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### Human:\nwhat is your opinion on my breathing issues?\n\n### Assistant: we are here to help you. i have some questions that you need to answer. since how long are you feeling breathing difficulty? does your problem aggravate on waking or it comes any time even at rest? do you feel that you need to take deep breaths? how is your sleep? ever did you wake up due to difficulty in breathing? if yes then how did it settle? revert back with the answers to the above questions to a pulmonologist online --> <link> |
### Human:\ni had a serious breakup with my girlfriend. i feel lonely. what do i do?\n\n### Assistant: relationship issues need to be settled down before it starts disturbing you. you have to fully understand what will it lead to and how will it affect your life in long run. when you get into any relationship for more than a year you start associating and sharing your feelings with that person which is quite obvious. in any breakup the reason for breakup is very important to deal with. you have not mentioned it here. if you had mentioned it would have been even more helpful in suggestions. suggestions: it seems that you have not yet accepted that you had a breakup. the reason for it must be challenged and accepted on your part. once you deal with that it will be easier for you to move on. try journaling or writing to an unknown friend (or to yourself) and share your emotions and feelings honestly. do not avoid recalling your memories because the more you avoid the more you get into it. go through it with the help of a counsellor and it will make you feel much better. follow up with the details of your relationship issue for the better management. consult a psychiatrist online --> <link> |
### Human:\nfor depression would it be sorted out if i go for counseling?\n\n### Assistant: from what you have described you could be suffering from depression. depression of such intensity requires medication and cure is possible in such cases. breath relaxation exercises or meditation is also helpful but not a substitute for medications. investigations to be done:1. thyroid profile. 2. zung's self-rating depression scale. differential diagnosis:mdd (major depressive disorder). regarding follow up:for further doubts consult a psychiatrist online. ---> <link> |
### Human:\nhow to overcome the fear of my boyfriend cheating on me again?\n\n### Assistant: i can understand your situation. after knowing that your boyfriend was cheating on you in the past you have repetitive intrusive thoughts that he can cheat again. this feeling of suspiciousness is normal to some extent but if it is troubling you making you restless and disturbing your daily routine then treatment is required. i will suggest you forget the past you have already planned to marry him. it will be better if you have positive thoughts in your mind. you can also visit a psychiatrist for counseling and behavioral therapies to learn how to control negative thoughts. keep yourself busy in work do some light exercises yoga etc. talk to your boyfriend about how you feel. it will help overcome negative thoughts. for more information consult a psychiatrist online --> <link> |
### Human:\nhow to remove acne black spots?\n\n### Assistant: i would suggest you to apply melalite xl cream (tretinoin) on the black spots at night in minute amounts. please consult your doctor discuss with him or her and take the treatment with consent. continue this for three weeks and revert back. revert back after three weeks to a dermatologist online --><link> |
### Human:\ndoes acne itch?\n\n### Assistant: was it just acne or may be some insect bit? because in acne there will not be any itching. so i think it is some insect bite and the same thing happened to another part of the body. due to scratching you further triggered the inflammation. i suggest the following treatment. consult a specialist doctor discuss with him or her and take the medicine with consent. mild steroid and antibiotic cream such as flutivate cream (fluticasone) is a good one. also can use fucibet cream (betamethasone and fusidic acid) once in a day. i suggest one antibiotic too. tablet augmentin 625 mg (combination of amoxicillin and clavulanic acid) twice in a day for 7 days would be a good option. i would like to add some oral steroid tablet wysolone 20 mg (prednisolone) for 3 days in the morning after food. revert back after a week to a dermatologist online --> <link> |
### Human:\ni have acne since the age of 13. kindly get me a solution.\n\n### Assistant: i have read your query and i understand your concern. acne has several grades depending on the type of lesions. in grade 1 i prefer to advise topical clindamycin in the morning and benzoyl peroxide alternatively with topical retinoids in the night-time. oral antibiotics are also given like doxycycline or minocycline or azithromycin in grade 2-4 acne. avoid hair oil application and oily food in the diet. in responding cases consideration is given to start oral retinoids. kindly upload the images so that i can actually visualize the lesions and advice you to my best. also mention the details of treatment you have already taken. revert back with the images to a dermatologist online --> <link> |
### Human:\ncan allergic reaction occur due to tylenol 3 or amoxicillin?\n\n### Assistant: i have gone through your query and can understand your health concern. the allergic reaction can be due to amoxicillin only because acetaminophen and codeine will not cause any allergic reaction. i suggest you to stop amoxicillin. you can use any of the cephalosporin instead of amoxicillin. for allergic reaction i suggest some antihistamine drug twice daily for three days. amoxicillin and other drugs of this group are very common to cause allergic reactions. as you have mentioned that you never developed such reaction in the past and this is the first time i tell you that it can happen. i suggest you not to take amoxicillin in the future. for further information consult an allergy specialist online --> <link> |
### Human:\nhow to judge a person wisely?\n\n### Assistant: every person has numerous traits or habits. a person is sum total of his thoughts words and actions. when you think of judging a person it is making a global judgment. if you really need to be objective you need to judge a person's actions habits and thoughts individually. but i get what you mean to ask. here are my thoughts on it: judge a person by how much he contributes to the welfare of others. judge a person on the basis of his thoughts. it is only thought which defines an individual. judge a person by his actions in the past and present. judge on the basis of how he treats his subordinates because there is only way of treating the boss. judge on the basis of his behavior during crisis not when things are going great. judge on the basis of what he does for the welfare of others not on the basis of how much he earns. judge on the basis of his common sense not his qualifications. judge not on his looks but on how he makes others feel. another thing to note is that it is neither wise nor necessary to judge people all the time. no one has perfect judgment. because judgment is subjective and based only on available facts not on the whole truth. besides it can make us prejudiced unnecessarily. also people change with time. for further information consult a psychologist counsellor online --> <link> |
### Human:\nmy brother's illness bothers me a lot. i am deprived of sleep. please help.\n\n### Assistant: pain of near ones make you feel helpless. this weakens your strength somehow. symptoms like lack of sleep disturbance and tension occur when you feel stressed for any reason. but you have to be strong for your brother. if you feel low he will become worse and lose his will power to fight the illness. follow these to be mentally strong: have a healthy and good diet for yourself. take good care of yourself. take a walk on daily basis for easing out. keep sharing thoughts with someone about how you feel. unless you make yourself equipped with strength it will not be beneficial for your loved ones. for a psychological counselling consult a psychiatrist online --> <link> |
### Human:\ni have pcos and had unprotected sex. are there chances of me being pregnant?\n\n### Assistant: yes for now you need to take i-pill to avoid getting pregnant within 72 hours preferably within 12 hours. but emergency contraception is not to be taken on a regular basis as it has progesterone and as you have been diagnosed with pcos (polycystic ovarian syndrome) there is already a long follicular phase (first phase of the cycle). you should consult a gynecologist for regular contraception like low dose oral contraceptive pills as they even help in pcos and regularising the cycle. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ncould omeprazole cause changes in ecg and increase the heart rate?\n\n### Assistant: anxiety and panic are the first possibilities. sudden onset of palpitations is a very unusual sign of heart attack. none of the investigation and symptoms are compatible with the heart attack. although there are some ecg changes like q waves which can be present are indicative of heart damage in case of heart attack. but your echo is normal and so no need to worry at all. there is also t-wave insertion in lead 3 and non-significant elevation in avr. so given these changes i would advise for some stress test like treadmill test or stress thallium which you did not mention anything about. if you have not undergone it then you can have it to rule out the possibility of inducible ischemia. the qrs prolonging of such mild degree is not significant and this much variation may normally occur with different ecg. it is not very common with omeprazole. for further information consult a cardiologist online --><link> |
### Human:\ni am suffering from post-ssri sexual dysfunction. please help.\n\n### Assistant: i can understand your concern regarding your symptoms and side effects of the medications. the symptoms you mentioned above are showing that you are suffering from dysthymia and moderate depression. depression itself is a cause of poor sexual drive. lexapro that is escitalopram may cause loss of libido and sexual dysfunction as you have already stopped this medicine long ago depression is the primary cause of your symptoms. i will suggest you try taking newer invented molecules like vilazodone. this drug has no daytime somnolence and sexual dysfunction. it will help you in early recovery. take it for at least three months and then stop slowly by tapering. consult your specialist doctor discuss with him or her and start taking medicine after their consent. within a couple of weeks you will feel better and these drugs have fewer chances of withdrawal depression when they are stopped and tapered slowly. behavioral therapies like cbt (cognitive behavioral therapy) or dbt (dialectical behavioral therapy) and counseling will help you to cope up your stress and will help you to maintain a happy state of mind. visit a nearby psychiatrist for a proper prescription and counseling. your symptoms are curable 20 % of the population spend some part of their life in depression and half of them overcome with this illness. hope my answer helped you. for further queries consult a psychiatrist online --> <link> |
### Human:\nsuffering from anxiety and panic attacks for the last 3 years. need second opinion on the prescription.\n\n### Assistant: i read your query and understood your concern. as per your diagnosis of anxiety and panic attacks there should be no doubt whether you need neurologist or psychiatrist. both these conditions come under the domain of psychiatrist and they are more able to treat these conditions. other than anxiety and panic attacks you have got addiction problem because of the wrong use of medicines. in my view there is no role of soltus in case of anxiety and panic attacks. if you feel fine with an online psychiatry consultation session (via phone or video chat) then i will be happy to help you. you con contact me by either putting a detailed query or booking an online consultation. |
### Human:\ni had a horrible panic attack two weeks ago. my arms and legs went numb. what can i do to stop this?\n\n### Assistant: the treatment includes some medicines and psychotherapy. 1) medication includes antidepressants (ssri's tci) antianxiety drugs. it is better to see some doctor before taking any medicine as the best medication for your panic attacks will depend on a variety of factors like presenting symptoms co morbid disorders and treatment goals. 2) psychotherapy (cbt i. e cognitive behaviour therapy) treatment of panic attacks. cbt works to help the patient to change his thoughts and perceptions that are contributing to fear and anxiety. once you begin to accept panic attacks you can start to change the way you respond to them. for example instead of reacting to physical symptoms with nerve-racking thoughts such as “i am losing control ” you can respond to them with increased calm and clarity. relaxation techniques such as deep breathing mindfulness meditation or yoga can be practised to help you get in touch with your relaxation response. repeating positive affirmations such as “despite my anxiety i accept myself ” can also help in getting past fear. by working on changing how you react you can start to remain in control during panic attacks. the next time you have a panic attack try to remember the three a’s of overcoming your fears: acknowledge accept and alternative response. these three steps can assist you in changing the way you react to symptoms and get through panic attacks with less fear. listed here is a simple step-by-step exercise that can help you overcome your fear of panic attacks: acknowledge - the next time you notice increased anxiety or panic symptoms simply pause and take a breath. take this moment to recognize that you are experiencing heightened panic and anxiety. this simple act of acknowledging your symptoms at the start of a panic attack can give you a sense of power over your fears. accept - rather than trying to run away from or resist your symptoms come to terms with the fact that you are having a panic attack. acceptance does not mean that you are giving in to panic but can provide you with the clarity needed to get through panic attacks. alternative response - instead of becoming wrapped up in your fear remind yourself that these are simply symptoms of a panic attack and that you have nothing to be afraid of. during a panic attack your flight-or-fight reaction may be trigger feelings of stress and fear. reframing these feelings can allow you to more effectively cope with them. so for example if during an attack you start to react with fear or a need to flee remind yourself that your symptoms will soon subside. instead of thinking “i am afraid of my panic attack ” try to reframe this to “i am feeling overly excited. ” when frightening thoughts such as “i am going to lose my mind” arise try to shift this perception be repeating to yourself “i am okay ” or “these feelings will pass. ” you can book for an online therapy or telephone counseling for further counseling and treatment from us. |
### Human:\ni am a hiv negative man married to a hiv positive woman. we would like to have a child. please advice.\n\n### Assistant: yes there are very good chances of you getting infected with your wife during sexual intercourse. so you should take proper precaution before sexual intercourse. yes. chances of a baby getting infected with hiv from a hiv positive mother are very high. you should consult a doctor for your wife's treatment during pregnancy with a drug called zidovudine to prevent your baby getting infected with hiv and she should not breastfeed her baby. hope i have answered your query. if you have further questions revert back to a hiv aids specialist online --> <link> |
### Human:\nin my 18th week of pregnancy clubfoot was diagnosed. should i undergo amniocentesis?\n\n### Assistant: clubfoot (twisted foot) is not an uncommon anomaly and its prognosis is good. it means it is correctable in most cases. amniocentesis is an invasive procedure. if you have already undergone biochemical markers like a dual marker or triple test and they are negative then the risk of other anomalies is very low. i will suggest you to take a scan from a fetal medicine expert near you. if no other anomalies are seen by him or her on that scan then just for a club foot amniocentesis is not required. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nare the opacities in my chest x-ray due to cold?\n\n### Assistant: there is an opaque small mass that could be just a normal blood vessel or an abscess or a cystic mass. but in order to confirm you need an mri scan of your chest. the cold and throat pain are not the cause of these opacities. for further information consult an internal medicine physician online --> <link> |
### Human:\nhow to confirm if my heart is in good condition?\n\n### Assistant: you have to reduce weight as you have family history of heart disease and obesity itself a risk for heart disease and diabetes. there is no problem with your cholesterol test. it is fine. to find out whether you have any heart problem at present or not i would advise you to get ecg (electrocardiogram). 2d echo (two-dimensional echocardiogram). tmt (treadmill test). in tmt it will be clear that whether at present your heart is fine or not. reduce weight by jogging 30 minutes a day. do not smoke. eat more of vegetables fruits and nuts. avoid cheese ghee butter and non-vegetarian foods. revert back after the investigations to a cardiologist online --> <link> |
### Human:\ni have taken harmoni-f for three months. now planning for a baby. when will i get pregnant?\n\n### Assistant: it will take 3-6 months for you to get pregnant. start taking folic acid tablet. hope it helps. consult an obstetrician and gynaecologist online for further help --> <link> |
### Human:\nother than chest x-ray what test should be done for cough?\n\n### Assistant: i understand your concern. see as you said your mother is suffering from active tb (tuberculosis) tb in the child should also be ruled out first. it may be just pneumonia but tb should be ruled out with some more investigations mentioned below. is the child gaining weight adequately? what is her present weight? was bcg (bacillus calmette-guerin) given at birth? when was your mother diagnosed and when tb treatment started? investigations to be done:1. mantoux test. 2. complete blood count. 3. gastric aspirate for afb (acid fast bacilli). treatment plan:an antibiotic should be given for seven days. regarding follow up:revert back with the answers to the above questions to a paediatrician online. ---> <link> |
### Human:\ncan frequent masturbation cause problems while urinating?\n\n### Assistant: i am sorry to know about your problem. frequent urination is a common problem called overactive bladder. other than this mild pain in the urogenital region can be due to neural pain. masturbation usually does not cause these problems. i hope you had already taken a course of empiric antibiotics. i would suggest you try taking capsule tolterodine 4 mg and tablet nortimer (nortriptyline) 25 mg once at night for a month. consult your specialist doctor discuss with him or her and start taking the medicines after their consent. for further queries consult an andrologist online --> <link> |
### Human:\ncan a breathing treatment given before a chest x-ray hide lung cancer?\n\n### Assistant: i have read through your query. please find my observations below. breathing treatments like nebulizers will not hide any suspected lung cancer when given before taking a chest x-ray. chest x-ray is a basic investigation used to screen the lungs field and heart and usually done as a routine investigation. a routine chest x-ray usually picks up any nodules or mass in the lung fields that might represent lung cancer and is not affected by the patient taking nebulization therapy. if there are strong reasons to suspect a lung cancer then a ct scan chest is the best investigation and gives complete detailed overview of the lungs. in conclusion breathing treatment will not hide a lung cancer when given before taking a chest x- ray. consult a radiologist online for further follow up --> <link> |
### Human:\nwill excess masturbation affect weight?\n\n### Assistant: frequent masturbation does not have much effect on your health. you can maintain a strict exercise regimen along with the proper diet you are having. start muscle strengthening exercises such as wall press pushups abs strengthening etc. drink milk every day with two bananas. apple is a must for once a day. maintain your weight does not decrease in any way. can have dry fruits in the evening such as almonds apricots etc. have salmon or tuna fish. have 8 hours of sleep which is mandatory. engage yourself in your work so that you do not get free time for unnecessary things. for further information consult a nutritionist online --> <link> |
### Human:\nis masturbation a harmful act?\n\n### Assistant: masturbation is normal and not harmful. it does not cause physical problems or sexual problems. masturbation does not cause hair fall. both are due to the effect of testosterone. in boys of young age the effect of testosterone is high which is normal and cause desire to masturbate. hair fall may be due to low vitamin or scalp infection or high testosterone. frequent sex is not harmful. you can do it daily. no you do not have premature ejaculation. ejaculation in less than one minute is pe. she can be satisfied before sex by finger or oral sex. it is better to pull the foreskin before insertion. if you have done oral sex for 8 months without any problem then no further issue. anal sex can be done but regular may cause tear in the anus and a condom should be used. for further doubts consult a sexologist online --><link> |
### Human:\ncan i conceive with adenomyosis?\n\n### Assistant: firstly let me tell you that sonography is not always suggestive of adenomyosis. it cannot diagnose it. for diagnosis you have to send biopsy of the uterus. in adenomyosis there is pain before during and after menses. there is also focal and diffuse type of adenomyosis. whatever you read on the internet is about diffuse or generalized adenomyosis. a few things on focal adenomyosis are available because most of the time it goes undiagnosed or has very mild symptoms that do not hamper routine. so just focus on the present and start trying for pregnancy. in fact if you get pregnant and pregnancy goes up to term or near term then there is a chance of cure from adenomyosis theoretically. if you do not have the symptoms of clear adenomyosis then there is a chance that it is not adenomyosis. so do not worry and take chance for a year. if you do not get pregnant then consult a gynecologist as normal people. for further information consult an obstetrician and gynaecologist online --><link> |
### Human:\ncan masturbation cause negative thoughts?\n\n### Assistant: masturbation will never cause these problems as you are having. semen is produced daily. so even if you do daily there is no harm. but too much of anything is bad as you can utilize your time for something useful to you. you have not mentioned your age. i suggest you to do masturbation on alternate days. do not stop doing it which will help you realize that it is not harming you. secondly negative thinking has nothing to do with masturbation. you should start doing some exercise daily. spend some time in meditation and prayer. learning yoga and meditation will help you a lot. for your depression i suggest you to consult a psychiatrist who will help you to boost your confidence with few medicines for a short time. be happy and find different ways to be happy. remove the fear of masturbation. for further information consult a sexologist online --> <link> |
### Human:\ncan excessive masturbation cause loss of energy and depression?\n\n### Assistant: masturbation is a normal thing. it is a myth that masturbation is wrong unhealthy and leads to weak body and mind. it is a normal way of a sexually healthy person to get self-satisfaction. the myth that masturbation is unhealthy is perpetuated by some quacks to earn money and fool people. the symptoms that you described such as reduced physical and mental energy known as anergia difficulty in thinking depression weak immune system and other physical symptoms are suggestive of depressive disorder. depression is a mental disease which can have lot of physical symptoms along with sad feeling weak and guilt. mind affects the whole body. a lot of times the cause of physical health problems is mental problem. the treatment for depression is antidepressant and counseling. also you need to get over your guilt over masturbation. for further information consult a sexologist online --> <link> |
### Human:\ncan i continue my pregnancy with a high tsh level?\n\n### Assistant: yes you are right. hypothyroidism can affect the fetal brain development especially in early pregnancy. thyroid hormone is normally very important for many functions of the body. it helps in the early development of the fetus. the brain is one of the parts of early organ development. in early pregnancy fetus mainly depends on mother's thyroid level because fetus itself cannot produce up to around 11 to 12 weeks (three months). there is no data available whether you have taken treatment early and adequately. but yes there is data that hypothyroidism can affect brain development and function in baby permanently and whatever damage occurs is irreversible. if you are taking thyroxine (levothyroxine) 50 mg and the level is this high then you need to increase the dose. and if you have started treatment just now then continue and repeat according to the doctor. as far as termination is concerned that is totally the couple's call. if you are prepared to take care of a mentally handicapped baby and related problems for the rest of life then you can definitely continue. if you are not prepared for that then you can go for termination. first control thyroid level and then try for pregnancy after you have a normal thyroid level. you will have to take tablets for hypothyroidism for the rest of your life. only dose adjustment will be required time to time according to the thyroid level. so the last choice is yours. you know what can happen. if you are ready for it then go for it and do whatever you have to minimize that. get treated for hypothyroidism more aggressively and control as early as possible. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nis masturbation the reason for my premature ejaculation?\n\n### Assistant: i can understand your concern. first of all i would like to tell you that masturbation is not the reason for the problem of premature ejaculation you are having. masturbation is a safe habit and most of the men masturbate. diabetes increases the risk of premature ejaculation. so i would advise you to maintain the blood sugar levels. if that is not controlled then consult your doctor for dose adjustment of the drug. for premature ejaculation you can think of taking dapoxetine. the drug is a ssri drug (selective serotonin reuptake inhibitor) and you can take it on as necessary basis. the drug will help to delay the time. the drug is safe to use and free of serious side effects. please talk to your doctor about the prescription of this drug. for further information consult a sexologist online --> <link> |
### Human:\nafter delivery how long should i wait to get my tooth pulled?\n\n### Assistant: you can go for tooth extraction in a week or two after child birth as the amount of local anesthesia that can reach the breast milk is very less and does not cause any serious complication. however you should once consult a neonatologist or your obstetrician and gynecologist to confirm depending on the medical health of your newborn. and then you can proceed for extraction without any worries. all the best for your delivery. for further doubts consult a dentist online --> <link> |
### Human:\nfrom the mri kindly explain the severity of my low back pain.\n\n### Assistant: your problem is sciatica but it has not yet progressed to a severe stage. at this stage you need rest and the following treatment. consult your specialist doctor discuss with him or her and take treatment with consent. tablet aceclo sr (aceclofenac) as needed do not use continuously. tablet mecalfa pg (multivitamin) daily in the night. when the acute pain is subsided please consult a physiotherapist for back strengthening exercises. for further information consult an internal medicine physician online --> <link> |
### Human:\ndoes my mri explain as to why am i feeling lost and confused?\n\n### Assistant: your mri of the brain is normal except some sinusitis. i would like to ask a few questions. since when are you experiencing these symptoms? do you have a headache or vomiting? is there any history of seizures or loss of consciousness? how is your sleep? are you taking any medication? i would suggest you get the following investigations done. eeg (electroencephalogram). contrast study of mri brain. if required lumbar puncture and csf (cerebrospinal fluid) examination. thyroid profile. anti-tpo (thyroperoxidase) antibodies. kidney and liver function test. vitamin b12 level. the differential diagnosis of your condition are as follows: depression. limbic encephalitis. encephalopathy. revert with more information to a neurologist online --> <link> |
### Human:\nduring masturbation i felt some pain on the back side of my neck and head. please help.\n\n### Assistant: masturbating 2-3 times a week is healthy unless you get addicted to the habit. this kind of pain or sprain happens due to increased blood flow to your penile region and vasoconstriction along with it. it resolves spontaneously once the excitation is over. this can be relieved by little stretching after masturbation or by doing exercises for 30 minutes every day. there is nothing serious to worry about. if the pain persists consult a sexologist online --> <link> |
### Human:\nwould you kindly suggest diet for a pregnant woman?\n\n### Assistant: a pregnant woman needs a good balanced diet. before going to that i will suggest you one thing. as your wife is hypothyroid the need for thyroid hormones increases by 50% in pregnancy. you need to increase the dose to 75 mcg. go for a thyroid profile and adjust dose accordingly with the help of your doctor. regarding diet plan have a glass of milk 300 ml twice a day. it gives the calcium needed for pregnancy. in the first trimester they face the problem of nausea and vomiting. so ask to take plenty fluids and more of vegetables and fruits. avoid oily foods in breakfast. in the afternoon should take at least four cups of rice with dal and vegetables. in the night three cups of rice or three rotis. take non-vegetarian that is chicken or fish twice a week. you can also have mutton once in 15 days. eggs to be taken daily or at least once in two days. for further information consult an internal medicine physician online --> <link> |
### Human:\nshould i cleanse my body before starting workout to reduce weight?\n\n### Assistant: it is really nice to hear that you want to have a change in your life. this will be an example for other ladies also. cleansing the body is essential but before that cleanse your mind with lots of positive attitude towards life. never forget to pamper yourself. always try to find some time to go through some motivational videos every day that will increase your motivation. fix a proper routine time everyday for waking up cooking prepare your children lunch snacks and dinner. go for an evening walk every day along with your children if possible so that you can look after them. follow a strict diet cut down carbohydrates from your diet chart and add more protein with cereals and pulses. add green vegetables and fruits. do meditation and yoga every day for a minimum of 30 minutes. spend more quality time with your children; play with them with lots of playful activities which will in turn become a workout for you. do stretching exercises for your upper lower body and trunk to improve your flexibility. follow these simple steps for a month and then you can post me back with your feedback. have a nice fresh beginning again in your life. best of luck. revert back after a month to a fitness expert online --> <link> |
### Human:\nis there any medicine in ayurveda for conceiving a baby boy?\n\n### Assistant: i just read your query. in ayurveda or any other branch of medicine there is no medication that will help you to conceive a baby boy. no medication can do that. moreover the chromosome responsible for baby boy (y chromosome) is inherited by the male partner that means the gender of a baby whether it is a boy or a girl is determined by father and not by mother. some people claim that they give medicine for baby boy and promote them in the name of ayurveda medicine but no medicine can do that. for further doubts consult an ayurveda specialist online --> <link> |
### Human:\nis there any harm in using ovasafe and duphaston if i plan to delay pregnancy?\n\n### Assistant: these medications are very safe. i suggest you folic acid supplements as it has to be taken three months before planning to for pregnancy. you can discontinue ovasafe and duphaston till you want to plan for pregnancy. but you can continue folic acid supplements. even if you take the medications there is no harm. the only thing could be that your chance of pregnancy will be high. as you do not want to get pregnant for the next months you can avoid those two medications. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nmy wife has thyroid and not able to reduce weight. please help.\n\n### Assistant: i read your query and understand your concerns. from the available values it appears that her thyroid function test is within normal limits but slightly at lower side. no medication is required in regard to thyroid as she does not have any symptoms related to thyroid function like fatigue irritability amenorrhea depression weight gain despite low intake of food dry skin and loss of hair to name a few. in case she has any symptoms then a trial of 25 mcg thyroxine (levothyroxine) should be attempted on a daily basis. for further doubts consult a general practitioner online --> <link> |
### Human:\nkindly suggest a diet plan to reduce weight and belly fat.\n\n### Assistant: you can practice some brisk home body poses and exercises other than walking or running. also reduce your calorie with low carbohydrate diet. have mainly two roti mix vegetables citrus fruits and cucumber. take vegan based diet less organic foods sleep more for a minimum of eight hours. hope you do not have problem of constipation. no stress no smoking and hard drinks (if any). no cola or sweetened drinks. avoid spicy foods outside street foods fried foods junk foods cream based foods. eat less salt and no sugar. have high quality protein rich foods whole wheat foods and also reduce or stop having rice and rice meals. both for your weight loss and tummy fat or extra visceral fats (unwanted body fat) i suggest to keep on mild exercises like yoga or body poses 15 minutes morning as well as before going to bed. mild walking possible but not heavy strenuous exercises. avoid rice but brown rice can be taken. do work out at gym and at least do free hand exercises for maximum time. you better have a calculated diet plan. cooking oil white oil or olive is better within 20 ml. so saturated fats like butter ghee fat containing rich dairy foods should also be avoided. no lentil local greens too much peas spinach cabbage or tomatoes. strictly avoid all trans fats rich foods. take soft bland timely quality foods with almost nil oils low or very low animal products and all related high animal proteins foods are strictly restricted with spare bad fats at home is best diet for you. the probable causes:high protein high fat containing foods and rich junk foods. treatment plan:1. diet. 2. exercises mild to moderate. regarding follow up:follow up after 15 days to a dietician online. ---><link> |
### Human:\nwhat is the recommended dose of folic acid while planning for pregnancy?\n\n### Assistant: i suggest you tablet folvite 5 mg of folic acid one tablet per day. the recommended dose of folic acid is a controversial topic. various doctors favor 1 mg to 5 mg per day. the best part is that the folic acid has no side effects. it is a water-soluble vitamin and an excess of it gets excreted in urine. so we recommend 5 mg per day to all our patients. when sufficient dose is harmless there is no need to take a chance by giving low doses. one more concern of mine is that you have to check with your neurologist if it is safe to go ahead with pregnancy while on lamictal (lamotrigine). the safety of lamictal is not established by studies. but if your physician has good experience with personal case series then i think you can continue. for further information consult a neurologist online --> <link> |
### Human:\nis mri with contrast useful for endometrial issues?\n\n### Assistant: there is likelihood of serum progesterone deficiency. et (endometrial thickness) 7. 7 indicates a luteal phase defect and spotting indicates irregular shedding. get a serum progesterone level test done. if low then cyclical progesterone would have to be started. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ncan i take spirulina 500 mg tablet twice to replace the intake of 2. 5 mg folic acid and vitamin b?\n\n### Assistant: the amount of folic acid or vitamin b available in capsule of spirulina is not sufficient to meet the daily requirements of these vitamins. so it is important to substitute it by other vitamin supplements. for further clarifications consult a general medicine physician online --> <link> |
### Human:\nkindly recommend an alternative for zincofer-xt.\n\n### Assistant: as this drug is composed of iron supplement and folic acid you can take any available iron and folic acid supplement even as two separate medications. you can take it in the morning with orange juice to increase iron absorption. for further information consult an internal medicine physician online --> <link> |
### Human:\ndoes my ecg look like i have ever had a heart attack?\n\n### Assistant: it is good to see your detailed history for which i have asked for. firstly your ecg is perfectly normal. for anything to be wrong in case of ecg the changes should be present in at least two consecutive leads at a time. in your case whether it is a t-wave or q it is always there in one lead which does not signify anything. as your stress echo and all cardiac enzymes are normal (far superior to ecg in diagnosing a problem) you are cleared from cardiac side. secondly you say that you were prescribed statins (atorvastatin). one of the most common side effects of statins is myalgia (pain in a muscle or group of muscles). the generalized body ache and dull aching in nature is a characteristic feature of myalgia. i request you to consult your doctor and immediately stop atorvastatin. also get your liver function test done. kindly ask your doctor to shift you either on niacin or fenofibrate if you are intolerant to statin. ecg is always interpreted by a doctor. the machine most of the times provide us with artifacts. do not worry; your ecg is perfectly alright. from your history you have severe anxiety levels and attacks called panic attacks. every attack of panic disorder presents with same symptoms as you have mentioned. i can feel that you are obsessed by the thought that you are having any sort of a cardiac ailment. try to overcome your obsession. if you smoke or drink then stop it. try meditation for at least 30 minutes a day and do regular exercise. i suggest tablet paroxetine 12. 5 mg once daily for 21 days and tablet clonazepam 0. 5 mg once daily for 21 days for anxiety. consult your doctor discuss with him or her and take the medicine with consent. panic disorder and your anxiety are induced by obsession and it needs to be treated. the probable causes:1. myalgia induced by statins. 2. panic disorders. 3. obsession induced anxiety. investigations to be done:liver function test. regarding follow up:for further information consult a cardiologist online. ---> <link> |
### Human:\nshould i avoid folic acid during mthfr pregnancy?\n\n### Assistant: truly speaking mthfr - methylene tetrahydrofolate reductase mutations are widely spread and all most one half of the population is having or carrying these mutations by different extent. by different extent i mean to say various levels of affection or involvement that is from very insignificant disease to severe disease. i do want to know that in which category you are now. this is fairly judged by the serum levels of homocysteine which is the protein that is increased in the blood. if you have a severe mthfr defect then you need to avoid folic acid and also need to screen some fetal congenital defects like spina bifida or anencephaly at an earliest. but if you do not have any specific symptoms with this mutation then there is no harm to take these vitamins. pai mutations (plasminogen activator inhibitor) could result in abnormalities in blood clotting disorders. this actually poses no bar for taking folic acid in pregnancy state. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nsuggest me any medicine and guide me reduce weight.\n\n### Assistant: the best way to reduce weight is by regular physical exercise and balanced diet. you can lose weight by reducing your intake of oily food and sweets. it is also important to space your meals in such a way that you have more frequent small meals (and not heavy meals). regular physical exercise in the form of some cardio and strength training will make you fit and strong. sleep and hydration are equally important when you try to lose weight. ensure that you take lots of fluids and that you get at least 6-8 hours of sleep per day. medicine to lose weight: as a doctor i never really recommend my patients to take medicines to lose weight. only one drug is approved for use in india- orlistat. if you really want to take it you can take tablet orlistat 60mg thrice a day (after your 3 major meals). as i have seen in practice and also research results say that orlistat does not produce too much change in weight. it shows just a small percentage of weight loss when coupled with low-calorie diet and exercise. and orlistat has its own share of side effects: fatty/oily stool oily spotting intestinal gas with discharge a feeling of needing to have a bowel movement right away increased number of bowel movements or poor bowel control. rare but serious side effects can occur: symptoms of liver disease (such as persistent nausea/vomiting severe stomach/abdominal pain dark urine yellowing eyes/skin) symptoms of kidney stones (such as back pain pain while urinating pink/bloody urine). bottom line: i do not recommend medicines for weight loss. i can make a good diet chart and exercise regimen for you if you would like to follow up in which case you will have to get back to me with your details- your daily food routine your work timings your daily sleep cycle the kind of exercises you prefer etc. i hope that answers your question. revert back to a fitness expert online --> <link> |
### Human:\nhow to reduce weight through yoga?\n\n### Assistant: as per the data your weight is too high for an individual. you need to rebuild your lifestyle by giving time to exercise and yogic techniques. especially fast rounds of suryanamaskara will help you with your problems. start slowly and day by day increase the speed of practice. also you can practice some dynamic yogic techniques along with it for faster effects. along with yogic asanas dieting also helps you to get rid of your problems. cut down the carbohydrates like rice and use finger millet and include plenty of fruits and vegetables in your diet. try to consume lemon honey and water daily morning in an empty stomach. please do not consume any fast food or junk food to lose weight. the main thing is that you need to be active in your day-to-day life. give enough time to workout and running meditation is nothing but controlling your mind which ultimately relaxes your mind and body. a relaxed mind will always have a healthy body. you can try practicing nadi shuddhi pranayama for nine rounds as a basic step. later on will proceed further. while practicing pranayama you have to completely concentrate on your breathing pattern and the changes that happening in the body. the probable causes:lifestyle changes. investigations to be done:bmi (body mass index). treatment plan:suryanamskara diet plan - lemon and honey juice consume more fruits and vegetable instead of rice and fast food meditation and pranayama. preventive measures:yogasanas workout running exercises and diet. regarding follow up:for further doubts consult a yoga specialist online. ---> <link> |
### Human:\ncan hiv cause throat inflammation as a presenting symptom?\n\n### Assistant: most of the doctors sterilize the equipment in a solution which is kept on their examination desk. you have not mentioned the time duration between exposure and the onset of symptoms though hiv does not cause throat inflammation as a presenting symptom usually. still you can have to get a hiv dna or rna pcr (polymerase chain reaction) test done to rule out any chance of acquiring an infection. for further doubts consult a hiv aids specialist online --><link> |
### Human:\ndoes hiv spread through toilet sharing?\n\n### Assistant: to be straight from the situation you described there is no need to worry at all. i do understand your obsession. at the outset you cannot be sure that the poop that has spiked onto your penis belongs to hiv infected person. assuming the worst case scenario hiv will not spread through contact with the following body fluids. sweat tears saliva feces or poop and urine. for further information consult an internal medicine physician online --> <link> |
### Human:\ni had unprotected sex yesterday and i am worried about hiv and other stds. what do i do?\n\n### Assistant: we do not know the hiv (human immunodeficiency virus) status of the person with whom you had sex and also your baseline hiv status the other thing you mentioned that you do not have medical access for next three months. considering the availability of only lamivudine and zidovudine on your ship and assuming that your baseline status is negative i suggest you the following. to start with zidovudine 300 mg and lamivudine 150 mg twice a day at 12 hours interval postmeal for 28 days. it is recommended to start it as soon as possible within 72 hours of exposure. do not miss a pill. the first side effect with these could be in the form of nausea vomitings and anemia. get your baseline hiv status hepatitis b serology hepatitis c antibody syphilis serology gonorrhea and chlamydia pcr and hemoglobin levels checked whenever feasible. take light meals. i advise you to use a barrier contraceptive (condoms) each time you have sex to avoid the risk of hiv and other stds (sexually transmitted diseases). reduce the number of sexual partners and avoid sexual contact with a person of unknown status. assuming the baseline hiv status is negative repeat your hiv-antibody test at three months and six months interval of exposure. consult your specialist doctor discuss with him or her and start taking the medicines after their consent. for more information consult an hiv aids specialist online --> <link> |
### Human:\nhad i-pill after unprotected sex but did not get periods on time. why?\n\n### Assistant: after the i-pill intake periods generally start in the next 7 to 10 days. so please be patient. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\nmy hiv tests fall under false negative. do i have hiv?\n\n### Assistant: out of nearly hundred person having sex with hiv (human immunodeficiency virus) positive person hardly less than one may get infected. the chances of acquiring hiv after sexual exposure is less than one percent. i would suggest you to get hiv rt-pcr (real-time polymerase chain reaction) and elisa (enzyme-linked immunosorbent assay) for hiv- 1 and hiv- 2 antibody from two different laboratory. as far as progression of the disease is concerned hiv-rna would be positive. false positive or negative do not occur every time. be positive. revert back with the test results to a hiv aids specialist online --> <link> |
### Human:\ni had unprotected sex. what are my chances of getting pregnant?\n\n### Assistant: please do not be worried. you have done a right thing by taking i-pill within 72 hours of last sexual intercourse. you were not likely to menstruate on your actual due date simply because it takes about 5-7 days for bleeding to occur after taking i-pill. it is also a known side effect of i-pill that the following menses may be delayed or may be heavy. in case periods do not resume in the next 10 days then you must do a urine pregnancy test to rule out pregnancy. if the test comes as negative then please do not take any medication. just wait for your periods to return till then practise barrier contraception. if the test is positive which is unlikely though keeping in mind that i-pill does not cause any congenital abnormalities in fetus you would need to make an informed decision as to continue or terminate the pregnancy (which can be done by medical methods in early first trimester after ultrasound scan confirmation). things can be tackled at each step. so please do not panic stress per se can delay your menses further. try to keep yourself relaxed. consult a gynaecologist online for further follow up --> <link> |
### Human:\ncan unprotected sex for a minute cause hiv?\n\n### Assistant: the chance of transmission of human immunodeficiency virus (hiv) by single unprotected intercourse with a hiv positive person is 1/200 to 1/1000. it is very low. she may be negative so she might have asked it. probably the test done was antibodies tests. it is considered as conclusive after three months. you can go for hiv-1 and 2 rna pcr (polymerase chain reaction) at this stage to allay your anxiety. the symptoms are not specific and do not suggest hiv. it may be due to any simple respiratory infection. you can get it examined by an ent specialist to relieve your anxiety about throat infection. for further information consult a hiv aids specialist online --> <link> |
### Human:\ni had unprotected sex. can hiv testing be a risk for me?\n\n### Assistant: let me answer your queries one by one. no you are talking about the case of extreme rarity and you have tested enough to prove yourself negative. your girlfriend has no chance to get acquire hiv. these are the most accurate test available and detect both antigen and antibody. no human immunodeficiency virus (hiv) testing will not cause a risk to you. i have seen two such cases in my residency. but you are not having hiv. for further clarifications consult a hiv aids specialist online --> <link> |
### Human:\ni had unprotected sex during my infertile days. can i be pregnant?\n\n### Assistant: please wait for a week for your period to start. if it does not start by then you will have to do urine pregnancy test to rule out pregnancy. period could have been delayed due to stress. another rare possibility is that of pregnancy. though you mentioned the days you had sex as your infertile days sometimes occasionally ovulation could be delayed making the days fertile. still you had taken emergency pill (though it is highly effective in preventing pregnancy protection offered is not absolute). so there can be little chance of pregnancy which you need to rule out first. if you want to rule out pregnancy earlier you can do blood beta-hcg test negative result of which will rule out pregnancy. other option as i told is to wait for a week. if pregnancy test comes negative and still period does not start you can induce period by taking tablet medroxyprogesterone acetate 10 mg twice daily for five days. period generally starts within a week of last dose of tablet. it will not induce period if you are pregnant. for further information consult an obstetrician and gynaecologist online --> <link> |
### Human:\ncan anxiety cause foot drop and twitches in the body?\n\n### Assistant: it is good that your foot drop is improving in a five weeks period. the twitches that you are feeling may be due to anxiety also. if it was als (amyotrophic lateral sclerosis) the foot drop would be unlikely to improve. as it is improving it is unlikely to be als. did you undergo any medical investigation for this foot drop? are you taking any medications for it? i suggest you undergo the following investigations. mri of the spine with a screening of the entire spine. ncv (nerve conduction velocity) of all four limbs. there can be many causes for foot drop. you should meet a neurologist for investigations to find reasons for foot drop and its proper management. for more information consult a neurologist online --> <link> |
### Human:\ncan hiv be transmitted through oral sex?\n\n### Assistant: frequency of sex has nothing to do with e. coli bacteria (escherichia coli). prostatitis is very resistant to treat so it is not necessary that if you have taken treatment it will not recur. sometimes you have to take 4 to 6 months of treatment for prostatitis. this is the main reason why you are still having the pain. semen and culture usually do not cover all std's (sexually transmitted diseases) and lower abdominal pain is a non specific symptom and can be attributed to prostatitis. yes hiv (human immunodeficiency virus) could be transmitted through oral sex. so if you know the person it is better to get her tested because if she is not hiv positive then you need no testing. nevertheless you can go for hiv 1 and 2 antibody test by elisa (enzyme-linked immunosorbent assay) method and hiv rt-pcr (reverse transcription polymerase chain reaction). i hope the above information is useful to you. for further queries consult a hiv aids specialist online --> <link> |
### Human:\nanxiety is every day of my life. rarely i do get a small break without anxiety. it has been 10 years.\n\n### Assistant: with your brief description it appears that you are suffering with some anxiety disorder most probably generalized anxiety disorder. the drug you are taking is neither sufficient nor appropriate when we are having a lots of safer and more effective drugs currently. i assure you that you can get rid of most of the anxiety symptoms with proper treatment. as you have the chronic problem you need to consult a psychiatrist online --> <link> |
### Human:\ni had unprotected sex and got ulcer in scrotum and mouth. will it be herpes?\n\n### Assistant: i assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. i have thoroughly gone through your case and can well understand your genuine health concerns. the probable causes:the scrotal issues are due to the dryness of the skin and skin hair follicle infection. there is hyperkeratosis on the scrotal skin. all of these issues develop due to unhygienic urogenital habit and unhygienic skin condition of the areas of the external genitalia. no need to worry as i am suggesting very effective remedies for you to get better in a short period. the mouth sores are due to throat infection and it looks like a mixture of bacterial and viral infection. so you need to start the treatment immediately. treatment plan:for genital skin issues:- 1. the most important medical remedy for you is to shave the area completely including scrotum pubic area and the groins with a blade. make it a habit to do undershave (armpits and the genital area) before the hair grow very tiny. 2. keep the area clean and dry and apply hydrozole (combination of hydrocortisone and clotrimazole) cream on the whole of the genital area including scrotum. 3. you should take a prescription for amoxicillin. keep taking paracetamol every 8 hourly until you no more have fever. 4. apply some gel like orajel (benzocaine) on the mouth ulcers and stay for 5 minutes. then rinse with tap water. 5. do gargles with scope mouthwash. take plenty of water and proper rest. regarding follow up:for further information consult an internal medicine physician online. ---> <link> |
### Human:\ni have anxiety disorder and was prescribed with 5mg lorazapam. but this dosage gives poor response. is it safe to take one more tablet?\n\n### Assistant: com. at this moment you can take another 0. 5mg but do not repeat it after that. tomorrow you can discuss your poor response to the 0. 5mg lorazepam either with your physician or you can discuss with me online if online therapy for a psychiatry consultation is fine with you. in my view 0. 5mg is a correct dose initially to manage anxiety disorder. hope another 0. 5 mg will help you at this moment. |
### Human:\nhad unprotected sex today. should my partner take contraceptive?\n\n### Assistant: if she is in her ovulation period then better to take an emergency contraceptive pill. ovulation occurs 14 days prior to the expected menses. imagine her periods is of 28 days then unsafe days are from 11th day of menses to 20th day. ovulation is unpredictable as the cycles of menses. so such a long unsafe period for extra safety. if you had sex before 11 days and after 20 days of first menstrual day then chances of pregnancy are very less. you need not take i-pill. if not then take i-pill at the earliest. for further doubts consult an obstetrician and gynaecologist online --> <link> |
### Human:\nsuffering from anxiety attacks which are of a sudden onset. i am a schizophrenia and heart attack patient.\n\n### Assistant: i assume that you are having good life with current medicines baring anxiety attacks. the possible reason for your anxiety attacks are: current medication- can you outline the onset of anxiety attacks after starting one or another medication that you are taking currently. part of schizophrenic illness- if you have these attacks irrespective of medication status that it is likely that these are the part of your schizophrenic illness. withdrawal effect of one or another drug- if you are inconsistent in taking your medicine then this reason is a strong possibility. the duration of anxiety attacks is one of the strong factor that determines the diagnosis. before we proceed for medication or treatment of these attacks you are requested to post more information about it. you can also book for an online phone or video chat consultation so the problem can be evaluated in detail. please provide the following details: duration of anxiety problem. frequency of problem. course over years or months. any association (decrease or increase) with current medication. duration of each episode. preceding factor to anxiety episodes. used coping skills by you. magnitude to which your life affected by anxiety attacks. any sleep problem palpitations dryness of mouth tremor restlessness. at this moment my advice is to shift the aripiprazole to morning time and continue the rest of the medicines. consult a psychiatrist online with the above mentioned details. ---><link> |
### Human:\nsuffering from anxiety and depression. doctor prescribed mirap and clonazepam. need a second opinion.\n\n### Assistant: mirap is a mirtazapine which is indicated for depression. in my professional experience it is not as efficacious as the ssris such as fluoxetine or paroxetine or citalopram. mirap at the dosage of 15mg does help the patient to sleep better but it is also known for significant weight gain upto 10lbs in 2 weeks. clonazepam is indeed an useful adjunct and helps with the anxiety component. but i only prefer to use it as an "as needed adjunct" and no standing doses. i can help you better if you are fine with booking a session for an online therapy for a detailed evaluation. |
### Human:\nmy 5 1/2-year-old son displays adhd symptoms for 20 days then for 10 days he has none. is it adhd or another condition?\n\n### Assistant: adhd and bipolar mood disorder (bmd) can coexist or be mistaken for one another. bmd usually is not diagnosed until young adulthood. however studies have shown that the earlier a person is diagnosed with bmd the more likely he is to have been diagnosed with adhd previously. in this case i would just like to reiterate that there is not enough information to discuss either possibility for your son. you mentioned that he becomes hyperactive for 3 weeks but not what his behaviors are like during those 10 days. you also do not mention irritability or mood swings just adhd symptoms. keep documenting the symptoms you are concerned about including what goes on in the home and at school when you see changes in behavior (do you work those weeks does he visit a relative or have a different aide in the classroom). you also mentioned that this began 7 months ago. i would also urge you to think about what also might have changed in your son's life about that time. consulting your pediatrician or a child psychiatrist should help you unravel the mystery of your son's behavior. |
### Human:\nmy son has add and mild autism. he has been successfully on concerta for 6+ years. can you help with his weight loss?\n\n### Assistant: stimulants in general tend to decrease appetite in certain not all children. over time this side effect seems to lessen but as in the case of your son for some children it may persist. weight loss is the result of this appetite decrease and not consuming enough calories during the day. therefore since the medication is effective and at "the perfect dose for him " right now i would suggest that you work on increasing your son's calorie intake. this however is often not an easy task! some suggestions include offering your son his preferred foods whenever he seems hungry; starting the day with a large calorie-laden breakfast early in the morning before the medication takes effect; increasing the calories in snacks during the day and at bedtime; and adding a high calorie supplement like ensure or shakes with ice cream etc. during the day. consult your pediatrician or a nutrionist to determine how many calories a day your son should be consuming and try to make sure this is the minimum he consumes to prevent weight loss. if you find this remains a problem i suggest you consult a pediatric nutritionist for additional suggestions. if the problems persists despite you and your son's best efforts you may want to discuss changing to a non-stimulant medication with your son's prescribing physician. |
### Human:\nmy son is 13 and is depressed. he has been taking vyvanse for the last 3 years and never had a problem. can you help?\n\n### Assistant: while any of the stimulant medications can increase depressive symptoms. it's important to pay attention to this change in your son's mood and take him to a mental health professional for an assessment. children diagnosed with attention deficit/hyperactivitydisorder (adhd) at early are more likely to suffer from depression as adolescents than those who did not have adhd according to a long-term study published in the october issue of the archives of general psychiatry. although it was an uncommon occurrence the children with adhd also were somewhat more likely to think about or attempt suicide as adolescents. the study performed by researchers at the university of chicago and the university of pittsburgh followed 123 children diagnosed with adhd at age 4 to 6 for up to 14 years until they reached ages 18 to 20. it compared them with 119 children from similar neighborhoods and schools matched for age sex and ethnicity. the researchers found that 18 percent of children diagnosed early with adhd suffered from depression as adolescents about 10 times the rate among those without adhd. children with early adhd were five times as likely to have considered suicide at least once and twice as likely to have made an attempt. please get your son evaluated. |
### Human:\nmy 17-year-old has stopped taking concerta after 10 years. what affect will this have on his adhd?\n\n### Assistant: seventy percent of teens diagnosed when they are younger continue to have symptoms of their adhd that affect their functioning as adolescents. once your son stops taking his medication (concerta) his symptoms will return relatively quickly. unless he has learned other compensatory techniques or has outside help his symptoms will affect both his academic performance in school and his relationships with others. if he is driving he may have more difficulty focusing and with distractibility. teens with untreated adhd tend to have more car accidents and get more speeding tickets. all of this should be explained to him and i would suggest that he go in for a visit to discuss this and his decision to stop his medication with his health care provider. i often use this situation as an opportunity for the teen to learn more about how his adhd affects him and why or whether he need to continue his medication to treat his symptoms. |
### Human:\ni've been taking respa-ar for allergies. i can't seem to get it refilled. will it be back on the market soon?\n\n### Assistant: try claritin-d which is located behind the pharmacy counter. i'm not sure if or when respa-ar will be back on the market. |
### Human:\nwhat is the role of a pharmacist in a community and how can he/she help a patient?\n\n### Assistant: i am very happy to answer this question. the pharmacist is the medication expert. we go to school for over six years and we focus on medications and how they work. i practice as a community pharmacist and my goal is to make sure my patients are taking their medications correctly protect them from drug interactions provide patient care services like medication therapy management and help them understand their disease. medications have a lot of side effects and can interact with foods over-the-counter medications vitamins and herbals. we should be a resource for you -- after all we are the most accessible health care provider! in many states you can now get your flu vaccination from a pharmacist. we should be a "vip" on your trip to the pharmacy. get to know us on a first name basis. (we don't bite i promise! ) always ask to speak to the pharmacist when you are picking up or dropping off a prescription; you can get some valuable information. we can advise you of side effects or answer even the most basic question of "what is this medication for? ” the best part of my day is talking to patients and making a difference. |
### Human:\nmy daughter is 15 months old has had severe feeding issuesshe lives on applesauce and fruitmelts and formulatests normal. she has had feeding issues since birth formula refusal throwing up entire bottle 2 to 3 times a day she also has hip dysplsia so far medical test are normal what should i do what is the matter with my baby\n\n### Assistant: get an evaluation asap. you can start with your pediatrician but sure to ask for a feeding evaluation which usually consists of a team of professionals. sometimes doctors will be hesitant if growth is on track but if a child is taking solid food by 12 months that is a red flag. the sooner she gets help the better. good luck! |
### Human:\ndoes your body know how many calories you eat or can you eat regularly but <1200 cals a day? . i am trying to lose weight. i have always been able to skip eating but now i am eating "something" every few hours. i have lost weight but want to lose more. i don't want my body to think it is starving if i don't adhere to 1200 calories a day. as long as i give my body food every few hours regardless of the caloric content. is that enough to keep metabolizing? one example is: i eat a raw red pepper at about 50 calories for a mid morning snack. it is food in my body but very low in calories.\n\n### Assistant: your body responds to food intake with hunger and fullness. even if you eat every couple of hours if it's not enough to fill you up you will likely get hungry. i don't know of any way to trick the body. that being said it is beneficial to eat filling foods with fiber like fruits vegetables whole grains and beans. i highly recommend you see a registered dietitian to help get you on the right track. if you lose weight gradually with proper nutrition it will be better for you and much easier to maintain (the hardest part of weight loss). also a dietitian can address any other issues that may be getting in the way of a healthy lifestyle. to find a dietitian in your area go to eatright org. good luck! |
### Human:\ni have trouble swallowing pills. can my prescription be made into a liquid?\n\n### Assistant: some medications are available in liquid formulations. many other medications can be made into a liquid formulation by a compounding pharmacist. be sure to let your health care provider know you have difficulty swallowing medications. they should be able to accommodate you. |
### Human:\ni need a list of foods that i can eat and list of foods to avoid with pancreatitis.\n\n### Assistant: generally a diet free from alcohol and low in fat is recommended for pancreatitis. i recommend you ask your doctor or dietitian how much fat you can consume per day (in grams). that way you can be sure you staying under where you need to be. these are general low fat diet recommendations: no fried foods or foods cooked in a lot of fat. if eating out always ask how the food is prepared. limit nuts seeds oils avocado salad dressings and butter naturally high in fat. you do need some fat but go easy on these items. choose lean meats and low fat dairy products. eat plenty of fruits vegetables and whole grains naturally low in fat. consume small frequent meals as they are more likely to be tolerated. for more tips on low-fat eating see this article. |
### Human:\nhello. i have heard that a whole foods plant-based diet reduces cancer risk. is this true? . there is a lot of cancer risk in my family but i want to live a long life.\n\n### Assistant: yes plant foods are associated with decreased cancer risk especially fruits vegetables whole grains and legumes. add more of these to your diet while limiting red and processed meats and you'll benefit over thelong run. for more on diet and cancer prevention see this webmd article. |
### Human:\ni am on a low carb 1600 calrie diet i am 224 pounds 45 year old male my weight is not coming off? . supplements; protein thermobol glutamine creatine.\n\n### Assistant: it's tough to say without more information. here are some possible reasons: you are not at the right calorie level. how did you decide on 1600 calories? a dietitian can help you figure out a meal plan -- and calorie level -- that is individualized to meet your needs. you may be over-consuming calories without knowing it. look for hidden sources of calories in liquids eating out and alcohol. a low-carb diet may not be right for you. everyone is different in how they respond to diets. maybe a change is needed. medications and activity can make a difference. always check with a doctor. your don't have much to lose. if you are very tall or always been bigger than average you may not need to lose much weight. if your health is good focus on incorporating and maintaining healthy habits instead. getting help from a registered dietitian can help you get to the root of the issue. for more potential reasons you aren't losing weight see this article. |
### Human:\nwhat can be absorbed by the stomach? . what percentages of various normally consumed foods and liquids can be absorbed into the body through the stomach. while i understand that the intestines absorb most of the nutrients we consume i was lead to believe that a potion of some foods and beverages were absorbed into the body through the stomach.\n\n### Assistant: the stomach does not absorb nutrients but it does play a role enhancing absorption of certain nutrients in the small intestine. for example the stomach secretes intrinsic factor which binds to b12 for absorption in the small intestine. stomach acid turns iron into a form that is better absorbed in the small intestine. and people who have part of their stomach removed may be at risk for osteoporosis because the stomach empties faster which can decrease the amount of calcium being absorbed and utilized by the body. anyone who has surgery to remove part of the stomach should see a dietitian to be sure they are not at risk for nutrition deficiencies. |
### Human:\nis it safe to have another baby after i delivered three by c-section?\n\n### Assistant: you can certainly consider having another infant. however all the information in our literature would tell you not to consider having an attempt at a vaginal birth. you are at too high a risk to consider this. i think of myself as very progressive and will always consider a vbac for patients but not someone like you. the issue for you becomes the more c/s you have the higher the risk of possible placental abnormalities. if the placenta lies over the cervix (called a placenta previa) with the number of c/s you have had there could be a significant problem that could occur (called a placenta accreta). you should always discuss with your health care provider your concerns. |
### Human:\nwhy does a1c jump up? 6. 2-11. 4. over the last 2 years my a1c has been 7. 8--7. 4--6. 4--6. 2 then this past check-up it jumped to 11. 4. i have never had one that high. i have not changed my diet--i have actually shed about 10 more pounds. i don't understand what happened.\n\n### Assistant: there could be a few things going on. first if you don't test your blood sugar regularly you don't know for sure that they haven't increased for some reason. some potential reasons include changes to medication. engaging in more or less exercise and timing and quantity of food/drink intake. if you drank more alcohol on vacation for instance that could cause blood sugar spikes. if you have been checking your blood sugar -- and they have been good-- than i recommend contacting your doctor to see if your a1c was either an error or due to something else. good luck getting to the bottom of this! |
### Human:\nbmi of 35. i am 29 a woman who is 4'11 weigh 178 lbs. my breasts are over dd. i am not fat. how can my range be obese? . i have large hips but they are mostly muscle. my breasts are the only other large fat content place on my body. are there better ways of determining a healthy weight?\n\n### Assistant: bmi is just a classification of weight and not a determinant of health. that being said carrying extra weight can increase health risk. first i would consider your size over time. have you always been this size or have their been increases lately? if this seems to be your normal weight than it may just be where your body wants to be. if it has increased lately you may want to take note of what has changed to see if it has affected your weight. next would be to look at your other health-related numbers. if you cholesterol blood pressure and blood glucose are all normal than those are positive indicators of health. regular exercise and a health diet matter too! lastly where you carry excess weight makes a difference. those who carry fat in the abdomen tend to be at higher risk for chronic disease like diabetes and heart disease. in particular figuring out your waist-hip ratio can help you determine if this is a concern for you (see this article for more information). weight is just one piece of the health puzzle. finding out about all the other pieces can help a great deal! |
### Human:\naccording the the paleo diet experts oatmeal is not good for you because it causes "inflamation. " is this true?\n\n### Assistant: some people claim grains -- even whole grains -- cause inflammation. but there is no solid evidence in humans to back this up. people with autoimmune diseases may have difficulty with certain grains especially those with celiac or gi disorders. but for healthy people there is no research to support this point. in fact people who eat lots of plant foods like whole grains tend to have decreased risk of inflammation like vegans <link> oatmeal in particular helps lower cholesterol and keep people full. randomized control studies are needed to prove this "grains cause inflammation" theory. |
### Human:\ntaking a stool softener nightly and a probiotic in am each day? . i am on detrol la for oab. it causes constipation. i had a bad episode in may 2015 and after my dr got me all cleaned he said to take a stool softener to get regular again but i also added a probiotic as well. . i am now having a bm each day but several a day. my question is really are they counter acting each other (stool softener vs. probiotic) - would the probiotic be the best way to go vs. the stool softener to combat the constipation (my fiber intake is better now also via my diet).\n\n### Assistant: i see no reason why they would counter-act each other. i'm not clear if your doctor wanted you to keep taking the stool softener or just take it to get your bowels moving. often times they are given temporarily. if your fiber intake is up -- and you are having more bms -- you could slowly taper off the stool softener. i would contact your doctor first since he/she prescribed it. probiotics can help with constipation but it depends on the strain. |
### Human:\nwhat vitamins are recommended for a 63-year-old with a spinal cord injury\n\n### Assistant: that will depend on what you are eating and your blood work. people with spinal cord injuries may need additional protein and fiber but that is not contained in vitamins. at regular physicals your health care provider should check things like vitamin d b12 and iron do see if you have any deficiencies. also a registered dietitian can help you determine if you need to make changes to your diet and supplement routine. for more see spinal cord injury: dietary issues |
### Human:\ni have frequent constipation feeling bloated and have bowel movements around 4-5 days on average. large-hard stools. that are difficult to pass and i'm asking now because it's been getting worse the past year or so and effecting my every-day life. <negative_smiley> what should i do? are probiotic supplements a solution?\n\n### Assistant: any sudden changes in bowels should be checked out by a healthcare provider. here are some things you can do in the meantime: increase fiber: gradually increase fruits vegetables whole grains and beans/legumes. these foods contain fiber that help with constipation. it's recommended women (19-50) get 25g of fiber daily and for men (19-50) it's 38g. see getting enough fiber. stay hydrated: while increasing fiber make sure you get enough water. when you are dehydrated water is reabsorbed from stool resulting in hard stools. keep active: regular activity also helps relieve constipation. walking dancing and hiking are just a few ideas to keep your body moving. add fermented foods: look for ways to increase foods with probiotics such as yogurt kefir and probioitc drinks. adding a probiotic may help but the research is not clear on this. see probiotics and digestive health. manage stress better: anxiety worry and stress can all affect your gi tract. working on healthy ways to handle daily stressors can help! see stress management. |
### Human:\nlactose intolerance. does lactose build up in your system so as to have issues over a series of several hours/meals? and do acidic foods exacerbate symptoms?\n\n### Assistant: lactose does not build up in your system but the severity of symptoms can be more severe or lasting depending on how much and other foods you ate. if you are having gi discomfort acidic foods may exacerbate your symptoms. for info see lactose intolerance -- topic overview |
### Human:\nhow much protein should someone with gout consume? . since higher protein foods can trigger gout attacks how much protein is safe for someone with gout?\n\n### Assistant: most helpful answer instead of thinking putting a cap on protein your better off balancing the type of protein foods in your diet. here are some tips: don't exceed 6 ounces of animal protein like chicken fish beef lamb or pork daily. 3 ounces is the size of a deck of card. you can get additional protein from low fat dairy sources such as yogurt milk and low fat cheese. plant sources of protein like nuts and nut butters are good and healthy too. avoid certain type of meat like organ meats an fish such as anchovies herring scallops trout and tuna. a dietitian can help individualize information to your specific preferences and lifestyle. journal about your trigger out your trigger foods -- see this article. |
### Human:\ndo ace inhibitors cause weight gain? . long term user of ace inhibitor and have gained a lot of weight. is there a connection.\n\n### Assistant: weight gain is not a common side effect of ace inhibitors. i suggest you see a registered dietitian to help you figure out the source of your weight gain. see this article for more on ace inhibitors. |
### Human:\nfruit is big part of my diet but i'm having issues with urge intontinence. what fruits won't irritate my bladder? . i recently saw a urologist for having severe issues with urge incontinence feeling like i had to go as frequently as every 10 minutes. he determined stress in my life was causing my muscle around my bladder to flex. i've recently been put on anxiety and stress medication which seem to be helping with that but the urge incontinence is still pretty bad a lot of the time. i've read a ton of fruits which are a huge part of my diet can cause bladder irritation. what fruits are best/safest to eat?\n\n### Assistant: the most problematic fruits that irritate the bladder are citrus fruits like oranges grapefruit lemons and limes. fruits that aren't acidic like pears apples grapes and melon are better choices. for more on trigger food and drinks see this webmd article. |
### Human:\ndoes acupuncture aid weight loss\n\n### Assistant: some science reveals that certain types of acupuncture may aid weight loss. acupuncture works by targeting pressure points linked to appetite and hunger. that being said acupuncture treatment does not trump making changes to diet exercise and how one handles stress. research shows diet changes are most important for weight loss. see ear acupuncture holds promise for weight loss. |
### Human:\nhow can i prevent nose bleeds ana are they linked to a deficiency of vitamins?\n\n### Assistant: there is no evidence that nose bleeds are linked to a deficiency in vitamins the only nutrition/lifestyle related contributor is high blood pressure and smoking. this article provides tips on prevention and potential causes. |
### Human:\ni eat 1 200-1 500 calories a day. is that enough? . i'm 19 5"3' female and weigh 120. for the past at least five years of my life i've been eating 1 200-1 500 calories which leaves me feeling satisfied energized and maintaining my weight. i've been eating a very healthy vegan diet and have eaten pretty healthy my whole life. i feel like i'm eating enough and i'm maintaining my weight but our "experts" say i need to eat more. i feel like if i ate more i would just gain weight but i'm at a healthy weight now. i exercise moderately.\n\n### Assistant: calorie needs are individual and depend on age gender lean body mass and your level of activity. since you are not overweight i wonder why you count calories at all. it seems to me if you eat well balanced regular meals and let hunger and fullness guide your eating you will get the right amount for your body type. emerging research shows that young adults who eat this way (often called intuitive or mindful eating) have lower bmis -- and disordered eating -- then those who don't. it may be that you started counting calories to lose weight 5 years ago. but i say ditch the calorie counting and learn how to trust and nourish your body instead. read more. healthy eating: recognize your hunger signals hope your weight is 120 pounds and not 120 kg. if the current calorie intake keeps you satisfied and energized you do not have to worry at all. if you are following any diet chart see to it that your calorie intake is between 1800-2100 calories which is normally recommended for a healthy person. |
### Human:\nwhat causes a large uterus?\n\n### Assistant: there are a few reasons for why the uterus measures larger than the dates. the most common reason is you are further in the pregnancy then you think. but since you had an ultrasound exam this is not the case. another reason could be you are carrying more than one child like twins. but if you had an ultrasound exam they should have seen this (although this can be missed). uterine fibroids (benign muscle tumor) of the uterus can make the uterus larger then you think. the other thing it may be is your doctor is wrong. it is just an estimation. i would not be too concerned about it at this time. when you see your doctor ask him about what the ultrasound exam showed. you can also call the office and speak to someone to read you the ultrasound results. uterus larger than the dates:? = wrong date (lmp) =polyhydramnious (excess amount of amniotic fluid in uterus) =larger baby (macrosmia) =multiple pregnancy =molar pregnancy =uterine fibroids =pelvic mass uterus smaller than the dates.? =wrong date (lmp) =oligo hydramnious =smaller baby (microsmia) =head engaged too deeply =genetic (maternal paternal small size) =intrauterine growth restriciton (iugr) =intrauterine death (iud) |
### Human:\nis eating fruit bad after meal?\n\n### Assistant: no eating fruit is great because it's healthy and sweet. and most people don't get nearly enough fruits and vegetables i n their diet. fruit contains vitamins antioxidants and fiber. of course if you're not hungry or are full than eating more food -- even fruit -- is not beneficial. |
### Human:\nvery high metabolism! very skinny! need help gaining weight! . help! please! i have a very very high metabolism and its impossible for me to gain weight! i am 17 years old. im about 5ft 7" and only weigh around 107 lbs. and its hard for me to consume loads of food because of school! (6am-3pm) so i need help! i need a plan for me because im so confused where to start. i also have this problem where i get full quick and get hungry quick. and if there's any pills i could take that could help me that'd be great\n\n### Assistant: early fullness could be a sign something else is going on so i recommend you get a physical and talk to a healthcare provider. i also recommend you see a registered dietitian for individualized advice. you can find a dietitian in your area by going to eatright. org. in the meantime here are some things you can do to get started: eat regular meals and snacks every day (5-6 times daily). try to plan your meals ahead of time and have items you can put together for quick meals. include 3-5 food groups at meals including a whole grain protein (meat/beans/nut butter) fruits vegetables full-fat dairy (whole milk/yogurt) and healthy fats. for example in the morning you might have a big bowl of oatmeal topped with fruit and nuts and a side boiled egg. lunch might be a big sandwich salad and soup. include 2-3 food groups at snack time which may consist of cheese and whole grain crackers or an apple with peanut butter or half a meat sandwich with veggie sticks. try to include at least one fat source at every meal: butter or nut butter on bread nuts on cereal salad dressing on greens etc. for more tips on how to gain weight in a healthy way see this article. |
### Human:\nhow long after changing my diet should i expect to see a drop of my blood sugar scores? . just curious. have recently been diagnosed with type 2 and have changed my diet significantly. how long before a diet change would influence my numbers?\n\n### Assistant: changes to your diet can have an immediate affect on your daily blood sugars. but as for as your hemoglobin a1c levels that takes about 3 months to see a difference. that is because the test measures blood sugar management over a 3 month period of time. if you keep your blood sugars down consistently your next test should decrease quite a bit. for more read glycohemoglobin (a1c) |
### Human:\nis adhd a chronic condition meaning medication will always be necessary? . an 11yr. old boy in my family has been taking medication for adhd for over 5 years. i'm aware that a usual side effect of his medication is loss of appetite which he experiences. in a group of boys his age playing baseball he is one of the smallest boys. are there alternative medications/treatments that would improve his appetite and possibly allow him to reach a more normal height/weight? i'm concerned this height/weight difference is beginning to cause or will cause self-image issues.\n\n### Assistant: it's important for you to keep in contact with the doctor to check if medication is needed and the different types available. not all affect appetite the same way. also some may allow you to skip taking them on the weekends when not in school. again researching and working with your doctor is key. as far as nutrition goes a pediatric dietitian can help you maximize nutrition for your son even while he's on medication. she or he will help you troubleshoot fluctuations in appetite and how best to time food offerings. also what combination of food and supplements are beneficial. also your son may be smaller due to genetics so consider your family history too. more reading: adhd drugs and growth |
### Human:\nhow whey protein might interacts with gluten intolerence. for the last few days i've been awakening with extreme fatigue and an oppressive headache both of which can last all day and are the exact symptoms of my gluten intolerance. after double checking my regular diet they only thing if found that seem the slightest bit suspicious is whey protein which is contained in the chocolate frosting i used sometimes. thus my question. any thoughts? . thanks sam\n\n### Assistant: first off i would call the company to be sure it is gluten free. if that's not it you may want to consider seeing a leap dietitian who can help you identify if there are other foods linked to your symptoms. often times someone with gluten intolerance will have difficulty with other foods. you can find a dietitian in your area by going to eatright. org. good luck! |
### Human:\ni read an artical that said you can take more than 10 000iu of vitamin d3 for weight lose. is that true? health risks?\n\n### Assistant: vitamin d is not given for weight loss but it is common for people with excess weight to have low vitamin d levels. a doctor may prescribe very high levels to bring levels back up. it is not recommended for someone to give themselves more than the tolerable upper limit of vitamin d (4 000iu) unless prescribed by a doctor. although toxicity is rare it can occur causing increased calcium levels in the blood. for more on vitamin d supplementation see this article. |
### Human:\nis pure almond extract considered a food allergen? . i am a cake and cookie designer and i am creating allergen content labels for my vanilla almond cookies. i use pure almond extract. is this considered a food allergen?\n\n### Assistant: yes it is. almond is a tree nut which is considered a food allergen. |