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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 my age 28 yearsheight 6 fitweight 58 kg i have TB in my past Presently iam healthy seminal report is quantity 20mlcolour milky whiteconsistency thick liquidreaction alkalnePH 70 total cout of sperms 10 million Dear Doctor my age 28 years,height-6 fit,weight 58 kg, i have TB in my past Presently iam healthy seminal report is quantity 2.0ml,colour-milky white,consistency-thick liquid,reaction-alkalne,P.H-7.0, total cout of sperms 10 million/ml of semen Motality after 1/2 hours total motile-10% active motile-10%,moderatelymotile-10%,sluggeshly motile-20% ,non motile-60% after 1hour total motile-8% active motile-5%,moderatelymotile-10%,sluggeshly motile-25% ,non motile-60% after 4hour total motile-2% active motile-00%,moderatelymotile-5%,sluggeshly motile-15% ,non motile-80% micro scopic morphology-10 to15% immature forms 08 to 10% tail less-02 to 04 %,pin head 01 to02%,W.B.C-4-6/hpf,R.B.C-no found, epithelial cell-not found,trichmonous-not found so pls tell sir i can be a fatheror not if not treatments are avilable for me. and duration as per abnomality which shows in my report. so taking medicine after showing doctor he gave me siphene-m and carnisure 500mg tablet and advice it to take two months so tell sir/mam it is right treatment for me and i will be father or not if yes how much time it will take.
### output:
| HELLO WELCOME TO Chat Doctor YOUR SEMEN REPORT IS NOT NORMAL. SPERM COUNT AND MOTILITY IS LESS. SO YOU HAVE PROBLEM TO BECOME FATHER. GIVEN TREATMENT IS RIGHT. IF NOT RESPOND THAN THERE R SO GOOD MED IN Homeopathy FOR INCREASE SPERM COUNT. FOR THAT WE REQUIRED MORE HISTORY PLS. MAIL ME MORE DETAIL Chat Doctor. Com there are so many mechanic also available nowadays so don't worry you will get result for your problem. 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, I am trying to conceive now , Follicular scan showed 1.2 mm by .7 mm follicle on my left ovary on 11th day . I have pcos and have irregular periods. Today is my 14th day , what are the chances of me conceiving this month ? I am taking melmet 1g and floic acid 5 mg.
### output:
| Hi, How are you doing ? Scan report is not reassuring. Follicles reach up to 13 mm then they stop, typical of POD. If they don't grow, they will not rupture & so no chance of pregnancy. Why don't you try to break the hormonal imbalance of PRO, so that may be you will get pregnant even without treatment. May I suggested is usually associated with Obesity, irregular cycles, no periods for few months & later heavy periods with clots & fleshy masses, or spotting on & off, Thyroid abnormality & prolactin problem indirectly. You develop that extra-pad of fat around the midsegment of body, especially waist, thighs & breast, no fat beyond elbow & knees. Excessive body hair growth, hair fall, dark shade over lower half of face, acne, oily face skin, black skin over back of neck, inner thighs & under surface of breast. May have a family history of Diabetes, especially father or his family. This will not allow ovulation to occur at time & so you cannot get pregnant, till treated. It also increases your chances of early pregnancy abortions. But this has a solution. Just delay pregnancy for few months. Your weight has to be Weight(in Kg)= Height (in CMS)-100eg- If height 160cms, 160-100= 60-65 kg is expected weight. Once you reduce weight to normal range, you won't need any medicine to get periods or to get pregnant & pregnancy will be healthy. To reduce weight -NO FASTING, No junk food/ fast foods/ red meat, reduce snacks in between mealsHave low calories' food, high proteinsRegular exercise, aerobics, yoga, brisk walking try to reduce 2-4 kg / month. Don't hurry on weight reduction, it will be difficult to maintain. As soon as you reduce at least 5 kg, you will see changes. Even if you are in normal weight range, try this schedule, it will help. Once this hormonal imbalance is corrected, not only chances of pregnancy is increased, but also the chances of abortion is significantly reduced. Hope I have clarified your query, do write back if anymore queries the best 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:
My Mum has been diagnosed with stomach cancer. She is 85 and it seems like it has not spread anywhere else. The doctors have told us that the treatment would be too harsh for her as she is quite frail. How long can one live with that kind of diagnoses. Thank you(Ireland)
### output:
| Hi welcome to ChatDoctorI have gone through your query and found that your 85 years old mother is caught with stomach cancer. In a way, doctors are right . Instead of giving her any harsh treatment, give her some Alternative therapies . I would like to know since how long she is suffering ? What all the symptoms of her sufferings ? Is she active Any vomiting ? Color ? Has no constipation ?other things to be mentioned ? Can be administered proper remedy after knowing the details.Meanwhile, give her Homeopathy is one them, tried and tested, successfully, in some cases G Meanwhile give her Carcinogen 200 weekly twice 1 dose . Then fortnightly thereafter. Keep vigil on her diet. Give her simple, nourishing diet containing fiber vitamins, minerals antioxidant diet suitable to her age . You can check from treating doctor, or a dietitian. Supplements which have no side effects can be administered to her which are rich in antioxidant properties. Lemon has strong anti-carcinogenic properties that are already been proven. Mixture, of extract of Lemon, Ginger, Garlic , Vinegar of coconut water, Bark of Maringá (Saharan) tree, Honey all in equal quantity in a dose of 15 ml, twice a day. With same quantity of water, before meals for 31 or 41 days as per requirement.a great antioxidant. Is good healer and also preventive. Take a 1/4 t spoon of turmeric powder twice a day, in a cup of hot milk after meals, Meals should be simple nourishing and easily digestible. Take care not to have constipation. Do Panama - Deep breathing slowly, according to her age & capacity & Walk for resistance against diseases and to strengthen the vital part of the body. Many heart and cancer patients have been benefited from this. You Can also apply Treatment by magneto therapy, is very simple and effective treatment gives resistance against diseases, is curative as well as preventive method of treatment, having no side effects Regular fort nightly or monthly check up from treating doctor is highly appreciable . Hope this gives reply to your query Take care. All the best & get well London hesitate to get back if you have any further query any doubt get back at Chat Doctor. Com |
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 m from Bangladesh... My daughter age is (3 years).. she do not eat any food (like khichuri, egg,rice) sometimes she eat some meal... but she only eat milk... when she was hungry only taking milk... my friend suggest me e practin syrup.... what i can do? plze help me.... (her weight &height also perfect but she does not take her meal properly)...
### output:
| Hello, Let me begin by saying that all tonics and medicines are unnecessary. All attempts at forcing her to eat must be stopped. There must be no persuasion on your part, no coaxing, no bribing, no threatening, and no punishment. All tricks to make her eat must be absolutely stopped. No walking about the room. She should sit up at the table and eat the food or leave it. Mother, you avoid anxious looks at the plate and no need for praise when she eats her dinner. No negative attitude if she does not eat and no suggestion that she is being naughty. Your daughter should not be prevented from doing what she wants to do because she has not eaten her dinner. If she does not want the meal, it should be taken from her. There should be nothing between meals. This includes milk. She must wait until the next regular mealtime. If it happens again at next meal, she should still be left without food. She will soon eat when she gets hungry and no one makes a fuss about what she eats. You may allow her to eat some meat course, then dessert, and return to the meat. Her mother, you, should make it plain that the food in front of her is all there is and that if she does not like it, she can leave, but that is all there is. Make her food attractive, with bright colors. Put a small amount on her plate and let her ask for more. There should be variety, so she does not get tired of one food. With her poor appetite, give her no more than a pint of milk per day. She should be allowed to help prepare the meal, helping with potatoes, fruit, and pastry. Allow to have meals with her parents or other child Chat Doctor. If she is playing with her food when the rest of the table has been cleared and washing up has been done, her food should be removed. If she cries, make no fuss, just allow a reasonable amount of time for her to eat, and then without any threats or argument, remove the food. See that she gets as much outdoor exercise as possible and avoid over-fatigue. A healthy three-year old needs 11-12 hours of sleep over a 24-hour period. 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 Doc, I have some questions for you. I experienced rapid heart beat last night after I ate fried fish and red spots occurred all over my body and I felt like my head was so hot that it seems like its going to burst. Everything went back to normal after I drink soft drinks (sprite). My parents gave me anti-allergy medicine but I was afraid to take it because It might make it worst. I also experienced this last week, after eating dried fish. I am 22 years old now, and when i was in Grade 5, i had an asthma attack. I cannot breath air and was taken in ICU after I ate Tuna Fish. Only those times I have those kind of reactions but most of the time nothing happens if i eat any kind of fish. Do you think I am allergy to fish, doc? What kind of allergy is it? If it will happen again next time, will it be a threat to my life?
### output:
| Hello. Thank you for asking at Chat Doctor. I went through your history. As you are not experiencing symptoms every time you eat fish, first I would think of Histamine fish poisoning rather than fish allergy. Histamine fish poisoning is a relatively common type of food poisoning. It occurs after consumption of improperly preserved or inadequately refrigerated fish (Fish require stringent refrigeration for preservation). It occurs due to presence of excess of a substance called histamine in the fish. The symptoms are the ones you described - skin rash, itching, headache, palpitation, sometimes breathlessness, etc. The symptoms develop within a few minutes of consumption of fish and usually subside by 6, rarely last up to 12 hours. A very important thing to know is that it is not possible to know whether the fish is likely to cause histamine poisoning by look or even taste of the fish. It looks and tastes same. Only sometimes one feels a typical peppery or burning taste in mouth while consuming fish, one can suspect it is rich in histamine and one should not consume it. Usually antihistamines medications like chlorpheniramine and sanitizing are used for treatment of symptoms. So, in your case, I would think of Histamine fish poisoning rather fish allergy. It is even more common wish some variety of fish like Tuna, Sardine, Mahi-mahi, etc. It is not an allergy. Furthermore, it is usually benign and self-limited, but rarely it can cause death. If you experience any serious symptom like difficulty in breathing, dizziness, palpitation, etc. it is advisable to go to ER and get examined by physician and treated. Hope this will be helpful to you. Wish you the best of the 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 been told I have temporal artiritis and the pr thing too.... diag on 4-29-15 - been on prednisone since and now my sed rate is back to 90 after going from 90 to 26 to 23 to 30 to 46 now I am back taking 60mg of pred everyday with no relief from headaches and pain - seeing a specialist on Monday - what other options are out there to reduce my sed rate??
### output:
| Hi welcome to Chat Doctor I have gone through your query regarding high level of sedimentation rate can understand your concern. Dear, I would like to know your age, are a male or female ? . ESR is no doubt quite high. Normal rate should be 0-20, and 0-30 in above 50 elderly female and 0-15 and in above 50 elderly male 0 - 20 in male For your info, most health problems are outcome of weak immunity due to our faulty lifestyle and food habits. Modification by following regime, of regular exercise, walk, yoga, Panama, meditation for proper blood circulation & cleansing of body and mind and including intake of essential nutrients regularly , helps strengthen immunity and gives resistance from diseases. High ESR levels can be outcome of inflammation of your arthritis and can be the side effect of its medication Prednisone. There are foods that can help to reduce inflammation. Balanced Diet rich in fiber , vitamins, minerals and antioxidants in natural form and antioxidants -ginger, garlic, fresh vegetables, fruits and flax seeds, blueberries and cranberries , pineapple. Omega-3 fatty acids, found in the oil of fatty fish, & Olive oil contains a type of antioxidant can provide extra protection against inflammation . ., A spoon of Turmeric powder with a cup of hot milk +a spoon of Almond oil at ed time is a natural antibiotic, antioxidant, helps alley pain and inflammation. Lemon juice with warm water, a pinch of salt and black pepper is an effective antioxidant and energizer. Avoid food that is high in saturated or trans-fats like fried, fast foods, refined sugars and fine floor products , tea, coffee, alcohol, sleeplessness, dehydration, constipation.worry, stress all induce toxins in your body.,it is advisable to consult your doctor before following any regime Hope this helps solves your query. Take care, All the best.Don't hesitate to get back if you have any further 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:
HI, I have a severe toothache (upper back jaw)and I did see a dentist yesterday and they said all my teeth were fine.I even did an xray but everything seems normal. I suspected for sinusitis. I did have a sore throat flu and fever couple of weeks ago which doctor prescribed an antibiotic for it. Then my fever and flu gone. But I noticed my nose not fully clear always feels congested but not runny. Few days ago I started having this very painful toothache which I cant sleep at night. It came and gone once in a while . I took a painkiller to ease the pain(paracetamol 500mg).I went to see a doctor yesterday afternoon and she gave me loratidine,pesudoeprine,piritone and flomist spray.But last night I still have a very painful toothache,and this morning again after taking all the medication the doctor prescribed 2 times (last night and this morning).I will go to another clinic for second opinion after this.For information I did feel a ittle bit pain when pressing the front face beside the nose(test for maxillary sinusitis).It is really painful although it come and gone once in a while.Any advice or recommendation? I was thinking of taking antibiotic for maxillary sinusitis for a week or so and monitor before meeting ent specialist.What do you think? Please help me doctor.Thank you.Abdul Rahman Halim.
### output:
| Hello, Your tooth discomfort may very well be related to your sinusitis. This is not uncommon. Please be careful before introducing more antibiotics. You may need a change in the antibiotic or a stronger dose, if what you have taken has not been fully effective. Please consult your doctor before taking any antibiotics. Definitely take medication to reduce discomfort due to congestion. This will help determine if you have an issue with the tooth, or it is merely a reaction to the inflammation caused by the congestion. Inflammation and the accompanying discomfort needs time to heal. Keep this in mind and try and reduce your discomfort while giving more time to heal. My suggestions are to use a toothpaste for sensitive teeth, fluoride rinses, maintain good day dental care, follow a bland diet with no acidic and spicy foods. Your mouth may be acidic and this can cause a sensitive reaction at the gum line. This can be severe if you have root exposure or recession. You may also be breathing through your mouth with the congestion. This creates a harsh environment and Chat Doctor. Your plaque is much harder to remove. Please make sure you are well HY |
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 STARTED TAKING LYRICA PREGABALIN ABOUT 4 TO 5 WEEKS AGO.HAVE SUFFERD WITH CHRONIC PAIN IN MOST OF MY JOINTS FOR ABOUT 4 YEARS NOW. OSTEO ARTHRITIS IN LEFT HIP BOTH KNEES. HAVE HAD TKR ON R/ KNEE. NOT SUCCSESFULL, STILL VERY PAINFULL WHEN BENDING. SPONDOLOSSIS IN MY BACK. BOTH L/R SHOULDERS TORN LIGARMENTS.THIS IS CAUSING PAIN IN MY NECK MOVEMENTS. HAVE MANY SLEEPNESS NIGHTS BECAUSE OF THE PAIN. I AM WORRIED ABOUT SOME OF THE SIDE AFFECTS OF THIS MED. LYRICA.. BED IS MY WORST ENEMEY. PAIN BECOMES WORSE. SOME SIDE AFFECTS SINCE I STARTED TAKING LYRICA. MEMORY LAPSE, DRY MOUTH, CONCENTRATION, PIN PRICKS NUMEROUS PARTS OF MY BODY,DROWSINESS,UNSTEADY ON MY FEET, ITCHING,HOARSNESS IN MY VOICE, WEIGHT GAIN OF 6 KIL, DIAREAHO AT LEAST ONCE A WEEK, AND EVEN CONSTAPAITTION SOMETIMES I THINK I SHOULD STOP TAKING THIS MEDICATTION . YOUR ADDVICE WOULD BE MOST WELCOME. REGARDS PATRICK ARNEL..
### output:
| Hello, Pregabalin can cause side effects like unsteadiness, memory loss, lack of coordination etc. The alternative is non-opioid analgesics like Acetaminophen and topical analgesics like Lidocaine patch, at a dose of 1.8 % or 5 %-applied over the sites of pain for up to 12 consecutive hours per day. Capsaicin 8% patch -up to 4 patches are applied once for 30-60 minutes. Over the counter preparations (Index)of menthol, methyl salicylate though weaker have an effect on pain. Anti-depressants like Duloxetine, Amitriptyline have also been used for chronic pain and benefits are outweighed by side effects in most patients. Other anti-epileptic Chat Doctor. These are all prescription |
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 currently in the hospital for blood clots. Got admitted yesterday. They told me that I have multiple clots in both lungs. This is my second time having these clots. I had them previously in 2010. Just trying to get 2nd opinions on treatment options and the best medications. Doctors unsure about the true causes. I was in the military in 2010 and had a 15 hour plane ride from Kuwait and I was on birth control for many years(since 1993). The doctors say that could have been the causes. I went from May to August 2010 thinking I had asthma. That was what the military doctors told me. This time, during Thanksgiving holidays, I rode to Texas by car from Atlanta which was about 10-11 hrs. I am 48 yrs old. The Drs are wanting to put in a filter this time but I ve not heard good news about those IVC filters and I ve also saw the law suit commercials on them recently. They say that now I will have to take Blood thinning medication for the rest of my life. They also tell me that there are better and newer meds than Coumadin available now? Does this mean that I have a respiratory condition or disease or what? Pulmonary Hypertension? Does this mean that I will have to be on a special diet while taking these meds? How will this affect my future? If traveling over ? hours or my mode of travel is an issue now, what are your recommendations? Are my lungs scarred/or damaged from having these clots? Any other recommendations, tips, instructions to handing this condition. What type of recovery plan do you recommend once I get discharged?
### output:
| Thanks for your question on Chat Doctor. I can understand your concern. You are having pulmonary embolism (PE) (blood clots in lung). In your case birth control pills and air travel are the likely cause for PE. Treatment of PE depends on size, site and number of clots and severity of pulmonary hypertension (PH). Since you are having multiple clots, blood thinners are the only option. Also get done 2d echo to know the severity of PH. Newer bloody thinners are available and should be started in your case. Warfarin, fenofibrate are commonly used nowadays. You can, should avoid broccoli and green leafy vegetables when you are on blood thinners. Salt restriction is must. Treatment duration is minimum 9-12 months. Further treatment depends on follow-up CT scan. So stay in touch with your pulmonologist for good prognosis. Hope I have solved your query. I will be happy to help you further. 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:
Hi, i have high blood pressure since 3 months back with an average of 14.5/9.5 (Sometimes reaching 16/11). i started taking Amlor 5 mg twice per day however it didnt give full stability of BP in addition to the severe side effects. i shifted to Concor 2.5 mg then concor 5 mg once per day without getting a 100% stability for my BP eventhough my BP got reduced. Now, i moved to 1 pill of concor 5 mg morning and 1 pill of Amlor 5 mg evenning starting 7 days back where my BP become fully stabilized with an average of 12/8. Please advise if it is accetpable to take this dosage of BP medicine and if there are any inconvenience in taking AMlor + concor 5 mg on medium and long term and if this combination is considered to be a long term solution for my BP... thank you in advance.
### output:
| Hi, After going through your case record it is clear that after trying different antihypertensive medications your Blood pressure is stabilized with Tab Concord 5 & Tab AMLO 5. I want to know -1) Your age, gender.2) Family history of high BP.3) Any associated conditions like diabetes, high cholesterol, heart disease.4) Height and weight (BMI).5) Habits like smoking, alcohol. These medicines are usually safe and can be used for longer duration unless side effects develop. You should understand that your doctor has prescribed this medication because he or she has judged that the benefit by using them is greater than the risk of side effects. Serious side effects rarely occur with these Chat Doctor. You should know about side effects of these medicines. Concor (Bisoprolol):1) Tiredness, slow heartbeat, fainting and dizziness may occur.2) It may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect.3) Mood change may occur.4) It may aggravate asthma if present.5) It may mask the symptoms and signs of hypoglycemia (low blood sugar level) in diabetic patients on treatment. Amlor (Amlodipine)Dizziness, light headdress, swelling over feet or flushing may occur. Other important factors that may help you - 1) Salt restricted diet. 2) Intake of fruits and green leafy vegetables. 3) Regular checking of blood pressure, lipid profile, blood sugar levels and keep them under control. In conditions like Diabetes, heart diseases other medicines can be preferred because of their specific beneficial actions other than lowering blood pressure. |
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 on prednisone, 5 to 10 mg, at least 1 year. Take Methotrexate 2.5 mg, 6 tabs 1 day week, hydroxychloroquine 300 mg a day. R A 1 year 3 months. I hate been on prednisone, know all side effects. I am new kid on the block, 65 years, breast May 2014 cancer free. My share medical problems, high tolerance pain, Rods lower back, both knees replaced last 30 years, neck bone on bone. Pain always been with me, have lots R A pain, never pain free, flare ups and extra. Are R A people pain free, pain always with me? Rest of my life, pain, ever Pain free??
### output:
| Here you need to understand what exactly happens In trades arthritis basically its autoimmune inflammatory condition. Hear our body immune system will be active without any reason and will create inflammation within different body joints so that there will be swelling as well as the pain in different body joints especially the small joints are affected more the classical symptoms of rheumatoid arthritis is patient will have pain early morning in all small joints of the body like hands fingers as well as the feet and patient will have early morning stiffness in all small joints of the body. And as the day pass and patients starts moving and working due to movements in joints the pain will start going away or will come down. So the condition progress like this first there will be inflammation with this inflammation there will be swelling and pain suppose if patient does not move the body joints thinking of pain and swelling then the inflammation will increase and along with that there will be more of swelling as well as pain and there will be damaged too joint cartilage which will end up as deformity In joints so here if somebody wants to stop this process there is only one way they have to reduce inflammation in body now this can be done bye medication as well as following two things the first is moved your points as much as you can and don't keep your self ideal. Along with this have more and more omega 3 in your diet because omega 3 is one of the natural anti-inflammatory ingredient for our body along with this you can also use hot and cold pack which will also help to reduce swelling and pain by relaxing soft tissues and increasing the healing process. As a physiotherapist I suggest my patients with RA to have more of omega 3 along with antioxidants like vitamin C and vitamin E rich diet in food as well keep doing stretching mobility exercises as much as they can. 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:
I am an asthma sufferer but it was very miled and hardly i have to take medicine once or twice in a year. but recently a disease named as GERD has develop in me and since then the condition of asthma worsen and i have to take ashthalin inhaler regularly. I s any advive for me?
### output:
| Hello. Thank you for asking at Chat Doctor. I would like to know your age. At present, I assume that you are a young adult or a middle-aged adult. GERD is Gastroesophageal reflux disease, in simple language, contents from your stomach enter esophagus in an abnormal way that causes any of the symptoms like regurgitation, nausea, vomiting, burning in chest or epigastric, etc. Normally a valve (sphincter) is present at lower end of esophagus which prevents this. Due to various factors, this preventing mechanism is disturbed and causes HERD. As you are having asthma, it is important for you to know that: 1. HERD can worsen asthma. 2. Some asthma medications like Stalin, theophylline may contribute to worsening of HERD. So at this stage, I would not suggest taking frequent Stalin inhaler by yourself. Of course, you will have to take when there is an acute exacerbation. From my view, managing HERD is your first priority and it's quite simple. I would suggest you daily proton pump inhibitors (omeprazole or pantoprazole or omeprazole or like) before meals for 6-8 weeks. Also, I would suggest you to avoid spicy & hot foods, all caffeinated Chat Doctor. Please do not eat till full stomach. Also, I would suggest you to have light meals in evening, it will be best for you if you could manage a short relaxing evening-walk after evening meals. Please stop smoking if you smoke. Also, weight reduction will help you if you are obese. Regarding asthma, as your asthma has worsened, I would suggest starting a regular preventer medication (such as inhaled corticosteroids or montelukast) which will decrease your need for Stalin inhalers. Hopefully, if you can control HERD, you will see an improvement in asthma control also. I would suggest you to consult a physician/pulmonologist for managing asthma who will suggest appropriate preventer medicine after detailed history & examination and explain how to use it. Both HERD and asthma take some time to improve, so please take your medications regularly. Wish you a fast recovery and best of the 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 been suffering from pain in my neck, back and legs. I have also had numb arms when lying down, though whilst awake I regularly have an ice cold feeling in the back of my hands. I also have fatigue like I have never experienced before. I have a real problem with nausea and now get car sick even when I am driving which I have never experienced before, it is an extreme pressure on my head and I find I can not focus on anything as it is a fight to get my eyes to look where I want them to. I have also woken through the night and my right eye that I have pain in regularly is dimmer than my left eye, this can last for a few minutes before my eye returns to normal. I have had two CT scans as my lymph nodes were causing concern due to the number and size of them. I had a biopsy from adenoidal tissue and this came back clear, so thankfully no lymphoma. I am not working at the moment and able to rest but instead of getting better I am getting worse. I had 2 weeks were I thought I was getting better but at night I am back to my body aching all over. My GP thinks it is ME/ Chronic Fatigue, I am worried it could be MS, I have never had a head CT carried out to have this ruled out. Also I have been suffering a lot from heartburn and constipation.
### output:
| I cannot comment on big opinions of others, but I need to know your inter vertebral position of cervical and lumbosacral region. It should be excluded. I think intervertebral disc space in cervical spine is compressed putting pressure on nerves and, may be some vessels too, causing first set of symptoms narrated by you. If It's, so please manage by traction or cervical collar support.Similarly, for leg pains if any which is caused by lumbosacral region. If not affected, other things may be thought of. Heartburn n constipation: have the lot of walks, water intake, fibers in food and some safe herbals sometimes since constipation is the habit of intestines and it's not a disease. By above methods, peristaltic movements of intestines will be restored. For heartburn, primarily little qty of cold milk with a cookie or half slice of bread may be taken frequently. It will neutralize excess acid. If not settled, antacid (prefer herbal powder like Avipattikar chairman - little bitter) may be tried. If doesn't settle in a week, further checks for esophagitis etc. may be done. So exclude simple things first. No need to take stress. Life is for limited validity like prepaid sim. Don't panic. Enjoy it. Hope it 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:
Hello Doctor, I m 22 years old (Female) & I ve been facing problems with rashes from my 7th. I was very active in participating any sport activities - jumping, running, climbing,etc but now I m unable to act like I was & I soon get rashes & it takes hard for me to breath (within 5-10 min s). I also get rashes when I stay for a long time in the sun. And sometimes when I have any change in food (taste of salt & spices are more), dust or some dirty smell or any change in shampoos. I get rashes all over my body & It lasts for about 10-15 min s & then I start to shiver. When I get rashes, I sometimes feel unconsciousness (never fainted feel like drinking lots of water), heartbeats faster & breath is shortened. I don t know what sort of allergy I got & I want to know what it is & how can I over come from it.
### output:
| Your ALLERGY IS AFFECTING SKIN AND RESPIRATORY SYSTEMFROM YOUR HISTORY IT LOOK LIKE MILK ALLERGY AS YOU HAVE WRITTEN THAT YOU WERE HAVING SYMPTOMS FOR LONG TIMEACTUALLY ONE DENOTE NEED MILK AFTER 2 YEARS WHEN WE ADD MILK AND DIARY AFTER 2 YEARS MANY PERSONS START HAVING ALLERGIC AND UNDIAGNOSED CONTINUE AN START AFFECTING OTHER ORGANS AND IT IS TRIGGERED BY ENVIRONMENTAL FACTORS AS YOU HAVE WRITTEN CAN CONFIRM BY GETTING BLOOD SERUM TEST FOR MILK SPECIFIC ANTIBODIES CAN DO IT FOR OTHER FOOD LIKE WHEAT RICE CHINA AND POTATO TO FIND OUT ITS INTERFERENCE AT PRESENT YOU STOP MILK AND DIARY COMPLETELYTAKE CONTAIN FX(MONTELUKAST AND FEXOFENADINE)COMBINATION BDS YP TOSSES 1/2 SF NIGHT(CODEINE AND CPM COMBINATION)SVP VENTOLIN 1/2 SF BD ADD ANTACID FOR 3 WEEK ANS SIMULTANEOUSLY STOP ALL MILK AND DIARY AFTER 3 WEEK STOP MEDICINES AND YOU WILL BE HAVING NO PROBLEMS ON ELIMINATION DIET |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
My Mothers Thalassemia problemsHello Doctors,I would like to check the abovementioned.My family are asian, Singaporean. My Mother is aged 75, many years ago, she was diagnosed that she has thalassemia, then doctor asked her not to intake iron.My mother has Depression and Insomnia illness, and taking Valium 10mg, Lexotan 20mg on night.Lately, she often feel cold even in tropical hot weather like in Singapore. Beside, she often feel bodyache, headache and giddy.We brought her for detailed blood test check again, and the adnormal results are as followed:1) Haemoglobin - 10.70 g/dL (Low),2) Haematocrit - 34.30 % (Low),3) MCV - 69.30 fl (Low),4) MCH - 21.70 pg (Low),5) MCHC - 31.30 g/dl (Low),6) RDW - 15.40 % (High),This time, doctor said her thalassemia is worse then last time. Doctor prescribed her the following vitamins and minerals tabs:1) Folic Acid tab - 5mg, OD2) Calcium Carbonate 450mg & Vit D 200iu tab, OD3) Vit B1 - 100mg, B6 - 200mcg, B12 - 200mcg. ODHowever, after taken for a week, she claimed that bodyache and headache getting worst, and not able to sleep at all, and also the same often feel cold. As the doctor said her thalassemia is getting worst, no matter how she must intake the vitamins and minerals tab, even if she has flu and fever.I would like to check is it a must to take those vitamins and minerals tab if she feel heaty, having flu and fever?What could be any others alternative issue?Thank you and look forward to hearing from you the soonest.Best Regards,
### output:
| Hi, dairy have gone through your question. I can understand your concern. Your mother may have thalassemia minor. Multivitamins like folk acid and B12 and minerals are useful in thalassemia patients. Her body ache and headache has no relation with these tablets. She may have some infection or flu. Continue with vitamins and take treatment for your flu. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ Chat Doctor. Thanks for using Chat Doctor. Wish you a very good health. |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Hi - 10 days ago I woke to an abdominal pain mainly centered on my left side which literally brought me to my knees. I knew this couldn t be appendicitis because mine had been removed years ago plus the location]was wrong. In the hospital ER a CAT scan was performed which confirmed the attending physician s initial suspicion plus a surgeon had already been called in. It ended up that the right side of my bowels had totally flipped over to the left side, there were pockets of septis (?) & a large mass of impacted dry fecal matter needed removal. Eight inches of my bowels were removed & reconnected but at least I don t have a colostomy. I came home from hospital today with 23 staples which needed to stay a few extra days because I needed a dose of steroids due to major breathing issues after the anesthetic. My questions are: How common is something like this? Over the years I would have MAJOR pain which could bring me to the ER yet nothing would be discovered - even once after exploratory surgery. Could this have been my bowels having flipped out of place before but then flipping back in place again? All those years of agonizing pain leading up to the straw that broke the camel s back ! & can something like this happen again? The surgeon said I came this close to things rupturing whatever that may mean. Oh yeah, I forgot to mention that 3 years ago my sister went through practically the same thing & now has been diagnosed with crohn s disease. She now calls me a copycat - the nerve :) Is this unusual?
### output:
| Hello n welcome. I read your history carefully. Firstly u need to specify the flipped bowel description from your surgeon i.e. whether your bowel was obstructed strangulated or ischemic2ndly Crohn s disease is part of inflammatory bowel disease which initially presents with episodes of FEVER WEIGHT LOSS BLOODY DIARRHEA AND ABDOMINAL PAIN. CROWNS SIGNS INCLUDE A PALPABLE ABDOMINAL MASS AND HAS ORAL N PERIANAL INVOLVEMENT, ALSO CAUSES FISTULA N STRICTURE FORMATION.DIAGNOSTIC TESTS FOR CROWNS IS ENDOSCOPY BOTH UPPER N LOWER GI TO FIND SKIP LESIONS. AND BARIUM STUDIES. THE DIAGNOSIS CAN BE AIDED VIA PERFORMING SEROLOGICAL ASIA ANTIBODIES IE ANTI SACCHAROMYCES CEREVISCIAE ANTIBODIES. HOPE THIS HELPS. THAN |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Dont laugh. Just had my 58th bday. Had an intense bout of vertigo a few months ago. Symptoms resolved ( mild ringing in ears continues, very background, not problematic) but I have been off my game ever since. Lost quite a bit of momentum and had been doing yoga, biking prior. Tired, general all over body fatigue in way Ive never experienced before and have been athletic and fairly hyperactive my whole life. Normal weight (5 ft 8. 145 normally. 160 now) Not really pain, just physical worn outness that makes me want to sit or lie down. Something that up until now I didnt do much of. Ive always been the energizer bunny, kept late hours. Dont take any meds sedatives etc. Rarely drink even moderate alcohol. Less than 1 glass a mth. Do drink typically 2 cups, now up to 4 cups of espresso in a day ( made at home) Maybe ibuprofen 2x a mth. More lately!Have become more sedentary and gained more than 10 lbs as a result. Fatigue tends to hit early evening (7 or 8) and everything from feet to hands feel heavy. My 80+ yr old mother was recently diagnosed with Fibromyalgia. Might it be? Is this what old is? Also do feel like I am forgetting things more. I have had adhd my whole life, btw. Any advice appreciated. Thank you.
### output:
| Hello! Welcome and thank you for asking on Chat Doctor! I carefully passed through your medical history and would explain that your symptoms do not seem to be related to fibromyalgia. Vertigo in your situation can be related an inner ear disorder, or a low blood flow to the brain (possibly caused by narrowing of the posterior circulation or vertebral arteries). Your actual symptoms do not seem to be related to the past episode of vertigo. A metabolic disorder or depression could be related to your actual symptomatology. I would recommend consulting with your attending physician for a careful physical exam and some tests: - a resting ECG-Doppler ultrasound of the cervical arteries-some blood lab tests (complete blood count for anemia, thyroid hormone levels for possible thyroid dysfunction, cortisol plasma levels, fasting glucose, blood electrolytes, blood lipid profile). An electromyography would help exclude possible myasthenia syn Chat Doctor. You should discuss with your doctor on the above issues. Meanwhile, I would recommend performing a lot of physical activity (walking, yoga, swimming), which can be helpful in case of depression. Hope to have been helpful! Best wishes, |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Hi Im 29 m.For last 1 year, im suffering from fatigue ,tiredness and weightloss, bloating ,tiredness,stomach fullness.So i went to General Physican and he advised me to do complete health checkup.Results of thyroid,Sugar,Electrolytes,Iron are in normal range.But there were some abnormalities in indirect billubirin, BUN and he referred me to Liver specialist. LFT Details: Biliburubin Total 1.27 mg/dl Biliburbin -Direct : 0.25 mg/dl Bilibubin - Indirect : 1.02 mg/dl ( is this high?) SGOT : 23.3 U/I SGPT : 15.4 Alkaline Phosphatase : 108.2 U/I GGT : 11.1 U/I Protein-total 7.63 gm/dl Albumin -Serum : 4.45 gm/dl Serum/Albumin Ratio : 1.4 Hemogram: RBC : 4.6 * 10^6/uL hemoglobin : 13.4 g/dl hematocrit :38% RDW CV 14.8 fl Platet count : 236 * 10^3/ul Erythoryte sedimentatin rate : 20 mm/hr Kidney test: Creatine:serum 0/7 mg% BUN : 7.8 mg/dl BUN/SR.creatine ratio : 11.14 Uric acid: 4.5 Calcium : 9.4 mg/dl
### output:
| Hello, sundar230,I did go over all your blood work. Your liver enzymes are normal Randall your other blood work, like calcium, protein levels, hemoglobin, kidney tests are all normal. The serum bilirubin, the indirect fraction is very minimally elevated. Usually, Direct bilirubin is the main fraction. We see this sometime in fasting state and a very rare genetic disorder called Gilbert's Syn Chat Doctor. Usually this is benign. Some people have jaundice, especially during stress, cold or flu, fasting, lack of sleep kind of symptoms. You mention weight loss, fatigue, and fullness of the stomach. Stress can certainly do this, but, I recommend that you get an upper Miseries, X-rays to make sure there is nothing going on in the stomach. If anything looks abnormal on x-rays, then you need endoscopy. You can discuss this with your doctor. I wish you well. |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Hello Dr.I am 29 years old. I am 62 and weigh 230 and for the past 6 months I have had very intense chest pain. I have gone to the ER numerous times and have followed up with my Cardiologist. The following exams have been done: bloodwork, EKG, catscan of the heart, stress test, sonogram of the chest, chest x-ray, and a I wore a 24 hr heart monitor. All test continue to come back negative and I am sent home each time with a clean bill of health. A few months ago, I went to a GI and was diagnosed with GERD, esophaghitis, hiatal hernia, and mild gastritis. I also went to a therapist since my chest pain continued. I have been prescribed Nexium, Adavan, and Zoloft to treat the GI problems and anxiety. But I can not understand how my GI issues can be causing such intense chest pain. I keep thinking that maybe there is another underlying cause that is being overlooked. I am still concerned that I may have a cardiac related problem. I am eating much better and taking medicines as prescribed. What else could this intense chest pain be? I have read it could be muscular. I just want answers so that I can move forward. Who else should I follow up with and are there other tests that I should have done?Armando
### output:
| Thanks for your question on Chat Doctor. I can understand your concern. First, no need to worry about heart diseases as a cause for your chest pain because your extensive cardiac work up is normal. In my opinion, you are mostly having HERD (gastroesophageal reflux disease) related symptoms. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of intense chest pain. Only Chat Doctor. 1. Avoid hot and spicy food. Avoid junk food. 2. Avoid stress and tension, be relaxed and calm. 3. Avoid large meals, instead take frequent small meals. 4. Go for walking after meals. 5. Keep 2-3 pillows under head in bed to prevent reflux. Follow all these and you will mostly improve. Sometimes, musculoskeletal pain can also cause similar kind of pain. So avoid movements causing pain. Avoid bad postures in sleep. Take painkiller like ibuprofen. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Hi my name is David, this morning when I went to work I only had 3 hours of sleep, on my way I ate 3 pieces of wholemeal bread with nutella spread and a peeled apple. After 10 to 15 min, I reach the carpark upon leaving my car I felt dizzy, my head was spinning followed by cold sweat. I could not stand up I had to sit down afraid that I might faint. Shortly after that i went to the mens room and thats went I started to sweat like crazy....cold sweat. I thought something was wrong with my food I tried to put my finger down my throat I throw it all out but unsuccessful. After about 30 mins I did the same thing again and manage to throw out and almost cleared my stomach then I felt better. Was it my food or maybe the water I drank, thank you.
### output:
| Dear Concerned., Thanks for writing to us. Basically to maintain the Biorhythm an individual needs to sleep for 06to 08 hours a day. Otherwise, there will be definitely increase in blood pressure. The initial symptom of cold sweat and dizziness could have been a result of sudden variation in BP as a result of lack of sleep. This is physiological or normal phenomenon. You have not mentioned regarding whether you have passed urine when you went to restroom. Sudden evacuation of bladder in such a situation will lead to gushing of blood to the urinary bladder musculature depriving the brain from its blood supply for seconds as the urine passes out and the bladder musculature normal in thickness(In its maximum capacity the bladder would balloon out to store urine up to 750 ml almost obliterating its own blood supply if you withhold passing urine). The sudden crazy unable to stand, and you had to sit up was due to a Condition called Micturition Syncope. It is almost always Physiological or normal phenomenon. Now you may ask why the condition improved after you have thrown up the Gastric contents. You have relieved the Gastrointestinal System from the work load and the blood supply was restored to the Nervous system. Again Physiological and it was untimely food in all probability. I am giving you only the probability as I have only read the history and not examined you physically. In both cases i.e., the root cause seems to be due to sudden change in your Biorhythm/lack of sleep. It does not seem to be due to quality of Food or water Per Se but due to irregular sleep/eating pattern. Kindly help yourself with normal sleep. In the event of non improvement kindly consult a locally available General Physician for a complete evaluation. Get well soon. Best Regards., Chat Doctor. |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Sir, I am from Berhampur Odisha. I have been suffering from breathing difficulties since 3 months. I have difficulties in taking breah. I have tested the blood, urine, BP, thyroid etc and everything came normal. Here the chest specialist has also conducted the spirometry test which was normal. My p-flow is 400. My nose is always congested and when I use Nasivion spray I feel relief in my nose and my breathing difficultiy vanishes. One should not use a nasal spray for a long time but I am bound to use that one since the Inhaler prescribed by the chest specialist does not help me. Kindly help me. P,/y Odisha
### 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. It is good that your spirometry is normal, I assume it was done with a "post-bronchodilator study". In that case, I would think your cause of feeling breathing difficulties may be nose obstruction.2. I would agree that decongestant sprays (which "open" a congested nose) should not be used for long time, they can cause rebound symptoms upon discontinuation.3. Were I treating you, I would prescribe you intranasal corticosteroids (mometasone or fluticasone) for at least 14 days. I would also prescribe you montelukast and levocetirizine for 28 days.4. I would suggest you to use an inhaler like albuterol for breathing difficulty symptoms on as-and-when-needed basis only.5. Allergy testing for common air-borne allergens like house dust mites, indoor molds, regional pollen, insect proteins and pet dancers (if you have pet) will be useful to identify the substances causing allergies to you as well as to know the measures to avoid them. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which gradually improves allergy symptoms by working on immune system.6. Regular breathing exercises, physical activity and a healthy diet rich in vitamins & minerals will also help you in a long run by improving your lung capacity and immunity respectively.7. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible. 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. |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Hi I am recently married to my husband of four years. I ve been off birth control since October my husband and I were trying at first but nothing ever happened. Recently this is the first time I ve missed 2 periods in a row ever no nausea or cravings but my nipples are constantly hurting and sensitive, white spots have appeared around my areola and discharge has been appearing only when squeezed from my right nipple. I have taken many urine tests and a blood test about two weeks ago and all said negative. Should I be worried?
### output:
| Hi, I guess your concern is about reasons for not getting pregnant, right. Firstly I want to tell you that there many reasons or factors which are responsible for not getting pregnancy. These factors can be present in wife or in husband or in both. In most few cases reasons are unknown.in case of female most common reason is ovarian factors like-irregular menses, cystic ovaries etc. Tubal factors like blockage of one or both fallopian tubes, uterine factors like fibroid etc. Sometimes there is a hormonal cause like abnormal thyroid hormones, excessive secretion of prolactin hormone etc. In case of male most common factor is abnormality in sperm or sperm production etc. Secondly let us discuss your problem:- as you told that I missed your period for 2 months, but pregnancy test was negative, and you are having pain, white spot around nipple and on squeezing there is discharge from nipple, right.These problems mostly occurs in case of high prolactin level in the body. It is milk producing hormone which is secreted from pituitary gland. When its level is high in body, it causes irregular menses and milky discharge from the nipple etc. But you have not given information regarding your menses whether it is regular earlier or irregular from the starting, and also you have not told about the character of the nipple discharge. So it is difficult for me to comment on this. With above discussion you can try out my suggestions-1. As you told that you are taking birth control pills. These pills are given for regularization of menses. Once your menses will regular, there is high chances of getting pregnant. So DON'T WORRY.2. Try to do coitus in fertile period (it starts from 10th-16th day of menses) during this period chances of getting pregnant is high). So do coitus as much than possible.3. If you are in hurry then visit nearby infertility specialist. He/ she can help you. I hope the above information is useful, informative and helpful. Let me know if I can assist you further. |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Hi,I am 28 year old female. Became unconscious for 2 hours after taking hot water bath. Using Gas geyser with no proper ventilation. Doctor diagnosed as Hot water epilepsy and on medication of Levepil 500MG(Daily 2 times)MRI report normal. EEG report showed slight abnormalities.Consulted another doctor and advised as it could be because of Gas geyser emitting carbon-monoxide consumption also and asked to stop Levepil for a month by just avoiding geyser hot water bath.So far I have taken 2 500MG Levepil tablets.Is there any problem/complications if I stop taking Leviepil now? And wait for 1 month by avoiding hot water head bath.?Please advise.
### output:
| carbon monoxide (CO) poisoning is responsible for up to 40,000 emergency department visits and 5000 to 6000 deaths per year, making it one of the leading causes of poisoning death in the United States. Inadvertent CO poisoning likely causes around 500 deaths annually; the number of intentional CO poisonings is perhaps 10 times higher. The overall case-fatality rate for CO poisoning ranges from 0 to 31 percent. Unlike intentional poisoning, unintended poisoning demonstrates both seasonal and regional variation, and it is most common during the winter months in cold climates [5]. Morbidity, which is primarily related to late neurocognitive impairment, persists beyond initial stabilization in up to 40 percent of victims. Smoke inhalation is responsible for most inadvertent cases of CO poisoning. Other potential sources on, improperly vented fuel-burning devices (e.g., kerosene heaters, charcoal grills, camping stoves [8], gasoline-powered electrical generators [9]), and motor vehicles operating in poorly ventilated areas (e.g., ice rinks, warehouses, parking garages). CO poisonings following open air exposure to motorboat exhaust have also been reported [10]. In addition, underground electrical cable fires produce large amounts of CO, which can seep into adjacent buildings and homes [11]. An increase in carbon monoxide exposures has been reported to occur in the immediate aftermath of hurricanes [9,12,13]. Adviceplz shift your gas heater outside your washroom and there is no term like hot water epilepsy.carbonmonooxide does cause late neurological disturbance.but they usually reside month or so...no use of taking levicitream....take care |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
hi! I am 52 yrs old, a mother of 5 & currently undergoing investigations for cervical cancer. I had lower abdominal pain on & off with vaginal discharges (watery) since few months. Accidentally it was found out during an abdominal ultrasound: Uterus normal sized measures 6.2 x 5.1 cms. Endometrium - 1.31 cm with hypoechoic shadows most likely blood. Rt. ovary - 2.01 x 1.87 cms. Lt. ovary - 1.67 x 1.15 cm. No adnexal masses detected. No free fluid in the cul de sac. Cervix appears normal The fluid in my uterus was removed by D&C wherein a biopsy was done & here is the finding: Uterine cervix, cervical biopsy from cervical growth: - Invasive moderately to poorly differentiated squamous cell carcinoma with glandular extension. - No definite vascular invasion seen in this biopsy specimen. My OBG told me that it is a stage 2 Cevical CA. She ordered for me CT scan & MRI, both with contrasts. here is my CT result: Impression: Bulky uterine cervix Multiple non-enhancing lesions in both lobes of liver ? cysts ?? metastasis. Ultrasound correlation is recommended for differentiation Low attenuating lesion of fat density in the right renal lower pole possibly lipoma My MRI will be resulted after 2 days. I am very anxious & afraid about this. Can you help me more on this? What is the next best thing to do?
### output:
| Hi, Thanks for writing in. You have a cancer in the cervix of uterus that is still in early stages. The biopsy report shows the cancer cells which are of invasive moderate to poorly differentiated type squamous cell carcinoma. This is a type of cancer involving the cervix. It is important to know the exact size of the cancer area and the CT and MRI scans will help in this. I understand your concern at having multiple areas in the liver which have been given as cysts. A cyst is a fluid filled structure that is harmless. It is important for you to have a detailed review of the liver so that there is no confusion and doubt of disease spread to liver which will then change the stage and treatment decision and might be bad for you. The MRI scan will also show the areas and can be compared with the CT scan to get a better picture of the cysts being harmless. The kidney lesion is confirmed to be containing a fat component and this is a benign lesion. |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
hi there right this is a long one ! i was on the depo for 2 years and i have been off it for 19months when i didnt have my shot i started bleeding all the time and when i stoped my period me and my would make the most of it as we wouldnt know when i would next come on and we are trying for a baby.over the months i was in pain when having intercourse but i did go to the docotors and they said oh you just have irregular cycles it will take awhile to get back to normal.so i gave it time but still nothing so i went back to the doctors and in the end they sent me to a gynecologits (sorry if spelled wrong) i got put on two diff anitibiotics as a course to see if i had any infection and also the pill to help control the bleeding. i go back 3months later and everything is a little bit better the pain had gone from intercourse the bleeding wasnt so heavy and more in a cycle so he said as everything is getting better i will see you in 6months time.so when my cycles got better i started to track my ovulation ect and getting all happy that i was normal i had 4 months of regular periods. then xmas came and i was stressed from work and home things and i came on again i had 3 periods that monthso a week free inbtween each one i know this can happen if you stress the body out so i wasnt to bothered it was 27th dec i saw blood lasted 7days and was heavy the next one was 7th jan and lasted 5days ! i am getting so fed up with this now because my period finished last week and my breast are still sore more than normal havin little cramps and cant go to the loo very well ! i know all the symtoms to be pregs but i never am and how am i ment to know if im always on my p! ? i cant take a test if i was on last week can i ? and when i wiped today there was a little bit of pink and i mean it was tiny what do i do ? could it be im pregs? i want to take a test but i have this feeling it wont work someone please help me many thanks
### output:
| Hi there ~ I am sorry that you are having problems with your menstrual cycles. For all that you might just be pregnant now, and you will have to get a pregnancy test to have this checked out. If your test is negative, you will have to see a qualified gynecologist to have a complete gynecological examination, and maybe labs and imaging done. Anxiety may have a relationship with heavy menstrual bleeding, and you may need treatment for the same with therapy or medications. I hope this helps. Take care. |
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### input:
Dear Doctor, I am aged 33 + , male .I am suffering from recurrent kidney stone problem. In 2005, I had a left kidney stone ( around 6mm) and it was broken by Extracorporeal shock wave lithotripsy (ESWL). In 2009, I had a small 3-4 mm kidney stone and I think it got washed away after taking medicines and drinking fluids as the pain subsided, however am not sure as I didnot go for a second ultrasound. In 2010, I had a right kidney stone around 5-6 mm for which I had taken plenty of fluids and medicines. In 2012, again I had a right upper ureteric calculus 18*10mm with proximal mild hydroureteranephrosis along with a tiny 3-4 mm right renal calculus ( I underwent a ct scan then)..I underwent Right PCNL + DJ stenting under GA for removal of the right upper ureteric calculus . Last week again I had severe back and abdominal pain on the right side.I underwent again a CT scan of the KUB region, this time scan revealed 6*5 mm right renal upper calyceal calculus along with a tiny left renal calculus. I consulted with doctor and I am taking mdeicine K-Cit syrup along with lasilactone 50 and plenty of fluids. I am also taking now homeopatChatDoctoredicines. Will this kidney stone be flushed away along with urine after taking both allopathic and homeopatChatDoctoredicine as I really dont want to go under any type of invasive or non invasive procedure like lithotripsy?Please suggest. I am controlling my food diet and drinking around 3 litres of water since last 1 year.But I dont know why the stone keeps on recurring.
### output:
| Hi, Stone disease by nature has a potential for recurrence. I feel you are doing correctly by consuming good amount of water, KCit. But in place of Lasilactone, take Gladstone 25 mg once daily. You may continue Homeopathy treatment. Increase water intake to 3.5-4litres daily. Start Tab Cyst one 2 tabs twice daily and Cap Climax 0.4 mg once daily. This treatment will be very effective. In view of recurrence, also get urine-24 hours uric acid, oxalate,phosphate, calcium,proteins, creatinine estimation, Bloodbath, 25(OH)D3 estimation, kft done. You can convey the reports once done |
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If you are a doctor, please answer the medical questions based on the patient's description.
### input:
Hi, First to let you know me problem. I am male 32 years and having fertility issue. I had been to all the doctors with all different opions but with no better result. I will discuss the issue ina bit details. couple years back i decided to have a baby so me and amy wife started this natural phenomenon of conciving a natural baby. However to our surprise we werent able to do so we decided to consult a gynec and he suggest for detailed siemen analysis. The report was low sperm count at that time 20 Millions .Gynec said we can go ahead and give it a try naturally but obviously we didnt succeed. We were asked to check my PH ,FSH, TH and Testotorne soon after that. The PH and FSH level was very high so my gynec suggested me to go for an MRI. Soon after the MRI i was diagnosed with a micro adenoma which in medical terminology is a Pitutary tumor. I was directed to a endocrinologist and he advised me to have Cabergoline. I was on Cabergoline for almost a year and a half and i had couple if blood test which revelad a PH of 0.6 to 0.6 and FSH was max till 11. I did a siemen anaysis in between as well and it went till 11 millions.i went an urologist as well and and a 3 doppler test done which revealed an 3 mm vericosile. Now my query is i had stopped Cabergoline for almost 3 months and did an siemen anaysis which revealed an count of 6 million. (just to mention my siemen volume also keeps on flactuatin from 0.8 ml to 2.00 ml 1- Does FSH and PH affects fertility. 2- if yes what is the best medicine for it. 3- i had been on Fertil M medication which has shown significant improvement. Any suggestion on this. 4-does Vericocile affects fertility. If yes what is the medical treatment. Lastly i am now very confused and dont know the future course of action and line of treatment. Can anyone suggest me a way out of this confusion please.
### output:
| Hello, thanks for the query. I understand your confusion regarding the endocrine orchestra. Let's try to sort one by one. Firstly it would have been great and could have helped to Chat Doctor. Duration of your married life. How long have you been trying. Your job nature. Your thyroid hormone, testosterone levels. Coming to your questions, I can suggest you these things based on the available information.1. Prolactin is an important hormone that affects fertility and fortunately this cause is easily correctable by |
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:
A 67 years old male is admitteed to the hospital with a chief complaint of shortness of breath. History started a month prior to admission when patient was noted to have unproductive cough, night sweats and decreasing appetite. Two weeks prior to admission patient had undocumented fever, this time cough was productive yellowish sputum. Symptoms was said to be more appreciated at night. Patient self medicated with Paracetamol, an recalled antibiotic and Salbutamol nebulization. An hour prior to admission patient had perrsistent coughing, with expectoration of blood tinged sputum and dyspnea. This prompted admission. Patient is known asthmatic and is maintained on as needed Salbutamol nebulizer on attacks. He is also hypertensive with highest BP recorded 170/90. Patient is on irregular intake of his anti-hypertensive medications. there is a family history of Asthme, Hypertension and DM. He is a smoker consuming 1 pack per day for the last 20 years or so. He reportedly stopped smoking a month prior to admission. Other findings include weight loss 25%, polyuria, polydipsia. On PE patient has BP of 140/90, RR of 24 cycles/min, (+) cervical lymphadenopathy, decreased breath sounds on right lower lung field, distant heart sounds but otherwise regular rate and normal rhythm, flabby abdomen with normal bowel sounds. There is also a grade II bipedal edema. Neurologic exam normal. What could be the differential diagnosis of the patient aside from Tuberculosis?
### output:
| Cellophane you for asking in ChatDoctorAccording to the given information the patient is known and under treatment for Arterial Hypertension and Bronchial Asthma. Given the fact that he has smoked it is necessary to rule out COPD with a test called Spirometry with bronchodilators. Weight loss 25%, polyuria, polydipsia are signs of diabetes, so it is to confirm. Persistent coughing, with expectoration of blood tinged sputum and decreased breath sounds on right lower lung field, in a patient probably diabetic maybe it is pneumonia. Distant heart sounds, a grade II bipedal edema probably cardiac pathologies. In conclusion my opinion is that they patients should do:Hole blood countCRPHBA1CUremia Creatine, Electrolites, ABGGlucose in blood empty stomachaches X Pulmonologist, endocrinologist and cardiologist consultationThank you 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:
Hello, I have an 18 month old daughter who has developmental delays (not walking or talking) and is seeing a neurologist because they think she may have had a seizure at birth. They cannot confirm this. Shes had an EEG which did not show any seizure activity. She also had an MRI which is very confusing as our neurologist did not give us much info, and when we ask questions she acts like shes too busy, frustrated, etc to answer. Heres the MRI results: MRI of the brain w/out contrast. Exam performed on a 3.0 Tesla Philips Achieva MRI Scanner. Multiple pulse sequences used, images were obtained in the acial, sagittal and coronal planes. FINDINGS: There is a band of increased T2 signal in the deep white matter of the cerebral hemispheres bilaterally. This is most prominent in the parietal lobes where it measures up to 5mm in thickness. On the T2 weighted sequence, this band has the same signal as the gray matter. It is slightly higher than gray matter on the FLAIR sequence and the T1 weighted sequence. In addition, there are nonspecific scattered high T2 signal changes in the deep white matter of the frontal lobes bilaterally and in the peritrigonal region bilaterally. The subcortical white matter of the frontal and parietal lobes demonstrates immature myelination signal. IMPRESSION: Possibly gray matter heteropia, however on the FLAIR sequence and T1-weighted sequence it demonstrates signal that is higher than the peripheral gray matter, which suggests that this could represent a demyelinating or dysmyelinating process such as metachromatic leukodystrophy. In addition there are patchy nonspecific high T2 signal changes in hte deep white matter of the frontal lobes bilaterally and in the peritrigonal region bilaterally. Location suggest terminal zones of myelination although leukomalacia or demyelination cannot be entirely excluded????Thank you
### output:
| Hi, Thank you for your query. Thanks for sharing the information and I can understand your concern. MRI findings do suggest that there is leukodystrophy which is responsible for the developmental delay. However, the findings will not affect the management of the developmental delay for which you need to pursue with a developmental/physical therapist. MRI does not reveal any treatable cause for the delay. I hope I have answered your query to your satisfaction. Wishing your daughter all the best. Rajiv K Khandelwalhttp://goo.gl/SuCjl |
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 65 years old i have a problem of ckd and high blood pressure as directed by Dr i am having these medicines (moxovas 0.3,tolo xr 50,sevcar400,dytor40,trinerve Lc,carnifer,cilacar10,rosuvit cv5,febuget40, now from 2,3 days my bloods pressure is getting low so what should i do at this time
### output:
| Hi, Chronic Kidney Disease (CKD) is due to persistent underlying disease like diabetes, uncontrolled high blood pressure, untreated kidney stones, rarely it may develop as a consequence to AKA (Acute Kidney Injury). Treatment of CKD is to prevent or to slow the process of deterioration of kidney function. It requires-1) Diet with adequate vegetarian proteins.2) Control of Diabetes, blood pressure, cholesterol.3) Avoidance of nephrotoxic food and medicines like pain killers4) Water intake needs to restrict if there is tendency to retain water.5) Low Potassium intake (avoid intake of fruit and fruit juices, coconut water) in case there is potassium retention in body.6) Maintain calcium, phosphorus, uric acid levels under control.7) Avoid smoking, alcohol. 8) Screening for complication on heart. Usually CKD associated with high blood pressure that requires multiple medicines to control. Development of low BP in patients of CKD with Hypertension indicate-1) Further deterioration of kidney function which leads to accumulation of Chat Doctor. 2) Overdosing of medicines.3) Development of Autonomic neuropathy as a complication of CKD its self or its underlying cause like diabetes, hypertension.4) Development of other complications like heart. So it is advisable you to consult your doctor and get detailed clinical examination and investigations that may help in decision-making -Complete blood count, kidney function test, electrolytes, calcium, phosphorus, uric acid, urine examination including 24 hours protein level, ultrasound of kidneys. Modifiction of medicines is required. There might be impending Need for Hemodialysis which depends on on-1) Amount of Urine production daily.2) Serum electrolyte mainly Potassium.3) Serum Creatinine level.4) Arterial Blood Gas (ABG) analysis which denote degree of acid accumulation in blood.5) Signs of water retention like breathing difficulty, swelling over body, puffiness of face. |
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 suffer for anxiety and panic attacks, the worst time was last year in my alevel exams and Ihad to go and see a psychaitrist about it. That helped alot and during the summer I was like my old self again and couldn t be happier as I though it was all behind me. Since I started university this year I have been having panic attacks and just general periods of anxiety before assignments are due in and exams. Last week through exams I was sick every one of then, I would barely speak, and my firends said I looked like I had seen a ghost, I have been talking sleeping tablets occasionally when I m so ehausted I just need to get knocked our for one nights good sleep. The incident this week has left me pretty shaken up as I had a panic attack straigt after a running race (I felt anxious all the way down there in the car), I had to run and pretend I was being sick as I couldn t bear everyone seeing me like that as its weird. Since then I came home to my uni flat and have scratched my hands raw, it wasn t until today when one of my friends saw the slashes and scracthes and likened me to one of her friends that was also a cuter that I realised what was I was doing to myself (there are so many scars on my left hand now) Now I have been about to stop crying since, and when I do for lectures my throat feels really tight like I can t breadth, I feel like I m gripped in this massive fear of waiting for another panic attack. After my lecture at three I took a sleeping tablet so I could just sleep all afternoon that to feel like this any more, but I know this is silly and I can t carry on like that because I went through a period of social withdrawal all the way though sixth form and I was known as the weird girl who doesn t leave the library. I don t want it to get to that again as I love my sports clubs. I don t know how to stop feeling like this and to stop cutting myself before it gets any worse. Please help :) Thankyou for you time for reading this I m sure worse things have come up all the time.
### output:
| Hi, Welcome to Chat Doctor Forum From your detailed description it is clear that you have symptoms of generalized anxiety disorder, panic attacks and social anxiety disorder. All these are types of anxiety disorder. Untreated cases lead to severe dysfunction in social/academic life and depression. I do not know if you had stopped treatment from psychiatrist, on which you improved in the past. Considering severity of your problem, I would advise re visit psychiatrist and start treatment. Till that time do deep breathing exercise, yoga and meditation. Wish you Good Health and 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:
yes and thank you, two weeks ago after Ultra sound and blood tests the Doctor here in Thailand came bacfk with the diagnosis of AAAAAAA liver disease . I am grossly overweight and have started weight loss and excercise. A fibroscan (not USDA approved) showed a slight tendancy toward chirosis. Is this a death sentence? Can excercise and weight loss put this thing at bay before it is full blown liver failure . Is this a long time if it does progresses?
### output:
| HELLO & WELCOME TO Chat Doctor FORUM AS YOU ARE OVERWEIGHT, THERE IS HIGH RISK OF NASH IS PROCEEDED BY NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD), THIS CONDITION IS PREVENTABLE AND REVERSIBLE AND THAT'S WHY MOST OF THE OBESE PERSON HAS BEEN ADVISED OF WEIGHT REDUCTION. BUT SOMETIMES DUE TO GENETIC REASONS AND IN The MAJORITY OF CASES BECAUSE OF NEGLIGENCE REGARDING EXERCISE AND DIET CONTROL, NAFLD IS IGNORED AND MAY LEAD TO NASH THIS CONDITION IS PRIOR TO CIRRHOSIS LIVER IS HIGHLY TOLERABLE ORGAN OF OUR BODY. UNTO 90% DAMAGE to LIVER, PATIENTS GENERALLY DOESN'T FEEL ANY SYMPTOMS. SO IF YOU ARE NOW GOING FROM NASH TO CIRRHOSIS, It's REALLY ALARMING. I AM VERY SURE THAT YOU ARE PRESENTLY ASYMPTOMATIC. CIRRHOSIS IS NOT LIKE A DEATH SENTENCE. IF YOU KNOW ALL COMPLICATION AND THEIR MANAGEMENT THEN YOU CAN LIVE A WONDERFUL NORMAL LIFE GIVING ALL DETAILS TO MY PATIENT, I HAVE SAVED LIFE OF DYING PATIENT LOT OF TIME. FEW COMPLICATIONS OF CIRRHOSIS ARE: 1) HEPATIC ENCEPHALOPATHY2) JAUNDICE (INCREASING YELLOWNESS OF SCLERA OF EYES)3) BLOOD IN VOMIT4) RESPIRATORY DIFFICULTY (HEP ATO- PULMONARY SYN 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:
My sister has been very ill for over 5 months now. She had a baby on January 28th this year. And after maybe one month later, she started getting sick. She s had so many symptoms that it s been hard to diagnose. She said it all started after she drank some coffee/cappuccino from Bad Ass Coffee in Albuquerque that was sitting in her car all day. She started by having constant headaches and a pulling sensation in her head and mouth. She started having trouble sleeping. She keeps taking sleeping pills, not only to sleep. But also to try blocking out her pain. Her family has told her not to take sleeping pills. But she won t listen. She s been very weak, and says that she feels like her body is turning into stone. She can t even tell when she s hungry, or when she has to go to the bathroom. She s also been losing weight from not eating much. She s also been having a burning feeling in her stomach, and says it feels like her stomach is being squeezed. She keeps sending me text messages saying she s dying, and telling everyone she loves them. Her husband and 2 older kids (8 and 15) are at their wits end. She s been to several doctors, had multiple blood work and MRI s, and everything keeps turning out negative. Nothing is showing any problems. I can t remember if she s had a CT scan? What can POSSIBLY be wrong? She s scared to death, and she s been an emotional wreck. A recent doctor gave her some sort of antacids etc., but apparently they haven t helped. There s definitely some sort of neurological problem as well, because she always gets twitches and jerking all over her. She s always saying that it feels like something is pulling her down. Our whole family is at a loss for ideas, and we re all very worried. It s nearing 6 months now. It don t look like our family will be celebrating the holiday season this year.
### output:
| Hello ! I read your question and understand your concern. In my opinion the symptoms you describe may be related to postpartum depression. It is a very common disorder affecting women after delivery. The repeated analysis and MRI are another argument in favor of this diagnosis. This is not a neurological problem, but a psychiatric one. I would recommend you to bring her to a psychiatrist, to examine here and to choose the best antidepressant for her. I am sure she will get better after starting an antidepressant. She has anxiety too, and here twitches in the body and the gastric pain are related to that. An antidepressant in effective against anxiety too. Hope to have been helpful! 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:
I am a 25 year old male Caucasian. I had an ultrasound about 7 days ago to check on gallstones which were originally found 4 or 5 years ago. The ultrasound showed Cholelithiasis is demonstrated , Incidental adenomyomatosis of the gallbladder . and Borderline hepatomegaly . . The report also says The liver is at the upper limit of normal for size, right lobe measuring 15.5cm. The liver is smooth in outline and homogenous in echotexture with a normal echo pattern. No focal hepatic mass. No splenomegaly . No ascites . . Also, my liver enzymes WERE elevated around 4 Oct 2012 (AST 40 U/L, ALT 77 U/L and GGT 72 U/L) and on 3 Dec 2012 mostly back in normal range except for GGT (AST 25 U/L, ALT 35 U/L, GGT 65 U/L). I do not drink and have only had a total of two or three standard drinks in total during my lifetime. Recent STD check showed no Hepatitis STDs. Additional possibly useful info: I weighed 85 to 87 kg around March 2012 (note I was not muscular by any means), between May and July I got my weight down (intentionally with a low calorie and low/almost zero carb diet) to 68kg and have been around 68 to 70 kg since that time. I am worried about my liver. What could be wrong, if anything? What follow up tests should I now get done? My G.P. seemed uninterested and more concerned about seeing more patients he can bill.
### output:
| Hello! Thank you for the query. If a patient in young age (like yours) has a gallstone, surgery needs to be done. It's because sooner or later, gallstones will start to giving you the pain and can lead to acute pancreatitis.However, your liver condition is not caused by gallstones. It's rather your diet has caused both, liver problems and gallstones. And as you can see, when you improve your diet, your liver tests get back to normal. This is a very good way to help to the liver and keep it healthy. Please avoid fatty foods, fried foods, spicy foods, alcohol and painkillers. Increase vegetables, whole grains and mineral water intake and your liver will be fine. No need to worry about it. You should also have your gallbladder removed. 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:
2/6/13 had thyroid removed, cancer spread to left V-cord nerve , it was also removed, leaving me with little to no vocal audio, Took one time dose of Radiation via mouth, All the expected after effects seem to occur except saliva gland problem. Bloody nose/s in both nostrils for weeks - never before interior mouth cold sores appeared - 8 months later sun makes face red super blotch - supposedly i have my T3 T4 thyroid hormone med Levothyroxine Sodium Tab 200mcg - one aday pretty much on track w/Dr. wanting it to be a bit high. two wks will b/test for the 200mcg,,, from 175 from 137 from start of 100mcg. Problem at hand NOW ! Softball size area left shoulder up into my neck feels like a crawling of a thousand ants, some stinging sensation - light pain usually is involved at the same time. Nov. i will be 71, i am 6ft tall large frame sorta muscular 25to35# over weight but carry it solid, move/work more like 50, Just can t seem to shake the extra 30 oe so # s - Altho i have been pretty stagnat sense the operation, and the damn near 2 months of preparing for Radiation was rough and then came the 7 days after Rad. treatmeant Wow !! that took the wind out of my sails, I take Metorolol Tartrate 25mg twice aday w/Chlorthalidone 25mg once aday - B/pressure averages 120/80 w/65 palse,, thanks
### output:
| You must have undergone total thyroidectomy with bilateral level II, III, IV clearance and bilateral central compartment clearance. The standard protocol after that is, after six weeks of surgery, thyroid scan, ablation of any remnant thyroid tissue with radio iodine. Also, you need to check you serum calcium levels also. After this surgery you need to take replacement for thyroid hormone for life. The dose of Chat Doctor. It takes some time to adjust dose but once adjusted is nearly constant and takes care of symptoms. The abnormal sensation you are having can be because of the damage to cutaneous nerve supply which usually occurs as we raise flaps during surgery. It usually gets fine after some time. Another reason for tingling sensation can be low calcium levels but usually is over face. So, wait for some time, do neck and shoulder exercises regularly, and you should be fine in some time. 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:
my mom says she is suffering from chest for the last one year. she had High BP complaint for about 10 years. a year back she got operated for hysterectomy. recently she complained a bit severe chest pain. i took him to a cardialogist nearby and was asked to carry out all tests. she is diagnosed with FBS of 135 mg/dL and PLBS of 235 mg/dL.LDL cholesterol of 120 mg/dL. In LFT, ALT was 73 U/L and AST was 38 U/L. In CUE blood was ++ and Leucocytes was ++. Pus cells was 10-12/hpf and RBC was 6-8/hpf. rest were normal. she got post prandial angina and rest angina. my doctor also asked to go for an angiogram ASAP. i would like to seek for an opinion not to pint out my cardiologists view but for clear understanding. i request you please suggest as soon as possible.
### output:
| Hello. Thank you for your question and welcome to Chat Doctor. I understand your concern. Chest pain can be elicited by many origins. It can come from the coronary arteries, from linings within the rib cage, from lungs, the esophagus, the stomach etc. Without further details, I would like to describe the angina. Angina (pain originated by blockages in coronary arteries) is more described like a heaviness or tenderness or squeezing sensation in the mid-chest, rather than clear-cut pain. It then can spread to the jaw, left wing, shoulder and arm. This is more triggered by physical activity, but, when the blockage reaches critical measures and/or the atherosclerotic plaque is unstable, it can happen in more frequent episodes, with less physical activity and, even, at rest. Furthermore, angina is the way of the heart to "scream for help" because it is not getting enough oxygen and nutrient supply. This kind of pain, if it is angina, happening at rest, demands a coronary angiogram, to quantitatively assess the possible blockage within the coronary artery, and to plan a strategy for treating it (with stents, merely medication or coronary artery bypass grafting). After carefully assessing and discerning about what kind of pain is this, and if it would sound like angina to me, I would also recommend a coronary angiogram as soon as possible. Of course, we only give recommendations. The choice is up to you. Good luck. I hope I was helpful with my answer. Take care. 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:
URINALYSIS , COMPLETE Test Within Range Out of Range Biological Ref Range Units COLOR PALE YELLOW LIGHT YELLOW - DARK YELLOW APPEARANCE SLIGHTLY CLOUDY H CLEAR SPECIFIC GRAVITY 1.010 1.005 - 1.030 PH 5.5 5.0 - 8.0 GLUCOSE NEGATIVE NEGATIVE BILIRUBIN NEGATIVE NEGATIVE KETONES NEGATIVE NEGATIVE OCCULT BLOOD TRACE H NEGATIVE PROTEIN NEGATIVE NEGATIVE NITRITE NEGATIVE NEGATIVE LEUKOCYTE ESTERASE 3+ H NEGATIVE WBC 20-40 H NONE SEEN - 5 /HPF RBC 0-3 NONE SEEN - 3 /HPF SQUAMOUS EPITHELIAL CELLS 0-5 NONE SEEN - 5 /HPF TRANSITIONAL EPITHELIAL CELLS NONE SEEN NONE SEEN - 5 /HPF RENAL EPITHELIAL CELLS NONE SEEN NONE SEEN - 3 /HPF BACTERIA NONE SEEN NONE SEEN /HPF CALCIUM OXALATE CRYSTALS NONE SEEN NONE SEEN - FEW /HPF TRIPLE PHOSPHATE CRYSTALS NONE SEEN NONE SEEN - FEW /HPF URIC ACID CRYSTALS NONE SEEN NONE SEEN - FEW /HPF AMORPHOUS SEDIMENT NONE SEEN NONE SEEN - FEW /HPF CRYSTALS NONE SEEN NONE SEEN /HPF HYALINE CAST NONE SEEN NONE SEEN /LPF GRANULAR CAST NONE SEEN NONE SEEN /LPF CASTS NONE SEEN /LPF YEAST NONE SEEN NONE SEEN /HPF **Panel Comments** URINALYSIS, COMPLETE plz suggest
### output:
| ``Hello and thanks posting your query on ChatDoctorYour urinalysis report indicates that there is presence of pus cells and epithelial cells in urine. Levels of leukocyte esterase is raised in urine which indicates presence of esterase positive bacteria in urine. You should get a urine culture done and start antibiotics according to the culture report. Rest of the findings are within normal limits. Thanks and 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:
My 3yrs old son is on home oxygen therapy now.On jan 3 2011 bronchoscopy was done bcs air isnt passing into his right lung puss has removed from right lung after that pneumonia had spread in both lungs.he was ventilated for 11 days( at high frequency also )from then he was on oxygen therapy on 2lts and his upper body has enlarged near rib cage we ask doctors about it . They said it is due to bcs of pressure applied by the ventilators.They said the problem was lower lobe had damaged(CT-scan report).Doctors said it will take 6monts to come out of oxygen.Now nearly 1yr over but no recovery .Now as we are asking ow much time it will take to come out of oxygen,they said nothing.Now was on steroids(omnacortil) & inhaler(puff). Pls tell what is his problem and his chest diaphragm is enlarged ,i tink it is barrel chest is it right or not
### output:
| My dear child your son has a condition called bronchopulmonary dysplasia following a severe attack of pneumonia, that has caused one lobe of lung to be damaged. There are 3 parts in the lung, the tubes called airways that allow air to pass through, there are the air sacs or alveoli that exchange the oxygen and carbon dioxide and then the part of the lung in between.basically lining is destroyed, and the elasticity is lost. This causes a lot of breathing problems -----and also he cannot exchange gases and his oxygen level will be low unless extra oxygen is given. These are the things one can help the repair process in the lung-----1. Give him very good nutrition, high energy formulas will help and vitamin supplementation especially vitamin A. Ca, Phosdphorous and It D for integration of Chest wall bone cage.2. Gentle chest physiotherapy 3. Protect from recurrent viral infections --good hand hygiene, avoid too many visitors, do not take him to malls or crowded areas, 4.avoid smoking, pets , perfumes,carpets near him.5. Medications like inhaled bronchodilators to keep airways open, courses of corticosteroids 6. Protectors like montelukast 7.regular vaccinations 8. There will be gradual recovery, may take a year or more ----follow up with a pulmonologist is a must, who will rule out some inherited disorders like cystic fibrosis and also with general pediatrician. I am sure with regular dedicated care your son should improve. |
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 currently taking suboxone 8 mg. However, over the last 5 days, I have had major dental work. I had Eleven extractions. Six last Sat, five yesterday and after the extractions I immediately inserted my brand new smile :) The dentures fit and I promised my husband (and dentist!) that I would never complain... just so happy to have my smile back. I had been taking oxycodone for many years due to numerous issues from a gastric bypass (my body wasn t absorbing enough nutrients) as well as complications from chemo. I am 55yrs old. I never had a problem with opiates. My doctor retired (poor man had colon cancer). I live in CA and everybody swears by marijuana. Not for me. So for the last 8 months my G.P. has me taking suboxone 8mg and 800-2400mg of Ibuprophen. I have apt w/G.P. tomorrow he has always been very difficult when it comes to writing prescriptions. Just asking for an antibiotic has been like pulling teeth....! So, my question is.... can I stop the suboxone today and take an opiate tomorrow for a few days and then go back to the suboxone? My dentist wrote a prescription for tramadol?? But the pharmacy said the insurance company denied it. Are there ant other STRONG pain medications out there that I m not aware of? It hurts so badly and I am a bit nervous because my next issue is foot surgery. I have always had a very high tolerance to medications. The anesthesiologist at Mt. Sinai had to give me 3 injections of ?? to put me out before my mastectomy! I sound like a cry baby, but it really hurts! The dentist said it should take about a week to heal. Any help would be greatly appreciated. Thanks in advance!
### output:
| Hello, This would have to be done by a physician of course. The blocker in Suboxone is short-acting and 2 days at the very most (and more likely 12 hrs) would be enough to get the blocker out of the system. The Suboxone is still there. It is a strong narcotic. It often helps the pain. The first thing which you may have already done is to go with a heavy dose of anti-inflammatories since this does not interact with the Suboxone and is a strong pain reliever for dental pain. The Suboxone could be stopped BUT anyone on Suboxone is a high risk of having addiction problems when not on it. 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:
Ok. I woke up Monday night with extreme pain in my back, arms, legs, and feet. I took 4 Advil and it helped the pain. But I was told I cannot continue the Advil so I was given Tylenol with coding. I get chills when the pain is bad, and it just throbs constantly. So my doctor dosent know what I have. I also get cramps in my thighs and calfs. I am in a lot of pain.
### output:
| Dear patient thank you for your question. I am sorry you are in so much pain. What I am interested in knowing is why the doctor told you not to take Advil. Also, it seems strange that he/she has not indicated what condition you might be suffering within any case I feel you may have a condition called fibromyalgiaFibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It is believed that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Symptoms of fibromyalgia:Pain areas: in the muscles, abdomen, back, elbow, or necktie types: can be chronic, diffuse, sharp, throbbing, or Severin circumstances: can occur at sightseer: difficulty falling asleep, sleep disturbances, or sleepinessGastrointestinal: constipation, nausea, or passing excessive amounts of gasohol body: fatigue, feeling tired, or malaiseMuscular: muscle tenderness, delayed onset muscle soreness, or muscle spasmsSensory: pins and needles, sensitivity to cold, or sensitivity to precognitive: forgetfulness or lack of concentrationMood: anxiety or mood wingspan: sensation of coldness or tinglings common: depression, flare, headache, irritability, joint stiffness, nervousness, painful menstruation, or tingling overtreatment of fibromyalgia:Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Alive, others) may be helpfulAntidepressants. Duloxetine (Cymbal ta) and milnacipran (Novella) may help ease the pain and fatigue associated with fibromyalgia. Anti-seizure Chat Doctor. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrics) was 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:
I have a couple of questions and wanted to see if they could be answered, and if I could use your answer in a memorandum to my military Commanding Officer. Once answered, can you also tell me what your qualifications are? My fiance underwent an emergency surgery on October 20, 2012. She had severe stomach pain and admitted herself to the Emergency Room on Fort Bragg at Womack Army Medical Center. I was away for training and unable to come home because we are not married yet. It was found that she had three ovarian cysts and they caused her appendix to burst. The surgeon removed the cysts and her appendix. Following the surgery, she has continually had stomach pain on a regular basis. This past week we admitted her to the emergency room again when the pain became too much for her to bear. Following the same tests that she had the originally had, it has been found that she has 3 more cysts on the same ovary in relatively the same spot. So after giving a brief description of her medical history, my question is this.....Would my fiance benefit from having someone around to take care of her medical needs while she is awaiting additional treatment for her ovarian cysts? As of right now, I am required to perform extra duties on base and I am unable to care for her whatsoever. So in your medical opinion, would it be safer and make sense for my fiance to have me around as much as possible to care for her medical needs and take her to her appointments, or to the Emergency Room if necessary instead of her driving herself when her pain becomes too much for her to cope with?
### output:
| Dear sir, as I understand you want to know is it necessary to be with your fiancé while she's having ovarian cyst? Well, you should know that problem comes when ovarian cyst rupture or become torsioned; this will cause sharp pain in lower abdomen and peritoneal inflammation which needs to be treated surgically in most cases. It can rupture today or never. Usually her gynecologist needs to plan her treatment and follow the size of these cysts. If it becomes too large it can be laparoscopic removed. So my conclusion is that you don't need to be around her all the time because many women have this kind of cyst and don't even know it. Also, every human can have appendicitis at any time without any risk factors so it doesn't mean that all men needs to have someone around him all the time. If she s going to need the emergency procedure for her disease she will definitely be able to Chat Doctor. Ovarian and appendix inflammation develops through 6-12 hours or even days... 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:
my son had an acute onset of back pain, loss of sensation in his left lower limb and buttocks followed in hours by loss of ability to pass urine, move his bowels or have an erection. he was rushed to hospital and had decompression of L4 L5. they said this was disc herniation. sent home about 30 hours later in a car on a three and ahalf hour journey. i am a physio. i went to ireland to him and he could mobilise independently, do stairs and was recovering bladder function although with burning. his GP diagnosed UTI. within five days his original symptoms returned. local hospital phoned dublin. surgeon said he had a routine follow up in three days, and to attend then. he was re-admitted from out patient clinic. he had second surgery following lump on MRI. they found a dural tear, said nothing else was there and padded it with a fat patch. no symptom reduction whatsoever. after saying he had cauda equina syndrome, they then said he didnt. he was given a third surgery. the motor ability in his left lower limb returned, some improvement in bladder and bowel sensation the same. over the next four days, he progressively lost the movement in his leg again.i cant understand these intermittent symptoms. if this is nerve damage, how did he regain the use and lose it twice. he is said now to have mormal EMG with some nerve damage of left lower leg. he has foot drop and grade 1 muscle power around his left hip and in left thigh. bladder muscle not working, he self catheterises. please help me. does he need a second opinoin? his is also pretty drugged for pain, muscle spasms only present after third op and his pain is worse at night he is 28 years old.
### output:
| Here first I suggest to check with fresh MRI of his back and if possible entire spine to rule out the issues with spinal cord and disc related issue. Now if MRI is suggesting any problem visit a different orthopedic doctor and take secondary opinion. If MRI report is normal then do treatment for his UTI. And do change catheter regularly every 15 days. As well follow up with medication suggested by doctor for urinary tract infection. Now for bowel, bladder function as well for spasm at back I suggest making him do certain abdominal muscle mobilization exercises along with spinal exercises and Lowe limb stretching exercises. Next for foot Chat Doctor. Here have patience and follow the steps I have given I am sure he will be fine soon. |
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:
A bit paranoid because Im not sure if I was exposed to toxic mold. I was cleaning out the fridge because it was a little messy and throwing things away, but then I found a small container hidden in the back of my fridge and it was about half or 3/4 filled with a large quantity of of whitish/a little gray mold. It also filled all the way to the top of the container as well. I spent about two hours trying to search online for what kind of mold it might be but there is many types of each toxic mold harmful to humans, and also a bit misleading because some have different colors too. Ive had some possible symptoms of what Ive read on the internet, but no sure still if its anything serious or what kind it was. I read that inhaling the spores can cause problems, and I think I may have as the texture of the mold looked fuzzy, and I had opened it close up in my face not know what it was. The symptoms I believe having minutes after were constant muscle twitching and spasms, I recall becoming very confused for a couple of moments when I was trying to Google more things and couldnt remember because of major confusions all of a sudden. I have had tremors, dizziness, foot feeling like it was asleep/crawling under skin ( I was not sitting on it, I have moved it around often ) and I stood up and walked around a couple of minutes or so and the feeling was constant and didnt go away.. during and a little after that my foot experienced some numbness momentarily. Then finally Ive been getting this migraine and I have no had a migraine in over two years now, so I got something to eat and took a couple Excedrin migraine hoping that it goes away. If anyone is to help, Id really appreciate it because Im a little concerned and just want to clear up my paranoia. Thank you.
### output:
| Hi there, Welcome to Chat Doctor, I understand your concern regarding getting exposed to toxic mold but based on the details mentioned in your query I am suspecting paranoia about fungal exposure. Most common fungi which grow on foodstuff are saprophytic fungi like Oomycetes and aspergilli. Most common symptom of inhalation of fungal spores is usually allergic asthma or respiratory symptoms like sneezing, wheeze and cough. The symptoms you mention indicate some kind of neurological weakness which needs to be examined and thoroughly investigated. Coming to your migraine, stress is the most common factor which triggers migraine. I suggest you quit worrying about fungal exposure and get the muscle twitching and spasms examined by a neurologist. 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, I am 32yrs and need some urgent help to understand my semen report. After confirming that my wife has PCOD, her gynaec also suggested my tests.Please let me know if this is a problem? Is it curable? Will it impact conception as we are eagerly planning a baby? SEMEN ANALYSISMacroscopicVolume:2.0 mlColour: Pearly WhiteReaction / pH: AlkalineViscocity: NormalLiquefaction time: 30 MinutesMicroscopic Sperm Count: 70 Millions/mlMotility *Active: 60%Slugglish: 10%Non motile: 30%MorphologyNormal forms: 80%Abnormal forms: 20%Other FindingsPus Cells: 6-8/HPFRBC: 1-2/HPFImpression: NORMOSPERMIA------SEMEN CULTURE AND SENSITIVITY (VITEK)IDENTIFICATION INFORMATIONSelected Organism: Enterococcus faecalis (Plenty growth)Benzylpenicillin: SENSITIVE (4)Ampicillin: SENSITIVE (Gentamicin: SENSITIVE (SYN-S)Ciprofloxacin: RESISTANT (>=8)Levofloxacin: RESISTANT (>=8)Erythromycin: INTERMEDIATE (4)Nitrofurantoin: SENSITIVE (Tetracycline: RESISTANT (>=16)Tigecycline: SENSITIVE (Vancomycin: SENSITIVE (1)Linezolid: SENSITIVE (2)Quinupristin/Dalfopristin: RESISTANT (8)Please let me know how serious is this problem of mine? Thanks.
### output:
| Hi, I will suggest you the best possible treatment options. I have gone through your semen analysis report, it shows normal sperms count. But presence of pus cells is a matter of concern. Please seek prescription support from your treating doctor for suitable antibiotics to get rid of the infection. For your wife, I will suggest that she should opt for a healthy diet and regular exercise regimen. Include more portions of fruits, salads and vegetables in daily diet. 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. I hope this answer helps you. Let me know if I can assist you further. 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:
My son seems to have lower back pain. Constant discomfort pain with shooting sharp pain ever so often. The last time he actually lost his hearing during the sharp pain with the dry heaves almost instantly. Could this be kidney stones, he does not have urine in his blood or stool..
### output:
| Hi Welcome to ChatDoctorI have gone through your query regarding lower back pain of your son. It is matter of concern. The majority of back problems stem from muscles that have been exhausted or strained. You need not worry, Almost every one suffers from back pain at some point in his or her life. Your son does not seem, having symptoms of kidney related problem. By following some simple steps, you can be back in the swing of things in just a few days. Take balanced diet containing all essential nutrients and supplements like fiber, protein, vitamins, minerals in natural form and antioxidant coconut water, lemon juice , ginger, garlic aloe vera juice, Turmeric powder with a cup of hot milk at bedtime, All help gain strong immune system & give resistance from diseases and relieve you from all pains. Increase your activity level. Do yoga . Stretch your back to keep it loose and avoid injury. Avoid front bending stretches and exercises from left to right stretching, while standing & lying on your back, on the ground or on hard bed, or any posture which gives you relief. Front bending not allowed. Take Homeopathic Arica 30 dose in then morning & evening and Chamomile 30 / 1 dose at bedtime. Only back bending action will help alley pains. Massage with heated olive oil or an analgesic ointment and Keep good posture. I would like to suggest you to Avoid processed foods carbs, sugar, fried, fast foods, Tea, coffee, alcohol and smoking, stress and Constipation. All produce biochemical and metabolic conditions in your body that will decrease your immunity, so avoiding is definitely the first step in the right direction to detoxing the body, boosting the immune system.meditation also gives peace relieve pains A key factor is determining whether your lower back pain is accompanied by other symptoms of kidney infection, including fevers and high temperatures, an upset stomach, cloudy, bloody or malodorous urine, and more frequent urination. Best way is to Always remember, if pain is severe or incapacitating, please see your doctor / professional and ascertain the actual cause of the problem. Hope this helps solves your query. Take care. All the best. Get well London hesitate to come back in case of any further 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:
I am 63 and about a year ago I started losing things that never left my house. I found my water in a cabinet and I think I may be throwing things away and not remembering doing it. I am involved in a lawsuit , I am being sued for the last 4 years...I am a retired lawyer...I cannot practice..I have lost briefs in my own house. I get lost while driving I have been alone since 2000. Divorce. Until last year I could handle anything. I stopped paying all my bills except utilities in July and put my house in my son s name. I don t want anything in my name ..I took care of my whole family my whole life. Everyone is dead except my brother whinherited 1/2 myparents estate so he doesn t need me and I haven t heard from him for 6 months. My son inherited the other half. I don t want to own anything...I will just give it away anyway. I give up I done want anything. I think I am doing things anf notremembering them. Ive had TIAs and a pulmonary embolism in my 30 s and have been on Warfarin since then I have an auto immune disease where my liver makes too much vit K but Im not afraid of it. I was just diagnosed with Afib. I feel like I have overwhelmed all my coping skills and my insides are turning on me including my YYYY@YYYY Thanks for listening. I have a tremer and my dr is scheduling an MRI... Im not me anymore..
### output:
| Degree understand your concerns went through your details. Sincerely speaking, I am proud of your attitude. People who undergo the hardship like you did, usually go havoc and here you are standing tall among them with your own views. Great. I admire you. Though I do not have words to you of consolation, but I do have words which should make you proud of yourself. You are not alone. Almost half of the world population are nearing old age and almost everyone suffering from physical and mental problems. Everyone is coping up. So, that is part of life. You told you are not afraid, but I will say you are brave, confident. You said you are not you, but I say You are definitely you. I think you achieved self actualization, wisdom. Now people need you as their wise teacher. There are needy people who want your advice. Find them and teach them the life. They will be happy. Rather you can only make them happy. God is with you. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. 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:
SIR ,I HAVE BEEN SUFFERING FROM BIPOLAR DISORDER AS PER my DOCTOR SAY WHEREAS I M SUFFERING FROM INSOMNIA RATHER THAN BIPOLAR. I HAVE BEEN TAKING 2MG CLONAZEPAM SINCE 1998 WITH TRICA THAN PROTHEDIN THAN MIRTAZE THAN NITROZEPAM THAN REMITAX THAN DIAZEPAM THAN VALLIUM UP TO 2010. WITH CLONAZEPAM 2MG I HAD BEEN GIVEN LITHIUM, IT SET ME BUT LITHIUM BADLY AFFECTED MY THYROID PROFILE SO AS IT SET ME MY DOCTOR STOPPED IT. THAN I WAS GIVEN 2MG CLONAZEPAM WITH 400MG QUTIAPIN PLAIN +600MG GABANEURON SR WITH 10MG ZOLFRESH SINCE LAST 4YEARS.NOW SIR THOUGH I HAVE BEEN TAKING THIS DOSE WITH SLEEP HIGINE LIKE WARM MILK WITH COWS GHEE AT NIGHT MY SLEEP DISTURBED AND I HAVE TO TAKE 0.5MG OF CLONAZEPAM AT MIDNIGHT. I THINK 2.5MG CLONAZEPAM IS HIGH DOSE. I WANT TO BE OUT OF THIS NEXUSES. WHAT SHOULD I DO? HOW CAN I ADJUST MY DOSE? MY MAIN ISSUE IS SLEEP EITHER DISTURBED OR INSUFFICIENT. I HAVE GONE THROUGH VARIOUS MEDICAL JOURNALS REGARDING THE ISSUE AND CONTENTS OF DRUGS WITH THEIR GOOD AND BAD EFFECTS.PERHAPS I MAY BE MY OWN PSYCHIATRIST OR NEUROLOGIST. SORRY SIR PLEASE GUIDE ME.
### output:
| Hello, You did not describe your symptoms, but according to your Chat Doctor. Main thing is insomnia for you; I will suggest you to first follow proper sleep hygiene along with medication like Mirtazapine along with benzodiazepine. In sleep hygiene:1) Do not use of your bed for any other work expect sleep2) Stop all activity half hour prior to sleep3) Take warm water bath before sleep4) Not to use of clock with sound in your be |
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 father 78 years age is suffering from parkinson & it is in a quite an advanced stage. Earlier it was deteriorating but was fine going to markets etc. Just 4 months back had orthostatic hypotenstion his pressure is falling drastically when he is standing up and then after waling for just a minute or so he starts shaking vigorously. We have shown to 3 neurologist given some medicine but still no improvement as such. Moreover he is having dementia was talking irrelevant things but still we were managing but now for the past two days he is just sleeping for atleast 18-20 hrs a day. He is taking very less food and whatever he is taking he is keeping inside his mouth and not swallowing. It is painful to see. I will jolt down the medicines he is taking-Syndopa 275 (1/2 tab 4 Times), Ropark 0.5 (1 tab 2 Times), Admenta 10 (1 tab 2 times), Galvus Met (50/500)-1 Tab, Nodon 2.5 (1 tab 2 Times), Aztor 10 (1 Tab), Floricort 0.1 (1 1/2 tab -in one day), Qutipin 25 ( Tab 1/2), Alfoo 10 (1 Tab), Syp Potklor (1 TSP- 4 Times), Tab Cognate (1 Tab alternate days) and Syp Somazina (1TSP 2 Times). He is taking so many medicines but still no improvement and one thing that is going on increasing is his aggressiveness. He is getting very angry when people scolds him or tells to eat he tries to hit him. Very painful to see -pls pls any suggestion on this are welcome. How to improve on it atleast we want it in a manageable level knowing that he is in a advanced stage. But still feels that something may be wrong some medicines added or removed can help him out.
### output:
| Hello friend,"It is painful to see" - you have written. I am a Homeopath. As a doctor belonging to a different system of treatment, it is also painful to read your letter. You were made to believe that your father will be improving by the twelve medicines he is taking at present and Hun Chat Doctor. From experiences, you should learn. Dear friend, you are invited to imagine a train accident taken place because of the loose bolts connecting between two iron plates of the rails. It was a small problem to start with, which could have got repaired by an ordinary laborer with the least technology, but a great calamity when the compartments of the fast running train got derailed and fell into a river killing Hun |
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 61 year old female, I had my gall bladder removed about 14 years ago, and I have had alot of problems since. 2 years ago I went for a choloscopy bcause of continuas diorea, which got so bad I was frightened to go out. This test was normal so I decided to go for a food intolerance test which showed up that I was yeast and lactose intolerant. Since cutting out dairy and yeast I am alot better but still have flare ups for no apparent reason. My lower right stomach below tummy button is quite tender and my stools are always a mustard colour and very loose. I am other wise in very good health and people say I look much younger than my years. I recently had a blood test for cholostral and it showed liver function was impaired, but a month later I had more tests LFT Thyroid and Hepetitas and all came back normal. Could you please advise me thanks Sandra.
### output:
| Hi.thanks for posting query at Chat Doctor. Read your question thoroughly and understood your concern. Gall bladder primary role is to store "bile".when gall bladder is intact, bile is usually secreted after having a meal rich in fat; bile plays a vital role in fat digestion. After gall bladder is removed, bile is continuously being secreted in small intestine and may reflux into stomach. As a result, gastric inflammation may occur causing pain and discomfort. Moreover, high fat meal induces more bile synthesis - further affecting gastric mucosa as well as bile is less concentrated and Chat Doctor. Advise:NO fat intake or decreased fat intake few weeks trial of OTC proton pump inhibitor (omeprazole/pantoprazole)to combat gastritis (after discussing with treating physician)mebeverine maybe used for cramping pain small meals Add soluble fiber, such as oats and barley, to your diet. But be sure to increase the amount of fiber slowly, avoid dairy products and caffeine post cholecystectomy pain maybe due to stones in common bile duct OR increased fat intake OR functional pain.advice:- get an ultrasound (abdomen) to rule out any stone remnants in common bile duct-also get a complete blood cell count(CBC) test-avoid eating stomach full and mouth full-avoid spicy food - add plain yogurt (Yogurt contains bacterial lactase, so you can tolerate it)hope to answer your concern wish you good and sound 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:
HI , I am wondering about myself were im at , I think I burnt out at work just pire 2009 and throwing a big contract away as I was working huge hours .so there maybe issues there relating to struggling with work .. ..I broke my leg 2009 not long after throwing contract and ended up in bed for 4 months and I pretty certain I got a hypoactive disorder .I hv changed a lot and dont understand wats going on , my marriage fell to bits but I think it was going anyway ..was married 14 years 11 good last 3 go worse moved out meet a lady 1 month after moving out and she turned out to hv adhd. I been with her for 15 months constantly breaking up n getting back together .she really trys to change but she has major jeliously and anger issuses..I find I am upset and angry with her behaviour of accusing me of things I am not doing all the time , she accuse me of trying to hook up with all other woman all the time wen im only interested in her . I sent her to her sisters once she turned up back at my place and slit her wrist in front of me .that was 8 months ago .2 months ago she attacked me and scratched my face quite bad , she been back up north by her mum since .I am alone hwere in nelson im drinking quite alote again I can do 5 jugs 2-3 nights a week . im struggling to go to work . not because of drink but I feel depressed dont care .I love this woman but dangerous to hv her back. I got her on to 4 different medicartions , pysho specailists , docters etc ,, I cant help her .not even sure I can help myself . I never talked to anyone before how I feel I just work thro stuff .could I need help
### output:
| Degree understand your concerns went through your details. I suggest you not to worry much. Your wife seems to be psychic and manic patient. There is no alternative than to continue the medications your psychiatrist prescribed. In addition, love and affection can cure her. You know her well. Forget your past. Your past can do nothing to your present if you ignore them. But if you don't ignore them, they shall haunt you. You are experiencing the haunting. Therefore, ignore your past, live in present, love your wife and live a happy life with her, and she shall be alright. Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition. 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:
I was rear ened by a buick lesabre while I was at a stoplight on March 12, 2012. Immediatly after the accident my whole right side from my neck to my lower back was sore. By that evening I had shooting pain down my back and hip and pain in my leg. I could barely move. A week later, my leg and foot was tingling and went semi numb. That turned to horrific burning and pain from my lower back, hip and down outer thigh to my foot and toes. I took the medrol dose pack two months after suffering with this severe pain. The pain returned four days after I finished the pack. I had physical therapy in the meantime and two months into that had an epidural steroid in my lower back. That dulled the pain a bit for about a month. Then it gradually increased again. I had an MRI of my lumbar and cervical spine that showed a small left later extraforaminal l bulge and protrusion at l4 l5 that the doctors say cannot be causing all my pain. I have been diagnosed with nerve root inflammation at l4 l5 by one orthopedic doctor and muscle strain by other orthopedic and nuerologists. Eight months later, I still cannot sit, bend, lift, reach or walk without pain in my back, hip and down my leg. I am taking mobic now. It just dulls the pain a little bit. I wake up with baseline pain every day and it increases with motion. I also find that my knee hurts with walking and moving too. What can I do to get out of pain? I am frustrated and exhausted. I had no preexisting conditions before my MVA.
### output:
| Hello, thank you for sharing your problem in Chat Doctor. Pains generated from traumas are in general complex pains. This means they have many causes : emotional, muscular, articular, bones and innervation. If your MRI didn't show any problem with your bone and articulations they can be caused by the torsion of all the muscles in that area. A big part of it can be caused by the hernia tic disc that was shown in MRI. Doctors might have said you that it can't be responsible for all your pain, especially if it is a small hernia tic disc. I believe that the pain also has his emotional components. In 2 patients having the same problem, the perception of the pain can be different and also in the same patient having a problem the perception of the pain can be different in different times. What I suggest are Anti-inflammatory non-steroidal Chat Doctor. You have to check out with your doctors if they can intervene. |
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 doc, i have 3 questions i need answers to and will greatly appreciate your help and response.1) i had unprotected sex 3 days after my period and took postinor 2 about 10hours after. Am i still at risk of getting pregnant?2) i have been having irregular periods for about 5-6 months now. what could be the cause/3) i usually have boils around my private part before or during my periods...is it normal or what could be the cause?
### output:
| Hallow Dear, Let me answer your queries one by one. 1. In fact there was no risk of pregnancy from the unprotected sex performed just 3 days after the period as it was far away from fertile period. The egg is formed 14 days prior to next period. It has life of 24 hours while sperms are active for 72 hours. Hence, a period of about 8-10 days is considered as fertile period. Intercourse during this period has maximum chances of pregnancy. However, your menses being irregular, it is very difficult to locate the day of egg release. (Maybe you could be having problem in egg release also.) Still, considering your menstrual irregularity, you have taken a wise step in taking Posting 2 after the unprotected intercourse. Posting 2 is quite effective post-coital emergency contraceptive pill if taken within 72 hours of unprotected sex. You have taken it after 10 hours. So you need not worry about pregnancy. You are well protected. 2. Your irregular menses need to be investigated thoroughly. There are many conditions that lead to menstrual irregularities. Some of them are Polycystic Ovarian Syn Chat Doctor. ...... it will fill your complete desk top if I start enumerating all of them. I can guide you on this issue thoroughly if you inform me your age, menstrual pattern, age of monarch (first menstrual appearance), marital or sexual history. You can inform me all this by asking a Direct question. Else, you may report to the Gynecologist. Irregular menses may result in infertility due to non-release of eggs. For the time being, you may try cyclical birth control pills for three months for regularization of menses as a preliminary step. 3. Boils around the private parts are usually due to infections; may be sexually transmitted infections like gonorrhea, herpes genitalia, etc. You need to report to STI specialist for correct diagnosis and appropriate treatment. You may need antibiotics treatment. Also, you will have take care of genital hygiene and be demanding for clean sex only. I am sure this has given you some direction on your reproduction health problems. |
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 gone to pain drs, therapy, chiro and foot doctors with no relief....I have siactic and foot pain and since last summer my left foot is turning outwards making me unsteady at times..also the left leg over the years has become uneven, making it seem shorter... injections, chiropractic, back surgeon, foot and ankle dr....Back dr says I have 2 nerves that are being pinched (from mri) and he wants to operate and put plate and pins in my back with a few months wearing a brace....the foot dr took exray of left foot and says my inside tendon is stretched, gave me a couple of different braces to wear, but not much relief..also had an mri of foot to confirm stretched tendon...said he could put a pin in outside of ankle to straighten my foot, but need to ask him if that would ease the pain, this is a constant pain...can t go walking anywhere, except to stores that have grocery carts...no mall walking or anywhere lots of walking is necessary...oh, also my spine is curved and I am 69 years of age...can t work out in the yard and much housework, I am not sure is pinched nerves and foot pain are related...if I got my back worked on, would it help my foot, don t want surgery , not knowing if my pain will go away...I know nothing is a guarantee...do you have any answers for me?
### output:
| Hi, thank-you for providing the brief history of you. As I understand by your history that you have a pinched nerve and also pain radiating to the feet. Since you took all possible treatments for it and no relief as such. Well, this makes me understand that your spinal muscles are too weak and need a workout to strengthen it. As we don't have medicines to strengthen the muscles. The first thing I will advise you are to meet a physical therapist. The use of therapeutic ultrasound therapy and TENS therapy will help reduce pain and inflammation in the muscles. If done properly, then pain level comes down to 50% in 3 days. The next plan is to implement exercises. Though painful and tiring but will surely help. Exercise includes -1. Core stability2. Pelvic floor Strengthening3. Spine muscle Strengthening4. Hip muscles strengthening5. Lower limb and Upper limb.6. Breathing exercises In my personal experience I have seen cases with failure of cortisone, Chat Doctor. We have a 99% success in they proper neuromuscular assessment and the specific muscle training will help you to the optimum results. RegardsJay In |
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 at the end of my rope. I have tried everything in an effort to cure my bad breath and nothing, I mean NOTHING works. My girlfriend just left me because of this problem. I have tried everything on the market. Every remedy offered, from the inexpensive to the very costly. I also tried natural remedies such as grapefruit seed extract, including the drops, nasal spray, mouth spray and the tablets. I have tried the colostrum, capsules as well as the powdered form, I also tried the liquid chlorophyll which did nothing but turn my tongue and teeth green. It has been four months and there has been no change. People can smell my breath from several feet away. I Get regular dental cleanings and I brush five times a day and my teeth appear white and clean my I even brush my tongue and it appears pink but my breath still stinks. furthermore, what makes it even worst is the fact that I can not smell it. I feel like CRAWLIN INTO A BOX and hiding everyday; how does one live the rest of their life this way. I FEEL LIKE A leper that has been exiled from society because of my breath. Someone please help me!!!! I will do anything. I am successful, educated, I own my home but, at the end of the day I have absolutely no friends. After surviving eight hours of workday {which by the way is how I feel from day to day} I have to muster the strength to get through the day.The the whispers, laughs and sly comments are all most unbearable. On top of all of this I have to come home to an empty house. My breath controls my life. To make matters even worst I work in the educational field so I have to speak regularly. What do I do??
### output:
| Thanks for your query, I have gone through your query. It is very sad to listen to your depressing condition, nothing to worry, be bold. It can be solved, no need to get depressed for halitosis. The bad breath could be because of the deposits over the teeth causing gum infection. Or it can be because of the pus discharge secondary to gum or tooth infection or any respiratory tract infection like sinusitis or gastrointestinal disorders. Consult an oral physician and get yourself examined to rule out these conditions. If it is gum infection get the teeth cleaned once and maintain oral hygiene after that. You can use mouth wash. If it is tooth infection get the tooth restored. If it is respiratory tract infection consult a pulmonologist and gastroenterologist if it is a gastrointestinal disorder. I hope my answer will help you, 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:
i ve had viral meningitis due to enterovirus. then developed peripheral neuropathy. it was so bad after a month i was crying in pain at night. loudly crying. finally went to ER to see neurologist as my gp had not referred me a few days earlier! saw neurologist, nerve conductivity test, ok, on 1500 mg day of gabbapentin. plus amatriptonlyne. pain still there but not as bad. now my legs are going numb and they are freezing while i sit at my desk. walking helps but minute i sit it is back. pain in my knee joints and right elbow. chills like fever, then hot, then cold. i am really scared. o, and mri last week showed no inflamation in my spine.
### output:
| Hello, Your situation should be evaluated more carefully. You mentioned that you have developed peripheral neuropathy but your nerve conduction studies are OK! Peripheral naturopathies are diagnosed by performing Nerve Conduction Studies, so I assume that your neurologist has found some clues for a neuropathy, but you were at early days, so the Nerve Conduction Studies were still normal. Although Gabapentin and Amitriptyline that you are getting are good choices to relieve pain, they might need several days up to 3 weeks to show maximum effect. There is one serious situation that you should be noted: You mentioned that your legs are going numb. This could be a symptom of a specific type of neuropathy called Acute Idiopathic Desalinating Polyneuropathy (AID), formerly known as Guillain Barrel Syn Chat Doctor. It is very important that this type of neuropathy is ruled out in your situation because it has specific treatments that should be done by hospitalization. On the other hand this type of neuropathy can potentially affect heart and respiratory systems and sometimes become dangerous. Also be noted that at early (even first few weeks) after this problem Nerve Conduction Studies could be normal. So, my advice to you is going to an experienced neurologist or a hospital which has a neurology ward. They will examine you, especially your muscle powers and reflexes, most probably repeat the Nerve Conduction Tests (EMG and NCS) and sometimes some blood or other lab tests to rule in or rule out the above-mentioned disorder (AID). Please, do not rely on those medications for the pain. They are important, but your more important symptoms are numbness and weakness of the limbs. 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:
Is it normal to have a swollen lymph node for 6 months? Hi, I am a 20 years old female. I have had a painless lump or swollen lymph node that has been in my neck for six 6 months now since December 2010 that can only be felt, but not seen. The lymph node is no bigger than the size of a half a dime and feels like a swollen kidney bean that keeps changing in size from small to big and then smaller again, but it never fully goes away. In terms of texture I cant tell if its firm, soft or hard. Its hard to tell. Anyway, I finally went to my doctor in early April 2011 to get it checked out and he put me on a weeks worth of antibiotics, and prescribed me some allergy and asthma medication. He also did a chest X-ray and blood test that came back normal. When I went back to my doctor he said that the lymph node had shrunk and that was a good sign and that it might have really been an infection. So he told me to observe it for a month and come back to check it out and if its still there he will send me for a biopsy. So far the lymph node is STILL there and it feels like it enlarged back a little, but that might be because I keep picking at it from worrying so much. So far I dont have any symptoms of fevers, night sweats, fatigue, persistent itching, or unexplained weight loss, in fact I gained ALOT of weight from anxiety and stress eating from the fear of this being lymphoma or some other cancer. Lastly, I think its in the posterior triangle area of my neck not sure of diagram of lymph nodes. Is it normal for a lymph node to be swollen for 6 months?
### output:
| Thanks for your query at Chat Doctor. I understand your concern and situation. You are having chronic lymphadenitis. Lymphadenitis occurs when the glands become enlarged by swelling (inflammation), often in response to bacteria, viruses, or fungi. The swollen glands are usually found near the site of an infection, tumor, or inflammation. Prompt treatment with antibiotics usually leads to a complete recovery. It may take weeks, or even months, for swelling to disappear. Sometimes it is seen that lymph nodes respond to treatment but with recurring throat infection there is changing sizes. You can get evaluation done by ultrasound guided FNAC or biopsy for AFB, culture sensitivity test for aerobic and anaerobic bacteria, cytology. This will clear your doubts. 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 there, otherwise healthy 37 yo female. Normal BP/Cholesterol etc. Have been suffering from occasional palpitations (feels like skips in my chest which forces me to cough for the past 2 1/2 years. I only get them a couple of times a month and sometimes I can go months without getting them. I am on 20mg Celexa for anxiety which was caused by these palps which really freak me out. Ive also had two episodes of really fast heart beat which I think was due to dehydration and not eating properly those days, Ended up in the emergecy room the first time that happened, all check out o.k. Ive been to a cardiologist, had a holter twice, numerous ekgs and been told these skips are normal that everyone gets them and that I am more prone to feeling them. My GP suggests upping the dose of celexa to 40mg which may help. I also take magnesium which seems to soothe them, do not drink caffeine at all and avoid simple sugars with the exception of alcohol from time to time and I do notice the day after drinking wine I tend to get them. I am mainly after some reassurance that these will not kill me and your advice on how to live with them. Thank you!
### output:
| DEAR USER, THANKS FOR CONSULTING WITH ChatDoctorI UNDERSTAND YOUR CONCERN.YES PALPITATION CAN BE CAUSED BY ANXIETY AND YOU CAN LIVE WITH THEM AND THEY WILL ALSO DECREASE WITH TIME.THEY Won't REALLY HARM YOU. DON'T WORRISOME ELENA TO 40 MG MAY ALSO HELP SUGGEST YO TO DO THE FOLLOWING1) IF YOU COULD MESSAGE ME WHY AND WHEN YOU BECOME ANXIOUS I COULD HELP YOU SOLVE IT2) 45 MINUTES OF MORNING YOGA WILL HELP YOU CALM YOUR MIND AND DECREASE YOUR ANXIETY3) TALK TO YOUR PARTNER OR CLOSED ONE ABOUT THE PROBLEMS YOU FACE4) AVOID STRESSORMESSAGE ME IF YOU HAVE ANY ISSUES WITH COPING YOUR ANXIETY I MAY HELP EUROPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS |
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:
Depression and anxiety query:Hello, I have an extreme child trauma history of abuse, neglect and various others. Have come out with a mixture of diagnosis (mainly and in no particular order: Depression, Anxiety, Social Anxiety, Obsessive Compulsive, Post Traumatic Stress and Borderline Traits). I have managed majority of these, but still struggle with Mixed- Depression and Anxiety symptoms. I have seen Psychiatrists this past year and have been on Pristiq for approximately 1 1/2 years now. I have tapered down from 150mg, to 100mg, to 50mg, to 25mg and have now come off of anti-depressants completely.I have very specific queries in regards to managing my symptoms. I wish to go on natural therapies mixed with Clinical Psychology treatment which I am currently in my 2nd year of therapy. I am starting on St. John Worts in a few days once the Pristiq is out of my system. I have been researching DMAE and Niacin quite extensively, but just not sure where to take it from here and would like advice as to an experts opinion as to my best options. I do not use illicit drugs, use nicotine nor on any other prescription drugs. I do however, drink more than Id like (3-4 times weekly, mainly weekends where intake is approx-5 s.d.). I have family history of depression, schizophrenia, bi-polar, anxiety, drug and alcohol addiction and abuse etc.If would really appreciate to have some advice from a professional in the fields recommendation.
### output:
| Hi, I can understand your concern about medication. Considering strong family history, Chat Doctor. Such kind of illness is like Diabetes or Hypertension which can be only controlled on medication and not going to be completely cured. Most of time illness is episodic, so you feel better in between episode and feels that you are able to control your illness-but remember next time when it reappears it going to be more and more difficult to treat and resistant one. Ongoing continuous medication saves you from this fluctuation and helps to maintain your quality of life as normal as possible. Medicines are like specific extract from your natural product with avoiding amount of other chemicals which not going to be needed for improving current illness. So it's always advisable to continue medicine and along with this continue psychotherapy from experts. Instead of mentioning name of psychiatric illness mentioning current disturbances will be much helpful to advise any further management. Hope this will help you. You can Post any further query if you have. |
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:
Last year had a L-Spine MRI which showed A well circumscribed 1 cm T2 hyperintense lesion on left mid kidney. Back pain for years. Pain got severe 3 days ago, when to patient first have in infection by urine or blood test, but +3 blood in urine and low blood count in labs. What could this mean?
### output:
| HI THANKS FOR YOUR QUERY.1cms HYPERINTENSIVE LESION IN YOUR LEFT KIDNEY COULD BE SUGGESTIVE OF THE FOLLOWING :1.RENAL CANCER.2.CYSTS WITH BLEED.3.ANGIOMYOLIPOMA-FAT CONTAINING LESION.4.METASTATIC DEPOSIT FROM UNKNOWN PRIMARY.SINCE YOU SEEM TO HAVE BACKACHE FROM 3 YEARS, IT SUGGESTS A CHRONIC PROCESS/LONGSTANDING DISEASE PROCESS.IN YOUR CASE THERE IS HIGH POSSIBILITY OF A MALIGNANT/CANCER PROCESS OPERATING DUE TO SUDDEN ONSET OF GROSS HEMATURIA(BLOOD IN URINE).IT IS EXTREMELY IMPORTANT TO RULE OUT THIS DIAGNOSIS IN YOUR CASE.SUDDEN ONSET OR SEVERITY OF PAIN CAN ARISE BECAUSE OF BLEED WITHIN THE Tumor.ALL YOU NEED RIGHT NOW IS AN ULTRASOUND GUIDED BIOPSY OF THIS MASS TO REVEAL ITS PATHOLOGY.THIS HAS TO BE ASSISTED WITH URINE FOR MALIGNANT CELLS.RENAL CANCER IS MANAGED BY PARTIAL OR COMPLETE REMOVAL OF THE KIDNEY, DEPENDING ON ITS STAGE WITH OR WITHOUT CHEMOTHERAPY.IF MALIGNANCY IS EXCLUDED, THE OUTCOME IMPROVES FOR ALL CYSTIC AND BENIGN LESIONS.CT ABDOMEN WILL HELP TO IDENTIFY ANY METASTATIC DEPOSIT/DISSEMINATED CANCEROUS GROWTH FROM AN UNKNOWN PRIMARY SITECONSULT AN EXPERT UROLOGIST Alongside A NEPHROLOGIST FOR FURTHER MANAGEMENT.CONCLUSIVE IMPRESSION:RENAL CANCER EXCLUSION IS HIGHLY ESSENTIAL.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:
Sir, i am 35 year old, arround 12 years back i was treated my mitral stenisis by balloon valvotomy, after that I was taking lanoxin and diuretic tablet and pencilline enj. Last year my echo show that now mitral valve is thick and fibrosed valve leaflet and I have moderate mitral stensis 1.58 cm2 with calcified tip. Along with this Aortic calve is also trileaflet, thickend and fbrosed with (moderate leakage) having Lt, Atrium dimension 35 mm and LA-Aorta (1.6).Left atrium dilated and left artrial overloaded. wall motion is normal and ejection fraction is 60 percent,.Sir here one doctor say that i have moderate heart failure and i need both valve replacement in near future, another says I can wait for few years.Now a days I am feeling palpitaion daily.I am taking 25 mg metopropal, dytor plus 10. how much time I can wait for valve replacement? both valve can be replaced at once?wtah would be the cost?and wahts is the expexted life expectancy after valve replacement? thanks
### output:
| Hello Thanks for posting here. I have gone through your description. Your mitral valve area of 1.5 8cm2 is classified as moderate. Patients with Moderate MS with symptoms should undergo a valve replacement. Your symptoms are only palpitations. You must get an EKG done to see whether you have irregular heart beats called atrial fibrillation which is common in mitral stenosis. Treatment for atrial fibrillation can be given if required. Aortic valve also has moderate leakage so surgery not advice at this point. Your LA size and aorta size are normal so again no indication for surgery. I suggest you be on lanolin, diuretic tablets and other medications at present. Yearly 2d echo must be done to see the valve stenosis and to evaluate ejection fraction. You MAY require surgery at some point of time. But heart surgery is to be done only when it's the right time and not as a preventive thing. Yes both the valves can be changed during the same surgery. I do not know about the cost of two valve replacement abroad, in INDIA it is about 3-5 lack depends on where you are doing it. The life expectancy after a successful valve replacement is more than 20 years, but it has to be done at the hands of a good surgeon, so please don't compromise on the cost. 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 name is Brianna, I m 20 years old and have a one year old daughter. I m married but my husband is in the military so its impossible for him to ever be home. I have a few issues mentally and I m terrified it s going to get out of hand and start scarig my daughter and I ve never been prescribed a medication that helps without side effects that effect daily life. I have tried anti depressants but they make me suicidal, hallucinate or really fat. I ve tried mood stabilizers but they work the first 2 months and somehow stop. I ve tried buspar which gives me electric shocks and seroquil which makes me too tired to be able to wake up and do what I need to do with my daughter . I m unsure what to look into, I know I have ptsd and thats where my issues stem from, but is there even a cure aside from therapy which I do over the phone? What should I do to take precautions so my daughter doesnt experience what I went through with my mother? I m not sure where else to turn aside from this website. I m not REALLY crazy all the time, but when I lose it I can t bring myself back without being self destructive and I feel like I m about to spiral. I dont know what to do to be the mother my daughter deserves. Any advice ? a pressure point or anything ? I know I sound desperate but I don t know where else to turn .
### output:
| Degree understand your concerns went through your problem. I suggest you not to worry too much. You are sure that you have PTSD but you don't know how to come out of it. Then I confirm that you do not know what is PTSD. I am sorry to say this. You should have given here what is traumatic experience you underwent. Second, Every person goes through some traumatic experience in his or her lifetime. And most of those people don't even know what is PTSD. May I ask how they tackle the situation? Any idea? Every such people go for advice from elders and elders say that it is very normal. They talk to those people and motivate them, and they come out of that situation within 2 months or so. In your case, you are carrying the so-called PTSD with you. The problem is not a briefcase, to carry with you. Leave it aside and concentrate on your life. Using psychotropic Chat Doctor. Please see a psychiatrist or psychologist for further advice. You might need psychological counseling., I am more than happy to provide telephone psychological counseling through Chat Doctor. Contact me through customer care, www.ChatDoctor .com.hope this clears your doubts. 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:
i recently went to the er with shortness of breath and a fever of at least 103 for over a week. The er doctor ordered a blood test to check for a blood clot, then a ct scan with the dye or whatever it is that you get through an i.v. The doctor let me know that I have empysema, swollen lymphnodes in my chest, pneumonia (at the time), and that the scan showed two spots on my lungs that he said could be some form of malignous cancer, I probably did not say that exactly correct, but those words was included. I did a follow up with a family doctor. He took a chest x-ray and did a breathing test on me. My percentage was 61 before a breathing treatment, and 81 after a treatment. He said he did not really see nothing to indicate cancer from the x-ray but I did have the swollen lymphnodes and he wanted to examine the ct scan a little more and have another one done in 3 months. Two radiologists, that looked at my scan results from the er, told me I needed to get to a doctor as quickly as possible, and I did, Im kinda concerned that he did not seem to take much interest in the possible spots and am very concerned and would like to know what I am dealing with. The COPD is bad enough and I have alot of trouble with shortness of breath just walking a very short distance and my back has began to hurt alot just under my shoulder blades. Any advice???
### output:
| Hello, I can imagine that these spots in the lungs are distressing, and I hope I can shed some light here. Pulmonary nodules (spots in the lungs) are fairly common, and as you know they can be caused by very minor/benign issues like an infection/pneumonia, or they can be serious and represent a growing cancer. In most cases there is no way to tell right away which one it is. With your COPD, and assuming that you have smoked during your lifetime, you are at a higher risk for lung cancer. The main factor that determines the next step is the size of the nodules. Bigger nodules warrant closer follow up. Smaller nodules can be followed at a wider time interval (for example 12 months instead of 3 months). Three months is a reasonable interval to repeat the CT to assess if there is any growth in the nodules and this is most likely what I would order for you as well if I was seeing you in my clinic (of course this depends on the actual size of and other characteristics of the nodules). If there is growth, you most likely will need surgical resection of the nodules depending on where they are located and the function of your lungs. I hope this answers your questions. |
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 22 yr old male and have had a lot of risky sex so I would not be surprised if these are HPV warts. However, they do not seem to be warts (or at least the types of warts you see/read about on the internet). These bumps are on the skin of my pubic area. They are mainly flat and roundish (however one or two of them looked more like a skin tag than a bump). None of them were of any significant size (all well under half an inch). So I squeezed them out. And for each bump it was the same. I would squeeze it and a solid mass would come out (sort of like a blackhead). The mass was not very hard like a pebble or tough blackhead, however it was not waxy or soft; it retained its shape if squeezed or pressed on but it was still fleshy. They were flesh colored although some had a darker hue to them. They popped out when squeezed as if they were lodged in my skin and each one was smooth and roundish (while the skin-tag looking ones were not). They would leave behind a small hole in my skin that would begin to bleed so I cleaned the areas with hydrogen peroxide and applied pressure. They are now scabbed over and healing. I do not know how long they have been hiding in my pubic hair (or how long they have not been in there). I just noticed them yesterday. However, a couple of months ago I did find one on the crease of my scrotum and inner thigh. And it did the same thing: I squeezed it, a fleshy mass came out, it bled, healed, and disappeared. I looked for it in the same area and have found nothing, so it seems these things respond to being dug out
### output:
| Hello, Welcome to Chat Doctor, Genital warts are caused by HPV (human papillomavirus). The virus is acquired sexually. Treatment options are either surgical/ local ablation with electrocautery, radiofrequency cautery, CO 2 Laser Or cryotherapy. Medical treatment options are topical 20% Podophylotoxin resin and 5% Imiquimod cream. The doctor may choose to either remove them surgically if there are just a few countable lesions Or else may choose to treat them medically if there are numerous lesions Or use a combination of medical and surgical treatment options. I would suggest that you take another appointment with your dermatologist regarding the most appropriate method of removal. If you strongly suspect you can get a Polymerase Chain Reaction test done on the biopsy to identify the strain of HPV causing the lesion. 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:
Hello,I am a 36 year old woman and I weigh 11 stone.My problem is that I have a pain in my thigh which I can t pinpoint,it feels like blood isn t getting down to my feet as the pain can shift from my thigh to the bottom of my right leg.massage can help but not always.It has got really sore that when I have woke up I have an inch long purple/black bruise which isn t sore to touch on the outside of my right thigh.walking as well sometimes helps but not always.thanks
### output:
| Hi, In your case, there are few information that would be very helpful for me (if you have provided): - do you have a low back pain (I assume not)- do you have a paresthesia in the legs or feet-did you have a history of any trauma to low back or gluteal area?- did you have a history of any intramuscular injection before the symptoms?- for how long do you have these problems? Please provide these answers to any doctor that you seek his/her advice in the future. Overall, based on the provided information, a thigh pain referring to the bottom of the leg most commonly originates from a nerve, a muscle or joint. I summarize them here: 1- Nerve: It is possible that you have a disk protrusion at a low back area. Sometimes a protruded disk induces pressure to the adjacent nerve and causes thigh pain. In some cases there is no low back pain. Also, if the sciatic nerve is irritated by any cause, it causes the same problem (this is a rare cause).2- muscle: a tight muscle area (Trigger Point) in some gluteal and thigh areas can cause posterior thigh pain with radiation to the leg. 3- Joint: There are small joints above and below any vertebral bone. We call them facet joint. If the facet joint of the L5 vertebra (the fifth vertebra) is irritated or damaged by any cause, it can cause thigh pain, which is sometimes not accompanied by a low back pain. In conclusion, if your problem is for only a few days you can take a 3-5 day course of an anti-inflammatory medication (such as Ibuprofen, Diclofenac, ...) and an anti-spasm medication (such as Baclofen), (certainly if you don't have any contraindication to use them. If you have the problem for more than 2 weeks you should be visited by a Physical Medicine and Rehabilitation specialist, Orthopedist, or Rheumatologist for a more accurate diagnosis. 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 have an area on my lower leg, ankle and above, that is red/purple in color. It is not really swollen, but it is a little warms to the touch. When you run your fingers over it, it feels bubbly like. It is slightly tender to touch, firm and almost like a band is around it. My feet have been swollen. On Lasix now and swelling has gone down a lot. Any thoughts?
### output:
| Hi, Dear thanks for the query to Chat Doctor virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear You seem to suffer from Varsity of the Short Saphenous Vein with multiple bumpy swellings. Your query data of tender lumps with firm to band like ring around, is very characteristic of the perforator bump popped of the Deep fascia of the lower leg and confirms clinically its diagnosis as -Multiple Varsity with Chronic Venus Insufficiency causing edema.Hence, Las ix which works in renal or cardiac edema is not the treatment for this Venus edema, which needs special treatment. Treatment-Get second opinion to assess the disease from Surgeon. Get Dual Image Color Doppler USG study of the Long and Saphenous Veins and confirm the extent of the Chronic insufficiency in your case. If the conservative treatment of 6 weeks fails, use this period to prepare the case for ELT for to correct the insufficient valves and for blocking the perforator feeder veins by polyvinyl ball embolization or by spring embolization, which would correct the Chronic Curiosities, in remaining future lifespan of yours. Conservative Treatment-is by-Rest/Elevation of the lower legs/-Reducing the Venus pressure and edema by Veno-stockings /-recouping the tissue health and body health by attending to DVT if need be/-Antibiotics/Painkillers-for if any Venus ulcers are there./-Good Diet and Vitamins prior to EVLT-surgery/ For this treatment GP and Surgeon and Vascular Surgeon team would be needed to treat your case. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. Chat Doctor. N.M.S. Genl-CVTS -Senior Surgical Consultant |
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 has just turn 12 months old, he is breasfeed on demand and has breakfast, bananas and fruit smooths, the odd rusk and dinner with a petit flue. On Tuesday he was diagnose with asthma and so after neubalisers etc we came home and he is on two inhalars, one for preventing asthma attak and the other to help him with his breathing, which we ll give him for a week. We are happy with all that, its just that since we came home he seems to be vomiting up everything he eats, twice or three times he has kept the breastmilk, this is acompanied by sticky white mucus and soild nappies with A LOT of this mucus, its been 24 hrs.,he is happy and smily but hungry and unable to keep food down, any ideas? He also had taken for 3 days stereoids 20mg for three days, I manage to give himwater, but I am still worried!!
### output:
| Hellos your son diagnosed a patient of asthma, so I will try to explain you some preventive measures for your son for asthma. He is now taking steroid and one more inhaler, if your son don't have any symptoms or discomfort stop all medicines. 2nd point is about the vomiting, he is having. The cause of vomiting may be due to gastritis developed by Chat Doctor. When such patient visit I advise my patient to take ondansetron syrup or mouth dissolving tablet before any medicine (inhaler or steroid) . Now I want to tell you that there are few causative factors responsible for asthma, these are dust, mite, pests (cockroaches) , hay smoking, sudden increase or decrease of temperature, pollen, molds, fine dusting powder. So if possible please avoid these factors. Measures to reduce exposure to indoor allergens. Wash all bed covers in hot cycle (55-60 degree C) every week. Treat carpets with tannin acid. Clean upholstered objects in dust cupboard. Keep dust accumulating dust board. Replace curtains with blind 7 easily washed curtains. Hot wash/freeze toys. Use vacuum cleaner. Encase mattress Keep pets out of living rooms. Install air conditioner or dehumidifier. Eliminate suitable environment for cockroaches. These measure will help your child. When such case visit I prescribe montelukast syrup with albuterol syrup 0.2 mg / kg body weight / day once or twice in day depending upon the severity of disease. Since this is a prescription |
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:
Wow... impressive. I am looking for THE BEST Radiologist at reading a CONE BEAM SCAN. Its critical, as I have necrosis in my sinuses, that is getting exponentially worse by the day. The DDS I saw sent me to an Endodontist, who did the scan. He sent it out to be analyzed by ? and the results were: Bone loss to Upper and Lower Jaw; involving some 15 teeth-----BUT SINUSES ARE JUST FINE????!!! Help please. I am frightened by whats happening to me. There is a hole in my Septum that must be considered large by any standard. My nose bleeds daily. and can bleed from both nostrils regardless of the side its coming from. To make matters even worse, I have Mitral Valve Prolapse. WHAT DO I DO? WHO OUT THERE KNOWS HOW TO REALLY SEE WHAT S THERE TO BE SEEN? I NEED ANSWERS & A PLAN OF ACTION, before theres no point in seeking help. Im not clear on the way this chat works. Can someone explain?
### output:
| Hello, I can understand your concern. In my opinion the bone loss of the upper and lower jaws that is associated with 15 teeth is a different problem than the problem of sinus and bleeding from nose. Let us discuss both problems separately. Usually, the bone level of jaw is where the crown of teeth (the part we see in mouth) and the roots meet. With age, due to lack of proper oral hygiene, due to presence of systemic illness like diabetes or presence of gum disease, the bone level may reduce in size exposing roots, making gums bleed, and making teeth loose in their sockets. Visiting a dentist for this situation will help as dentist will perform scaling and root planing which will remove the bacteria, calculus and debris in the gums making gums healthier and stronger. You can also massage gums by using gumex gel daily for about 10 minutes. Make sure you mention to dentist about your heart valve problem as some treatment modifications will be required for you. Regarding the sinus problem, it is difficult to examine sinuses properly in an x-ray that is taken by dentist for examining teeth and bone status. Also, the problems you are facing of bleeding nose and previous bone scan presenting bone necrosis indicated towards some sinus problem. However, it is difficult to advise regarding that in absence of bone scan examination right now. Thus, I would advise you to visit an ENT specialist for the sinus and nose bleed problems. I hope this information helps you. Thank you for choosing Chat Doctor. I wish you feel better soon. 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:
Hi my age is 32 Years, I had a follicle study done. It reads as follows ; 9th Day - ROF & LOF : No DF - ET : 5.6mm, Collection in POD : Free 11th Day - ROF & LOF : No DF - ET : 7mm, Collection in POD : Free 13th Day - ROF & LOF : No DF - ET : 8mm, Collection in POD : Free What does the above report indicate ? Is there any chance of getting pregnancy ?
### output:
| Hi, I appreciate your query would clarify the report of your follicular study to you. On the 9th day, in the right and left ovaries (OF and LOF) - there was no DF - which means, dominant follicle. Again the same findings persisted till the 13th day, that is there was no dominant follicle in any of the ovaries. ET - refers to endometrial thickness which was 8 mm on Day 13. Collection in POD was nil, which is normal. Now, to explain a normal follicular study to you. By day 9, the ovaries start producing dominant follicles, that is among the many eggs present in the ovaries, one starts maturing to develop into the dominant egg for that month. By day 13 generally, if you have a regular 28-day menstrual cycle, the dominant egg reaches a size of 20 - 22 mm. Generally on day 14, ovulation occurs, that is the mature dominant egg is released from the ovary, and it is then ready for fertilization by the sperm. This is the normal studyHowever, in your case, there is no dominant follicle seen till day 13, which means that you are having an ovulatory cycle. That is, no mature egg is developing for ovulation this month. Anovulatory cycles are a major cause for not being able to conceive.POD (Polycystic ovarian disease) is one of the leading causes of an ovulation, apart from other conditions. You need to consult a gynecologist, and undergo further investigations for POD to rule out the cause of this follicular study. Also, you might require treatment and ovulation induction (medicines to stimulate formation of follicles in the ovary). In case your cycles are delayed (longer than 28 - 30 days), there is a minor possibility that your follicles are maturing later than normal, for e.g., in a 35-day cycle, the day of ovulation would be 14 days before periods, that is on day 20 or 21. Hope this helped 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:
HI there, I am at 36 year old woman who is physically fit and very healthy. I weigh 56kg and 172cm. For several years now I have had inappropriate sinus tachycardia. I run or exercise 5 days a week and usually my heart rate is around 160-180 on exercise. On resting first thing in the morning it I have felt it at 50 but never any lower than that. Early this week I felt sick and dizzy - I measured my h/r and it was 43. It went down to 39 but sat around 40-45 for a few hours and then came back to 60ish and the other sypmtoms disappeared. The same symptoms occured 2 days later while in the shower and again my h/r was 45. 2 days later again and I went to the bathroom. I felt dizzy while on the toilet (first thing in the AM). I went to get off and collapsed. My husband found me and after 1 minute was able to rouse me (I remember falling but no more). When the ambulance got here my b/p was 140/80 which is high for me (usually around 100/60 ish) and my heart rate was 43. I have the doctors stumped as my ECG only showed bradycardia. This morning the same dizzy symptoms and nausea occured while lying in bed. It was first thing in the morning and unusually my h/r was 75 then dropped suddenly to 45 within a minute. It was regular but did not stay low the entire time - instead fluctuating between the 40ish and 70ish mark. I am waiting for a halter monitor and will be seeing a cardiologist at some point but just wondered if you had any ideas? Thanks for your help!
### output:
| Your low blood pressure has many causes, but let me focus on the most common :1- it may be idiopathic, as you say you are healthy and do exercise 5 days a week, many people complain of hypotension. If that, a fixed dose of ATP injections may strengthen your heart to achieve the suitable blood pressure, but you should first exclude any other cause .2- Aortic Stenosis, is narrowing in the aorta (the biggest vessel) which gives the blood to all your body tissues. An Echocardiogram is recommended to make sure, especially as you said (collapsed)3- Thyroid hypofunction (cretinism) , but it comes with weigh gain . And is diagnosed by a thyroid function test . (TSH, T3, T4) |
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:
Ive been diagnosed with Telogen effluviem - Ive had shedding hairs for over a year and lost about 50% of it all over. It was thought to be my lowish iron but taking iron has made no difference. My bloods are normal - Im not menopausal or thyroid. The texture is really different - before it was fine (thick), straight and silky - it is now wiry, flyaway, soft and woolly feeling. When I wake in the morning I have an aura of fine hairs all around my head. Conditioners make no difference - in fact they make it fall out more if anything. It is not coloured and has not grown for about a year. Can you suggest anything?
### output:
| You seem to be suffering from excessive hair fall and Though your blood levels are normal, the overall hair growth and rate of growth may be affected more in your case due to other causes. In your case, the hair fall, maybe prolonged due to other factors as well, such as poor nutrition, stress, lack of rest, low iron and hemoglobin levels, Dan Chat Doctor. For your hair to grow well, it needs sufficient nutrition. Fever, typhoid, recent illness, water change, work stress, pollution etc. is a factor. Any illness or course of medication, application etc., taken a year ago when your complaints started could have changed the hair texture. It does happen rarely. Though you have been on treatment with iron, you will need to continue it, as hair growth follows a cycle over a period of 1-3 years and takes time for new hair to grow. These causes need to be considered and treated as they affect hair growth. For now, you may start with Du cray Anaheim serum to scalp at night, along with hair supplements daily like Collinear or pronged capsule to stimulate new growth. This needs to be continued at least for 2-3 months to see results. Use mild shampoo and conditioner like Anaphase or Renoir for hair growth start with the treatment as advised and see a doctor for follow up. But do keep in mind it will take time to improve. It would help if you could narrow down on a possible cause and avoid it. If your hair is very thin and scanty on the scalp, and medical methods do not work well for you, after a few months of observation, certain new surgical procedures can be considered such as PRP, mesotherapy, lasers, etc, as will be advised by your consulting doctor after observation, if they feel that it will be a good option for you. This is a later option which stimulates new hair growth. Also get a good nutritious diet, avoid stress, pollution, get good rest, required for healthy hair. Hope this guides 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:
Do I have anxiety?! I am a 17 year old female in Grade 12, about to graduate this year. I started getting these feelings in grade 11- around the end of the year. I felt as if my confidence had completely been wiped out. I used to be an outgoing person, I loved to be outside, I loved to do things with my friends, and family. I loved to be around people. I feel these feelings started after I was kicked out of my house. I had moved in with some friends and my boyfriend. I felt depressed for a little while after that; I then felt like uneasyness around other people. I thought maybe it was just because I was around people I didnt really know, or thought were familiar. I feel its been getting worse---over moderation. It comes for a little while, then dies off... and I feel normal, but I somehow I think of that feeling again, and I know its lurking.. and it will be back. I feel uneasy around people, I cant look some people in the eyes; for a long time, its even hard sometimes for a short amount of time. I feel so judged by other people, and Its like im scared what people think of me, or what they say. I twitch sometimes, I feel really uneasy when people look at me, or stare at me. I also get shakes sometimes, I feel cold . I walk around a feel a skip in my steps, and I feel like my legs arent a part of me. I just feel so awkward and out of place, I don t know what to do; I know I should go to the doctor---- but please someone tell me what I should say or do? can anyone answer me please. I know for a fact that I am not crazy. I need some hope. the only person I can feel normal around is my boyfriend, but lately I have been getting the feelings AROUND HIM! AND I hate it, because right now I feel he is all I have.. SOMEONE ANSWER PLEASE!
### output:
| Degree understand your concerns went through your details. I suggest you not to worry much. For other people, you may sound crazy, but for us, you are perfect. You are a teenager. You have some developmental tasks such as role identification, which is a bit confusing. Conflicting. Don't worry. Every teenager goes through these paths. You are just disappointed with your current life. Avoiding others and avoiding going between people, are behavior which are part of these conflicts. Don't misunderstand. Forget and ignore these problems and concentrate on your studies and career. In case if you need more explanation in this regard, please post a direct query to me in this website. I am happy to explain. Hope this answers your concerns. 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 had cervical laminectomy surgery for spinal stenosis in Aug 2010. Since then I have a real tight neck that wants to keep dropping , neck pain , light headedness, back pain, occasional loss of balance and trouble walking and climbing steps. I recently lost my job because of these issues. My Neurologist thinks it is all coming from the neck tightness. My Neuro Surgeon disagrees and sent me to Physical Therapy and a Pain Management Doctor. They both agree with my Neurologist. The Pain Management Specialist told me that there is nothing that can be done. He told me 1 out of 10 or 1 out of every 12 with this surgery end up like me. In the past 3 months I started experiencing tremors in my right hand, right arm, shoulder, neck & head. Aggressive at times. I have tremors pretty much daily now. My Neurologist retired but wanted me to get a second opinion because I am progressing. I have not yet had a second opinion away from the same Medical Practice. I was about to when my Neuro Surgeon called and wanted me to get a Neck MRI. She referred me to another Neurosurgeon she works with to have more surgery. I saw the new Neurosurgeon. He explained he wants to take the hardware from my previous surgery out of the back of my neck and put it in the front to hold my head up. I was told it would not relieve the pain or any other symptoms I am having. I was also sent to another Neurologist in the same practice. She has no idea what is going on. Parkisons was ruled out. Both Neurosurgeons think there is something else going on and it s not coming from my neck. I can feel everything coming from my neck. I have had since May 2 neck MRI s & 4 Botox Injections, in the last 30 days an EEG, Brain MRI & CT Scan. All are normal except CT scan. It was to check healing for removing metal in my neck. I have an appointment to talk about that in a few weeks. Do you think there could actually be 2 different problems? My neck is really tight and like I said before I feel everything but my hand and arm tremors coming from my neck. I am really confused.
### output:
| Thanks for writing to us. You have complex story with multiple issues and not pointing to a particular one problem. Tremors can happen in severe cervical spine stenosis due to weakness in extremities. Do you have significant weakness in hands? Neck Chat Doctor. Difficult to tell you the exact answer however if neurologist ruled out other brain related disorder then you may consider doing anterior cervical surgery. 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 had my last period 9 months ago, I thought i was pregnant but after many home preg test that all said negative i gave up, I then went to a doctor around 4 months ago , he gave me a pregnacy test as well, it said negative, i dont have any symptoms except lower back pain and peeing often which i had for years now. Since 4 months ago i went to 3 more doctors the last one a week and a half ago , explaining to them i no it sounds crazy but i think i could be almost 9 months pregnant, The doctor laid me down ( im over weight but not serverely) and pressed on my belly, and he said i could be pregnant but if i was there was no way i could be 9 months, I have a easy belly to feel around in is what he said and that he would be able to feel something, He as well gave me a preg test and it said negative, I asked for a ultrasound but he refused and said he thinkgs i have gallblader issues. DO you thik i still may be pregnant? what are the chaces of someone 25 yrs old, pretty healthy, 54 165 lbs be 9 months preg and not look or feel it?
### output:
| Hallow Dear, I do empathize your problem. A pregnant uterus of 9 months would have completely filled the abdomen, and you would have felt the fetal movements 20 weeks onwards. Even your so many pregnancy tests are negative. So let us rule out the possibility of pregnancy; though I feel ultrasonography would have been a better tool to clinch the diagnosis. Ultrasonography would help us find out the status of your ovaries, whether they are Polycystic (PCs), whether you have any infection of the uterine lining like tuberculosis, and so many other conditions also. Considering your high BMI, the chances of Polycystic Ovarian Syn Chat Doctor. You may get your blood checked for FSH, LH, Prolactin, Estrogen and Progesterone. Also, please get your Thyroid function tests (T3, T4, TSH) performed on your blood. If needed further investigations may be suggested. I would advise you initially to take some Progesterone preparation like Tablets Devilry for 5 days. After discontinuing the pills, you should get your menses within 4-7 days (if amenorrhea is due to hormonal imbalance). I sincerely feel, ultrasonography may throw some light on your mysterious delay in menses. Please keep in touch (maybe by asking me a Direct question) after the suggested steps and investigations. |
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 had a cough for nearly 8 weeks. It started off with a tickly then dry cough. I was coughing mucus and then by sinuses became congested with plegm. The doctors advised inhalation and my chest is clear. I went back a second time and was given the same advise. So I took sudafed and dry cough medicine . The third time I went back I saw a different doctor who gave me Oxytetrocycline, this was about 3 weeks ago. Last week I went back and saw the doctor I saw in my first 2 visits who advised chest is clear and do inhalation. I requested if a chest Xray can be arranged. So last Wednesday I went for a Chest Xray. The nurse then said the doctor has advised me to make an appointment for the next day as my Xray report will be discussed. They will send it urgently as it usually takes 2-3 weeks. Later my doctor phoned back and advised me of 3 things; 1) If I can go in to the surgery and do a blood test as my lymph nodes seemed inflamed and Xray was not clear. 2) Doctor is arranging a CT Scan 3) arranging an appointment with the Infectious Diseases Clinic. Then in the weekend I lost my voice and felt really bad sinuse congestion and was constantly coughing mucus. So I went into Badger and was given Klarid 500mg Tablets (Clarrithromycin). Today the doctor phoned back and all blood tests (blood count etc) came back normal except ESR & CSR is raised. My Ct Scan scan I am awiting for appointment and my appointment with Infectious Diseases Clinic is next week. My doctor also suggested the Infectious Diseases clinic may do a biopsy of the lungs. The advise was vague. I am a bit concerned. Can you please advise.
### output:
| Hi welcome to Chat Doctor forum. Thanks for calling Chat Doctor. F. As you describe you had an upper respiratory disease, and got relief with the inhalation. You had reinfection you had lost vice temporarily. All this suggests allergic cough. Series of tests are on, and you have reached to infectious disease hospital. I suppose a cough of more than 1 month duration must be tuberculosis of chest, May be primary or secondary. The lymph nodes also are suggestive of possibility to be tuberculosis. I advise you to consult a T.B.specialist, or a chest physician for diagnosis and treatment.Don't worry you will be fine after treatment. 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 13 year old daughter has been having stomach pain often for years. We have always thought this was lactose intolerate and that she should avoid milk products as much as posible we use moderation. This has worked but recently(2-3) they are getting worse. These are the things I have been thinking Reflux, Food Allergies She does have cramping at her period time but controlled with pain relivers. We are going to her doctor today any suggestions on bloodwork labs testing to recommend to her. I cant handle it anymore I have kept telling her for the longest time youll be ok but maybe something really isnt ok.
### output:
| Hello. Thank you for asking at Chat Doctor. I went through your daughters' history. From your history, I would first think of chronic gastritis or gastroesophageal reflux disease. I would like to make suggestions to you as follows:1. If she has never been tested for food allergies, I would suggest testing for food allergies, especially, milk, peanut, wheat, soy, eggs, tree nuts, fish, shell fish. She needs not to be tested for all the foods above, choose the foods she is normally/frequently eating. Food allergies, especially milk protein allergy, can cause chronic gastritis. It important to know that milk protein allergy is not same as lactose intolerance. One has to avoid milk and all milk products in milk protein allergy.2. For treatment, I would suggest her a 6-8 weeks course of antacids like omeprazole or pantoprazole before each meal. It is important to remember that she should take continuously for minimum 6 weeks even she is free of symptoms as complete healing of inner lining of stomach/esophagus takes 4-6 weeks.3. If she has to take frequent pain relievers, I would suggest preferring paracetamol to all other pain medications. All other medications like ibuprofen, diclofenac, mafenamic are notorious to cause gastritis. Paracetamol is considered the safest among pain medications in terms of gastritis.4. I would also suggest her to avoid hot & spicy foods as well as caffeinated beverages. A soft, bland diet is would be the best. 5. If she does not improve with above measures, I would think of H.pylori infection and treat her with appropriate antibiotics after necessary tests. Hope above point will be useful to you. Wish your daughter a quick recovery and the best of the health. Should you have any further query, please feel free to ask at Chat Doctor. 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 have had a Percocet addiction for 35 years and have had many Dr.s in that time span. I was up to without exaggeration, eating 240 10mg p s, 98 30mg oxycodone pills, as well as an assortment of 5mg pills which were always at my disposal. I have cancer and have severe back injuries but along with the p s I also had monthly access to 240 2mg xannax pills which after awhile Ihad no problem eating all of the above each month and would look for some more. I died 4 times in a 6 year span due to double pneumonia which the Dr.s told me my medications were playing a large roll in this. When I was 16 I became an atheist due to my brother dying, he was my favorite and I became very drug dependent to kill the pain. This lead to my later addictions and no matter what I tried I could not escape their grip.The last time I was in the hospital I said Lord I do not know if you are real but if you are I am begging you to open my heart again to you and I need your help or this will probably be it for me when I leave the hospital, I have had enough, and this is only the drug portion of my life I would not wish the things and amount of death I have had to witness on anyone. I am the last of all my friends left alive and I am 53years old. Over 40 friends have passed on, 2 of which I grew up with from the age of 5, others just would not listen. I lost 2 older brothers, 1 my 1st year in highschool the other 8 years later of an overdose. Needless to say ptsd, depression and other problems haunted me until I did as many drugs as possible to bury the pain, but demons only stay buried so long which I found out the hard way. tiny2882@comcat,net
### output:
| Respected user, hi I evaluated whole long query in total details thoroughly.* Now only options left for you is holistic healing with herbs & other things.* Current respiratory details & status are not mentioned with symptoms to figure out for the pneumonia, but for mental condition I can say that only & only thing which can help you to any extent is very deep meditation sessions on highly regular basis 2-3 hours of dedicated YOGA daily which will give your inner soul & subconscious mind the level of peace you are lacking at present. Hope this helps you. Welcome for any further assistance. Thanks for using Chat Doctor .com & giving me an opportunity to assistWishing you a healthy life ahead. Regards dear 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:
Test Name HSV 1 IGG, AB HERPESELECT In Range Out Of Range Reference Range Lab TBR HSV 2 IGG, AB HERPESELECT 0.14 0.00-0.89 INDEX Interpretation -------------- Negative Equivocal Positive TBR Value ----- 0.90-1.10 1.10 This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening. This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening. PERFORMING SITE: TBR Quest Diagnostics, One Malcolm Avenue, Teterboro, NJ 07608 Laboratory Director: Janet Piscitelli, M.D., CLIA: 31D0000 what does this mean
### output:
| Herpes Simplex Virus (HSV) is the virus that causes cold sores around the mouth and also can cause sores in the genitals. Type 1 tends to live near the mouth and type 2 tends to live near the genitals, but they can live in either place. The symptoms are usually burning or pain followed by a sore which can look like a little collection of bubbles or bumps with some redness around it. The sores will heal on their own, but you can take medicine to help this along. The sores can come back and tend to do this when you are run down, tired, stressed or the immune system is not working right. Some people take medicine every day to prevent outbreaks of the sores. You can have a positive blood test for herpes but no sores. This means you have been exposed to the virus and may be carrying it. Everyone is different. Some people get lots of sores and others may never get an outbreak again after the first one. The best thing you can do is take care of yourself. Minimize stress, get enough sleep, eat well, etc. |
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 muhib khan...before 4month s ihave suffering by lower abdominal pain...diagonosis report are urinari trac inection mild..octor pescribe me imipramine 25mg+aceclofenac 100mg+omiprazol..i take those drug..and my lowe abdominal pain back again...also pain to my scoturm....then my doctor pescribe cipoloxacine 500mg daily 1+0+1=7days....but my lower abdominal pain r continue...better to talk about this i take imipramine 25 mg only 11 days...bcs o that its may be reaction and my whole body were rashing.icching...but when i take off this medicine before 25 days...but this reaction are stiil now..and i have too much pain of my lower abdomine...i take now hydroxizine...10mg...bcs its help to me few hours to verry bad pain relief...i m a student...And i have very poor...what can i do sir? what medicine i take now?
### output:
| Hi ! Good evening. I am Chat Doctor answering your query. Discomfort in the testis could be due to ignored repeated trivial trauma, which causes inflammation causing pain/discomfort in the same. Testis being an intra-abdominal organ embryo-logically, brings the nerve supply to it from above, and so the pain in the testis is frequently radiated/felt as a discomfort in the abdomen/pelvis area. In your case your urinary tract infection might have spread to the testes giving rise to such pain in the testes. If I were your doctor, after a thorough physical examination I would advise you for the following:1) Support your testes with properly fitting undergarments.2) Avoid standing for prolonged period, and avoid lifting heavy weight if you do.3) Advise you for a routine blood tests like a CBC, AEC, Bag, HIV test and a urine routine/microscopic examination followed by a culture and sensitivity report if need be and advise antibiotics as per the report.4) Avoid indulgence in any sexual activity if you are active sexually which would prevent further trivial trauma if any to the testes, apart from precipitating any kind of infection if present. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. 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:
my dad has stage 4 metastatic esophegeal/gastric cancer. Diagnosed july 2010. bad road from dianosis on. has only been able to recieve 1 1/2 rounds of chemo due to complications/side effects of chemo each time. just came home 4 days ago fron 2 1/2 week hospital stay from severe nuetropenia leading to ecoi in gut , psueomonis and a fungal infection in blood, creatinine levels went up to 2.9, then stabalized back down to 1.8 as of dishcarge. Now, ( and since hospital stay) is incontinent of urine and pretty much incontinent of very loose/ diarrhea stools. speaks of having halluciations i.e. the clock going back and forth between 3:05 and 3:12 one night every time he awoke and looked at it. Feet/legs are swelling up. Cannot or is afraid to eat anything solid--over last week, has had to pass a stool with in minutes of taking a bite.( was taking j tube feeding since january but stopped after this last hospital stay due to infection in gut and has not been able to resume because feeding they tried to give in hospital worsened the diarrhea.) Now on TPN at home. and has not eaten anything by mouth for 2 days. Told (if able to tolerate at all) that the 4th and final chemo drug available may given a < 10 % chance of living 2-3 months. So I /he knows the end is near. But, with what Ive described he current condition to be. Could it really only be weeks away? Wondering how it progresses from here on? mostly only sits getting up to go to bathroom frequently. went out of house for 1st time since hospital today and walked short distances in a few stores with a walker. Can you given any idea of what would think pronosis/time left is by symptoms?
### output:
| Hi, dear He has stage 4 cancer. It is metastatic esophageal and gastric cancer. So surgery is not possible. He can not tolerate chemotherapy. So no treatment should be given. Moreover, he is on total parental nutrition. Overall prognosis is very poor. Life expectancy is very less. Generally it is not more than 6 months. It depends on many other factors also. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very 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:
I am a 26 year old female that has a 1 1/2 yr history of shortness of breath. Initially was hospitalized with tachycardia/dehydration, influenza swabs negative along with PE studies. Low grade fevers. SOB ensued from there. A mono spot came back positive about 8 months later but no definite timeframe that we can pin down for when it happened. Chest x-ray s and CT s normal. End of Jan 2010 a mediastinal mass was found, resected Feb 2010-benign thymic tissue. Ended up with elevated left hemidiaphragm. Myasthenia gravis has been ruled out. PFT s normal except for decreased MIP and MEP s. Multiple respiratory infections, pneumonia x3. Pulmonology can t figure anything out. Cardiac workup has been negative including echo s, stress tests, cardiac enzymes, CHF workup, etc. Sats 97-100% on RA. Shortness of breath about the same at night, have to rest going up a flight of stairs. No peripheral edema. Multiple prednisone bursts and antibiotics. CT s and chest x-rays have been clear of anything. Shortness of breath is unchanged since mediastinal mass resection. Run low grade fevers (99.4-100.5) very frequently. WBC never elevated. Getting ready for another referral to another facility. Any ideas what this possibly could be. I have an asthma history, currently on Flovent 440 mcg BID, also have a hx of GERD and have had 2 nissen fundoplications (1st on failed). Recent EGD shows no evidence of reflux. Allergy testing has been negative, immunoglobin levels have been checked. Have a hx of low ferritin levels, just finished 8 IV doses of Venofer. No change in symptoms. Also found growths on thyroid, biopsies negative, TSH and free T4 levels WNL. Running out of ideas, my primary MD and all specialists that have been seen all agree that something is wrong, but can t figure it out. Any ideas would be welcomed.
### output:
| Hello, * I would recommend contributing anxiety as the prime concern cause of breathlessness in this case before looking for other organic causes. * Best handling of stress, anxiety with meditations, behavior cognitive therapy and supportive care is a must to proceed for best possible outcomes. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. Patel, General Surgeon |
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If you are a doctor, please answer the medical questions based on the patient's description.
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Hi! I have ALWAYS had periods like clockwork - 29-30 days but this months I spotted on cycle day 27. I never have early periods and never spot. I did have unprotected sex with my husband around ovulation - cycle day 13-14 by bbt charting. The spotting was a small spot of mucus with pink and brown streaks and it happened again later that evening. I was bleeding heavier the next morning but I noticed it looked pinker than usual and it didnt last the entire day. I usually have a medium/light flow on the first day that turns into a very heavy flow by that evening or the next morning. I have noticed brown/pink tissue when wiping yesterday and today and one small tissue clot came out when I urinated yesterday,CD 31. I have had severe bloating, mild constant cramping, moody, gassy, headaches, shooting pains in breasts, indigestion/heartburn, insomnia and my bbt has stayed around 97.3-97.5 (usually 97.0-97.1) since. I had BFN on CD 29,30,31, 32. Could I be pregnant? THANKS!
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| Hello, and I hope I can help you today. Pregnancy symptoms vary widely between women, and many of the same symptoms (including a temperature jump) occur with PMS as well as pregnancy, and the most common sign of pregnancy is actually a missed period. Urine pregnancy tests purchased over the counter are just as accurate as a doctor's office, so if you already have had multiple negative tests, you are definitely not pregnant. Your menstrual cycle may be irregular this month for a number of reasons-the most common one being the stress of trying to become (or avoid) pregnancy. So if you are trying to conceive, I recommend just having regular unprotected intercourse (at least 2-3 days/week) without BBT charting, actually because your body temperature only goes up AFTER you ovulate, so if you wait for your temperature to go up, you can miss your fertile time. Furthermore, if your cycle is longer than average, your ovulation actually occurs later, more around day 16-17. So I would wait a bit longer and see if you develop a full menstrual flow. Once you do, the bloating and other symptoms should go away. If you continue to have irregular cycles, you may want to see a local physician for a hormonal evaluation. I hope I was able to answer your question today and that my advice was helpful. Best regards, |
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Hey I m really in a bad spot right now with every passing day its harder and harder and harder to do anything I cant function anymore I don t see the point anymore my memory , focus basically all of mental health isn t there I feel like a slow retard and I very rarely consume any mind altering substances also I have very little energy to do anything. When I m not depressed I don t care about anything and the things that I should care about and feel happy about them. I can feel how my brain or my whole self is just degrading with weeks,months and years passing, I have been trying to resolve it for years now, I ve taken antidepressants for 1.5 years altogether and the result I have is even worse mental function and weak emotions, more like ignore everything around me type of mentality, I respond very little to social activity (i.e. talk very little, don t know what to say, don t get the jokes or not find them funny). I feel like the end is near. I ve spent loads of money on supplements , herbal remedies to try and get more energy and fix my mental health but no big results came from that. I m so sensitive to everything and even the slightest things can upset me so much that if something really bad happens I think I might just end my life because from inside it s too much to handle. And I have another problem, I don t feel anything when having sex no joy or nothing and I can t reach orgasm s, I ve started my sex life when I just turned 17 and I m 23 now, male. If I don t get help and get better I think it s gonna be the end of me soon. I m sorry to pour all of this self pity on you but I m lost for hope and I can t talk to anyone about this because its pointless it s not gonna change anything if I do. Steve.
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| Dear Steve, I don't know what were the medicines you tried. But there are a lot of them (around 35) if one antidepressant did not suit you some other will be helpful. Maybe you are having Bipolar Disorder ad presently in a depressed statePsychotherapies will not be of great help at this stage. Electro Convulsive Therapy (ECT) is a safe and effective treatment for severe depression. More effective than any other treatment. It is a painless procedure with proven safety. Unfortunately it is a treatment which most misunderstood (due to propaganda by antipsychiatry groups). In spite of having long years of experience and good scientific evidence supporting it, the treatment is not popular due to these misconceptions. I think you should consult a psychiatrist and discuss this option. Also watch this videotape://youtu.be/oEZrAGdZ1i8 |
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I had a RTA 10 yrs ago in which one the injuries I sustained was closed internal degloving injury to my right thigh, I was operated on successfully and had no further problems. 10 weeks ago however, I sustained a serious fall to my right knee, upon investigations I had a suspected MCL sprain. MRI and X-ray results showed dramatic subcutaneous edema throughout knee joint and popliteal fossa and muscle belly, no fractures or tears visible. 4 weeks ago and literally overnight I developed enormous free swelling that moves with gravity on my right thigh, accompanied by acute numbness and severe pain at the sight of the original scar. I also have severe pain witChatDoctorpression to the thigh and am unable to bear lying on my side. I have been tested on ultrasound both for DVT and a pelvic/ abdominal, blood tests, X-rays, all clear. Could the degloving occur again as a result of the recent leg trauma? And if yes, which is the best imaging to find the problem? I am a heavy person, but I know there s something wrong with my thigh - it is 9cm larger than the left despite having tried all avenues to reduce swelling, and has been ongoing for a month. Any advice please. Regard Mrs Mir
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| Hello, I have gone through history, and I am sorry to hear about what and all you have gone through. I will ask you a few questions - are you diabetic or have any signs of High blood pressure? If not checked please check it once. As you mentioned you are heavily built and also having injuries to the ligaments of the knee this must be a disturbance occurred to the normal vasculature due to fall. As the whole body weight might have gone through it. You need to allow the healing process to occur as there will be microvascular trauma to the small capillaries. If you aren't diabetic I would ask you for quick icing technique as it will create a stimulation to cold effect to the sensory system leading to the closure of the capillaries. Which may help to reduce the swelling and pain. Also, you can request the physician about the medicinal ointment for the healing as brand name varies from country to country I would not be able to guess which is available in your country. Besides, try keeping the limb over the pillow and immobilized, so the healing of capillaries takes place. For you ligament injury you need to check with the orthopedist as, if it has gone to full tear then you should be following the guidance of the orthopedist. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. |
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My wife is suffering from "Paranoid Schizophrenia" and it has been detected in the year 2003 and she is under medication (Arzu 15 mg + Flunaxol 2mg)by a private psychiatrist in Delhi who is MBBS and MD from AIIMS. The disease was under control till Sept, 2010. But now it has relapsed and the doctor has changed the salt (Serenace 3 mg) and till date it could not be controlled. It has been confirmed by AIIMS, Delhi. Now, I have some queries regarding this :1. Whether it is curable.2. Is there any test for the disease.3. Whether you advise to visit your hospital. AK Goswami11A, Srijan ApttB-9/8, Sector-62Noida
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| Hi, Thanks for writing to Chat Doctor .1st of all, let me give you some information about schizophrenia. According to DSM IV TR, schizophrenia has 5 subtypes and paranoid schizophrenia(schizo) is one of them. In paranoid schizo, there are hallucinations and delusions prominently as chief complaints. Schizophrenia occurs due to biological reasons especially involvement of dopaminergic neurotransmitter pathway. Certain brain structures also involved specially basal ganglia. So schizophrenia is also like other physical illness where brain is involved, and other psychosocial factors make impact over illness and its prognosis. Unfortunately, there are no any specific test yet to make certain the diagnosis of schizophrenia, but a good psychiatrist can diagnose the disease by using DSM OR ICD, classical diagnostic systems present for psychiatric disorders. Schizophrenia has long term remitting and relapsing course. Paranoid schizo has particularly good prognosis than other type of schizo. Patient may need to take very long term medications. Sometimes if patient become defaulter for treatment then it's possible that in the future, that molecule may not work. Illness gets worsened after stopping medicines so it's always better to continue the medicines for long run on which patient is stable. There are many Chat Doctor. In general population per se, 100 people suffering from schizo then 33 gets completely alright, 33 will have few symptoms but at quiet manageable level and rest not going to improve.in your case, your wife got almost improved in past for 7 years, that itself shows very good prognostic factor. So there are every possible chance of getting almost improved again. Hope I have answered your query, |
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Hello, I had a sexual encounter back in July where the condom had come off. I believe it came off as he was pulling out but not to certain if it came off due to the friction i felt while having intercourse. About 5 days later, i woke up with severe diarrhea that Ive never experienced in my life that had went away the next day and i also had a loss of appetite and the food i did attempt to eat that next day, had a strange metalic taste along with spotting....Ive taken several pregnancy tests and after taking them, i had all negatives. The spotting had continued along with thrush and Ive never experienced that along with the metalic taste which can also be caused from the dehydration however, the diarrhea is what scared me. When I went to the er, The Dr. did a pelvic exam and drew blood and I was told i had bacterial vaginosis and prescribed flagyl. Two weeks prior to that, i had started a new diet consisting of fish and high in vegetables however i had very little bowel movements...Im unsure as to whether that could be typical ARS symtpoms, from the diet, or food poisioning? Since that incident four months ago, Ive experienced muscle twitching in my lower back that has happened within the past two months, sensitivity to the light, pelvic pain. Does this sound like typical ARS symptoms? I spoke with the guy i had intercourse with and he told me he got tested after i asked him about it and he also got tested about 2 weeks ago and he tested negative for everything. Ive also been experiencing severe fatigue, muscle aches, difficulty sleeping at night, some instances where im hot which has been ongoing for two months now and more painful periods. Does this sound like ARS symptoms or could this all be related to stress....Ive also had a dream about 2 weeks ago where i was tested in the dream and told i was HIV positive along with very vivid dreams. Does this sound like typical ARS symptoms?? Please help as im worried and worrying has taken over my life
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| Hi, Welcome to Chat Doctor. I understand your concern. The only way to confirm your HIV status is to test your blood sample for antibodies against HIV 1 and 2 by ELISA. This test will relieve your anxiety and stress. The symptoms you have mentioned in your query are not of AS. Bacterial vaginosis is caused by anaerobic bacteria which are usually commensalism of the genital tract, and you have been correctly treated by Flagyl. I suggest you undergo the HIV test and confirm your status instead of imagining the worst and worrying unnecessarily. Thanks. |
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I am 61 and have been diagnosed with cerebellum ataxia. What is the lifespan of this disease. I know there is no cure or medication that will help me. As time goes on I realize it will take over my body. with in 4 yrs I can not walk without a wheel walker and my balance is so bad I need assistance when without the walker on wheels. I am starting to have slurred speech and now my younger sister is starting to get the same symptoms just out of the blue. It gives me an empty feeling not knowing what can become of my life. I am a positive person but I truly need to know more information on this disease to satisfy myself and my sister. If you will give us some answers on this matter we would be so greatful. We do have doctors but they never gave any info on this subject to really learn more about it. We are both the type to put it straight in our mind that what is happening is what it is and we take it day by day. We are easy going and just want to evaluate what is in store for our future years. Preparing our mind for what is coming is important for us and our families. If you could give us some insight on this rare disease it would be of great help to us for setting our minds up in the future. Just in four years time I have really seen a big change in my body and walking and speech. I will be anxious to recieve your reply. Thanks for helping me. Vickie Welsh I just wasted my time and yours......it was never mentioned in the begining that there would be a charge. I am unable to pay out anymore on doctors. After paying out 5,000.oo a year for me and and same amount for my husband. I m sure you can understand that I am strugglling enough trying to pay for medical bills as it is. So sorry to have bothered you just was looking for some other doctors advice as a 2nd opinion. Thanks for reading what I had to say. Have a great spring.
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| Hello You don't necessarily need to pay. There is a free public forum. Its just that in the premium pay section you get your answers more quickly and have the possibility to exchange with doctors through follow-up answers. Regarding your query, I am afraid that more info is needed. Cerebellar ataxia is only a descriptive term, Latin for balance and coordination issues due to cerebellum (little brain) involvement, but it doesn't say much about the cause. There can be many causes so more information on tests you've had, imaging and genetic ones in order to properly classify the ataxia and its prognosis. So please write again providing such information. Hope I have answered your query. Let me know if I can assist you further. |
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I have had lower back issues for many years now. I didn t have or don t remember having these issues before I worked as a jailer. However, after a couple of years as a jailer I started having pain, close to sciatica . I worked as a jail for over 7 years. Due to the everyday pain I went into a different career, but the pain is getting worse. I had an MRI done and the doctor told me that my last lumbar doesn t sit on the lower one correctly, but he didn t go any further with it and just gave me pain meds and muscle relaxers when I had a flare up. I have moved to a different state where the doctors are so less inclided to give out pain meds that I really don t take them. Not to mention that I can t afford to go into the doctor every 2 weeks. Needless to say that I am in pain everyday now. Most of the time it is bearable, but all I have to do is step wrong or bend over wrong and I get a sudden and really sharp pain in my lower back, that radiates into my hips. I have constant aching in my buttocks , back of my leg, and calf . My new doctor did an xray , and found that I have occulta spina bifida , and said that this must be what my other doctor saw on my MRI. My pain is all day long but can be managed with IBU, but I have what I call a flare up where I get a sudden shooting pain. It originates at my lower back and shoots into my hips. Once this happens I have pain going down my buttocks, back of my leg, and stops at my calf. When it flares up I have a harder time walking as it feels my hips and lower back are going to fall fowards. I can t bend over unless I turn my legs outwards and squat down with my legs to my sides. If I try to bend over any other way I can cause for this sudden shooting pain, and if it hurts enough I end up bed ridden for a couple of days. Also, it can happen when I am walking. Doctors here seem to act like I should be ok and that its all in my head, but its not.
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| Dear one welcome to ChatDoctoru described the symptoms well, it shows the severity of pain u have. With this it seems that you're a case or bilateral neural pain due to compression of nerves at back.pl go for MRI.physical exercises give u good relief.donor avoid medicine, these reduces yours discomfort, gives u relief.it will be a better option if u can go for Phototherapy, as we provide it & seen good response in these cases. Get well soon Chat Doctor. |
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My 73 year old father had a direct laryngoscopy on 8-1-2014. Afterwards in recovery he complained of burning pain in his back and there was a red square on his skin where he said it hurt. on 8-10-2014 we took him to the ER with pain in his back and side and they said he had pneumonia. During the next few weeks after several more trips to the ER and two to his Family Physician and two stays in the hospital treating pneumonia, all with constant back and side pain on 9-6-2014 an xray of his chest to look for pneumonia (again) exposed a T6 and T7 compression fracture of the spine that was acute. Is there something in this procedure that caused this fracture? He walked into the procedure and lived independently at home before the procedure with no complaints of pain. he does have osteoporosis which this ENT knew of before the procedure. He had a clear chest xray and was released by his family doctor for the procedure on 7-18-2014. From 8-1-2014 to 9-6-2014 he progressively worsened with pain to the point of walking leaned over at a 90 degree angle and now he cannot walk and will be in long term care. Did this procedure cause his fractures?
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| Laryngoscopy is a procedure done by specialist till your neck level or upper respiratory level to view the larynx and surrounding area for problems like voice change, hoarseness of voice, dyspnea, irritation cough etc. It can not affect back spine practically. There is possibility that his spine was extremely weak due to osteoporosis and due to some improper posture while doing the procedure spine came under pressure, and he started having the problem. Burning sensation and pain in back shows damage to either soft tissue near the spine or damage to spinal nerve or disc at that level. However the conformation can be done by MRI of affected spinal level. Based in result here you have to take opinion from spinal surgeon or orthopedic doctor on further treatment planning. Boost the patient with calcium and vitamin D as directed by doctor. In severely damage spine here doctor may ask for surgical correction also. In that case you can also take secondary opinion and go ahead with needed treatment. After this consult a physiotherapist for rehabilitation part and also take suggestion in posture as well spinal exercises which will help the patient further to improve strength and stamina of spine. You can also use hot pack at home for some more relief and soothing effect on soft tissues. Take care. |
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Had Mirena inserted in October, developed an itchy dry flaky patch on my labia...it doesn t spread, doesn t go away, and I have tried anti fungal cream, hydrocortisone, steroid cream...steroid cream reduces it but never goes completely away. What is this?
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| Hello, Thank you so much for your question. Itchy on labia can be from vaginal discharge from IRENA IUD. Vaginal discharge is abnormal when it occurs with the following symptoms: Itching of the vagina or the area around vagina, redness, pain, or swelling around the vagina, discharge that is foamy, greenish-yellow, or has blood in it, discharge that smells bad, pain when urinating or having sex, pain in the lower part of the belly, fever. Different conditions can cause abnormal vaginal discharge. The most common causes are: An infection in the vagina, cervix or uterus, a reaction to something in the vagina that a woman forgot to take out, such as a tampon or condom, a reaction to a soap or other product that was in the vagina, changes in the body that occur after menopause. You should not treat abnormal vaginal discharge by yourself. Treating yourself can cause your symptoms to get worse. If you have abnormal vaginal discharge, see a doctor so that he or she can figure out the cause. Your doctor will talk with you and do an exam. He or she will also take a sample of your vaginal discharge, and do lab tests on the sample to look for an infection. The treatment will depend on the cause of the abnormal vaginal discharge. For example, different vaginal infections are treated with different medicines. If you have a vaginal infection, your doctor will want to figure out what type of infection you have so that he or she can treat it with the right medicine. If it caused by certain types of infections, your sex partner will also need to see a doctor for treatment. Sometimes you can help prevent abnormal vaginal discharge by using warm water and unscented non-soap cleanser to wash your vulva (the vulva is the area of skin around the outside of the vagina), taking baths in plain warm water, and not using scented bath products, not using sprays or powders on your vagina, not douching (douching is when a woman puts a liquid inside her vagina to rinse it out, not wiping with baby wipes or scented toiler paper after you use the restroom. Hope I have answered your question. Let me know if I can assist you further. Best regards, |
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Hi. When i m nervous my hands start trembling. For example, I play the flute in band and whenever I have to audition for one of the band directors or play infront of everyone by myself, i get really nervous and start trembling. How can this be prevented or what can i do to stop this from happening. I also notice i tremble very little even though im not nervous. This has been going for a very long time now.
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| Hi and Welcome to Chat Doctor ... Thanks for your question. From your question I gather that you become excessively nervous and have trembling of your hands, especially during social situations. So, in other words, you seem to be having an "anxiety" problem... Generally, anxiety can manifest itself in two ways: 1) psychological... i.e. feeling nervous, tensed, unable to relax, etc. and 2) somatic... i.e. bodily symptoms like trembling of hands, rapid beating of the heart, sweating, etc. Now, it is important to know whether your anxiety is confined ONLY to social situations or whether you keep experiencing some anxiety most of the time and are unable to relax completely. If your anxiety is only confined to social situations and if you are feeling well and relaxed during other times, then you most likely are having "Social Anxiety". Having some amount of anxiety is normal, but it becomes abnormal if... it is either excessive or if it affects your normal functioning... So, if you feel that your anxiety is present too often or too much or is interfering with your functioning or performance, then you may be having an anxiety disorder, and you need help. Therapy for anxiety disorders is usually of two types: 1) medication and 2) psychological therapies like behavior therapies, talking therapies, etc. This choice would be based on the severity of your symptoms, the availability of a good therapist and of course, your personal choice as well. Often, relaxation techniques such as breathing exercises, progressive muscle relaxation, yoga, etc. can help a lot in reducing anxiety symptoms. You also mentioned that you have mild trembling even when you are not nervous. Some people can have a mild basal tremor which is called an "essential tremor", which is generally harmless and does not need any intervention unless it is disabling. I would suggest that you consult a psychiatrist locally, so that he / she would be able to assess you in detail to find out what type and how severe your anxiety is and whether you need any medication or any other therapy for the same. Please feel free to clarify any doubts that you have... Wish you all the best. |
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ok i think i may have a big problem.... please dont laugh.. about 7 months ago i stick a sausage in my anus while materbaiting to make it feel better when i came.. now at night i feel just one worm in my anus tht lays its eggs i suppose or trys to anyways lol ive noticed tht wen i put toothpaste around my anus it flips out and runs into my intestines were i cant harm it. and then it pops up again at a later time. i have no symptoms at all, the only thing tht i have is A FUCKING WORM IN ME I DONT KNOW HOW TO GET RID OF! and im too scared to tell anyone how i actually got it.... ive told my mom and she says its pinworms.... as u can tell its not fucking pinworms... someone please! anyone help me out with this.
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| Hello, It seems you have pin worm infection which can easily be cured. Since if proper measures are not undertaken, this infection is likely to recur. The following treatment and prevention recommended for pin worm infection.-A single oral dose of Mebendazole or Albendazole, repeated in two weeks, is effective in the eradication of pin worms.-Do not use your toothpaste to get rid of the worms as it is not effective in the total eradication of the worms.-You may apply carbonated petrolatum or other antiparasitic creams or ointments to the perianal region may relieve itching. The infection can be prevented by:1. All family members or classmates must be treated simultaneously.2. Personal and group hygiene must be improved: You must wash your hands before eating, and refrain from activities such as scratching the perianal area), finger-sucking, nail-biting, and your nails should be trimmed.3. To reduce your risk of getting or spreading infection, wash your hands thoroughly after having a bowel movement or changing a diaper and before eating.4. Daily morning bathing and daily changing of underwear help remove a large proportion of eggs. Showering is preferred to avoid possible contamination of bathwater.5. Careful handling and frequent changing of underclothing, nightclothes, towels, and bedding can help reduce infection, reinfection, and environmental contamination with pin worm eggs. These items should be laundered in hot water, especially after each treatment of the infected person, and after each usage of washcloths until the infection is cleared. Hope I have answered your query. Let me know if I can assist you further. |
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### input:
I was in a motorcycle accident 4 weeks ago and got pretty beat up. 5 fractured Ribs and road rash. I hit the front of my right thigh hard. All the bruising went away but my right leg is still swollen. My thigh is numb and burns. It also feels kinda hard?
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| Hi, Thank you providing the brief history of you. As you mentioned you met an accident and have injured 5 ribs, and you have on bruising over your thigh and swelling of right leg. Since you mentioned you have numbness and burning sensation over the right thigh it could be healing of the soft tissue of the skin. But to ask, have you taken any x-ray or MRI of the lumbar spine. As usually in RTA one shouldn't ignore spine. Any injury to spine is initially undetected and later gives symptoms. So I will recommend taking that.Also, to advice you, is to perform regular breathing exercises. There are types of it and a physical therapist can teach you.- Deep breathing- Purse lip breathing-Costal Breathing-Abdominal breathing.- Coughing and Huffington - perform all exercises by placing the hand over the injured ribs. As it will restrict the mobility of the ribs and will not interfere in healing.Also, this breathing exercises will help you gain strength in the muscles of respiration and also the abdominal muscles. Post this kindly do some simple upper limb and lower limb exercises to keep the joint mobility maintained and also the muscle property. Muscles should not go into wasting. Also you need to keep the right leg over the pillow when you are lying down to remove the metabolic waste. Due to metabolic waste the healing can be delayed to its better to focus on each corner. Later on once Your ribs turns out to be good, slowly progress to core stability and spine stretching so in future you will have a good and strong spine. As you must have noticed about the professional riders they all have a good abs, it is because to have a strong spine. Spine is the important segment of the human body which connects the upper and lower half of the body. Later on you will be focussing on lower limb strengthening as the best, so the weaker muscle becomes strong, and you have a strong regain. Also, if possible kindly take an MRI just to have a doubt clear that the spine is safe. The symptoms of burning and numbness can be because of it, so for ruling out this one doubt its on a safer side to get it done. I hope to see you soon with your motorcycle again. With the grace of God I wish you a speedy recovery regards |
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MY NEPHEW WAS DIAGNOSED AS BEING DEPRESSED hE IS A FULL TIME COLLEGE STUDENT WHO WAS RAISED BY MY SISTER UNTIL HER DEATH 4 YEARS AGO. hIS MOTHER DIED WHEN HE WAS A TODDLER AND HIS DAD IS BIPOLAR AND NO HELP TO HIM.. hE HAS NO INCOME SO i SUGGESTED THAT HE GO TO HIS STATE MENTAL HEALTH SERVICES. tHEY PRESCRIBED ZOLOFT BUT HE HAS HAD NUMEROUS SIDE EFFECTS. i ADVICED HIM TO MAKE ANOTHER APPT. TO EXPLAIN THAT THE SIDE EFFECTS. hE DID AND THEY INFORMED HIM THAT THIS IS THE ONLY MEDICATION THAT THEY COULD OFFER HIM. HE IS AT HIS AUNTS HOUSE ( HE IS MY GREAT NEPHEW) AND HAS BEEN CALLING ME SOUNDING VERY DEPRESSED. hE MENTIONED THAT HE IS VERY ANXIOUS AND VOMITED 4 TIMES YESTERDAY WITHOUT HAVING EATEN. i AM IN CINCINNATI AND HE IS IN ATLANTA. SINCE HE HAS NO INSURANCE I URGED HIM TO APPLY FOR THE AFFORDABLE HEALTH PROGRAM. COULD YOU PLEASE ADVISE ME AS TO HOW I CAN HELP HIM? dEPRESSION RUNS IN OUR FAMILY. i AM ON MEDICATION FOR IT AND MY DOCTOR HAS MONITERED MY MEDS TO SEE WHAT WORKS FOR ME AND IT HAS BEEN EFFECTIVE SO I KNOW THAT THERE IS SOMETHING THAT WILL WORK FOR ME AS IT HAS FOR MY SE AND MY SON. hE IS ALDO SEEING A COUNSELOR.
### output:
| Hello, welcome to Chat Doctor. Zoloft contain sertraline. It is a good medicine for depression. But at initiation of treatment or on dose increment patient used to have some side effects like nausea, anxiety, insomnia or restlessness, which resolve in 4-7 days. Sertraline also take 3-4 weeks to show improvement. In my opinion it is better to continue Zoloft as advised by mental health professional. Chat Doctor. 99doctor.com |
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:
good afternoon doctor m rohan 22 years old i have allergy of smoke it causes cold and further asthma some breathing problem what precautionshould i take? i used inheler frequently is it effecy my immunitive power & how can i improve my immunive power by daily diet?
### output:
| Hello Rohan, 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 suggest you allergy testing for common air-borne allergens such as house dust mites, molds, pollen, insect proteins, pet dander, etc. This will help you identify the substances causing allergies to you as well as to know the measures to avoid them.2. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which will work on immune system to gradually improve allergy symptoms over a long period.3. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.4. I would suggest you to use inhaler as suggested by your doctor. (There are two types of inhalers, some are to be taken regularly and some are to be taken for symptom relief on as-and-when-needed basis). Inhalers do not affect immunity unless a very large dose is used for long duration (a few years), so please do not worry about it. Of course, it is important to know that inhalers are very good to control the symptoms, but they are not helping immunity too. So other measures to improve immunity should be taken simultaneously.5. For improving immunity through diet, vitamins, minerals and antioxidants are very important. Usually we get them from fresh green vegetables, fresh fruits and some other sources. Packed foods that contain preservatives/colors/flavors etc. are not considered good, so as excess of fried foods, that do not have much of nutrition value.6. Some patients experience worsening of cold/asthma symptoms after taking cold foods like cold water, cold Chat Doctor. If it is true for you, I would suggest you to avoid them.7. Apart from diet, regular physical exercise, Yoga, breathing exercises including Panama and stress reduction including relaxation & meditation practices are very important to improve immunity. Yoga & Panama also help to improve lung capacity which helps asthma patients and may reduce requirements of inhalers with long term practice. 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:
mam, i m 22 yr old married,29 weeks pregnant,edd is 25 august 2010.since my perids were irregilar ,i came to know only at my 26th week,till now i hav not taken my iron tablets or tt injection,yesterday usg was taken it s found dat single fetus wid cephalic presentation,150/min-FHR.active fetal movements seen ,fetal kidney liver bladder spine normal,no congenital anomalies detectable and cervical length is 2.8cm.and the expected fetal wt is 1229gms.BPD-71mm,HC-260mm,AC-232mm,FL-56mm, mam,i need to know whether any problem 4 my child and for for not taking early medicatons,i m very much anxios since my delivery date is near.and v r having daily intercourse with no dificultes rather it gives me gud slep.is it permittable?it will be so kind of u 2 reply me via phone.pls sought out my doubts to relieve my tension . urs sincerely mrs.simiwaseem.
### output:
| Hello dear, I understand your concern. In my opinion the absence of intake of medicines might not hamper your pregnancy in your case. Because till now the growth of the fetus is adequate for the gestational age. I suggest you to get your blood work up done to know the HE status. From now on its enough if you take iron rich diet like green leafy veggies, dates,figs, zaggery, liver etc. and iron supplements. The dosage of iron tablet will be based on your HE status. Coming to TT injections you can complete the TT injection 2 doses during the course of pregnancy before delivery.2 doses are given each one month apart. Also take calcium rich diet and calcium supplements. Take healthy nutritional diet. Adequate fluids up to 3 liters per day to prevent urinary tract infection (UTI) is needed. Just I want to tell you regarding the cervical length of 2.8 cm whicChatDoctores to be near to term short cervix. So take strict bed rest. Avoid physical strain to prevent complications.Also, the intercourse might be better avoided keeping in view the short cervix. Usually stick is applied for short cervix but as you are 28 weeks the application of stick might not be that useful. Anyway discuss regarding that with your doctor.Otherwise, nothing to worry. Hope this helps. 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:
Hello Doctor,My Daughter aged 3.9 is having Adenoid and allergy problem- ( both tests are done). She was hospitalized at the age of 2.5 yrs for RTI and intravenous was given for5 days. there after, I tried homeopathy- it failed and since March 2010, she is under regular medication of Seroflo/ Budecort puff . When ever, the intensity of cold is high , she takes asthaline puff and steroid syrup. With that she improves- but again the problem reoccurs within a month and almost in every two months I need to give her steroid syrup. The ENT is saying to go for adenoid operation while, the pediatrician is saying not to do it before 6 years. Snoring is relatively much less compared to her earlier ages, sleep at night is normal, though she gets spell of coughs 3-4times in sleep, weight is good and activity is normal except when she gets the acute attack of cold- that time she is very irritated, aggressive--. Please suggest
### output:
| Hello. Thank you for asking at Chat Doctor. I went through your daughters history and understand your concern. I would like to make following suggestions for her:1. As long as her current treatment, I would agree with most of it.2. Regarding need for removal of adenoids, I would agree with your pediatrician that efforts should be made to preserve adenoids up to age of 6 years as they important for a children immunity. 3. I would like to emphasize the importance of device and technique of using inhalers (Aeroflot/Decor). If they are not perfect, the Chat Doctor. In my opinion, for a 3.9 year child, metered dose inhaler with spacer with mask is the best inhaler equipment. Please make sure her technique of using the inhalers is perfect by reviewing it in presence of your pediatrician. Also, regular cleaning and changing the spacer every 6 months is advisable.4. Were I treating her, I would add regular montelukast in above treatment, which may improve her symptoms and reduce need for repeated steroid requirements. 5. A healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.), avoidance of the allergens (to which she is allergic) and avoidance of dusts & smokes are also important measures for her. Hope above suggestions will be helpful to your daughter. Wish her the best of the health and a bright future ahead. Should you have any further query, please feel free to ask at Chat Doctor. 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 have pilonidal sinus which I had surgery on 3 years ago. Lately it has re-emerged and is giving me a lot of trouble. it is inflaming and generating pus every month, i will then burst it, drain it, and clean it and it s ok for a month, then it starts accumulating again. I am clean and i use depilatory cream. Should fucidic acid help? or maybe a bactericidal? i m reluctant to do the operation again as I cannot afford such a long recovery period away from work...and with the 50% chance of it reappearing after surgery i don t think it s so worth it. Is there some possible remedy other than surgery? maybe some cream i could apply daily? Thanks!
### 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. Cause and treatment of recurring colonial sinus -post surgery-I would advise you to take Second Surgeons' opinion while you treat with medicines. Do it under guidance of Surgeon, who could give you option of -Chemical cauterization painful and time-consuming process, Which I would advise only if you don't want to- opt for -Radical Surgical Excision -of the Coccyx with Excision of the Colonial Sinus with its fistulous branches-by team of surgeons as Coaxial bony tip is the cause of recurrence most of the time, / -which could be later on maintained with Dermatologist who would take care of the gluteal cleft, by preventive care of seborrhea dermatitis or any other cause as diabetes, to prevent recurrence of colonial sinus with recurring abscess. Still I would suggest you to take Second opinion from ER Surgeon and Dermatologist, as I don't have any first hand clinical information or a photograph of this extensive health problem. You have to take this treatment undercover from ER Surgeon and Dermatologist. So to rule out other causes I would suggest you to consult ER Surgeon and Dermatologist, who would treat according to the cause found. And act fast on the above suggestions, which helps you to plan treatment with your ER Surgeon and Dermatologist. 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:
sir my father has an heart problem ........ he had gone through all tests for it n angio gram test was also done in KGH doctors suggest him that they need to put two stunts ......... we are thinking to visit putaparthi for the treatment can i get any sort of advice from u n doctors said they are blocked 70-80% so asked us to to be done by 15-20 days
### output:
| Hi and pleased to answer you about your father stent option. Coronary angioplasty is one of the therapeutic options proposed to the patient after coronary angiography. The degree of stenosis is a primordial argument, but it is not the only one. Even if coronary stenosis is considered significant (> 70%), the decision to perform coronary angioplasty should correlate to other factors: - The clinical status (chest pain) - electrical modification (st+ and st-) - enzymatic elevation - Evidence of myocardial ischemia provided by the upstream examinations and which often motivated coronary angiography (stress test, scenography). The indications for coronary angioplasty have been widened by the effectiveness of anti-aggregation treatments (reduction of the risk of thrombosis) but also technical advances (in particular active stents). At present angioplasty is often an alternative to surgery. Decisions and discussions are made on a case-by-case basis to enable the patient to benefit from the best therapeutic option for myocardial revascularization. For complex cases (multi-truncular, diabetic ...), cardio logical societies have developed decision-making tools such as EuroS core or Syntax Score. These scores make it possible to choose objectively the therapeutic option with the best "benefit-risk" for the patient. The risks associated with the prolonged antiaggregant combination associated with active stents lead them to prefer in many cases bare metal stents, which require only a much shorter anti-aggregation treatment. Active stents are of interest only to selected patients, in case of monotone lesions with a high risk of restenosis with lesions more than 15 mm or diameter of the vessel reached less than 3 mm or diabetes. Or in the case of first instent-restenosis of a bare metal stent, total coronary occlusion, stenosis of left unprotected common core or multi-renal lesions with a high risk of restenosis, Angioplasty is preferred to surgery (CABG or Coronary artery bypass grafting) after medico-surgical discussion. I urge you to accept the suggested method by your 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 in the middle of changing doctors do to the Affordable Care Act. I was seeing several doctors who are not on my list because I had a PPO for the last 30 years as of. What I need to start off with is where is a doctor that could be my primary care physician. I would prefer to have an internist. I have several different issues. I had severe osteoporosis but the doctor that was seeing me is awesome but he is not on my insurance plan.Since then I had a 90% compression fracture at T-11 which because of my condition I had to undergo surgery and the results are less than just okay. When they went in to repair it my two other vertebrates collapsed. I actually need to find someone who can help me because there are other issues; severe migraines lasting at least half of every month. I had broken my shoulder went thru therapy, I no this sounds hard to believe BUT,My therapist over-extended my arm(shoulder) yelled out oh my...I think I tore it tendon. And she was right. AFTER SURGERY a month went by and I started feeling awful. PAIN IN ABDOMEN and not keeping any food down. a few weeks and 2 hospitals later and not getting any better I was diagnosed w/pancreatitis. (AND NO I DO NOT DRINK!) I COULD GO ON AND ON BUT I WON t.
### output:
| Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As most cases with osteoporosis needs attention to strengthen the bond which only can not happen with calcium supplement or Vitamin D3 supplement. In my clinical practice I recommend more of physical therapy as there is a lot of physics to understand here in calcium deposition and also the Strengthening in the bones. Also, I recommend physical therapy with slow and gradual muscle Strengthening first and then gradual weight-bearing. Also, the therapist you chose needs to understand your case first and give you priority attention as physics applied to your case should be completely different from what conventional physical therapist apply have treated similar cases and got the 99% recovery in them with proper and graded physical therapy. Anything worked out within the physiological limits of the body and assessed from movement to movement can help the recovery. Slow and steady wins the race. And developing a good physical and functional status is of utmost importance proper implementation of the physical therapy needs to be assured. For any further queries/doubts/rehabilitation related questions you can ask me directly, and I will be happy to help you in all possible way.regards 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:
HI, I HAVE HAD A SMALL WORRY GO ON FOR A FEW WEEKS NOW. TO START EVER SINCE I WAS LITTLE I HAVE HAD A FEW SMALL STIFF, BALLS , IF YOU WOULD, MAYBE THE SIZE OF A PEA, ONE IN MY JAW, CHEEK, NECK, AND BEHIND MY EAR (COMMON PLACES OF LYMPH NODES). THEY HAVE BEEN STIFF AND PAINLESS FOR AS LONG AS I CAN REMEMBER, SINCE I WAS PROBABLY 14, I AM NOW 24. AS OF LATELY (3-5 WEEKS) I HAVE HAD CLOGGED EARS, SMALL PAIN IN MY JAW, AND UNDER MY JAW (WHERE MY LYMPHNODES ARE). I HAVE GOOGLED THINGS AND ALL THAT DOES IS STRESS ME OUT. AS FOR LYMPH NODES IN MY ARMPIT OR GROIN I REALLY CANT EVEN FEEL ANY, SO NO PAIN OR ANYTHING WEIRD OR OUT OF PLACE THERE. NO NIGHT SWEATS OR WEAKNESS EITHER. I WAS JUST CURIOUS IF THIS IS SOMETHING TO BE WORRIED ABOUT OR AM I STRESSING OVER NOTHING? ANY ADVICE WOULD BE HELPFUL! IF I SCHEDULE A DOCTORS APPOINTMENT WOULD A EAR NOSE AND THROAT DR BE APPROPRIATE? THANK YOU VERY MUCH
### output:
| Hi Dear, Welcome to Chat Doctor. Understanding your concern. Thanks for your query. The symptoms you mention in query are clearly indicating that the lump is lipoma. LIpoma are over growth of fat tissue under the skin. They are generally painless. But the become painful if any nerve (sensory nerve) or blood vessels involve with them. Sometimes they can also be called as angiolipoms when they become painful. I would suggest you to consult dermatologist as well as surgeon for proper examination and to rule out other causes like lymphadenopathy. Doctor may surgically remove lipoma, perform liposuction, may prescribe antibiotics. For now give warm compresses twice a day and take ibuprofen(if not allergic) and acetaminophen for pain. Hope your concern has been resolved. Best Wishes, |
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