Panama, eat healthy food, sleep properly and do regular ROM and strengthening exercises. Improve your endurance levels as the metabolism should function good and support the immune system. As you must have Google by now what your condition is all about. So kindly focus on all proper guidelines. Surgery might give a temporary relief but nothing more accurate than the self-induced efforts to fight back. All the best. I can prescribe some exercise if we get some close communication. Thank you

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have dysautonomia. I often have abnormal ECG readings when I m feeling very bad. Today s reading is moderate right and mid precordial disturbance. Negative T in V3 V4 with small negative T in V2 V5. When I feel good ECG is normal. When I am symptomatic often my oxygen will show drastic dropping for 2-3 min as low as 67 then raises to mid to high 80 s as soon as I lay down. It s normal. 97/98 when I feel good. It s rare been trying to get in orphan disease clinic. Drs have trouble treating my symptoms. I am 46 I was 35 when I first got sick. My grandmother had same symptoms and passed at 49 of sudden cardiac death. I am under close care of Drs but the past 2 yrs have become more symptomatic. Array of autonomic dysfunction. POTS. Respitory a fib a flutter recently developed neurological raynauds and Printzmetals. I wonder if the Printzmetals causes the abnormal ECG. And oxygen flux. Oh when oxygen drop hr goes high. Usually 140-160 then drops as oxygen rises. Not sure if fast hr makes oxygen look low or low oxygen makes heart go up but I know something interferes with my berating because I can feel it drop and feels like an elephant on my chest before the reading shows it s dropping I can say it s fixing to drop without seeing reading and I know when it gets back up. If it stays in the 80 s I don t feel the change Sorry for info overload. I know my diagnosis. My question would be thoughts on the ECG? Thoughts on how dangerous is the oxygen flux is? And any treatment ideas? ranexa helps the Printzmetals but I can only tolerate it in 2 week intervals due to kidney pain. Take clonazepam .5 when my heart rate won t slow at bed time but can t take during day and drive so my hr runs around 120-140 most days and I manage to function when it gets higher I have to stay home and take clonazepam Can t take beta blockers because of POTS and my blood pressure already runs low causing me to pass out. I take saline to treat that at home. Again Sorry for info overload. I know my diagnosis. My question would be thoughts on the ECG? Thoughts on how dangerous is the oxygen flux is? And any treatment ideas? ### output:

Hello, I have gone through your query. Thanks for using Chat Doctor. Indeed, yours is very complicated case and I need to know entire detail, every investigation to give you proper guidance. Regarding your query on ECG and heart rate, I can tell you that heart rate increases with Chat Doctor. T wave changes which you are describing may be due to coronary spasm of printzmetal angina. Once the spasm subsides they disappear. As regarding POTS, it is small fiber autonomic neuropathy for which take plenty of fluids and very low dose Beta blocker will help to control heart rate without affecting Blood pressure. Have you undergone investigations for Collagen disease? I would be glad to know and discuss with you regarding your case if I get feed back from you best wishes

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My husband is 27 years old and has been sick for the past 4 years. First he went to his doctor as he lost alot of weight (around 2 stone) in a short space of time, and would fall asleep alot. Suddenly he was admitted to hospital with abdominal pain to his right side (which he still has today). They took it as his apendix, and removed it, but they told us that it was not enflamed enough to cause the pain he was experiencing. Since this he has been to a G.I. consultant and she diagnosed him with crohns disease, which was two years ago and has now said he dose not have crohns disease and will confirm this with a sample from his bowel this may. Also he has haemochromatosis, and oesteoperosis in his hips and lower spine, at a density of -6.5. He is in contant pain in his lower right side and this pain has travelled into his lower back and shoots down his right leg to the front and into his bum on the back. We got him an mri in 2008 and they said he had a trapped nerve between two discs, and put him on medication for it. We got him another mri in july 2010 and they have said this is not the case anymore and his mri is clear, he just has a minor curveture in his spine. His osteo doctor said there is nothing surgically he can do to help him. He attend pain clinics to manage the pain but we dont understand why no one can tell us what is wrong. He is on 100mg of Lyrica twice daily, 10mg amitriptyline once daily, 100mg of tramadol hydrochloride every four hours, 60mg of codeine phosphate hemihydrate with 100mg of paracetamol every four hours, 20mg omeprazole twice a day, and sleeping tablets at night. He can hardly walk up and down our stairs in our home. He is like an old man trapped in a young mans body and we are desperate as we feel we have no where else to turn, we have literally tried everything, ie. physio which the physio therapist said he can not work with my husband ubtil his pain is managed, he has tried reki, acupuncture, meditation and all of the above medication which he is still on. Please can you give us something to go with as we are at our wits end. Thanks, kind regards Miriam ### output:

Hi miriamNothing to despair as MRI is clear. All he should do is wear a lumbosacral brace during daytime, avoid bending, lifting,physical therapy, massage with muscle relaxant gels and reduction of either tramadol or Conan, increase of dose of amitriptyline to 25 mg instead of 10 mg and use gabapentin 300 mg twice instead of lyrics. Addition of methycobalamin 1000mcg if your doctor agrees. Too many opioids make a patient lethargic, and if pain can be relieved by local measure, gels,brace, massage would be safer best wishes, regards

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have what feels like small bubbles bursting in my chest that makes me cough and get light-headed. I took a 14-day round of Prilosec, thinking it was acid reflux, but it hasnt gone away. I eat well and Im physically in shape (run every morning)... But, Im concerned about this. ### output:

Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. You seem to suffer from Herewith regurgitation of Burping gases accompanied by Guardian/amoebic enterocolitis. The indigestion and excess food fermentation with enterocolitis and accompanied malabsorption, leads to bloated gases from spastic intestinal sphincters systems and imbalance of motility of the intestinal and gastric movements with reg urge of Acid reflux and gases causing bubbling up with burping, causing cough from the acid reflux / and or from esophagitis which makes legal afferent more hypersensitive and hype reflexive, giving rise to cough from acid reflux. Remedy Suggested-Treating only by Prilosec, therefore needs to be supplemented with-tab-Ciplox Oz-1 x 2 per day x 7-10 days time-treating accompanied-protozoal and bacterial infection Cap PPI- Panto-D-1 x 2 x for 4-12 weeks -with LES (lower esophageal Sphincter)regulators. Morning-30 minutes walk, Plenty of fluids, Butter Milk- 2 times a day. Porridges with rice for 1 week,Butter Milk x 2 times a day.Cap Sporran- to stabilize bacterial flora, Avoid spicy, nonveg, fried diet for 1-2 weeks. Avoid street hotel fast foods would keep your bowels healthy and fit. Stool testing, to control amoeba and guardian protozoa/ bacterial infections, would keep you away from its recurrence.Thus, these complaints are from-giardial / bacterial food induced HERD with burping of trapped gases in the chest with bubbling up of the gases in the chest with acid reflux esophagitis, causing cough ultimately. And wound need treatment for 4-12 weeks in some cases.2 weeks treatment with Prilosec is therefore ineffective. Hope this reply would help you to resolve the health issues with help of doctors attending on you. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link-http://doctor.Chat Doctor .com/Funnel?page=askDoctorDirectly&docId=70229Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had a rash 4 weeks ago and sins then things going worse I went to doctor and he sayed it was scabies but and should treat it with cream that kills it once a week...but after two or 3 weeks things are going weirder so I went to other 3 different doctors they promised me it wasn t scabies...but I do see how fast they spread special at night I got them on different spots around my body and they spread really fast..Some parts were treated but still they appear randomly...also when I rub an area and wait for 5 or 15 min...i see a white worm appears on that spot and many of them same moment from the skin...so things are confusing...i don t want to take things lightly but everyone say it s not big deal and ignore it..even doctors but I m sure it s scabies when I compare my skin reactions and behaviour with those who have them in the Internet...any suggestions? also I asked for skin test many times to the doctors they sayed I Don t have to...because scabies can t be seen....i really want to act early as this thing can be hard to avoid complete if became ignored...i was researching a lot for many ways to kill it...but surprisingly scabies can only be killed with hot water at 50 digress for 10 min or do sauna...or use permithlin once a week...but no other new technology exists to kill it completely? I think a device of UV sun ray beam projector over the kind as a treatment of some kind will kill them all forever and even the eggs...everyone says scabies are easy to deal with...i mean the doctors...but it s not and it s also fast on spreading...i thing any government worldwide should work on developing something towards it.. because it s extremely fast on spreading in many ways..and when someone didn t managed to treat it early they can kill the person specially if he got low deface system like me.....i really had enough from suffering...because I just survived from alcerative collaitis after 9 years of suffering and this scabies need to be cured somehow.. ### output:

Hello, Since you have a history of Ulcerative colitis your immune system may be compromised. If it is scabies, you can apply Scabies emulsion(Certified (0.1 PW/v) + Lindane (1 PW/v) in the area affected, leave it for 45-50 minutes & then take a bath. Repeat this again after 15 days. It should clear out. In the meantime, wash all your clothes, bed covers & bedding in hot water & detail. Put your mattress in sunlight or change it, get a new one. For believe you can apply ointment Bactrian in the area affected. Take care of your personal hygiene, do not star your clothes or toiletries. Avoid sex while you are being treated. You are suggested to list ER or GP to get clinically assessed because your symptoms are indicative of hookworms. You should get stool (R/E & C/S) examination done to study the presence hookworm-eggs in the stool. Furthermore, you may need a course of anti parasites medicines(Mebendazole). Hope I have answered your query. Let me know if I can assist you further. Take care

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, Am a Medical student currently doing my final year. From my child hood onwards i have a problem with shyness , Over Self conscious. Now i have fear of public speaking,blushing, anxiety ,lip shivering etc... I think am more active mentally than physically, because if am seeing someone then i ll guess myself ,what the other person is thinking about me and I ll act on that guess eg: I ll guess he/she is thinking badly about my standing position,my laugh etc etc..and I ll feel uncomfortable with that. This same is happening on all other daily activities. Because of these problems,Am very bad in mingling with friends and other social circles. My medical school life also getting distracted because of this,Am not even able to ask a doubt to my teacher even if am alone with teacher,if am asking a doubt I ll think for many minutes like what she ll think about me,what if my language is bad ,what if my question is bad etc etc... Also sometimes I ll have a fear or am afraid to ask something to someone, I have good patience,but if i get angry and saying something ,then my lip will shiver, Blushing on my face etc. Am making my own thoughts about what other will think of me. Because of all this I can t walk in public in a relaxed state,my mind will always be in working state.If am talking in a group who are not too close to me,then my lips will start to shiver, uncomfortable etc because during the talk my mind will be working on others like where are they focusing,are they focusing my talk,lip movement etc..are they laughing about me etc.... Am only good with my few too close friends.. because of the above problem,I only have few friends,I ll always be at my home ,I won t go out like others.. In summary i can say, I have self consciousness , fear, Blushing, anxiety, Nervousness , Panic etc.. Doc, Is there any ways to change all this ? Am very sad in medical school because of the above issues, Am very much like to perform on some topics on my class,but I ll hide from these stuffs .. ### output:

Hello. I read your query. Since you are a medical student you yourself can see and admit the solution of the fear........that's is only and only to be courageous enough to throw away them all........I know you must have tried lot and would have failed to do so. But always remember that in this world the people see in you what YOU show. Whenever you meet some new person and start becoming conscious .....just think that he will observe your fear only if you show him (by your body language, lip shivering etc.) try to control that immediate change of behavior. One more thing you can ask your own self......even after allele...........if the opposite person don't like your speech, or question, or presentation.....then what will be the result?? Nothing....no one is going to hold you in jail.....never be afraid of the result......never fear to try. If you fail then try better and stronger. You just need some self motivation. You can try some personality development coaching if you want. No need to go to psychiatrist. Need to do self evaluation. There must be some activity which you're never afraid of, which you are confident of....try to involve in them to built up confidence. Hope this helps you. Thank you. Best luck.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi. My daughter, 18, began not feeling well on Tuesday. She was achy & tired. On Wednesday morning she woke up with puffy eyelids & still not did not feel well. On Thursday, eyes still puffy, body aches, and she had a mild fever of 99-100, & then it went up to 102 in the evening. Same symptoms remained on Friday with fever remaining between 99-100 when using tylenol. I took her to the Dr. on Friday. Dr. wasn t sure what she had - something viral? Flu? NO blood work was taken. Although we are not aware of any tick bite (we are in a high tick area), we discussed the possibility of the tick disease, anaplasmosis because 2 of our close neighbors were recently diagnosed. Dr. suggested waiting things out through the weekend to see how she did and wrote us a script for Doxycycline and left if up to us on whether we wanted to start it. Fever went up to 102 again on Fri. night. Saturday morning we gave her 1 doxycycline & tylenol. Thoughout the day, fever averaged about 100.6 then went to 101+ during the night. Before bed we gave her a 2nd dose of the Doxyclycline which she threw up within just a few minutes of taking. Eyes seem to get more puffy the higher the fever. After throwing up the Doxyclycline, we did not give it to her again and have continued with tylenol or ibuprofen to try to keep the fever down. Tonight follows the same pattern, fever up, body aches worse (legs feel crawly to her at times), & eyes more puffy again. Cool compresses do not bring down the puffiness of eyes. We re not sure what to do next. Start her back on Doxy, take her in tomorrow for blood work? She is visibly uncomfortable. She has also had a decreased appetite. At times, in addition to the puffy eyes, her face looks somewhat swollen. No sore throat but some swollen glands in neck. Please help. Thank you ### output:

Hello, her symptoms seem a lot like influenza although other illnesses (viral or bacterial) could have caused the same symptoms. Since there are not many symptoms to guide the diagnostic procedure, you've got the choice to wait and see or to do some tests. Some useful tests include the complete blood count and the c-reactive protein (CRP). Increased white blood cells (with polymorphonuclear renomination) and high values of CRP likely indicate bacterial disease which needs antibiotic treatment. Low CRP values usually accompany viral illnesses, although none of the above is 100% error-free. Worrisome symptoms and signs include faintness or orthostatic hypotension, very high pulse rate, decreased urine output, shortness of breath, too many breaths/minute and decreased cognitive functions. I hope I've been clear enough, without too much medical jargon.I'll be glad to provide further clarifications though, if you're still left with questions. Kind Regards!

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have made a habit of masturbating at night for a good amount of time. I am uncircumcised, but i still sometimes use lotion for an added sensation. I have always wiped myself completely clean of any and all lotion after masturbating with it, as well as semen. I even pull back the foreskin and fairly roughly wipe off the glans and parts of the head that are usually unexposed. I have been doing this for years, and before recently, haven t had any problem with it. I am also a virgin and haven t had sexual contact with a girl in over six months, so an STD is not an option. I have been masturbating with lotion for about a week now that I m home. Two nights ago, however, I woke up in the middle of the night to a severe itch on the underside of my penis and scrotum. I couldn t sleep, so I scratched it until I was comfortable again. I woke up to slightly reddened skin on the underside of my penis and scrotum. The itch went away during most of the day, but at night, again, I masturbated (this time without lotion). Yesterday, I woke up to slightly more irritated skin, becoming more red and becoming slightly swollen around the scrotum and foreskin. Now, my penis and scrotum are very red and irritated, and my foreskin is very swollen. It is also slightly painful. I have been reading a lot about yeast infections, and it seems like that is the probable cause of this. I don t know how, since I have been cleaning myself with the same routine for years and I haven t had any trouble until now, but nevertheless, it seems like the logical decision. However, what deters me from thinking this is that the day before I started noticing the itchy penis and scrotum, I was out in the woods doing yard work, and it is very probable that I rubbed up on either poison ivy, oak, or sumac. I think this because even though my genitalia was the first area to become itchy, and is at this point still the worst, I have been developing rashes on other parts of my body. Is it possible that I touched my penis before adequately washing my hands and the poisonous oils from the plant spread that way? Or is this just a side effect of a yeast infection? Is it a possible solution to just wait this out, or should I seek medical attention? ### output:

Hello I share your concern, I will try to help you out in the best possible way. Looking at your description this could be STI or infected ulcer may be due to trauma during masturbation or an allergic reaction. I would like further information help you better relevant medical history like metabolic disease or hormonal disorderly recent exposure to unprotected sex? You should ask your doctor for few investigations to confirm the diagnosis like Urine culture and sensitivity test Blood for CBC and liver function test or urine test are advisable if it is a chronic issueMaintain good hygiene Wash and clean it with antiseptic solution or soapbox can apply antiseptic ointment externally. Use condom during sex if you are sexually active Hope this answers your question please feel free to ask for more clarificationThanks and regards

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, today I witnessed my elderly father(80 years old) suddenly find it difficult to walk. He could not seem to move his legs . My mother had to help him sit in his wheelchair and put him to bed. His hands were twitching constantly and he was unable to hold anything. He has been unable to chew or swallow his food however he did drink when a cup was held to his lips. My father has experienced bouts of this over the last 3 months,the last one being 9 days ago. My Mother has told me that usually after a few hours my Fathers motor skills and speech become normal. However todays attack was longer than normal. He has suffered with severe ulcers on both his legs over the last 4 years and has been hospitabilised a number of times with bad infections. My Mother has consulted the GP and they have refered my Father to a neurologist however we are still waiting to see the consultant. Can you give us some understanding of what could be wrong with my Father please ### output:

Hi, I am Chat Doctor. I have read your message. I think I can help you. The symptoms of the query are quite suggestive of a stroke. The sudden onset of the symptoms, the motor weakness, the swallowing and speaking difficulty, the shaking of hands. All symptoms are suggestive of the diagnosis of stroke. The fact that he had been having similar episodes over the last 3 months is suggestive of mini strokes that we call TIA medically. These are usually warning signs of an impending stroke. I am unaware from the query about the duration of the symptoms. Within 4 to 8 hours onset should be treated urgently and should be visiting an EMR as soon as possible. He will need urgent treatment. If it is more than that, he needs to meet a neurologist who will probably perform a CAT scan of the brain with or without the angiogram (depending on the protocol of the hospital). As per the report of the CAT scan, medicines may be initiated. I think a low dose statin and antiplatelet should help. I would suggest a scan prior to the initiation of the medicines because the closest differential is a possible cerebral hemorrhage (less likely in view of the mini strokes) where these medicines are not to be given. Meanwhile, I think you should start him on physiotherapy for the motor weakness. Another chance I want to consider here is possible diabetes and hypoglycemia attacks. If the GP has thought about this as a possibility and tested sugars, there is probably nothing to worry about. Otherwise, hypoglycemia in a diabetic patient would explain the brief episodes. And a hypoglycemia can also explain the prolonged symptoms. In such a case, sugars need to be well monitored. The third possibility I need to consider is a vasculitis. This is a common cause of stroke, but usually is thought of in young patients. The last 2 causes I have considered in the view of preexisting foot ulcers which cannot be explained by TIA or current stroke as the ulcers predate the stroke. I think you need to get the scan and meet up with a neurologist. Unfortunately, as explained, I cannot suggest medications without the scan. I have tried to make it as simple as possible. Please feel free to contact me for any further clarification. Best of luck,

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: MY MOTHER IS 52 YEARS OLD WITH SEVER OSTEOPROSIS. SHE IS ON STEROIDS FOR ABOUT 5 YEARS FOR ASTHMA . HER ASTHMA IS SEVERE. A MONTH AGO SHE FELL AND HAVE SEVERE PAIN DUE TO DISC COMPRESSION. SHE HAVE CONSTANT BURNING SENSATION IN BOTH HER FEET AND SHE IS ON HEAVY PAIN MEDICATION. NEURO SURGEONS WE HAVE CONSULTED SAY THAT SHE IS UNFIT FOR SURGERY AND ONLY PHYSIO THERAPY AND TIME WILL HELP HER RECOVER. THE MRI REPORT SAYS MULTILEVEL DEGENERATIVE DISC DISEASE INVOLVING L3-L4 AND L4-L5 LEVEL. AT L3-L4 LEVEL, RIGHT PARACENTRAL DISC PROTRUSION NOTED CAUSING RIGHT LATERAL RECESS NARROWING. AT L4-L5 LEVEL, RIGHT LATERAL DISC PROTRUSION NOTED CAUSING RIGHT LATERAL RECESS NARROWING AND RIGHT RADICULAR COMPRESSION. ON THE LEFT SIDE, THERE IS ENCROACHMENT OF LEFT NEURAL FORAMINA WITHOUT ANY RADICULAR COMPRESSION. IMPORTANT. I AM I PAKISTAN SO CONSIDERING THAT A NEURO SURGEON MIGHT SEE 20 TO 30 PATIENTS IN THE 2 HOURS CONSULTING I AM NOT SURE IF THEY ARE TAKING THEIR TIME TO EVALUATE MY MOTHERS CONDITION PROPERLY. SHE IS TAKING MULTIPLE PAIN MANAGEMENT MEDICATION INCLUDING OPIOIDS AND STILL CANT WALK MORE THEN A FEW STEPS AT A TIME AND CANT SIT. THE BURNING SENSATION IS CONSTANT AND I AM WORRIED THAT MIGHT LEAD TO SOMETHING WORSE IN THE FUTURE. I NEED SOME ADVICE AND HELP. THANKYOU ### output:

Hi Woman, Your Mother seems to be suffering from complications of degenerative disc disease. Since she in on steroids do make sure she is taking Calcium and Vitamin D3 supplements to help prevent progression of Osteoporosis at her age. The pain she experiences is due to nerve getting pressed by the degenerated and herniated discs from her spine. She can try using a Lumbosacral corset belt to attain better posture while walking and reduce her symptoms. Usually, the main exercise you will be asked to do is that of extension which is leaning backwards by propping yourself up on your elbows when lying on your front. This mobilizes the joints but more importantly closes the area of the prolapse and reduces the disc prolapse. If the disc prolapse is reduced the tear in the disc can heal.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, I had sex with prostitutes and also had oral contact, sometimes the condom broke off after sometime i got burning in urine so I was admitted in hospital for urine infection, I had got my Hiv test done which was negative. Since somedays Im having Gastritis and I am showing Dr.Harshal gadhikar for that who is giving treatment of Razo20, lesuride25mg for 1 month, i have completed that course but still lot of burning sensation in stomach and womiting sensation. My toungue develops white coating everyday with some red spots for which I had shown to a skin specialist who had given me Mucopain gel, Tantum oral rinse and Ginicast oral paste which i had applied but did not get any relief, is it because i had mouth contact with prostitute who was having pan masala and should get tested for oral cancer, could you please tell me who are the good oral cancer doctors in Pune and what are the tests to be done for oral cancer. I am attaching my photos of the tounge, kindly suggest. As i have read about Hiv in articles it is said that the symptoms may develop in 2 or 3 years depending on the immunity of the body, so do i have symptoms which are the signs of the disease but may take time to come out in the Elisa Hiv test reports. I get lot of sweating in the legs and in hands, since some time I remain in confused state of mind and forget things. Is it possible to get an Hiv test done through the saliva or from the toungue, kindly suggest some tests. I would like to take appointment from you if possible to explain and show my reports. ### output:

Hello, I can understand your concern. I have a few question for you that can help you in deciding if the lesion can be cancerous or not. Firstly, can you scrape the white lesion off the tongue leaving red areas beneath? If you can scrape it, then it is either tongue coating due to plaque or fungal infection called candidiasis. If you are not able to scrape off the white part of the lesion, then it can be pre-cancerous condition called Leukoplakia. The test to confirm if you have oral cancer is biopsy of the white lesion of the tongue. It can be done by an oral surgeon. To answer your other question, the blood test that identifies HIV antibodies is the best test to confirm presence of HIV infection in your body. It is more sensitive and reliable than saliva or other tests. The test can be done in a week after suspected infection of the virus. If it comes out negative, then it has to repeated after 3 months as HIV antibodies can reach detectable level in blood as late as 86 days after infection. If that test comes negative, then there are 97% chances that you are not having HIV infection. In case of negative tests for oral cancer and HIV infection, you should contact a physician for investigations regarding general physical health of you. I am afraid we cannot provide you with any reference of a doctor in your area. You can ask your family physician to refer you to one. I hope this information helps you. Thank you for choosing Chat Doctor. Let me know if you have flow up questions. Best,

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello. Ive had a cold with a lot of congestion and, having asthma, Ive had a LOT of coughing. Now the back of my neck hurts on both the left and right side when I turn my head. Im assuming this is from the cough and congestion but as the cold is getting better, the neck soreness is not going away. Hot shower helps, as does massage, but Id like a bit of reassurance :) THANKS! ### output:

Hi, Dear,Thanks for your query to Chat Doctor. Dear I read facts of your query and reviewed it in context to your health issues submitted in your query. I understood your health concerns and feel Concerned about them. Based on the facts of your query the reply of your query is-Your current health issues seem to be due to -the Cold aggravating your asthma with accompanied bronchitis. This would create more problems like the one -straining of neck muscles and chest muscles from repeated coughing and asthma causing dyspnea. The neck soreness is thus from strained neck and with accompanied? Viral Myalgic, which would recover with time and treatment of Asthma by -Antibiotics/ Bronchodilators/ Plenty of fluids and proper bronchial Chat Doctor. This is therefore more alarming condition and situation needs to be dealt by urgent Consultation with Chest Physician for ruling out TB / and other causes for this. The fact that hot showers and massage helps in relieving is more rewarding as this Myositis from Strain would resolve with Pain killers and NSAIDs supplements for few days timeTherefore Cause of these complaints in your case needs to be investigated by Chest X-ray and by blood tests and if need be by CT Chest. Other causes need to be verified, as discussed above. For this you need to consult Chest Physician. Dos in your case-Check With Doctors as suggested above-Rest and Fluids in plenty with Bronchial Care. You need to Urgently plan Corrective Antibiotics and other care, as your case is a bit complicated and seems to be neglected. Get physical check with Chest Physician who would do needful Chest X-ray and other investigations. There are many causes which need to be verified amongst the causes discussed above before planning specific investigations and remedies. High protein / high Calories diet to built up body. Vit B12 and Folic Acid- to stabilize the body and bronchial stress.Thus, You should consult Chest Physician. This would resolve the complaints of yours. Constant follow-up with local family or specialist Chest Physician for long term would give you long remissions of sucChatDoctorplaints in time to come, which would depend on meticulous follow-up treatment of your health concerns. Just don't worry and be patient and co-operate with your doctors, till you verify with your attending doctors. For early recovery-please follow above dos which would resolve your complex health issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard to following link-http://doctor.Chat Doctor .com/Funnel?page=askDoctorDirectly&docId=70229Wishing Good Healthy Life!!

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I went into the ER thinking I was having a heart attack they did all the tests EKG stress test and blood work they said I was not having a heart attack and gave me some prilosec and cosaar for high blood pressure which I thought was weird cuz my BP was 161/91 all freaking out and once I was laying in the hospital bed it was no higher than 128/80. But Im not a doctor and they are the boss. Anyway They sent me home with orders to follow up. Doctor took more blood to check thyroid glucose and cholesterol. Thyroid checked OK glucose 101. Cholesterol no so good. Triglycerides 239 LDL 133 HDL 26 total. Cholesterol 207. Doctor scheduled the soonest appointment to fit me in one month from now almost 2 from the Er visit. Here is the deal since I got out of the er I still feel bad every 2 /4 days Ive been getting a pain that goes through my chest starts on the left and goes to the right after that I get light headed and dizzy with an terrible fear that Im going to die. I try to calm myself but it wont go away till I lay down. After that Im wiped out for a day or so till I force myself to get up and go do some physical work. This weekend it happened again and I was wreaked all weekend I forced myself up for work and now I have pain just above my stomach or upper stomach but below my ribs or bottom rib again this pain will go away if I lay flat. I have had a lot of burping and gas since I started the prilosec and cozaar. Im 37 years old and scared that Im going to die from this. What is wrong with me. ### output:

Hello, First remove the fear of dying, nothing will happen as your cardiac work up is negative and also symptoms doesn't fit in heart attack. I need to know more about the symptoms, like precipitating factors, factors that increase pain etc. Mostly it's a gastritis and reflux disease. You have upper abdominal pain, nausea, bloating, burping, does there is increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis. You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg before breakfast once a day for 2 weeks instead of Prilosec. Or you can DSR form of Prilosec as well. Along with this you'll need SYR sacral O two teaspoon three times a day for one week. Also, you can End sachet once in a while, if having severe pain. Secondly does this pain increase on applying pressure over the area, if yes it could be Costco Chat Doctor. Does this pain increase on deep breathing and coughing etc. if yes it a pain arising from lining of lungs and needs NSAIDs treatment and evaluation.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: COULD ST. JOHN S WORT CAUSE HIGH BLOOD PRESSURE AND BLOOD THINNING? I TAKE THE RECOMMENDED 300MG 2 TO 3 TIMES PER DAY. I BELIEVE I HAVE MINOR DEPRESSION AND FIND IT DIFFICULT NOT TO BE ON IT. NOW I AM WONDERING IF IT WOULD BE BETTER TO SWITCH TO A LOW DOSE OF PROZAC? WOULD THE SIDE EFFECTS AND INTERACTIONS OF PROZAC BE BETTER SUITED FOR ME? I have recently been diagnosed with high blood pressure and now take a water pill. I am 35 yrs old, and I am overweight. My doctor had thought that my ADD (dexedrine) medication or smoking might be causing this. I went off of the medication for several weeks, but there was no change in my blood pressure. I stopped smoking for 3 months, and still no change. I have lost a little weight, but I still have much further to go. Is it possible that the St. John s Wort herbal supplement I take faithfully 2-3x s everyday could actually be the culprit? Also, could it be thinning my blood ? Strange question I know but I also have acne and occasionally I unconsciously scratch my face. If this causes my blemish to bleed, it doesn t stop for up to an hour. I actually now have a septic stick that men use for nicks when shaving in order to get it to stop. It has been quite embarrasing as this happens a couple of times a week while I am at work and I have to hold a tissue to my face for an hour or longer. Last night I didn t realize that my face was bleeding as I do not recall scratching myself. I had a trail of dried blood down the side of my face. ### output:

Hello, What I will advise for now is please stop everything and meet up your cardiologist. First thing to understand that bleeding doesn't stop of happens when there is low platelet counts. And having such fatally worse situation its better not to try out anything without a proper guidance. Medical professionals are continually doing research and this is just to improve the lifestyle of the humans suffering from any conditions. Herbals, ayurvedic, homeopathic etc. needs to be assessed for something as the research is not that advanced and the number of sample they take is too less. Coming back to our case rather diverting it. First foremost thing, meet your cardiologist. Get blood routine checked. Next follow the medicines he gives you. Followed by this indulge yourself in physical exercise and diet plan. Try to do meditation. In my practice of 12 years I have received complaints of people at Early age having a high blood pressure. But with good prescription, they have recovered well. The prescription includes medicine, diet and exercise. We need to understand that there are a lot of marketing platforms to sell their products, but we should be even sensible to when to use what. In your case herbal medicine is contraindicated as your body is rejecting by providing by excessive symptoms. Please allow the medical professional to take care of the case for better lifestyle. Jay In Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am taking Betnesol Forte tablet 1mg (to control my asthma) from last 1 and a half year as i suffer from asthma.Have gained 15kgs and my face has become totally round with double chin. would like to discontinue the tablets as i am having too many health problems due to it.I started taking these pills as when my asthama increases i have a very bad total nose block.so to avoid that i started this tablet and now i am too much used to it.Please its request to help me stop Betnesol Forte and control my asthma too. ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. I would like to know more about you like - your age, since when you have asthma, what are other medications that you are using, what are other medical conditions that you are having, what are your nose symptoms, have you undergone any testing, etc. Based on above details, I would be able to make suggestions more specifically. 2. There are many options to control asthma other than oral steroids (like Benson Forte).3. Were I treating you, I would suggest you lung function testing (spirometry) to know your lung capacity and severity of asthma. It would help me choose your Chat Doctor. 4. I would suggest you intranasal corticosteroids, montelukast and inhaled corticosteroids for at least 1 month. Please note that intranasal and inhaled corticosteroids act locally and have much less side effects as compared to oral corticosteroids.5. I would also suggest you to consult an ENT surgeon who will examine your nose cavity from inside as you have long-standing noes obstruction.6. I would suggest you allergy testing to identify the substances causing symptoms to you. Based on allergy testing report, you can follow avoidance measures and an Allergist-Immunologist may prescribe you allergen specific immunotherapy which is a long term treatment of allergies.7. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.8. I would also suggest you regular exercise and a healthy nutrition which will improve your lung capacity and immunity respectively in a long run.9. I would also suggest you weight reduction as obesity affects asthma adversely. Please consult a professional exercise trainer and dietician to manage your weight problem. Of course, steroids-induced obesity will improve gradually once they are stopped.10. A SPECIFIC CAUTION: As you are taking oral steroids for 1.5 years, please do not stop them immediately - it can cause life-threatening condition. Please consult a physician, he will gradually decrease the dose while increasing other medications and only over long time your oral steroids will be stopped. Sudden stopping oral steroids is dangerous. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead and I'm sure with proper consultations and skillful treatment, you will be able to lead a healthy life. Thank you & Regards.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i am 23 year old male i have had jaundice once when i was born and 2nd time at the age of 14 and now again i am suffering from jaundice i have done my blood test in which serum bilirubin total and direct are above the normal levels AL-T(SGPT) is 2245 out of 30-65 ,gamma gt (ggt)149 and alkaline phosphatase 151 .my current doc has kept my case under observation i wanted to have a second opinion i am currently suffering from nausea which makes me really uncomfortable . ### output:

Hi there, thanks for putting your faith in Chat Doctor. I would rather appreciate you for a more concise and detailed note of your history. However, I would have preferred to know the bilirubin levels though, as well as any associated symptoms like itching, decreased appetite or vomiting you experience along with increased levels of bilirubin as jaundice is a symptom which is basically the rise of the yellowish pigments (bilirubin in your body) which are normally converted by liver in soluble forms and excreted into your gut to be excreted out of your body with the stools. The first such incidence of its rise which you experienced in your neonatal life which resolved itself is a type called physiological jaundice, and it is not considered to be a disease, so you need not worry about that, but the second incidence in your adolescence might be because of acute hepatitis which in the majority of cases is viral. But its recurrence is a bigger concern for me as it needs a detailed evaluation to rule out any other cause of chronic liver disease. Though such higher levels of ALT are usually present in Hepatitis A or E which resolves by itself between 1-2 weeks approximately. Your GGT levels indicate around 5 times of the normal levels of your age group which is suggestive of intrahepatic homeostasis or inflammatory hepatitis again favoring an acute inflammatory cause which is likely viral mostly and is water born disease with self remission. If these levels were as high as 10-30 times we would have suspected any obstruction of bilirubin outflow (aka biliary tract diseases) which are unlikely in your case. Also, that there are some diseases which interfere in conversion of insoluble bilirubin into soluble ones or in the excretion inside liver cells due to enzyme deficiencies, which when present or detected in adolescence or afterwards is Gilbert's disease in most of the cases which needs monitoring only along with symptomatic care with no long term treatment need. If I were your physician I would have ordered viral sexologies for hepatitis, along with an ultrasound for liver size and structure as well as outflow tracts from liver and their patency, along with an albumin globulin ratios. I would also have been interested to know synthetic functions of your liver by monitoring INR to see for any need of vitamin K supplementation. The ideal treatment is rest, Fluids, HY Chat Doctor. Also, that if you were experiencing and symptoms of itching, decreased intake, severe vomiting or

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have fallen twice within the last 8 weeks. Saw my General Practioner...he thought it might be ataxia...sent me to neurologist...all the test results were great he said. Neurologist sent me to cardiologist...had blood work, Holter monitor for 24 hours, ekg, echocardiogram, and tilt table test. Blood work normal, echo revealed pericardial effusion and tilt table test (I thought I was dying).....gave me nitroglycerin under my tongue...I was hot, sweating, pressure in my chest...was brought to point of unconsciousness...but did not completely pass out....wet my pants and the nurse said she did not have a bp on me for 5 minutes...call from cardiologist today....said test was normal but wants to change my TOPROL XL to Pindolol and follow up in one week.... please explain all of this to me.....if nothing is wrong (although I think something is not right) why change my meds...I don t adjust well to med changes...... ### output:

Hello. Ataxia is a condition where there is imbalance during walking - conditions causing it are those affecting the cerebellum part of the brain or the inner part of ear. Your general practitioner thought your falls were due to ataxia and hence referred you to a neurologist. Since, your neurological tests were normal and there were no abnormalities in the brain like a blood clot or tumor in the cerebellum part, the next cause to be ruled out was syncope due to any heart issue. Hence, your neurologist referred you to a cardiologist. Syncope is temporary loss of consciousness which may be caused by temporary decrease in the blood supply to the brain. This might be the cause of your falls. Heart issues like inadequate pumping or irregular heart beat may cause syncope. The pericardial effusion on echocardiogram suggests that you have some fluid in the space between your heart and its covering i.e. pericardium. This fluid if sufficiently large in quantity may compress the heart and prevent enough blood from filling inside it. It may also be the cause of your syncope. However, if it was minimal fluid, it causes no symptoms. The tilt table test is done to basically reproduce the symptoms of syncope while continuously monitoring your heart beat and blood pressure and other vital signs. It was positive in your case as it caused syncope i.e. decreased the blood supply to your brain for a short time - which caused the dizziness and near loss of consciousness. The tightness in the chest is also a symptom of decrease in the blood supply to your heart. Your cardiologist must have deduced that something similar might have happened which caused your falls i.e. your blood pressure must have been below that which is needed for blood to reach your brain especially when you stand up (this is called orthostatic hypotension). Hence, he changed your BP or heart medication from tool XL (metoprolol) to indoor to reduce the variation in BP. The new medication might cause lesser reduction in BP so that the brain will get enough blood supply. This new medication should not cause any adverse effects, so you need not worry. Hope I have cleared your doubts. Wishing you good health. Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Had numbness with almost a menthol sensation from my foot to my face on July 5th...all on my right side...included leg, outer torso, arm and half my face...lasted approx 5 hours. Have also had numbness/tingling around my eyes and nose over the last year...none of these symptoms caused blurred vision or slurred speech and was able to function normally. Had an MRI on July 21st...Here are the findings: There is a focus of the T2 bright signal demonstrated in the subcortical white matter of the left frontal lobe. This measures approx 4 mm in diameter. The findings are nonspecific, although in a 45 year old woman do include demyelinating and disc spinous processes such as multiple scierosis. EDEM, vasculitis, or Lyme disease can give similar appearance. Small vessel ischemic change is also possible. Diffusion weighted sequences are unremarkable without an acute process seen. The ventricles are normal in size and configuration. The orbit and paranasal sinuses are within normal limits. Impression: Solitary small focus of white matter change in the left frontal lobe of unknown clinical significance. My history...Had an Head MRI in 2010 due to family history of aneurysms...MRI was clear. Also was diagnosed with Lyme 5 years ago...suffered joint pain in right knee/left arm...took 30 days antibiotics...one year later had similar symptoms and antibodies were high(not sure it that is correct term) so went on another round of antibiotics. Have recently had similar joint pain, but very inconsistent and not frequent(3x for only a few minutes over the last month...comes on w/o any cause). current Meds...25 mg Adderall for ADD/125 mcg of synthroid for hypothyroidism and just added 81 mg of aspirin as a precaution incase I had a TIA. Hadn t heard from Neurologist until I called today...was told not life threatening and they would go over results at my follow up which is at the end of August. After hearing this I requested the MRI report...I am looking for some thoughts of what might be going on or what my next step should be. I do have a Great Aunt on my mother s side that had MS. Thank you! ### output:

Hello Small hyperintense focus in deep white matter of brain may be due to ischemic changes resulting from involvement of small blood vessels(vasculitis), demyelination, post Lyme infection,post-traumatic etc. Ischemic changes resulting from blood vessels changes in diseases like hypertension, diabetes mellitus, dyslipidemia. So, you need monitoring of conditions that leads to ischemic changes like hypertension, altered lipid profile, diabetes mellitus so that further progression of disease can be halted. You need investigations like routine hologram, RBS,LFT, RFT, Lipid profile, ultrasound of abdomen. Proper treatment depend upon findings. You also need follow up scan. Multiple sclerosis(MS) is associated with many findings, it needs clinical correlation. Take Care Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Doctor,I had a spinal fusion in May 2017 but was readmitted with severe gastric symptoms which was put down to allergy to medication for pain. I have lost 13 kilos and have just had a breath test whicChatDoctore back positive. I have been burping and had flatus all these months. Could the infection have occurred because the gastro nasal tube or mask have been inadequately cleaned?( I used to work in theatre). Should my husband also have a breath test? I also have had candida which has been treated. Many thanks Jan Reid Sydney ### output:

Hi, After reviewing your question I assume you mean a positive breath test for H. pylori? I am sorry to hear the amount of discomfort that you've been through. This is how I would proceed to look at your case:1. Your symptoms are very peculiar for peptic ulcer disease or gastritis. Both are different ways of getting damage done to your stomach. An ulcer is like a crater which may or may not be prone to bleeding. Gastritis is a bit like having multiple pinpoint sore spots, causing pain and discomfort. A positive breath test may mean that you have H. pylori infection. As uncomfortable as this is, it is usually very treatable. Were you on many painkillers because of the spinal fusion? If yes, then they would certainly have contributed. 2. I don't think a mask has anything to do with this. A sterile nasogastric tube taken out of the bag is very unlikely to bring infection to the insides of the stomach. Nasogastric tubes, however, do cause a bit of irritation in the stomach lining. While they could have a very small contribution, I doubt they have had a significant effect. 3. The problem at hand seems to be the H. pylori infection which is a bacterial infection of the stomach lining which causes wear and tear in the stomach. This bug is acquired by the orofacial route. What this means is that someone with H. pylori sheds the bacteria through their stools. Sometimes, because of poor hand hygiene, they may pass it on to others, especially through food. The new victim ingests these bugs and in this way H. pylori finds a new home to infest. I don't think your husband having a breath test will add to anything if he does not have symptoms. 4. An unintentional weight loss may signify a gastric ulcer (in opposition to peptic ulcer)5. You may benefit from a look down into the stomach through gastrostomy. It will give a great deal of information. Your weight loss is also an indication of getting you a CT scan of the abdomen to ensure that there is nothing dangerous in play. 6. Treatment would include amoxicillin, azithromycin and an acid tablet such as omeprazole for a 10 to 14-day course. Since these recommendations include a gastrostomy, you will eventually have to visit a physician or a gastroenterologist to have it done. Gastroenterologists are also excellent at managing h. pylori infections, along with ulcers and gastritis.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been diagnosed with a mediastinal mass. In 1996, I had 2 thoracic surgeries due to cryptococcal pneumonia. I lost my upper left lobe of my lung cavity. Ten days later had to have a pericardium graft to seal my lower left lobe that the pneumonia had begun to damage. I took several rounds of diflucan antibiotics till my blood cell counts returned to normal. I m currently being seen by pulmonary specialist who feels that this mass is a result of scar tissue. Over past year I have noticed changes with my pain level, night sweats, shortness of breath, etc. anxiety / stress causes my chest to constrict as if a boa constrictor is squeezing the breath out of me. By having the 2 surgeries I lost 4 of my 5th left rib when I was only to loose 4cm! In the beginning my doctor diagnosed my situation as being scar tissue, another physician referred to it as a left hilar mass, now they refer to it as a mediastinal mass. I m scheduled for a pft test this week & have had chest X-ray last march, followed by cat scan w/ contrast last April ,& finally a cat scan this past Friday but contrast couldn t be used because after 8 attempts to have an IV contrast was cancelled. Medical assistants stated I wasn t dehydrated. They could pull the blood but when they tried to flush either vein blew or dried up . Specialist says I m not a surgical candidate . They do consistently use the term mass & not tumor. What s the difference & chances of my recovery? ### output:

Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. You seem to suffer from -Streptococcal Pneumonia with fibrotic lung and with COPD. Mediastinal Mass could be from-Scarring or Could be from Cryptococciosis spread from streptococcal Lung infection which was excised last. Because of this extensive mediastinal mass, Specialist says yo you're not a surgical candidate. They do consistently use the term mass & not tumor. Q- What's the difference-Ans-NO practical difference, but in your case-it has different meaning-like-you mostly have extensive -radio-opaque mass-in mediastinum, indicating extensive lung lesion spreading to mediastinum also. Only possibility of care and cure -is by antifungal medicines. & chances of my recovery-are grim in your case. But see if you get benefits from antifungal medicines. Hope this would help you to plan further care of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 39 year old female, I had epigastic hernia op, with local anaesthetic some 8 years ago. immediateldy following op I found it difficult to breathe in my right side, and I seemed to, at that time have to push something in, to breathe, although this was some way to the right and lower of where the small op took place. the plastic surgeon who did the op, mentioned that I did not have a particular kind of scan from my gp, to show him, so he was unsure of to what extent there would be a hernia ,when he opened me up. I am wondering if only part of the hernia was seen and fixed,as the little pea sized bump which was the hernia is seemed to have become fine. I get electric shocks in my mid section, often, it seems my whole right side has become affected, with sensations in my skull on the right side of a kind of seizure. also my right side becomes stiff and sort of stuck, and my lower body seems to have contorted/twisted , with my toe rotated,the big toe,so my previous centre of balance is altered, when I manage to meditate and relax back to an equilibrium , right/left side, I can feel something in the centre of my body,which to me feels like the sixe of a broad bean, that really does not feel right. note, all of these and other symptoms have been discussed with different doctors, who mostly have put it to stress. also it really feels like there is a real physical thing wrong, which is debilitating on a daily basis, which I think, it somehow affecting me neurologically, rather than psychologically, as some have said. please help ### output:

Hi, Dear,Thanks for the query to Chat Doctor. I studied your elucidate-query in depth. I feel concerned about the worry and fear expressed by You for the wrong surgery done. In my opinion you require re-exploration of the repaired hernia to relieve post-operative local-electric shock like pains ...and others. I would diagnose this -"as-post-operative-obsessive neurosis", which needs to be investigated-with-Surgeon as follows-i-Please get the USG /CAT scan study, which would fix the reason creating electric shocks-which mostly is-due to the strangled nerve while repairing your epigastric hernia.ii-I would have done re-exploration -of the repaired part and would have exiled the fibroneurotic area -after clinical and operative localization of the problem area as expressed by.iii-All your post-operative psychological problems are organic defect related and not merely due to psychologic behavioral problems felt by most of the doctors. I do agree with you on this issue that there is a physical post-operative defect which is causing all the trouble you have.iv-So please act on the lines suggested by me herein above- and request your surgeon-for -a re-exploration of the repaired hernia-to remove the neuro-fibrotic area-involving the nerve in the repaired tissue.v-Hope you would recover with these health tips. Furthermore, I would love to attend your queries soon. Have a good time.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been having a lot of pain that continues to worsen over a 2 year period. The doctors was running test only on my lumbar area because a couple of years ago I had decompression surgery in L4-L5. However I found a doctor who listened to me & ran the test I requested. However he only said come back & see me in a couple of months without any therapy & advised me to go online & look up cervical exercises & make sure I keep my neck lose. In addition he said massages would be good. Please see MRI results below:At the C4-C5 level, a broad based disc osteophyte protrusion appears to be present far lateral to both the right and left and posteriorly extending 3 mm posteriorly and centrally with asymmetric compontents towards each nerve foramen greater on the right than the left of approximately 5 mm to the right. Severe right neural foraminal stenosis is noted with moderate left nerve foraminal stenosis the noted. Contact of the exiting nerve root on the right and left may be present. Anterior cord contact at this level may be present with mild to moderate central canal narrowing to approximately 9 mm.At the C5-C6 level, broad based disc osteophyte spurring is noted that may relate to a broad based disc osteophyte protrusion of approximately 3 mm centrally. Moderate to severe left neural foraminal stenosis is noted with moderate right neuroforaminal stenosis. The anterior thecal sac is thinned but the anterior cord is not obviously contacted. The exiting nerve roots may be affected bilaterally particularly on the left.At the C6-C7 level, a centralprotrusion is noted of 4 mm. Moderate left neural foraminal stenosis is noted with mild right neural foraminal stenosis noted. Mild central canal stenosis is noted with the central canal narrowed to 9 mm. Anterior cord contact may be present. This protrusion descends slightly centrally.My concern is no one has treated me & the pain is so severe that just going to pick up a few things at the grocery store puts me in a lot of pain. While trying to shop I have pain in my feet, hands, and backaches within 15 minutes on my feet.In addition I still work but am in constant pain. The pain in both hands, pins & needles in my buttocks, headaches and the most recent added symptom is dizzeness! When I get home I soak in hot water then go to bed to get relief!Should I be concerned that my doctors has not put me into therapy? Can I end up with permanent paralysis? What should I do now?Thank you.BD ### output:

Hi, Thank you for posting your query. After going through your MRI cervical spine report, it seems to suggest a moderate to severe degree disc prolapse at multiple levels witChatDoctorpression of the nerves at these levels. This could result in neck pain as well as arm pain. In addition to physiotherapy neck exercises, I would advise you to use cervical collar (soft) and use medications such as pregabalin or gabapentin to reduce the nerve pain. Please get back if you require any additional information. Best wishes, Chat Doctor. Ly/

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Maybe about 6 or 7 years ago i was diagnosed with Hepatitis C and mild liver damage. I also have the upper part of my body done every year. This is where the doctor checks my stomach? Why I do not know. So, my question is what does it mean when he states that my liver is stable? ### output:

Hi, How are you? My name is Chat Doctor. Thanks for writing to Chat Doctor and I hope to answer your question today. Hepatitis C virus, as I am sure you are aware, damages the liver cells. The liver has an enormous capacity to regenerate, meaning if part of the liver is damaged, then new liver cells are formed to replace the damaged liver (unlike skin where damaged skin is replaced by scar). The problem with hepatitis C is, it is present constantly in the blood and liver and continues to damage the liver continuously. Just like a rubber band can be stretched only so far before it snaps, so is the regenerative capacity of the liver. Depending on how virulent the hepatitis C strain is, over the course of 10-30 yrs, the liver exhausts its capacity to regenerate and just like skin, the damaged liver cells starts getting replaced by scar tissue - this leads to hardening of the normal supple liver - A condition known as Liver fibrosis which later on leads to liver cirrhosis. The problem with this is, under normal circumstances anywhere between 1200 and 1500 ml of blood flows through the liver per min. When the liver is normal and supple, this blood can flow easily through the liver. But when the liver begins to stiffen or harden as in the case of cirrhosis, this blood is met with great resistance during its flow through the liver. This is called as "Portal Hypertension". So the blood starts to look for alternate routes to return to the heart and the most accessible route for it is through the veins of the food pipe (esophagus and stomach). The problem with this is, the veins in the esophagus and stomach are very thin walled and are not used to carrying this much volume of blood. So they distend to a great degree (a condition called as varices) and sometime even rupture with catastrophic consequences. This is easily diagnosed by upper GI endoscopy where the largely dilated veins can be seen. But in your case, since multiple upper GI endoscopies have not demonstrated any varices, it means your liver has not reached a state of "portal hypertension" yet and the disease seems not be progressing or is "stable". If I was your doctor, I would also get a "fibrosis" which is a special scan of the liver to look at the amount of stiffness or hardening of the liver. This can be repeated regularly to see the progression of the fibrosis. I would also explore the different treatments for hepatitis C infection. The gold standard is of course a liver biopsy which will demonstrate the exact status of your liver. I hope this helped, and I do hope you will get better soon. Please write back to me if you need any further clarifications especially the treatment options available to treat hepatitis C. Have a great day

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: HI SirIm from India bangalore.Im suffering from left side stomach pain past from 1 year 8 month.Did the scanning before 6 month endoscope, ultrasound and urine cultivation test. IM taking the treatment past from 1 year 8 by changing the doctors because it is not getting curable. 22-Mar2012 upper gastro intestinal endoscopy:: Impression :Duodenal erosious (Post bulbar) 6/4/12 Before 12 months back, i went to concert the gastoenterities doctor, he did the scanning of ultrasaound and urine cultivation test. Ultrasouund will be normal and urine cultivation test is e-Coli bacteria 1 lakh count.Then he sugest for urologist, urologist give a treatment to urologist test: ultrasoung KUB, trasrectal sonography, uroflometry16:04:2012tablet Cefoprim 500mg 1-0-1 7 daystablet unirub 20 bg 1-0-1 7 daystablet cranpac 1-0-0 30 After 2 weeks i got motion in blood then he suggestted looz syrup 17-5-2012t niffutin 100mg 0-0-1t cranpac 1-0-0t unirub 20mg 1- 0-03-7-2012t Sepmax 1-0-1 7 dayst pantazole 1-0-1 7 dayst lactogent 1-0-0 30 Doctor he is not able to cure the disease, my immunity power also gone low after taking the too many antibiotic.He again tell the scanning of CT SCAN---KUBMCUCYSTOSCOP and he told the scanning to my wife Gyac opinionpap smeacu/scan abd+pelvis i did not done any of the scan because he is not given the clear picture.i suffered him a lot from the doctor.Please help me on this, how do it has been diagnise ### output:

Hi welcome to Chat Doctor forum. Thanks for calling Chat Doctor. Forum. You are suffering from left abdominal pain, changed many doctors, and used many medicines. No cure since one year eight months. The causes of left abdominal pain are, gastric pain due to peptic ulcer, irritation by irritant foods. Pancrias pain, worms in the intestine, infection of the kidney, writer, or bladder, or stones in the ureter, or bladder. The other causes could be psychological due to long-standing problem, and it is secondary to the actual problem. I advise you to practice yoga meditation, reading books of your interest, hearing music, and internal or external gardening. Try to take more of curd, bland foods like bread etc. Avoid UN timely food, spices, junk foods, and oily foods. Wishing for a quick and complete recovery. Best regards.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My husband (who is normally a very fit and healthy 32 yr old) Got a very bad diaorrhea bug last August which he had for 2 weeks. He lost a lot of weight and looked grey. Since then he has constantly been ill. He gets cold after cold and over xmas he had flu which which was so bad he was bed ridden,got a chest infection and wasnt eating. Because of these recurrent illnesses he went to his gp who sent him for blood tests. They came back with a 2.5 WBC and slightly low HG. He was sent for repeat and the WBC was still only 3000.He is always tired and just looks awful. We are feeling very afraid. We would just like to know what he should be having done (test wise) as we feel a real lack of care at our practice. Theyve told him his wbc is low and that they will test again in 3 months. But what should he do in the mean time? He just cant get his immune system up and he is a secondary school teacher. Any advice would be gratefully appreciated. ### output:

Hi Welcome to Chat Doctor Your query regarding the recurring illnesses of your husband show that his immune system has become weakened so he falls prey to one trouble or another. It is indeed a matter of great concern. To strengthen immune system of your body you have to take care of few points which not only serve as preventive but also as curative measure. Because proper nutrition is an integral part of a healthy immune system, the kitchen is the perfect place to find natural home remedies to boost your disease-fighting abilities. Include simple nutritious food including fibers, minerals, vitamins, protein Antioxidants like ginger, garlic, Onion, coconut water, green veges and fruit like gave, Almond, carrot Curd, strengthens white blood cells and helps the immune system produce antibodies.vitamin E & C , Folic acid & zinc also are major players in the integrity of the immune system, to be taken in right quantity. Avoid fried, fast foods' tea, coffee alcohol Avoid constipation as you know it is root cause of all Allstate exercise integral part of your regimen as it plays an important role to help immune system to produce antibodies to boost disease - fighting abilities. Do Walk, Yoga, Panama , Deep Breathing , and latter on Kapalbhatti, & Exercise to strengthen you system Try to relax. If stress causes you to lose your cool, you could be impairing your immune system shrinking your thymus gland, creating major problems in you BR>So mental worry and anxiety should be avoided at any cost. Take good night relaxed sleep. Should take a level T spoon of turmeric with a cup of hot milk with breakfast and at bedtime and almond oil with it, is a great antioxidant and relieves mental mention. Lemon juice in a glass of water before every meal gives strength and immunity following this regimen regularly, and regular checkup and treatment by your physician will lead him to road to recovery, gives assurance of sound health ahead Hope this will solve your query, Take care. Wish him fast recovery All the Westmont hesitate to get back if you have any query.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Respected Sir, i was 25 when i had a varicocele surgery done on me way back in 2007, eventually my sperm count increased from 10000 to 20 million then. Later I dint follow up the sperm count i used to masturbate regularly and also had the habit of holding the cum when reaching climax,then again masturbate. In 2010 i was diagnosed with epididymitis then i had antibiotics and i was fine. Offlate i was again experiencing that dragging pain in the scrotum and pain in back if i was standing for long, I am too worried if i could impregnate my future wife as i am about to be married.i consulted the doctor and there is a slight varicocele and i am placing the result of scan below. My doc says i could go ahead marry and if am unable to impregnate in a year i could go for a varicocele surgery. I am too worried scared and stressed.. before two weeks i had a wet dream and the semen was very watery (its been more than a month i quit smoking and alcohol) and am not havin morning woods and even if i have its not that hard. i masturbated today after a 40 days period there was no proper erection and i got ejaculated immediately and the semen was watery although am having proper food habits. kindly advice. my scan reports below. my blood & urine tests showed normal as said by my doc. please help. Right testis -4.0x1.8 cms Left Testis- 4.0x1.6 cms Both Testes are normal in size and shape The echopattern is uniform bilaterally. No evidence of cysts, mass or calcification is seen. The epididymis appears normal bilaterally. THERE IS MINIMAL RIGHT HYDROCELE RIGHT SCROTUM SHOWS MILD DILATION OF VEINS OF 2.2- 2.5 MM AT REST AND 3-3.5MM ON VALSALVA. LEFT SCROTUM SHOWS THROMBOSED DILATED VEINS REVASCULARISED BY COLLATERALS WITH REFLUX MEASURING 3MM AT REST AND 3.5MM ON VASALVA Impression: *EVIDENCE OF GRADE I - II VARICOCELE IN RIGHT AND LEFT SCROTUM AS DESCRIBED ABOVE. *SONOGRAPHICALLY, TESTES AND EPIDIDYMIS APPEAR NORMAL BILATERALLY,BOTH TESTES SHOW GOOD VASCULARITY. ### output:

HelloThanks for query. Your Scan report reveals bilateral grade one Varicocele with apparently normal testicular function . It would have been better if you could have done semen analysis and posted the report to make precise comments about your fertility. At the outset I would like to emphasize that Varicocele surgery may or may not improve sperm count. You need to consult qualified Urologist for problem of Erectile Dysfunction and get investigated to find out the cause of ED. Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had unprotected vaginal intercourse with a female who turned out to be a heavy intervenious drug user. We only had intercourse for 2-3 minutes, and I did not ejaculate. We were engaged in intercourse before she was completely undressed, and when her shirt was off, I saw that she had track marks on her arms from injecting drugs. That is when I stopped and left. That was 8 months ago. About 2 months ago, I got very ill, with sevear headache, nausea, and a presistant strange taste and smell would not go away, and my auxillary lymph nodes (armpit) swelled, but mostly on the left side. I could feel something was going on in my auxillary lymph nodes, and it gave me a very squirmy feeling, for lack of a better term. I could not sit still. I was very ill for about 5-6 days, and then, for the most part, it subsided, but not completely. To this day, most every day, I still have that taste and smell in my mouth, and when it happens, it is accompanied by a very fatigued feeling. I have also been having consistant muscle and joint pain, and a lingering, but not very sevear headache, that comes and goes, probably due to the sinus pressure I can feel in my cheeks, eye and forehead area. I find I am tired far more often that usuall as well. I also have occational pain from my inner thigh and groin area, on both sides, but again, mostly on the left. I suspect that that is my groin lymph nodes are causing that pain. And more recently, in the last 2 weeks, I have had consistant dry mouth. I am an active, yet currently unemployed and uninsured 33 year old college student, and have never had presistant symptoms like this in my life. I have done much research in the last 2 months and suspect that I may have contracted HIV. Can you tell me your opinion of the level of risk of the situation where I think i contracted the desiese? Also, is it normal to have no HIV symptoms whatsoever for six months post possible exposure, and then one day, become consistantly ill with multipule symptoms? I would also like to know what happens for possible treatment options for someone who is uninsured. Thank You for your Assistance. ### output:

Hello Major signs of HIV :1 Weight loss =======1 month.2 Chronic diarrhea=====1 month3 Prolonged fever=====1 monthMinor signs are :1 Persistent cough for one month2 Generalized pruritic dermatitis 3 Recurrent Herpes zoster4 Pharyngeal candidiasis 5 Chronic progressive & disseminated Herpes Simplex 6 GENERALIZED Lymphadenopathies ( as you are having). Antigen antibody HIV RNA test is most accurate. Western blot is most accurate. In my opinion you should get these tests. All the symptoms mentioned are an indication of HIV. About the treatment it depends on after diagnosis establishment. As far as about INSURANCE, I don't know much. Hope this will help you.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: The question is about my son. 18 yr old athlete. He was lifting weights doing an overhead press. He felt a pop or crack in his neck and some pain. very soon after that he got a Migrane headache. He has got them before when he didn t have good sleep habits. This Migrane seemed stronger than previous ones but he did not throw up. The next day he woke up with a very sore neck and numbness on the left side of his body. The numbness was in the back of his arm and down his leg. We took him to the hospital and he started a bunch of tests. MRI s, Echo, ect. Things they found were. The possibility of two very small dots on the occiptial lobe of the brain which they said could be there and if so could represent a stroke but also could not really be there. They said he has Chiari Type 1 which could be the cause. They don t believe there has been a disection of arteries in the neck according to MRI s. He did not have a PFO. We left the hospital yesterday with a wide range of possibilities from very scary to no big deal. He continues to have numbness in his left arm and leg. Also he hasn t had a stool movement for a couple of days which is atypical. My questions are 1. If its just a pinched nerve then how long would the numbness typically last. 2. from looking at the information on the web is it possible he had a Sporadic Hemiplegic Migraine (SHM) and if so how long does the numbness usually last in those cases. 3. Does the Chiari have an effect on the nervous system after an injury. The web seems contradictory in this area. 4. Can a stroke or mini stroke be associated with a minor neck injury. 5. How do we know if the chiari is affecting his nervous system. My son is a college football player and its a big part of his life. So this has the family very concerned. ### output:

Hi, I passed carefully through your question and would explain that your sons symptoms could be related to a possible stroke. Regarding the pinched nerve in the neck, it would also cause irradiating pain in the arm, triggered by neck movements. So, I don't think this is the case. Besides, it would be signs of spinal canal compression or stenosis in the cervical spine MRI study. Regarding the dots in the occipital lobe, there is a special sequence in MRI, which is called DWI, which can differentiate if they are acute or old. Regarding Migraine, it could be migraine if the numbness recovered within 72 hours, but it is usually associated to motor deficits too. The Chiara malformation can trigger headache and neck pain during an injury, but it usually causes chronic signs like headache, dizziness, gait imbalance, etc. It does not lead to such acute clinical situation. Anyway a follow-up every 12 months with brain MRI is necessary to see if the cerebellar tonsils are in the same position or if there is presence of siringomyelia (which is a common complication of Chiara malformation). You should discuss with your doctor on the above issues. Hope I have answered your query. Let me know if I can assist you further.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello. I have spinal problems. Diagnosis: Spinal Disk Hernia. Have an awful, constant pain in my back and down my left leg. In 2013, I ve had a surgery according to this diagnosis, but in the next 3 months, the pain increased again. The pain itself is note gone, neither before surgery of course, but nor after it (totally gone). Could you please tell me if I can send you my MRI result? To know,it is a right diagnosis or not? Is there any hope to deal with it? I appreciate any kind of your answer. Thank you in advance. Bests - Lika. ### output:

Hi, thank you for providing the brief history of you. Since you mentioned you had disc herniation and have undergone surgery for the same. Post surgery the pain hasn't come down. So this shows it is a failed back syn Chat Doctor. Apparently now what you need to understand is the herniated disc is out of the body as the surgeon planned. Post this, the need is to undergo a graded planned exercise rehabilitation, which had to be performed under the specialist. Now since the pain hasn't come down, and it is increasing that means that the spinal muscles are not strong enough to hold the spinal column at required intervertebral disc space, and any little weakness is leading to nerve entrapment again. I will advise you to undergo a fresh MRI and compare with the pre-surgery MRI. Any comparative study at this point will be of great help. Along with painkiller if your Surgeon wish to prescribe you can go ahead with it. Also you need to now totally focus onto the physical therapy only. As reoperating the same level again as per my thinking will not give any benefit. The physical therapist will help you firs with therapeutic ultrasound therapy which will lose the scar tissue in the back. Later on the use of TENS will be symptomatic and as per the need. The physical therapist may apply the myofascial release of the spinal muscle spasm. Which will help to get some mobility of the spine. Now moving ahead you need to undergo a strong rehabilitation plan. As you core should become like 8 packs but over a period of time and with the limits of you physiological pain. You will even need to strengthen the spinal muscles to get the intervertebral disc space back to release the compression on the nerves. Post that strength conditioning has to be planned as the body functions as a unit. Strength conditioning will help the unit to function in equilibrium which will be of great input. I have seen the cases like this and all have responded well with pre-planned and graded rehabilitation process. Also to mention that it is slow and steady, but gradually you may get to see the difference. I have myself treated cases with 99% of success rate. Now It's my luck or the effort of the patient that he recovered, but I have 99% scorecard. The one who kept patience all recovered even with an abnormal MRI my patient can climb 13 floor in 100 seconds without a pause. Well to cut down the story and come to help you, please organize physical therapy and get treated. With the grace of God I wish you a speedy recovery

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi,I have been with my partner for 3 years we just got married 2 months ago. I was tested for all STDs going into the relationship and again when I was pregnant with my now 18 month old. I had a pap smear in April 2009 but am not sure if I was tested for stds. I had a copper IUD put in me late December and when I went for my check up in Jan they took swabs when I complained of abdominal pain and having to pee frequently. They came back clean but I phoned up my GP for antibiotics for a UTI since this is fairly common after having an IUD put in the Dr didnt test for it. Well the pain went away but come back a couple of weeks later. I put it to the back of my head as was very busy with exams and planning wedding plus thought I had to suffer through it cause of the IUD. We went away on honeymoon and had pain while sex. I thought it was the IUD and went to have it checked and was sent to another clinic after the first clinic took swabs. They did swabs at second clinic and both tests came back positive with Chlamydia! I have not cheated and the only person that I have had sex with is my husband for the past 3 years. Of course I accused him of cheating and he swore that he hasnt cheated on me. He went to get a full STD check and to add to the confusion he has come back negative for any STDs. I am so confused as to how I could have gotten this.Before my husband got tested I was told that it was possible that he had Chlamydia and I was resistant to it and then when my IUD was put in I finally caught it. Is it possible for my husband to be carrying Chlamydia but not have it and not test positive for it?Also I am worried that I have something else perhaps cervical cancer and it has had a reaction with the IUD and given me false positive results?? I am still peeing frequently and having abdominal pain even though I have completed all my antibiotics. I will add that I have not had sex with my husband since all this has gone down and also he when he went to the clinic they gave him treatment for it even though they hadnt gotten his test results back yet.I am so confused and upset and I need answers as this is taking over my life. ### output:

Thanks for your question on Chat Doctor. I can understand your situation and problem. First, no need to worry about cervical cancer because you're all reports are negative for cancer. You are having chlamydia infection due to IUD in uterus. IUD weakens local uterine defense system, so women on IUD are more prone to STD s. You are mostly infected through your husband. Male urethra is very protective against infection. So your husband might be carrying chlamydia without infecting him. And during sexual Intercourse, you are infected. Since your defense system is weak due to IUD, you are having symptoms of infection. So better to get done sensitivity report for guidance of effective antibiotic therapy. No need to worry about cervical cancer. Hope I have solved your query. Wish you good health. Thanks.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been very sick with an asthmatic type illness. I am a substitute teacher and had to leave school on Monday, due to feeling as though I were going to throw up when I bent over, not being able to breath,upper respiratory especially and nasal region. I took Benedril liquid, what I had left, have run out of my Zyrtec and get more tomorrow, am extremely weak and asked other subs to cover the rest of the week for me. I cough continually and am very weak. When I visited an doctor for allergies, her told me I was extremely allergic to Elm trees which are all around the back yard. I ride a lawn mower with a mask that usually works. This began to happen on Saturday with sneezing 9-10 times each and I rested, hoping I could work on Monday. My allergist it may also be dust and pet dander. When I mow there is a lot of dust and I do have two dogs and a cat who are my only family. I have rested now for two days and am not much better. I have been wheezing with strange noises coming from within my chest. I did not go to the emergency room, nor the same doctor because I feared it would be the identical respond as previously. I was just watching the news and heard about this virus that has affected many throughout the nation. I seem to have the same symptoms and they keep reoccuring, which cause me to be unable to sub. I could use the sub money, since I only have Social Security to live on at this point. I have been a Superintendent of Schools in SC and my friends can tell you that I am not over reacting or a hypocondriac who may think he/she has everything that comes along. I really need help and everywhere I turn, I hear you just have allergies like everyone else. My throat closed the other night and I had to drive to my neighbors and wake them up to help me. I could not speak to tell them what was wrong. They finally figured it out, knowing my situation. I see that there are no doctors available in WV where I live, but I could drive to Alexandria, VA if necessary. Could you help in anyway? I do not have a credit card to pay today, but could get one tomorrow at a convenience store and will continue to chat. Please tell me what to do? ### output:

Hi, Welcome to Chat Doctor, I have read your whole query. From which it seems that you might be having allergic asthma due to elm tress or dust. Now, Asthma is itself an allergic disease due to cold or dust or pollen or grass etc. irrespective of the triggering factor. You can go for pulmonary function tests if not done. Treatment is mainly symptomatic which might require inhalation steroids, beta agonists, anticholinergics as MDI or rota haler as a regular treatment. To decrease the inflammation of bronchi and bronchioles, you might be given oral antihistamines with mast cell stabilizers(montelukast) and steroids (prednisolone) with nebulization and frequently steam inhalation. The best way to cure any allergy is a complete avoidance of allergen or triggering factor. Consult your pulmonologist for thoroughly clinical examination and treatment.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I m not sure if you can help me or not. I ve had lower abdominal pains which have worsened over the past three months. I was in hospital six months ago with an infection which was diagnosed as a sizeable cyst of 4inches on my left ovary but nothing was done and I wasn t given a follow up appointment. Since then, a similar pain has developed but worse on my right side which some days leaves me doubled over and a pain in my lower back started about a month ago. The pain in my left side is more of a dull ache which never goes away but the pain in my right sometimes is a sharp, burning pain. Some days it feels like extreme period pains but I never used to suffer during that time and now I m sometimes bedridden for a couple of days. I m not sure if its linked. I finally plucked up the courage three weeks ago to go and see a doctor who took blood tests. I d been told to go back this morning for my results. Unfortunately, the original lady doctor I d seen has since left the surgery and my appointment this morning was with a male doctor. He told me my levels of CA125 were 67 and although slightly elevated, it was nothing to worry about. He has arranged for a pelvic ultrasound in three weeks. However, he has ruled it out as anything to do with my ovaries and is suggesting that because of the pain in my back, it could be something called Scoliosis . He has also referred me to a musculoskeletal Clinic for an assesment. I ve never had any problems with my back previously. I can t see how this can explain the severe pains I m having and why this wasn t explored further when I was in hospital. I also can t find anything on the internet about what the level of CA125 should be? Should I get a second opinion or just wait for three weeks till my ultrasound? I d refrained from getting worried or reading anything on the internet till just now because what the doctor said, doesn t make sense. Now I m concerned that some of the symptoms of ovarian cancer are symptoms I ve had over the past couple of months. I m 31 yrs old and have never had children. I am asthmatic though and my recent cervical smear came back clear as did the other blood tests they did for thyroids etc. I m sure though that after I d told the doctor how I was feeling he would ve mentioned it as a possibility but he didn t mention it at all. Any advice you can offer me would be greatly appreciated. ### output:

Hi and welcome to Chat Doctor. It usually very difficult to determine is ovarian cyst malignant or benign. These cysts are most commonly benign, and it is recommended to do frequent check-ups and evaluate dynamics of growing. Malignancies grow much faster and infiltrate surrounding tissues. There is really no better approach then it was recommended in your case. There is a possibility of laparoscopic biopsy, but it is invasive. I suggest doing these ultrasounds and if something suspicious is founds then it can be easily removed. CA125 is confusing many women. This is a tumor marker, but is also found in endometriosis, benign cysts, PID and some other intra-abdominal tumors and disorders. Wish you good health.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi sir, my name is bindu. age is 19. my marriage lost 1 year. iam not pragnant. i consult a gynacolagist. she chesk palicular study 4 day s. she tell eggs is not forming. she sujjest benforce-m toblets daily three times. i regulary three times using. iam not pragnant till date. please tell me benforce-m toblet is usefull or not? ### output:

Hello, Thank you for your question. Infertility is defined as the inability of a couple to become pregnant after one year of unprotected intercourse in women under 35 years of age and after six months in women 35 or older. The ability of a couple to become pregnant depends on normal fertility in both the male and female partners. Because pregnancy requires normal fertility in both the male and female, health care providers routinely involve both partners in the evaluation.A woman can have trouble getting pregnant for different reasons. Include: problem with ovulation. Ovulation is a time in a women monthly cycle when the ovary releases an egg into the fallopian tube. Women have the highest chance of getting pregnant if they have sex 1 to 2 days before ovulation or on the day of ovulation. It is 14 days before your last menstruation period. Problem with the uterus or fallopian tubes-for example, some women have scar tissue in their fallopian tube from past infection or surgery. Endometriosis- is a condition that can cause pain in the lower part of the belly. Your doctor will talk with you a do an exam. He or she will do often do tests to try to figure out the cause of the problem. Plus, your partner might need to be tested too. But don't be surprised if your doctor can not tell you what is wrong. It's not always possible to find out why a woman cannot get pregnant. For you have a problem with ovulation. The method of ovulation induction selected should be based upon the underlying cause of an ovulation(no ovulation) and the efficacy, costs, risks, and potential complications associated with each method as they apply to the individual women. Option include: Weight modulation(keep your BMI in standard level), Camphene citrate, Metformin or other indulin-sensitizing agents, Gonadotropin therapy, Aromatize inhibitors, Laparoscopic ovarian diathermy, assisted reproductive technology. For your problem your doctor choose to use Metformin(enforce). Insulin resistance in commonly observed in women with PCs. Correction of hyperinsulinemia with metformin has a beneficial effect in ovulatory women with PCs because this leads to an increase in menstrual publicity and enhanced spontaneous ovulation. However, live birth rates are not as high as those achieved with camphene. A consensus group has recommended against the routine use of metformin for ovulation induction except in women with glucose intolerance. However, the addition, metformin may provide additional metabolic effects that are beneficial for pregnancy. If you are overweight, losing weight might help you become pregnant. Hope I have answered your query. Let me know if I can assist you further. Best regards,

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: what causes the stomach pain of a gastritis to act on the solar plexus, making heart tachycardia and anxiety. I control the anxiety quit good, but it causes pituitary gland and the sexual Chakra to interact, resulting in a turning disk of purple and deep pink red spiral and that opens me the third eye, traveling out of the body and finding myself in a nebula in outer space. If I turn the body to another side, i get to another place. That symptom happens while awake and i just need to close my eyes to travel. When solar chakra is seen, a golden disk with black number 6 appears, the numbers are multiple, it looks like a psychedelic arrangement. I am meditating often and can get in that state when i keep myself in a state of dieting and hypoglycemia . Then I control the effect, when it happens when the stomach pains, I can t and it brings me just anywhere. I have a light Barett-syndrom, a spot of a few millimeters, but permanent gastritis symptoms and any false step in food-taking results in sever pain. I made 40 years of power-lifting, resulting in a light stomach hernia and this hernia is destroying my whole life comfort. I use Nexium , i take it when such periods appear only. Recently the doc gave me Telmisartan Micardis, I stopped that mdecine because it causes short breath and did not well control the heart tachycardia. I got dehydratation problems resulting in stiff blood and heart arythmia what cause high blood pressure. I returned to Inderal for that problem of fast heart beat and it works best without any problems, Taking it just a few days leaves that symptoms pass by. I was anxious subject since ever and sometimes it goes just over my will-power which is quiet powerful, since I practice theurgic control of my sub-conscient, being a long time Hermetic Kabbalist teacher. Ayurveda and Yoga helps and meditation does well, but this too cannot repair broken pots. I repaired a lot on spiritual basis, but i stand face to a wall when I try to access the stomach. ### output:

1. ANXIETY due to pain of Gastritis could result in Tachycardia, otherwise can't think of any other reason causing rapid heart rate.2. Because you have a light Barrett syn Chat Doctor. 3. could be possible Castro esophageal reflux disease (HERD) due to lax lower esophageal sphincter (LES) resulting in reflux of acid back. (reflux esophagitis)4. Avoid foods which are difficult to digest like oils and fats, which make stomach to release more acid, avoid tea, coffee,smoking, alcohol,sour foods (pickles, tamarinds,vinegar, curd)5. Fibers are necessary in the diet as they help in the digestion.6. Eat slowly, avoid haste, chew properly and avoid over eating.7.check stool for worms, hemoglobin for anemia, ultrasonography of gall bladder, gastroscopy for H. Pylori infection

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 50 year old male with a history of cervical spine injury. I have had a disc-ectomy with fusion in 2012 and in Feb of 2013 reinjured my neck in an auto accident. I, in the past greatly benefited from Oxycodone 10mg, It totally worked for me. Other medications such as Nambumetone, Naproxen, Cyclobenziprine, Amitriptyline, Prednisone, as well as several others were not effective. I am an electrician and I do a lot of tasks that are posture compromising. I am often required to crane my neck for extended periods, ( a recent pain management Dr did not know what craning of the neck meant) I have to access crawl spaces and attics. I have to manually bend conduit, and work overhead. I have to work above suspended ceilings off of a ladder, outstretching and reaching to pass wires along, By days end I am in agony. I am unable to get my current primary care physician to prescribe the one medication that works for me. Oxycodone.. I am aware of the dependency risks. I am also aware of some of the warnings that come with the medications they are so freely willing to give me. Shouldn t the decision be mine as to which risks I am willing to take. Nambumetone for example has risks of gastric bleeding, increased incidence of stroke and a slew of other possible side effects. The Amitriptyline has been shied away from for years as an anti depressant because of far safer forms of antidepressants currently available, yet they are more than willing to let me take it for neuropathic pain, even-though it is ineffective. How does one approach a physician about prescribing Oxycodone, without appearing as someone seeking it for less than honest reasons? I genuinely benefit from the 10 mg dose. It worked wonders the 8 months I was on it. it worked so well I opted not to have the additional fusion surgery recommended after my 2/10/13 accident.. When I opted out of having the 2nd fusion surgery the surgeon subsequently ceased prescribing the oxycodone & told me to get it from my PCP who is unwilling to prescribe it, and now I am once again contemplating having the surgery. I actually had the most productive 8 months in over 5 years while taking Oxycodone. My pain was managed, my pain associated depression was non existent, I functioned at work, and got things done at home after a day at work. Now I just barely make it through the day, and when I get home I am a couch potato, to sore to do anything. . YYYY@YYYY ### output:

Hithanks for using Chat Doctor Oxycodone is an opioid derivative, and it helps in controlling pain. If you are getting relief through it, then u can take it. But try to control the dose. With time u will get tolerance to the dose, which could lead to increase the dose. U can take it on sos' basis, it would help u to control the tolerance and dependence pattern. In any case u need our help u can connect us. Thanks

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, My aunt is nearly 56 years of age, suffering from fourth stage breast cancer . She was initially diagnosed on May 2010 but failed to get treatment at time. She did however visit a doctor in June 2011 and her surgeon advised to reduce the size of the tumor before she could be operated on. Her treatment started in June last year (2011) with 8 courses of AC. Regular checks were done but somehow the chemo did not have an affect. Her hormone receptor tests are negative by the way so the only likely treatment could have been chemo, radiation and surgery. Her oncologist then got her on 5FU which did not have any effect on the tumor as well. Now she has secondary liver cancer as well which has taken over two of the sections of her liver. Her chemo stopped a couple of months ago as she did not want to go through any more of it. She was on pain killers and trying out Reiki treatment to manage day to day aches. She would complain of stomach pains and sometimes had trouble passing stool. Then a few days ago her health deteriorated when she started shivering and was admitted in the hospital. The doctors explained that her sodium levels had gone down. Now over the last few days she has been suffering from what looks like ascites (stomach really blown up and hand and feet hard as wood) but the doctors are not draining her stomach of the fluids. She cries due to the severe stomach aches and her urine has turned almost black. Her eyes are yolky yellow and she is on constant pain killers and catheter for her urine. Her breast cancer is reeking blood and needs regular changing. Today they informed us that her platelet count has gone down to 28,000 but still havent informed us whether we should arrange for a blood transfusion. The hospital she is in is not a cancer hospital as this was the one closest at the time when she fell ill. I personally feel the doctors are not taking this case as an oncologist would as a- they have failed to address the ascites issue b- are treating her like a normal patient even when they have all her reports in front of them. They inserted a food pipe today as well so that they can give her food via that. I just feel that since she has been admitted her health is deteriorating even more. Do you think we should change hospitals. Or is this normal in her case to suffer so much. Concerned niece - El ### output:

Before I answer your question, let me inform you that I am an experienced oncologist and have been working at a dedicated cancer hospital for some time now. Let me make a few things clear to you before I move on to the specifics. Maybe you know them already, but nonetheless. Firstly, your aunt cannot be cured of her disease by any form of treatment. Secondly, the treatment that she has undergone so far before this admission seems to be largely correct from an oncological point of view. Finally, to your query. Treatment at this point is aimed only to provide her a good quality of life and to prolong whatever life we can. From what I gather she has gross ascites and her liver is failing as well due to the disease. So she would benefit in terms of pain by Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i AM AN INDIAN LADY OF AGE 27 AND MARRIED SEVEN MONTHS BACK.EXPECTING AN ISSUE BUT THERE IS NO IMROVEMENT AND I AM HAVING A SONOGRAM REPORT FOR YOUR KNOWLEGE.PLEASE TELL ME IS THERE ANY PROBLEM..? SONOGRAM REPORT DATE 19/03/11 Name ; Vijayasundari (age 27) WHOLE ABDOMEN 1.The liver is normal in size and shows uniform echotexture with no focal abnormality. 2.The gall bladder is normal sized and smooth walled and contains no calculus. 3.There is no intra or extra hepatic biliary ductal dilatation. 4.The pancreas shows a normal configuration and achotexture. 5.The pancreatic duct is normal. 6.The portal vein and the IVC are normal. 7.The spleen is normal. 8.There is no free or loculated peritoneal fluid. 9.No para aortic lymphadenopathy is seen. 10.No abnormality is seen in the region of the adrenal glands. 11.The right Kidney measures 10.3*4.1 cms. 12.The left Kidney measures 11.3*4.6cms. 13.Both Kidneys are normal in size,shape and position.Cortical echoes are normal bilaterally.There is no calculus or calyceal dilatation. 14.The ureters are not dilated. 15The bladder wall is mildly thickened (4mm) .There is no intravesical mass or calculus. 16.The uterus is anteverted,and measures 8.6*3.0 cms. 17.Myometrial echoes are homogeneous.The endometrium is normal. 18.The right ovary measures 4.5*2.0*4.4. cms(22 cc). 19The left ovary measures 5. 4*2.4*4.4 cms(31cc). 20.Both ovaries are enlarged and show multiple,small,peripheral cysts. 21.Parametria are free. 22.Iliac fossae are normal. 23.The post void scan shows 88cc residual urine. IMPRESSION: = Polycystic ovaries. = mildly Thickened bladder with significant post void residue ### output:

Hellos clearly mentioned in the ultrasound report that you are having Poly Cystic Ovarian Disease (POD or PCs). Since you are having pod and I want to explain few things about POD. Please read it carefully:Signs & symptoms:1 An Chat Doctor. 2 Menstrual irregularities, dysfunctional uterine bleeding or amenorrhea.3 Obesity with glucose intolerance.4 Alteration in LH/FSH ratio.5 Elevated serum testosterone and an

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I was diagnosed with an injured ankle as early as July 12th 2011 . The 1st doctor I went to diagnosed it to be a sprain and advised me to wear a compressive ankle socks with just some ointments and anti inflamatory drugs . I continued carrying on normal activity without giving the leg much rest . A week later i went to another doctor who advised partial rest with the same ankle socks Another week and with an MRI scan i was diagnosed with a ligament tear of the right ankle . I was made to take complete rest with a plaster of paris to support the leg . My movement was restricted completely as the cast was too heavy . Since i m someone use to sleeping on my right side i could not avoid sleeping on the right ankle despite the cast . Ws taking Zerodol tablets . The cast was put for 3 weeks and was removed on August 17th . As there was tremendous swelling i was given was therapy for a week . Even after that i restrcited my movement keeping my leg elevated as much as i can and tried walking with the help of a walker . I have got back to work on September 12th . An 8 hrs of desk job and climbing stairs my leg swells profusly and by the end of the day it looks like i have a mild elephantisis on the right foot. I had severe clotting and pain on the little toe on the rigth leg which has greatly come down now . But the sweeling of the foot inhibits normal movements and at times when i try walking normal i feel pain. I m still unable to walk normally and can feel mild pain at the ankle . The leg is normal only if its elevated and given rest . I can only mildly move the foot up and down and have not gained complete felxibility . My doctor has not advised any form of Physiotherapy apart from moving the toe digits and moving the foot up an down. I am currently taking Ubicar medicines I wanted to know if its normal for the leg to swell tremendouly even after nearly 2 months of removing the cast.? How long would it take to heal completely ? Is there anything that can be done to stop the sweliing ? ### output:

Hi, Your problem seems to be going for a long time from 2011. So to answer your questions it is not normal for the foot to swell up so severely even after two months of removal of the cast. Complete healing of the will depend on if you have a blocked vein or a chronic deep vein thrombosis. For this you need to a Doppler study which is an ultrasound examination which will tell you will need if the veins are OK, if the other parts of the limb are OK. Now since the swelling is there for a long time you will need to use anti DVT stockings (or anti-varicose vein stockings) which goes above the knee. This should be worn throughout the day. All this only if the ultrasound exam is normal. Along with this need elevation while sleeping and sitting at home. And exercises for the whole limb to regain muscle strength and activate the blood flow. Hope I have answered your queries. Let me know if I can assist you further. Take care

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hey. I m 34 years old who had an abortion at age age 27. I now need a baby an have been trying for years and can t get pregnant why is tha. Also fo two weeks now I have been feeling slight movement in my belly the uppersection. Could you say why. My birthday is the 11 of this month I will be 35 ### output:

Hello mam, thnx for trusting Chat Doctor doctors for your health related queries.I guess your concern is about getting pregnant....right...I got the picture.well lets ANFR to your question with small discussion below with d info u have shared with us.1.age, apprx 34 yrs....women of age group 18-40yrs r called reproductive age group, here the chances of pregnancy are more,,,after 50yrs chances nil...42-45yr transition zone, chances of pregnancy are NT as high as 18-40yr nor as low as 50yrs.I hope y am I stressing the importance of your age....understood NASA????means to say u have high chances of getting pregnant....so don't put ourself into unnecessary tension.now I would like u to focus on interfertile PERIOD,it starts from 10th-16th day of menses....here ovulation occurs,this ovum meets sperm n women gets pregnant....in this period if u do more episodes of intercourse the chances of pregnancy are more....usually women don't get pregnant either there is problem in wife or husband sometimes both....with the information u have shared about u, i guess nothing wrong from upside.still u haven't shared info about your menses....so I cant say 100% no problem on your side...u haven't shared info about your husband.how old is he??WTA is exact age??was it a late marriage for him???so I can't comment are there any mean from husband side...but, even any problem is there, dont worry,CZ here comes the advantage of 21st century technology. The name of technology is ART-assisted reproductive technology.ex.IVF the bloating sensation you are experiencing may be BCZ of gastric problem.it has nothing to do with pregnancy...well with this small discussion u can try out my suggestions:-1.have patience....don't put unnecessarily ourself into tension.2.I insist u n your husband to have more episodes of intercourse during fertile period(scientific mean told already ABV)try this for next 4-5months,this solves 90% of your problem3.if you're in very hurry or no results after 4-5months then visit a nearby gynecologist/infertility specialist for further help hope this WZ informative enough, helpful n useful for your query.regards: Chat Doctor. .(had abortion at 27yrs...now about to com 35yrs still not getting pregnant....I can understand your psychology,don't worry all women goes through this phase....have patience.I pray god that u get blessed with baby as fast as possible, hopefully, TWINS!!!!!!)

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Sir/Ma am, Iam an anxious first-time mother based in Chennai. My daughter is 10 months 28 days old. Her birth weight was 3.5 kg, current weight 11.8 kg. She s on breast feeding & solids. She had been suffering from cold & cough for the past 4 days. At first we tried giving T-minic drops alongwith the Nasoclear nasal drops(prescribed by one doctor). When her symptoms got bad, there were coughing fits & audible wheezing, we consulted another paediatrician who s also a professor of paediatrics. After check-up(by stethoscope), he also used a device(that i later understood was a pulse oximeter), the readings were 95 & 70,(the sensor was put on her finger & toe respectively). The doctor appeared to be busy not allowing us time to ask questions or doubts. While he never explained anything regarding the findings, except that it should be 99 instead of 95,and that there was heavy phlegm in her chest built up due to cough syrups. He later proceeded to give the following list of medicines to take: 1. Montair LC kid 5ml @ N for 30 days 2. Liquid Advent Forte Syrup 2.5ml @M & N for 6 days 3. Liquid AB Phylline 10mg/ml 2.5ml @M & N for 7 days 4. Ivepread tablet4 @M-A-E-N for 3 days 5. Liquid Ceroplox 100 2.5ml @M & E There s no immediate family history of obesity, sugar or asthma(but my husband s grandmother had asthma, i don t know if that counts!). I would first of all, like to know, if it s safe for her to take so many medicines. It s extremely difficult to administer any of the above medicines(esp. the tablet which dissolved in water, is too bitter for my liking!) In just half a day s dosage administering, she s begun to show disinterest in eating & feeding breast milk. During the night, she also threw up twice(part of her solid intake & the other time, her breast feed!!) Does this mean, we should stop(any or all)the medicines?? Won t she have side effects? How to continue if her appetite s affected & her vomiting increases? Please find the time to explain & clarify, as i have to keep giving her the meds the next 3 days & I don t want my baby becoming sicker than she is, because of the drugs. An immediate response is highly appreciated. ### output:

Your child seems to be having wheeze associated with acute respiratory infection. This is a viral infection does not need antibiotics (perplex, advent forte). An oximeter reading of 95% is absolutely normal. You have not mentioned the respiratory rate of the child, if the respiratory rate is less than 60 then there is no need to hospitalize.Moreover, too many medications have been started without proper investigation. Please take a repeat opinion as the prescribed medications are not rational

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear Doctor, This is Diptiman Chakravorty age 32 male, obese individual height 5ft 7 in, weight 122 kgs. Two years back, I was diagnosed with fatty liver. Last month, I started feeling extremely weak and consulted a Dr. Blood tests revealed low Haemoglobin levels of 10.8. Last year it was 14. I was advised upper GI endoscopy, Colonscopy and stool for routine and occult blood tested. Upper GI endoscopy result:-Gastritis in antrum and healed duedonal ulcer. Colonoscopy report :Normal. and occult bleeding in stool negative. Dr prescribed Vivolib 500, Omez 500, Kinpride, Pibizyme, ursocol 300 and mild iron supplement Livogen(once daily at night). Within a week my hb levels went to 12.2 which Dr says is not bad.Other drugs described above are being used to treat gastritis and fatty liver. II have also been asked to loose weight. I am not diabetic and do not smoke or drink alcohol. My query is does gastritis cause such types of anemia, and how long should I continue to take Livogen (iron supplement)? Moreover, I am worried whether taking iron supplement will damage liver(fatty liver)further and am I in the taking the right medicnes for my condition? MY SGPT and SGOT are at normal levels at present..my present energy levels are low, yet I am walking 20 minutes daily.My doctor loosing weight gradually through exercise and diet modifications will help, but I am worried about anemia :-too much iron :-liver damage, too less anemia. How do I strike a balance. Please advise accordingly. I am still young and keep worrying constantly due to my helath conditions. ### output:

Hello, You are definitely a high risk for Fatty liver disease. If you don't consume alcohol then it is Non-alcoholic fatty liver disease. Weight reduction and restricted intake of Refined carboy Chat Doctor. No specific medications are available to manage Fatty liver except for vitamin E intake. You need to monitor you Serum lipid profile and blood sugar profile. Now coming to your anemia. I would need to know your complete blood profile to check for the nature of anemia. If it is iron deficiency anemia intake of Iron intake will help. Only in specific conditions like Thalassemia (even carriers) and Haemochromatosis oral iron intake is to be restricted. Once the hemoglobin level is normal you need not continue Iron intake. Astral gastritis usually does not reduce He levels. Only severe erosion in the GI tract, bleeding ulcers and vascular malformations can cause low He levels. Usually Stool for OBT is positive in these cases. I would suggest you to monitor your He levels and check stool for Routine examination (as worms are a common cause for anemia). You may discontinue your iron supplements once your He level normalizes and monitor henceforth. Hope I have answered your query. Let me know if I can assist you further. Take care

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Doctor, I have two questions for you. First, what can a nephrologist do to help my 87 year old mother with an unexplained low sodium problem? Her GP wants her to see one and the appointment is set for next Tuesday. I understand that a nephrologist deals with acute kidney problems which has not been a problem for my mother. And second, is there any reason why I can t use salt tablets to help keep the sodium up until we see this doctor? Previously, my mother s GP and neurologist have looked at the medicines she s taking to no avail. Her neurologist has said that the low sodium led to a few of her seizures. My mother is a heart patient with an irregular heart beat. She had a pacemaker put in several years ago and had surgery to put in a stint in 2001. In addition to this, she s a Type II diabetic, has significant arthritis in her shoulders, knees, and hands, and - in the past 2 years- has had 4 seizures with 2 prior seizures that were misdiagnosed as TIAs by her former doctor. She has frequent headaches in the area where the seizures have a occurred. The medicine she takes is as follows: Omeprazole DR- 1 tab (40 mg) taken - AM Digoxin- 1/2 of a 250 mcg tab taken - AM Isosorbide DN- 10 mg 2x per day Metoprolol Tartrate- 1/2 of a 25 mg tab 2x per day Pradaxa - 150 mg tab 2x per day Levetiracetem (Keppra) - 750 mg 2x per day Loperamide (Immodium over-the-counter) - 250 mg as needed for diaahrea I ve been able to keep her blood sugar down but she has sudden bouts of diaahrea, which we know can cause sodium and dehydration problems. We had a renal panel done yesterday and the results came back today saying her sodium was down to 128. She has seizures at 126. I wanted to give her sodium tablets but her GP said not to do that until she sees the nephrologist. In the meantime her GP knows that I am concerned that she will have another seizure. Any information or advice you could give me would be very helpful. Thank you, in advance, for your time. K. Dennison ### output:

Hi, Thank you for posting your query regarding your mother. I agree that nephrologist deals with kidney problems, but he also deals with abnormalities in sodium or potassium levels (as these abnormalities are common in patients with kidney problems). I also agree with you that there is no harm in increasing the salt in her diet to improve her sodium level. However, we have to cautious as giving her more sodium can also worsen her heart status. Her current medications seem to be fine and can be continued. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, Chat Doctor. Ly/

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am suffering from pain on my back, at left side flank.. When I consulted doctor he said that it doesnt seem like kidney pain but still it better to go for some tests, which were Renal function test, Clood CP and ESR and X-rays.. Renal Function tests are normal.. result is as follows.Normal RangesSerum Urea 3.9 mmol/l 3.3- 6.7Serum Creatinine 93 umol/l 70-115 Serum Sodium 141 mmol/l 136-149Serum Potassium 4.1 mmol/l 3.5-5.0Result of Blood CP and ESRBlood count TLC 8.0 4.0- 10.0 X 10 9/LRBC 5.59 4.5-6.50Hemoglobin 13.7 13.0- 17.0PCV 0.45 0.40-0.54 I/LMCV 81.0 76.0-96.0 fLMCH 24.5 27.0-32.0 pgMCHC 30.2 31.5-34.5 g/dlPalatelet count 170 150-400 X 10 9/LDifferential Leucocytes CountNeutrophilis 47 40-80%Lymphocytes 43 20-40%Monocytes 04 2-10%Eosinophils 06 1-6%Erythrocyte Sedimentation 04 0-9 mm at 1st hourURINE REColor Pale YellowSP Gravity 1.015pH 6.5Reaction AcidicProtein NilGlucose NilRBCs NilWBC/HPF 2-4/HPFPLease guide about the decreased MCH and MCHC adn increased Lymphocytes. though these are disturbed by little margin but still what could be the possible reason for that and which test should I go for next... ### output:

Hello and welcome to Chat Doctor, All blood parameters - hemoglobin, hematocrit, MCV and RBC count are all within normal limits. The total leukocyte count and differential leukocytes are also within normal limits. The decrease in level of MCH and MCHC are not explainable as the hemoglobin hematocrit and red cell counts are all within normal limits. This decrease could be due to instrumental error. However, there is nothing to worry. Small errors can occur due to a small change in the calibration of the machine. If you are very much concerned and worried, you can get the tests repeated. The differential count shows slight increase in lymphocytes. The range which is given by a particular laboratory is based on values obtained in the majority of patients. A small variation can be expected, and it is normal. There is no major change in the differential counts and thus, it does not indicate any disease process. Thanks and take care Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 30 year old woman who has been getting frequent infections. In the last two years I have fought recurrent UTI with pyelonephritis, recurrent pneumonia, and most recently had Strep throat that did not respond to initial therapy. It got so bad that I felt like my upper airway was obstructed and I was (painfully) coughing up dark army green coloured phlegm. Now I have left flank pain which is associated with a decrease in urine output, change in colour to muggy yellow/brown with some discomfort. This happened just a couple of months ago for 3 weeks and the doctor prescribed cipro for a UTI eventhough she didnt really think I had a UTI. I did not take the drug until the pain became excruciating. It did not help. About a week later the pain got better suddenly on its own and the day after that I had Strep throat. It seems that I do not have a functional immune system. I have asthma and get migraine headaches during every period. I have recently been diagnosed with generalized anxiety disorder with panic episodes and have had major depressive disorder for about 10 years. Many people think that my frequent illness is hypochondria but I dont just THINK Im sick, I AM sick as proven by numerous culture and sensitivity results and blood in my urine with my last episode of flank pain. Please help... Is there something really wrong with me or is it all in my head? ### output:

Hello dear, Welcome to Chat Doctor. I figured your concern. It is normal condition, that after severe diseases you feel anxiety about your health. I wanted more details about your urinalysis and urine culture, you did not treat your kidneys properly, thats why you have relapse of disease. I suggest--Urine analysis and urine culture-Ultrasound of kidney-If you have infection in urine the best treatment is ceftriaxone 1,0 2 times a day intramuscular for 5 days, then pharaonic 1 tablet 3 times for 2 weeks, then cyst one 2 tablet 2 times for 1 month. If you have stones in kidneys you should take Stone 1 15ml with 1 glass of water daily for 14 days. -For prophylaxis of recurrent UTI you can use Nalidixic acid(Seagram)1 tablet 4 times for 7 days, Cyst one 2 tab 2 times for 1 month, ayurvedic medicines, other antiseptics.-For Bronchial Asthma take Allegra 1 tablet in bedtime for 10 days, Montelukast 1 tablet at night for 1 month-Absorbents(charcoal)3 tablets 2 times for absorption toxins and gases for 5 days-Visilac, Darolac 1 capsule 2 times for normal flora of intestine and increasing of immunity.-Exercises, swimming walking -Hypoallergenic diet, plenty of water every day.-Phototherapy(boiled water from flax seeds, peels of pomegranate, hair from corn etc) Take care! Recovery soon Chat Doctor.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, i am 15 years young :P... nearly 16. I m 4.11 or 5ft. I ve been this like since 2 years short like really short my sisters are taller just me!!! anyways i weigh about 7 and a half stones i think. Anyways moving on i ve been masturbating for like 2 years since i was 13 ready to be 14. Mainly from using the shower head into massage mode down there.... (clitros) :/ Well i ve always wanted to stop,stop and stop but no i just wouldn t. I was really healthy well not healthy you know just not i ll like i always am recently. I don t know if anything is related and making sense!?!?!!? I ve been suffering from insominia for quiet a while now but it s gone better my doctor offered me to go to psychiatrist but i said no (she doesn t know this)... She kept on asking me what i was stressed but i didn t know myself so i made some story up! Well it was true but i wasn t stressed over that! I think it s making me ill...?? i don t know but i want to stop!!!! I ve been also suffering from hayfever/allergy for a year but i ve gone better with medication. But when ever i come out of the shower after masturabting i start sneezing and wheezing :( I m also having memory problems... (my doctor doesn t know this aswell) She said she couldn t sort out so many problems at once! So i didn t bother She s pathetic. :/ I forgot things e.g. if i washed the plate i won t remember if i washed it or not or what i did few mins ago unless i try to remember it! My long term memory is really really good i remember things when i was 5/6 years old... my sisters don t even remember that. But my short term memory is really bad!! I have so many other problems but i know their will be no conclusion to it! I also think i have herps or gential warts... but i m not since i haven t got it cheacked!! And don t intend to. I don t really care about much of my problems but i want my memory to stay as good as it was before and i don t want to be stressed! Well im not but i get stressed if someone tells me like i m ill! Who wouldn t... but i just get stressed extra!! Okay did i waste your time?? What can i do??? Thank You x ### output:

Hey, I really want to help you. You should start by helping yourself and letting others do that. first, you feel guilty of masturbating. It is perfectly normal for your age. If you are having sex then only you can have sexually transmitted diseases like warts etc. so don't stress. Write down your problems one by one on a paper in order of intensity. Then try to resolve them in same sequence. It is because of the guilt, that you are unable to concentrate on your studies or stuff, hence u feel like memory loss. Just try to give attention to details.You're perfectly normal. I don't feel anything is wrong with you. All you need is counselling for adolescent conditions. Talk to you mom first., then friends and then psychiatrist. You will be fine.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: We have a son who has shown unusual signs for some time....this past four years. He has studied at university, is very talented musicically , and is very athletic and physically fit, but has shown some extremes .He is 28 yrs and had been working with GNS Science in field of Geo Physics. He seemed at times disorientated in the latter 6mths out of his working for 2yrs there. We were very concerned and made inquiries after concerns where our son was doing bizarre things like running for hours late at night or deciding to experiment with physics problems etc to excessive hours etc or seemed apprehensive . Also lacking insight in some situations where things are appropiate or inappropriate. In the past he had always been very courteous, responsible, sensitive to needs and peoples situations. So this was quite out of character and most unlike him, and made us realize something wasnt right with him. After making iquiries at his workplace we also realized he had had treatment Larium ( Malaria innoculation ) by his GNS Science Co as part of a prerequisite in case of posting in Indonesia. We wondered if this could have triggered some of the behaviours now evident which point to possible Schizoprenia especially Catatonic symtoms ( stationary in one position for lengthy periods) social withdrawal at times,explosive reactions, fear of cellphones , Internet, and not wanting to communicate or enter into any decisionmaking. We have observed a deterioration and isolation, intolerance to light , curtains always drawn, repetitiveness and routine etc, Because of the Privacy Act we are not informed by his Dr or Psychologist and so we asked for a referral to privately have an assessment of his Mental state. He is receiving some help from Psychological counsellors but we would like to see someone who could advise us on how to help our son recognize his need for specialist medical help as we also want to minimize areas of inaccurate diagnosis. We are his parents and have been supporting him and caring for him but feel very shut out in helping for his recovery plan. It seems that the System is happy to allow his condition to continue for years while we know that the longer this situation is left untreated the greater the damage can be to our sons health. Please can you advise what we should do . and possible harmful side effects ### output:

Degree understand your concernsFirst of all let me assure you that there is nothing wrong if a man who is wholeheartedly doing his studies and is so concentrating that he is mistaken as catatonic. Visit any professional colleges, and you will find at least 10% students like your son, and they would be toppers. It is also common that parents don't like these. They want their child to be active, social, lovable etc. Second. Have you talked to your son about this? If not talk now. If yes, what is the outcome. Let me know. I consider this as normal now. Mind you, You cannot judge your son as schizophrenic or catatonic because you are not trained in that area. Nowadays people sit and play video games hours together without interruptions. Will you call them out of world? Please take your time to assess the situation.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am just trying to understand where my back pain is coming from. I feel at the end of 2011 and have had progressing problems ever since.. I had a MRI done 2 yrs ago...it says at L2-3 there is a 1.8mm left lateral disc protrusion that causes mild to moderate left sided foraminal stenosis...At L3-4 there is a 1.4mm Left lateral disc protrusion. this causes mild to moderate foraminal stenosis. At L4-5 there is a 1.5mm bulging disc and facet hypertrophy. this causes mild to moderate bilateral foraminal stenosis...At L5-S1 there is a 1.5mm bulging disc and facet hypertrophy this causes canal and mild to moderate bilateral foraminal stenosis. I went to a few drs they told me nothing was wrong. I had sent my images to the lazer surgery center and they told me that I would need a fusion in this world but that drs would help me...I have been to 3 different nuerosuregons..the last one sent me for a myleogram because I have a spinal stimulator that does not work and he told me that I only have one slight bulging disc and hes not sure where my pain is coming from and to modify my stimulator. My pain management dr told me from my MRI looked like I had a few herinated discs...he then touched my SI joint and I jumped so I know that there is an issue there and he wants to do injections. So what does this MRI tell me? Do u think that the Nuerosuregon is not being completely honest because he doesn t want to do anything because I am too young? The pain is getting progressivly worse and what he is telling me that the Myleogram says does not mesh with my mri or what I feel. My symptoms are like sharp pain in my lower back. Im at an 8 pain all the time. I do get soreness down my butt.. I feel like my nerves are pinched causing leg aches. I haven t gotten any better just worse and we are going on a few yrs. I cant work cuz I can t sit up at a desk like I used to. I also have Fibromaylgia. So any info that u can give me would help. Thank u very much! ### output:

Dear Sir/ Madam, Thank you for posting your query at Chat Doctor.come advice you to start with conventional method.1. Lifestyle modification:- do not put on weight-comfortable walking shoes-proper sitting-maintain proper posture while standing, sitting(use mirror for visual feed back)- go swimming or float, the turbulence of water will keep the muscle relaxes and spasm free and strengthen the core muscle-Do not lift heavy objects- Do not forward bend-Prolong standing and sitting should be avoid, have intermittent break-yoga2. See physiotherapist anti inflammatory and muscle relaxant-help in reducing pain and strengthen the muscle still pain not coming down seek orthopedic get an opinion for injection. If no option and still pain full rule out possibilities of surgery with surgeons. Please revert if you need any further information. With best wishes,

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Iam 38 yrs/Fe 61 kg Family H/o Asthma suffering from chronic cough initially mild fever with yellwish sputum local Dr gave Augumentiin 625 mg bd and cough syp.cough persist with white sputum again started on Inj. amikacin250mg bd, Nacfil gold bd 3days. Seen pulmonologist took xray chest and sinus normal study.PFT 340 gave Pan D bd, Romilast B 10mg 1/2 bd , allegra 120 Hs. Am I suffering from asthma this is my first episode cough occur once at night and end of congh some drag sound comes.doinh normal work.In Walking Able to cover only half distance compare to previous. Is this meds ok. My health will b ok ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. First, I would like to know more about you like - a. Since when do you have repeated cough? b. Have you had wheezing or breathing difficulty? If yes, how frequently? c. Do you have nose symptoms of allergy - nose obstruction, sneezing, running nose, etc.? d. Do you have headaches, facial heaviness, tickling in throat, etc.? e. Do your symptoms worsen in any particular season? g. Do you have symptoms like burning chest, nausea, feeling fluids in mouth, especially after a heavy/spicy meal? Above details would help me to know your complaints better. 2. Regarding diagnosis, I would like to mention here that PFT 340 only cannot diagnose or rule our asthma. PFT with post-bronchodilator response would be more helpful to know whether you have asthma. Chest X-ray is always normal in asthma.3. I would also think possibility of sinusitis. X-ray sinus is not the best investigation to diagnose sinusitis. CT scan of sinuses is considered a better investigation or sinusitis.4. I would also suggest you allergy testing for common air-borne allergens like house dust mites, indoor molds, regional pollen, insect proteins and pet dancers (if you have pet). This will help to know whether you have allergies, also to identify the substances causing symptoms to you as well as to know the measures to avoid them.5. At present, I would agree with your current treatment. Should you have wheezing of breathing difficulty, I would suggest you to use albuterol inhaler on an as-and-when-needed basis.6. In general, I would suggest you to have plenty of warm fluids during day to maintain HY Chat Doctor. 7. Regular physical exercise, breathing exercises and a healthy diet rich in vitamins & minerals will also help you in a long run by improving your lung capacity and immunity respectively. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi, i am 50 years old male living with wife and have a son and a daughter,both are studying. for a few weeks a am feeling giddiness in my head . my work includes computer related work. i consulted a physician and he advised me x-ray of my neck. after seeing the x-ray film he advised me 6 hours use of cervical collar and neck exercises.on 18th of june, at about 11.30 in the night i felt very high heart pulpitation.i recorded my b.p.with a digital machine,it was about 160/100, pulserate 124. myhands and legs had been very cold,i felt very restless. i was taken to the local govt. hospital where they used saline and some injection. next day i consulted a physician(MD, Cardiologist). he advised me petri beta-10 in the night and after ECG diagnosed anxiety and stress. the other day ,i went to patna and consulted a DM Cardiologst.he did HOLTERMONITER TEST AND TMT and said that i have no cardiac problem and advised Rivotril 2.5, half tablet every night. i came back to my place and started doing neck exercises. on 25 june ,i took harassment due to certain marriage ceremonies and in tne night my B.P. again shoot to 177/90, pulse 115. I took one full tab. og rivotril and again went to the hospital where they gave me dexona and some emergency medicines.but on this day i was more relaxed than the previous one. last night my B.P. again shooted to 160/90, pulse rate 125. i took half tab of rivotril and one tab of petril beta . after half an hour , imy B.P. was normal i.e. 116/76, pulse 75. my question is what should be my next step of treatment and why is my B.P. going high suddenly., why my heart beat excelerates so much and if it happens in the night , what damage it can do. ### output:

Degree understand your concerns went through your description. I suggest you not to worry much. From the given details, I can surely suggest that you are anxious. Stress and anxiety go hand in hand. The high blood pressure with tachycardia without any cardiac or digestive symptoms surely points at anxiety and apprehension. You should learn to relax and handle the stress and anxiety. Do not take self medications. You may also be obsessed with blood pressure monitor. The moment you tie into your arm, the BP rises, but in actuality it is not. Therefore, please do not take BP medicine without expert advise. Continue the current medicines, exercise, do relaxation exercises, meditation etc. Psychotherapy treatment should also help you immensely. If you still require my services on this aspect, you may post a direct query to me on this portal. Please include as many details as possible. I shall provide psychotherapy treatment tailor made for you which should help you good. Hope this answers your query. Available for further clarifications. Good luck.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: This is regarding my mother condition.29/09/2013 : I was coming back to home with my mother in car. Our place was about 20 minutes distance. Suddenly at 2:30 pm she complained severe headache on right side, her right eye become red, her voice got slurred and i noticed that her left side of face is drooping.Suddenly she started vomitting, i stopped car got a bottle of cold drink, gave it to her which she holded in her right hand and i started driving car again, after a moment i noticed that she was still holding the bottle in right hand, i asked why u r not opening the bottle (i could not understand thather left side has become weak) now i rushed car to the govt hospital in the mean time she vommited 2-3 times more. Doctors on duty said that this is cerebrovascular accident and referred to speciality hospital in Ambulance. At 4:00 P.m i reached a good hospital and CT was done in emergency which showed Right basal ganglia bleed. She was planned to be on conservative medical management. She was on same protocol for a week following commands like raise ur right hand , bend your right knee and do you have pain she nodd in yes and touched right side of forehead telling the site of pain, opening eyes on pain only not spontaneously and speaking few words.07/10/2013: at around 4:00 P.m she deteriorated (subfalcine orientation) to GCS score E1V1M3, electively intubated and Decompression Craniotomy surgery was planned. She was operated on the same night and large part of right side Of Frontal,parietal and Temporal bones were removed and Scalp was sutured back to provide space for swollen brain toexpand.25/10/2013: after so many days after surgery she is in minimally conscious state, neither on ventilator nor on oxygen,respirating by herself , open eyes sometimes but closes soon, understanding a little but cannot express anything neither follow commands, Bed ridden need assistance everytime, and most of the time keep her right hand on face or on Right craniotomy site.Now the Medical doctors are planning to shift her to room from ICU and after a few days discharge in same condition, as they said they have done what was required and now brain injury will take long time to recover however disability will be there.Is she in coma?Is she in minimally conscious state?Yawning and chewing are good signs or bad ?please put some light on her situation ### output:

Hi, Thank you for posting your query. It is unfortunate that your mother suffered a major brain stroke (hemorrhage), resulting in damage to several parts of brain. Some degree of brain injury is permanent, however, some improvement would occur. Detailed neurological examination, along with tests like EEG and PET scan can help us diagnose her current status, whether she is conscious or in vegetative state. In any case, one has to continue supportive care and wait and watch for any recovery. I hope it helps. Please get back if you require any additional information. Wishing you good health, Chat Doctor. Ly/

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am 36 weeks pregnant, for the last several weeks i have had upper stomach pain that comes on suddenly usually after eating. I have been to my OB and the ER. They told me it was a gallbladder problem and ordered several tests. Urine, blood, and sonogram. They all came back normal. So they told me it was Billiary Colic, put me on a NO FAT diet and sent me home swear it would get better. It has not. Now I am having more symptoms. At times I see tracers (like someone threw glitter in the air) and my blood pressure normally runs low 60/80 ish but recently has been about 120/90. I keep asking them if that is something to worry about and they tell me no. The stomach pain is not improving, and before the no fat diet i was gaining about 2 lbs per week. I had these same symptoms late in my last pregnancy as well, and ended up having a small stroke during my labor. with this labor quickly approaching I am scared it will happen again. Please help me I am in pain and at a loss as to why. ### output:

Hi, Thanks for the query. I understand your concern. * In late pregnancy, the size of uterus in enlarged & it occupies most of abdominal cavity. Creating short of place to bowels. This causes mechanical hurdle in digestion & travel of food through gut which does not coincide with release of digestive enzymes in digestive tract. This causes digestive deficiency. - Pregnancy hormones make intestinal movements sluggish, thus partially food stands long in the intestines... leads to more gas formation. Thus increasing more distension of abdomen & sometimes constipation. - In such condition normal eating habits cause overload on digestion . This adds to lack of digestion. * ALL above factors cause stretching abdomen & stretching of abdomen causes pain & discomfort. * All of your investigations are normal, so way out for the problem can be- - Eat small & frequent servings (every 3 hours) - Each serving should contain fibers (salad/ vegetable/ fruit). Chat Doctor. (12 glasses in 24 hours)- sufficient fibers with water make improve intestinal movements. This improves digestion. - Add light exercises in your routine. Simple yoga exercises/ walking... This stimulates functioning of gut. - Avoid spicy, oily & difficult to digest food. - You can add digestive enzymes over the counter/ with your doctors advise improving digestion still more. * the stroke you mention you has during last delivery must not be related to abdominal pain. It must be something related to your blood pressure(which is normal at present. But psychological stress can cause high blood pressure / low Blood pressure also can produce fainting & weakness. Both the conditions can raise problem.) - Please stop worrying, eat as advised, start doing light exercises/ have weekly pregnancy & BP.check up / inform your treating doctor about last episode. So that all preventive precautions will take at your delivery * it would be smooth ! Thanks.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Possible ms? having what feels like to have more feeling in one of your hands than the other Having your feet and arms and hands feel numb or like they are falling asleep when you are using them Fatigue Moving slow like you are weighed down (moving through wet cement or mud) Pain- sharp/dull/itching/burning/tingling/ tearing Hiccups Completely forgetting to do tasks often Random bursts of laughter till I annoy myself and I have to nap it off even though I am not tired and I have had adequate sleep Motor skills are often difficult Tingling on one half of tounge Tingling(pins and needles) in hands and feet and face (full or top of bottom or one side or the other) Sore face(weak, fatigue) Hot or cold hands Head rushes or dizziness Slurred speech Numbness in extremities Wobbly gait and unable to walk straight Balance issues and running into things you know are there MS hug(crushing and you can even get a shallow breath, also with knifing sharp pains that are never dull normally occurs for three days and occurs a couple times for each of those days). Frequent urination Hand tremor Hard of hearing Heavy legs and arms (they feel like a ton each) Trouble speaking(lost for words or trying to speak and not being able to say it, being tongue tied ) Shooting pains Especially in the temples or lower jaw and elbows and wrists What feels to be carpal tunnel in my wrists but isn t since it goes away and comes back(pain) Being extremely tight everywhere (legs, back,arms.....) Stiff and rigid body(everywhere) and especially in wrists and fingers (so much in fingers) Muscle spasms in inner thighs, and outer and in butt, arm, neck especially Spasticity hands, and legs Having muscles seize with pain associated with it Eye pain like when I wake up in the morning Feeling tired after a sufficient rest Having fingers subconsciously be pulled down by an invisible ribbon and held tight and stiff till I had to wait to move them. And eventually had to loosen it with my other hand manually Dropping almost everything Uncontrollable emotions esp uncontrollable bouts of laughter Drinking slightly cold water and getting extreme goose bumps on only my right side of my body Thanks , Bridget ### output:

Here as you know you have explained all possible euro symptoms which can be there with many of the euro problems. I suggest visiting a euro physician and go for proper evaluation and diagnosis first. And then plan for treatment with medication and physiotherapy management for pain, to improve balance, coordination and muscle strength. You can also consult a dietician for advice on food especially on anti-inflammatory diet advice because most of euro issues starts with inflammation in body. Also practice exercise advice at home as per physiotherapist suggestion. You can also use hot and cold pack at home for painful soft tissue for some more relief in pain. It will take time for you to become all right since you have multiple issues. And here I have given general guideline to follow up since I have not done any physical examination. But I am sure this will be helpful for you if you follow it step by step. Take care.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi well I want to give you some basic info, my name is Jenn I am 18, 5 1 and very overweight . Anyway I recently got diagnosed with cellulitus due to a scratch by my dog. I am on Augmentin the highest dose 875-125mg twice daily, my question is this can Augmentin cause nerve damage? Other then the cellulitus I have been having health issues but doctors think its anxiety/panic attacks. Anyway I haven t slept really for 8 days, I was having panic attacks in my sleep. I recently started taking the augmentin (day 3 in the morning) and I feel worse, YES the swelling in my arm is going down but I am having back pain , bad tension headaches, (I have been having weakness only on my right side for about 3 months now in the middle of testing) and also starting today (2 days into the antibiotic) my feet ( both) feel very stiff its unvonfortable sitting for to long (can this be caused by not sleeping or something else??) and my legs are weak and I can not stabd for very lobg my back hurts, and I get dizzy. But strangly when moving my feet feel a BIT better. But now a frightening new symptom appeared and I don t know if it is from the Augmentin (this NEVER happened to me before.) My right ring finger is bent and doesnt want to straighten but can be straightened if I really try to but just resting it it remains in a bent shape ( not at the tip the bend is more towards the middle and bottom) and now my fingers from time to time spread out the dont stay side by side when I m resting my hand it doesn t really hurt its just very annoying and when I squeeze stuff it s very week and I can t squeeze that hard (this problem with my hand is only the right one) also it feels like an electric shock going through my hand and fingers when I do tasks with it it s overall weak but the ring finger is VERY weak and can t do anything with it (what can this be I m nervous!) also I have had tests for Lyme (negative), a bunch if blood tests to do with my heart (fine), anemia (fine), Mono (negative) no diabetes, and I have had 2 EKG S both fine. My only medical problems are asthma (even though I know if your diagnosed it never is cured its always in you just dormant but I haven t had an attack or needed my inhaler in over 7 years) and carpal tunnel other then that Medically I have no other issues. Sorry this is so long I really appreciate your help and time! ### output:

Hi, you are using augmenting for cellulitis, but you are experiencing headache, backache, panic in sleep, dizzy, feet stiff, etc., every test of all systems are fine. Most probably the changes are due to the allergic reaction of the augmenting, and also due to the gastric irritation. As the Chat Doctor. I to my patient with such symptoms prescribe omeprazole, risperidone, and antacid gel. If some changes persists you can go for exchange of the antibiotic. Thank you.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I m a 53 y.o. female.Living in Louisiana .. Meds: Atenolol (BP), Prilose( GERD )c; nasonex , clarinex. Carry an epi-pen and use benadryl or zyrtek prn. Had complete hysterectomy in 1998; tonisllectomy 2005. Recently diagnosed with Type 2 diabetes (July 25, 2012) and took diabetes meds for a month with great results and meds were d/c d (oct 4) after a one month med vacation (from Tradjenta -sept 4).I have extensive food and medication allergies and intloerances. Food allergies include cayenne (muscle weakness), nectarines (anaphylaxis), black pepper (facial rash);oranges (itchy welts). Intolerances include milk, blueberries, cinnamon. Some foods cause itching with no rash (but require benadryl and last for about 8 hours--like tuna). Med allergies include biaxin, penicillin (rash), neurontin, lexapro,cardura- all of which make me itch; codeine (vomiting). I have been following a portion-controlled diet of 1/4protein,1/2 non-starchy vegetable and 1/4 carb at each meal.. and have lost about 25 lbs since getting the diabetes diagnosis. I cannot pinpoint the source of this itching.I recently had scratch tests for wheat, garlic and bell pepper--all negative. I do know that the smell of certain spices and seasonings make my right ear (which always feels congested) feel full until I put a cotton ball in it. Question: For the past 3 weeks or so, it seems that if I am hungry (empty stomach) or thirsty, I start itching...not sure. Still trying to pinpoint exactly when it happens..but face gets itchy, then it moves to the lips or nose or head or arms or palms or feet or ear or throat or eyes might get dry and itch a bit around the edge of the lids..It (the itchiness) moves around. It does not last long (maybe 1-5 minutes in each place). Don t know if Ishould j ust treat the itch, ignore it, or continue to look for a cause for it. ### output:

Hello, Your food allergies come under salicylate intolerance and some foods (very high in salicylates) can cause itching but no rash. Vomiting to codeine is an intolerance and unrelated to the food allergies. You could have urticaria and just like diabetes (autoimmune condition), you should get a complete blood count, TSH profile done with TPO antibodies to exclude a thyroid disorder. It quite often co-exists and a TSH alone is not sufficient to find this autoimmune hypothyroidism state. Long acting antihistamines and thyroid treatment (depending on results) could lead to much better control of symptoms. Thanks.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Dr. Charles, I am Prashanth, an Indian, Male, 43 years old, 174 cms and 68 kilos. My LFT result (done by fully automated, bar coded, bi-directionally interfaced Roche Cobas Integra 400 Plus) shows the following abnormalities: 1. Total Biliruben: 1.4mg/dL(ref: Upto 1.3) 2. Direct Biliruben: 0.40mg/dL(ref: Upto 0.3) 3. Serum SGPT( ALT ): 89U/L(ref: 10-40) 4. A/G Ratio: 2.04(normal 1.3, Moderate 1.5-1.8, High1.8-2.4) The other abnormalities are: Lipid Profile: (Method: Enzymatic Colorimetric Assay done by fully automated, bar coded, bi-directionally interfaced Roche Cobas Integra 400 Plus) 1. TC: 226(ref: 125-200) 2. TG: 183(ref: 75-150) 3. HDL: 38(ref: 40-70) 4. LDL: 151.4(ref: 75-100) 5. VLDL: 36.6(ref 40) 6. TC/HDLC Ratio: 5.9(ref: 5) 7. LDLC/HDLC Ratio: 4.0 (ref: 3) Haemoglobin: 18.7(fer:13-18) Cervical Spine AP/Lateral Views: 1. Loss of Cervical Lordosis -- Para Spinal Muscle Spasm 2. Spondylotic Changes of C4, C%, and C6 vertebral bodies seen 3. I V Disc space of C5-6 is decreased I had a laser assisted removal of a prostatic uric cyst in 2009. Please let me know if I should be concerned about my liver mainly, and anything else : ) Thanks, Prashanth ### output:

Hi Prashanth, Thanks for the detailed description of your query. Your Liver Function Test (LFT) is slightly deranged from the normal. There is nothing to panic about it and as such no immediate management of it is required. Repeat the LFT after 3 months and check for the results. Your Lipid profile seems to be deranged and is concerning. You must start right away with dietary change and lifestyle modifications including exercises. Get an ECG done too. It seems like you may require lipid lowering agents (Medications) too for this. The cervical spine x-ray shows changes as you mentioned. But nothing needs to be done surgically for this as of now. You will benefit by physiotherapy and neck exercises. My suggestion to you is to get back to your primary care physician and seek his guidance about the management plan. Hope you are in fit health at the earliest.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My MRI report shows some anterior endplate spurring. They maintain relatively normal height. The discs are desiccated. There is retrolisthesis of C6 on C7. There are posterior disc bulges at the C4, C5, and C6 levels mildly compressing the thecal sac but not the cord. The nerve roots are unremarkable. Impression: Degenerative disc space narrowing with degenerative retrolisthesis of C6 on C7 and small disc bulges at the C4-C5, C5-C6 and C6-C7 levels. I use heat to relieve the pain and it will last a few hours. My doctor would give me an anti-inflammatory drug, but I d like to do it without those kinds of medication if possible. Would keeping my neck at rest with cold packs (or heat ) for a week or two help the healing? (I did that with a heel spur -stayed off my foot for two weeks and used ice and it completely healed my bone spur.) Didn t know if it was better to keep using my neck to prevent stiffness or if I might cause more damage by using it. I do stretch every morning (to be able to function during the day.) Also in the lumbar area my report was : The vertebral bodies mainain normal height. There is grade 1 anterolisthesis of L4 on L5 with midl anterolisthesis of L3 on L4. The conus terminates at T12-L1 and is unremarkable. The disc are desiccated and there is moderate disc space narrowing at the L3-L4 and L4-L5 levels. There is a broad base disc bulge at the L3-L4 level. This with the mild anterolisthesis of L3 on L4 is causing mild spinal stenosis along with some ligamentum flavum hypertrophy . The anterolisthesis of L4 on L5 is causing mild to moderate spinal stenosis along with associated ligamentum flavum hypertrophy. The neural foraminal fat on the left is compromised at the L4-L5 level secondary to the anterolisthesis. What exercises would be recommended and what would be contraindicated? Again, heat has helped and stretching helps immensely. I just need to know what I would need to avoid to prevent a worsening of the degeneration and what I should be doing to strengthen my back. Thanks ### output:

Welcome to Chat Doctor. You have cervical and lumbar spine problems. These are age related changes in the spine. There always two concern- one local neck /back pain due to disc and facet joint degeneration and arm / leg pain due to nerve pinching. Treatment depends upon your symptoms. We can not reverse the changes, or we can not stop the progress however we can definitely delay the progression. I would suggest continuing the neck and back muscle stretching and exercise to strengthen the muscles around your spine. You need to work on your neck / back/ abdominal / gluteal muscles and hamstrings. Consult a physical therapist to strengthen those muscles. Avoid weight lifting as it increases the intradermal pressure and not good for already damaged discs. Thanks.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i gave oral and he ejaculated he did not go use the bathroom then a half hour later we had intercourse we used the pull out method and on top of that i was ovulating and the next day we had sex again and he used the pull out method again what are my chances? ### output:

Helllo mam, thnks for trusting Chat Doctor doctors for your health related queries.I guess your concern is-probability of u getting pregnant???well let's have short discussion about semen n sperm...semen is that white lotion thing what guys ejaculate.in this lotion small sperms will be there, which meet ovum n women beams pregnant....semen is sticky in nature...imagine u have had a very oily food,even if u wash with soap water still u can feel that sticky nature for sometime.same way semen is...it is sticky in nature...u said 1st oral was done,he ejaculated .then u guys had missionary,,,or vaginal sex...so though he might had ejaculated there are chances that some semen might be sticking here n there.....fewer chances.but chances r there...moreover u were ovulating...its this high time when chances of ovum meeting sperms AR high.....now, pull out method...this is also sort of good thing....but Jen a guy is doing either oral, vaginal sex.guys have a pre ejaculatory phase,were small secretions would b accumulating...they don't ejaculate of course,,,chances r there that this secretion sometimes cause pregnancy,,,,well with ABV discussion u can try out my suggestions:-1.have patience,wait for another 3-4days for menses to occur as per expected dates, if menses happen you are not pregnant,2.if menses doesn't happen after 3-4days/or you're in very much hurry to get rid of tensionfull mind-am i pregnant....u do urinary pregnancy test.this test kit is avail bl at affordable prices in your nearby medical stores...buy it, do it by ourself. If its negative you are not pregnant,,,if positive visit a nearby gynecologist for further help3.if still u in dilemma of pregnancy then a scan(ultrasound of abdomen n pelvis)can be done, in scan its possible to see an embryo/baby is there or not...but NOT NECESSARY DEAR...RELAX....4.use condoms...some husband/guys say we don't feel exact natural sensation, so we can't use it....n some say we used condom, but as we did zhabardhassttt sex condom ruptured!!!!!!!for this also solution is there, its i-pill.available at your medical stores at affordable prices...I hope this was informative enough, helpful,useful for your query.regards- Chat Doctor. (having regular healthy sex lifestyle Bowen couples is very good and advisable too...but a small presence of mind, u can use condom n can make girl free of medicine side effect n boy from being in psychological tension whether his GF has become pregnant)

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am Debendra, 37 years from India. I am an epillepsy patient . The first fits stoke I had in 1988. Generally the fits strokes were happening in the month of January and August, only and only during the first stage of sleep. Never ever I had a stroke when I am awake. As per the CT scan repot there is a calcified focus in the left posterior parietal region possibly old healed granuloma . Since 1997 till 2002 I was taking Zen Retard 400 mg 1 tab/day. Then till 2005 I took Zentard 200 mg 1 tab/day. During these days though i was feeling the pre stroke symptom such as blinking of eyes for few seconds, feeling confused, stress , an odd feeling of flying the body in air, feeling of the hands are too long etc, during the months of January and August only, but never had a fits stroke. Then the doctor advised to stop medicine. 1 month after stopping the medicine, i had a fits stroke. Ofcourse it was followed by sleeplessness for 2 days and intese work pressure. Then the doctor advised to continue Zen Retard 200 mg 1 tab/day again. I was frustrated and did not see the doctor after that and continued Zen Retard 200 mg 1tab/day till April 2009. Then stoped taking medicine. But 15 days after stopping the medicine, I had a fits stroke. I saw the doctor. The EEG report was normal. The advised it may be because of extra mental stress and lack of adequate sleep. I was prescibed Lonazep 2mg 1tab/day. Since then I have been taking that medicine. Now I have no pre stroke symptom anytime expect feeling very uneasy sometime when lack of sleep due to stress. But perhaps due to impact of medicine I get severe body pain in the morning. My previous doctor did not respose good on my last visit. So I dont wish to see the same doctor. What should I do now? By nature I am very calm, more patience but now a days because of family and personal tensions I feel irritated and loosing the patience. I am physicaly very fit and atheletic. Please advise. ### output:

Hi... Thanks for this query. As a patient of epilepsy you must know that before stopping any antiepileptic Chat Doctor. Secondly by nature AED are CNS depressants & hence abruptly stopping any AED without dose reduction & proper taper may cause recurrence of seizure which evidently happened in your case. Third & most important point is Epilepsy either controlled or poorly controlled is an independent risk factor for Psychiatric problems; most common of which is depressive illness. Your current symptom profile of feeling excessively stressed out/overwhelmed, irritability, body pains, fatigue etc. are indicators that you are probably suffering from mild-moderate depression. Hence, you need to consult a Psychiatrist for a full formal evaluation & treatment of your stress related problems followed by evaluation by an MD (medicine) or DM (Neurology) doctor to decide upon whether you need further continued treatment with AED. Good Luck

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 55 year old female. Went to ER with rectal bleeding and GERD . Admitted on December 18, 2012. Was put on bland diet . Three days later had Endoscopy and Colonoscopy . Was told endoscopy found mild gastritis . Colonscopy results normal. Rectal bleeding was probably from hemoroid. Was told I had a couple of class I or II hemoroids. Told to follow up with family doctor and GI doctor released from hospital December 20, 2013. Folowed up with family doctor who put me on Sucratfate every six hours. Tried to follow up with GI doctor was unable to get appointment until January 18, 2013. Still having severe pain and developing a fever of 102.4 called family doctore who told me to go to ER. ER doctor had cat scan of abdomin results showing inflamation of bowel. Told to follow up with GI doctor was put on Metronidazole 500 mg 3 times daily. After 4 more attempts to get an appointment with GI doctor followed up with family doctor. He intervened on my behalf and was seen immediately. GI doctor did rectal exam which was extremely painful. He told me to continue Dexilant every 12 hours on empty stomach, sucrafate 4 times daily on empty stomach. Sent me for blood test and stool tests. I am no longer allowed to see the GI doctor as I was told I did not get along with his stafff???? GI doctor told me I was extremely sick and to find a GI doctor immediately. He would call me with test results not to call his office. Still not able to keep in food or liquid. Horrible anal pain. No test results at this time. Today is Janauary 13, 2013. GI doctor did call my family doctor in front of me said something about infection and colitis . Question how could I have an infection and colitis when my colonoscopy was normal? What should I eat or drink until I can see another GI doctor? Called to get appointment with new GI doctor. They were supposed to call me back as soon as my records were sent to new GI doctor to see if they would consider accepting me into the practice. No call back thus far. I have excellent insurance. I am in horrible pain. ### output:

Hi.you have written that you are having Extreme anal pain. But didn't mention whether it is seen while passing stools or even in normal daily activities. If at all it is seen during passage of stools, most probable cause could be Fissure in ANO. It is break in the anal canal.It's not a serious condition. Nice to hear that your Colonoscopy was normal except for Hemorrhoids. But, after colonoscopy, there is every chance of getting infection and colitis. But, there should be pain in the abdomen, associated with Diarrhea sometimes. Please take plenty of liquids, high fiber diet before you meet new GI doctor. Even hemorrhoids may also get relieved with this daimyo can also apply ointment locally in the Anus with the prescription of your doctor. Hope everything goes on well.Don't worry. Regards

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi My son of 13 year old has allergies and asthma related condition. it is been 5 months now that he has a chronic cough, I took him to pulmonologist and long doctors, we tried taking albuterol, allergy pills, it helps but nothing seams to be good enough to cure him from that cough. we live in Maui hawaii, he had to change his lifestyle, he was an outdoor boy and now he always has to stay inside......please can u help? I did some researches on line and came across sensory neurophatic cough, or cough-variant asthma how can be diagnosed? . What about Xolaris Omalizumab can it help? ### output:

Hello, Thank you for asking at Chat Doctor. I went through your sons history and can understand your concern. I would like to make suggestions for him as follows:1. There are many causes of chronic cough. I would like to know more about him like - a. Has he ever had wheezing/breathing difficulty? b. Has he ever required nebulization? c. Does he have nose symptoms like running nose, nose obstruction, sneezing, etc.? d. Does he have regurgitation of sour fluids after taking heavy/spicy foods? e. Does he have headache, post-nasal Chat Doctor? Does he have any family member with allergies/asthma? g. Is he routinely exposed to dusts, smokes or air pollution? h. Does he have weight loss, loss of appetite, etc.? Above details would help me to think of possible causes of chronic cough. Further investigations could be suggested based on the details.2. As your current diagnosis is asthma, I would like to mention that asthma can be diagnosed by spirometry with post-bronchodilator reversibility test. 3. I would also suggest him allergy testing, which will help you identify the substances he may be allergic to and also to know the measures to avoid them.4. Based on allergy testing, an Allergist-Immunologist may prescribe him allergen specific immunotherapy which gradually improves allergy symptoms by working on immune system.5. For asthma, I would also suggest him taking montelukast regularly as a controller medication.6. Personally, I would not suggest him to avoid outdoor activity and restrict him life for many reasons - a. physical activities are very important for improving immunity and lung capacity, which help improve asthma control. b. Restrictions at his age of 13 could have psychological consequences. c. With proper use of controller medications and management of allergies, most of the asthma patients can live life without any limitations.7. Sensory neuropathic cough or cough variant asthma are better diagnosed by experts, usually pediatric pulmonologists. I would suggest you not to be confused by the ocean of information that is available on internet. Thorough history taking, physical examination and prompt use of investigations is required for making diagnosis of a chronic cough.8. Omalizumab can be helpful in some subsets of allergic asthma/rhinitis, but it is not the first

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi my blood work was perfect last year but I had it re taken yesterday and it came back elevated white and red blood cells as well as elevated albumin and calcium and elevated protein and mpv and hgb and hct!! Rest seems good! I had cervical cancer 16 years ago and last pap was fine! This doctor just wants to re check in two months but don t these mean cancer ?? ### output:

Hi welcome to ChatDoctorI have gone through your query regarding elevated white and red blood cells. I can understand your concern . Dear, you have not given your age nor your blood count of your test. Abnormal, high or low, reading of counts can be indication of some grave problem and gives us warning against diseases So beware and mind it Prevention is better than cure Magnitude of the survival advantage from improved nutrition, can even be greater than the magnitude of the treatment effects being targeted in current clinical Chat Doctor. Your doctor has given you to recheck in 2 months time. I would like to suggest you to modify your lifestyle for enhanced of your immune system, side by side your physicians' guidance to fight the imbalanced blood counts, is one of the most effective treatment options in my view . Avoid processed foods carbs, sugar, fried, fast foods, Tea, coffee, alcohol and smoking all will produce biochemical and metabolic conditions in your body that will decrease your immunity, so avoiding is definitely the first step in the right direction. Detoxing the body, boosting the immune system . One of the important strategies to achieve healthy body is a diet rich in fresh, raw whole foods. More of high Fiber, protein, fruit, egg fish, fish oil for Omega-3, green leafy veges. To keep metabolism on right path to increase the strength of immune system, take all supplements full of antioxidant serve as antibiotics. Raw garlic, gingerCoconut water, Bitter gourd juice 25-30 ml Lemon juice with water twice before meals, Turmeric powder, +a spoon of almond oil level spoon with a cup of hot milk with B/F & at bedtime, goats milk preferButtermilk with lunch Algebra juice 25 ml +AMLA juice 2 spoons Physical activity in order to renew healthy cell and rebuild itself, so you should make exercise a lifelong commitment, but never overdo. Do 30 mins walk/ exercise - from head to toe, yoga, Panama - deep breathing, Kapalbhatti / Laughing aloud. Proper rest, meditation & positive thinking, to detoxify mind & body & give immunity to your system, to accelerate the process of recovery. The condition is REGULARITYAbove regimen will surely gradually, help you to lead happy, worry free, healthy life ahead Many have been benefitted by These therapies which slow the growth of bacteria and kill on mass bases. Get an appointment with YOUR DOCTOR AFTER 2 MONTHS ANS SEE THE DIFFERENCE and review your reports please .HOPE THIS HELPS SOLVE YOUR QUERY Take care All the best. If any doubt mail at

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am 30yrs old and have had two miscarriages in the past. currently i am on obimet 500mg BD, folic acid, ecosprin, evalon forte, fertyl super, wyselon and undergoing follicular study. On day 15th endometrial thickness is 5.5mm, left ovary follicle 20X16mm,rt ovary follicle 12X9mm. Are these good for conception or not? ### output:

Hallow Dear, I believe your cycle is regular and between 28 and 30 days. Then, your egg release (ovulation) day would be somewhere between 14 and 16 day. The egg is released 14 days prior to the next expected menses. However, since you are on Camphene for induction of ovulation, this calculation is invalid. Your ultrasonography scan also suggests that you are quite close to ovulation. Usually, a healthy egg is released by follicle between the size of 18 mm to 21 mm. Though right ovarian follicle is smaller in diameter, your left ovary has got a good-sized (20 mm x 16 mm) follicle. It may rupture any time to ovulate. Maybe you would be given Injection of Chat Doctor hormone for bringing about ovulation. Eggs released from follicle of size between 18 mm and 21 mm release the best quality eggs who have potency for successful pregnancy. However, your endometrial thickness is not up to the mark; it is just 5.5 mm thick. For successful implantation of fertilized ovum, endometrial thickness between 9 mm to 13 mm is most conducive. I do not feel this endometrium can give you a successful pregnancy. You are on Ferry which is Camphene citrate. This medicine is used for induction of ovulation. However, due to its anti-oestrogenic action, it affects the endometrial growth adversely. According to my opinion, you should let this cycle pass without pregnancy. Since there is a problem in endometrial thickness, you should work on it by estrogen preparations. Furthermore, color Doppler study of endometrium will be more informative about the deeper layers of the endometrium. You should attempt the pregnancy when the follicle is between 18 mm to 21 mm in size and the endometrium is between 9 mm to 13 mm in thickness at the time of ovulation. May be, if endometrial growth is adversely affected by Camphene, you would require HMG/Chat Doctor protocol for ovulation if you cannot ovulate naturally. You have been put on Obi met, which is Metformin. It was (and is still) a belief that this medicine helps the ovulation better with Camphene citrate. However, the recent studies have shown that there is not much of a difference with or without Metformin; instead the use of MYO inositol has proved to be more successful with Camphene citrate. Please take the opinion of your infertility specialist before you attempt the pregnancy to avoid unsuccessful pregnancies or conceptions. I hope this helps you.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Im allergic to cold and slightest of cold wind gets me down with cough cold fever.This time it persisted for long and did not healed after 3-5 days medication.I then saw a specialist and after XRay of nasal passage and examination he diagnosed it a minor case of rhinosinusitis.He put me on heavy antibiotic(1000mg Clavam twice aday) with anitallergic(snizid) and vitamins for 7 days and told it will take a month of recover from the infection.I kept visiting him for a month every 8th day where he reduced the capacity of antibiotics and antiallergics and the salt.In my last visit he again got my XRay done and told to take 7 day course and no need to come.Then he prescribed Telekast L.He adviced to take onetab a day extended for 14 days when I told him I easily catch cold. Ive been regular on my medicines but a day before I came out in morning without woollen cap covering my ears and happen to catch same cough and soar throat.I have been gargling and taking steam1/2 a day. How do I cure and increase stamina against cold so I do not fall prey at slightest of exposure. ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. As an Allergist-Immunologist, I would suggest you allergy testing for common air-borne allergens such as house dust mites, molds, pollen, insect proteins, animal dander, etc. This will help you identify the substances you may be allergic to and also to know the measures to avoid them.2. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms over long duration.3. Treatment of rhinosinusitis requires a lot of patience and care. Regular steam inhalation, usually twice a day, is very helpful in rhinosinusitis.4. I also prescribe my such patients regular montelukast + Levocetirizine (Telecast L that you are using) for long periods.5. X-rays pick up changes in sinus cavity very late, so I usually do not suggest repeated X-rays to decide treatment.6. I would also suggest you regular breathing exercises like Panama which may help over a long time.7. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.8. Regular healthy dietary habits like a diet rich in vitamins, minerals and antioxidants, adequate fluids during day to maintain HY Chat Doctor. 9. Cold air does not cause "allergy", but it acts as an irritant. So it is always advisable to avoid exposure to cold air by adequate covering nose and ear openings as well as scalp by proper clothing. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello,I am a 34 yr old women with 2 children, 5 and 3.I was diagnosed with PCOS 6 years ago when trying for 2 yrs to fall pregnent with my 5yr old. Fortunately i was able to fall pregnent with no medical assistance. and again after about 8 months of trying with my 3 yrs old. i have been trying for the past 12 months to fall pregnant again with no luck.I have Hypothyroidism and taking 10o micrograms daily since i was about 12yrs old. i have been taking my temp and checking the position of my cervix as i find it very difficult to know when im ovulating. i have very painful cramps around when i think im ovulating, but often not backed up with egg white mucous. my periods have been regular 28 day cycles since my 3 year old was born, up until the past 3 months, which have started to be out by a 4-7 days late. this month i didnt get my period for 48 days. i had had intercouse a week before i got period on day 41 and had severe pain to the point i was going to go to the hospital. it did subside the next day after taking some pain killers.i saw my GP who sent me for an ultrasound. the results were: uterus is in anteverted position with bulky appearance, measuring 95cc. Myometrium is heterogeneous. Endometrium appears unremarkable, measuring 12mm. Right ovary, there is a 1.8 x 1.7cm thick walled hypoechoic structure with internal echoes. no abnormal vascularity demonstrated. left ovary appears in remarkable, measuring 7cc, right ovary measures 12cc.I have had all the usual blood test, ChatDoctor, prolactin, progesterone, testosterone, thyroid, shg. all have come back within normal range.I am unsure what this all means. Will this make it harder for me to fall pregnant? should i even try? would this cause complications if i was to fall pregnant? Regards Lisa ### output:

Hi there, I have understood your concern. I will suggest you the best possible treatment options. First do not panic. Please consider that you have already been able to get pregnant twice. Please keep taking your thyroid treatment meticulously, monitor TSH levels every 3 months. For your PCs, I will suggest you to opt for a healthy diet and regular exercise regimen. Try to have optimum weight, with body mass index OD 23. Avoid deep-fried foods, bakery products and refined sugars. Avoid substance abuse if any. Start on Folic acid, vitamin B 12 and Omega-3 supplements at least 3 months before you plan to get pregnant. This helps to prevent many problems during pregnancy and delivery. As your remaining reports are normal, you need not worry about getting pregnant. You can simply get USG done for follicle study, to know the day of ovulation. Accordingly you can have unprotected sex act, or GUI on the day of ovulation. I hope this answer helps you. Thanks.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I was playing in a softball tournament this past weekend and slid into home plate. It resulted in a skin abrasion on the left side of my left legs shin bone. It s about 10 inches long and 3 inches wide. I also have a 3 inch scrap about an inch wide on the inside of my right knee. Both abrasions were really soar after it happened but I was able to finish the rest of the game and walk with a small limp the rest of the day. Sunday night was restless when it came to sleep but, nothing compared to Monday night. I had a relentless leg throb in both legs all night long. I slept a total of 45 mins. Last night I actually slept through the night while keeping the larger of the two abrasions outside out the blanket while I slept. They have both had a lot of heat coming off them ranging at a 7-8 on a 1 to 10 scale. They have both been oozing a clear to diluted yellow puss. My skin is hard and tight around the larger of the two abrasions and it s tender to the touch. I ve also had a fever on and off since this has happened Sunday afternoon. The most pain I feel from all of this though is when I attempt to walk. I ve been out of work all week because It s too painful to walk on my legs. I ve been on bed rest keeping my legs elevated on pillows. The only time I get off the bed is to use the restroom and shower. The moment I shift my legs to the edge of the bed and proceed to put my weight down on them to walk to the bathroom I feel an intolerable heart throb in my legs. I walk on my toes on my left leg and i brace myself on my right leg with a hop between leg shifts. I cry every time I shower and use the restroom because the pain is so intense. If I can hold onto something to keep a lot of the weight off of my legs It doesn t hurt as bad so, needless to say I ve been using a lot upper body strength to get around. I don t feel any pain when I lay in bed with my legs elevated but the pain grows intensely when I attempt to walk. I ve been taking Tylenol extra strength 500mg (1) before I got to sleep every night. The abrasions are developing scabs around the outsides but, the center is still a foggy yellow colored scab. What is the best pain killer to ingest? What is the best abrasion dressing to use? What is the best ointments for abrasions? I m a 23 year old female. Please help. ### output:

1) Tylenol is enough for abrasions, or you can take NSAIDs like Ibuprofen for pain relief2)As the wound is big it is bound to take some time to heal completely. The foggy part in the center is exudate and antibody collection that will help in healing. 3) Abrasions are best left uncovered for faster healing. I would suggest and antibiotic ointment like Tobramycin to prevent wound infection4) I would also like to suggest getting an X-ray done if not already done. Thank you. Stay fit and happy recovery.

If you are a doctor, please answer the medical questions based on the patient's description.

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: 24 yeard old female, mum of 2 boys ages 4 and 1. On my sons 1st birthday I was run off my feet all day. Later tat night when I finally sat down to relax I called my mum. during the phone call I began to get chest pains and a sharp pain when I breathed. I ignored the pain for about an hour and stayed on the phone but the pain was slowly getting stronger so i told my mum i had to get off the phone. I went and sat on the lounge and then it got really bad, like something was squishing my chest through to my back which was also aching. It was getting harder to breath because with each breath I got a sharp pain in the chest. I called my husband who was in the other room and asked him as I thought it might help, if he could run a bath for me. So he ran into the bathroom to do as I asked, and in that short time it became alot worse I tried walking round the room a couple times to take my mind off it but it was so bad. The pain was even more intense, the sharp pain when I breathed in, the dizziness, the cold sweat and the feeling like i was going to be sick. I tried to walk into the bathroom but as I walked out of the loungeroom I felt like if I didnt sit I was going to pass out and fall so I sat in the hall way, but then layed because i couldnt sit. My husband came out of the bathroom and called my parents, who only live round the corner. So they came over and by the time they got there, which only took about 2 mins, I felt alot worse, I could barely breath, the pain was extreme, I couldnt move. My parents rang an ambulance. from the beginning, I had this sharp pain that slowly seamed to travel up my chest, like i could point to it and follow it up, by the time the ambulance got there this sharp pain was traveling up my neck towards my jaw....although the pain everywhere else was extremely strong, I could feel it was easing. the paramedics took my blood pressure which was 60 / 40 and took me to hospital. on the way to hospital the pain eased some more, by the time we got there it was an ache. I was left in the corridor for about 45 mins and then the doctor spoke to me, gave me an iv for dehydration and some mylanta, but by this time all the pains had gone except for an ache and felt like my chest was badly bruised ...could this have been a heart attack ?? ### output:

Hi, From your description the pain is more likely to be corrosion Chat Doctor. I really understand your feelings as sometimes the can cause a very severe pain. Sweating and low blood pressure can be consequences of your severe pain. In this case usually a tablet of Ibuprofen or Paracetamol helps to reveal the pain, but sometimes there is a need for a treatment for a week. Anyway to be in the safe side I would advise you to undergo some examinations for the final diagnosis, as it is not possible to diagnose a patient online only based on complaints, but in my opinion, there shouldn't be a heart problem. Take fearsome back if you have any further questions