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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: When eating breakfast this morning--it was a rather dry breakfast--my mother had a coughing fit where she coughed up most of the food with mucus. Later she had half a banana with oj and had no problem. For lunch she was eating a Healthy Choice meal with spaghetti and some chicken and garlic. She had another fit, much shorter this time, where again she coughed up what she had eaten. Both times she had the coughing fits she said her upper chest was tight which was relieved after she coughed up the stuff.My mother just turned 99, takes 50 mg metoprolol in the morning, 25 mg at night. She also takes 20mg of generic lasix and 10meq liquid potassium. She is supposed to start back on coumadin 3mg tomorrow. She was hospitalized in early january with coumadin toxicity and rectal bleeding, which turned out to be internal hemmorrhoids. She has had 2 banding procedures and tolerated that well.She is taking a baby aspirin until she starts back up on the coumadin, and I will give her that in about an hour. I took her blood pressure this morning right after the coughing fit and her pressure was up to 170 over 102. I took it again when she was coughing recently, and it was about the same. I figured I would take it again after she has sat quietly for an hour. When she came out of the hospital she was using only 1 of her pills, the metoprolol. Her nifedipine was added back in but was bringing her pressure too low. She was switched to generic Norvasc but that made her ankles swell and she was not able to lay down without feeling overwhelmed. She did have some fluid in the lungs. That drug was stopped and she was put back on her diuretic but at a lower dose. She improved with that. However, she says she feels blah and sleeps often during the day and then cant sleep at night. She will feel anxious in the morning but usually that improves in the afternoon. Because her ankles are not elevated her ankles swell. I asked her how shes feeling now and she said pretty good. Sorry to ramble like this but she never had 2 fits in one day. In the past she has had a fit if the bread was too thick or dry, but she never reacted to the chicken margherita before. The family too tends to run to dry sinuses and post nasal drip, which Ill use an over the counter saline solution for to open up the nasal passages.Any thoughts? ### output:

Hi, it's possible that your mothers coughing fits account to be normal, since it was a Chat Doctor. I would advise giving her only semisolid food that will be easy on her food pipe and her gut since she is prone to hemorrhoids. It will be easier for her to swallow and digest if the food is more soft and watery. Her age is the reason her Gastrointestinal tract must be narrowing, hence sometimes when swallowed too fast, food can go to the wrong pipe(viz air pipe), causing a coughing impulse, since the epiglottis is sensitive, and it responds to touch by a cough impulse. Hence, I would say it is nothing to worry about, when she gets this coughing spell out her in a position where she can cough out everything she swallowed since it is necessary to avoid aspirating food. After the spell, and only after the spell has subsided, and she has thrown out all food, and she is in her senses, give her a glass of water that she can slowly sip n swallow, which will ease the healing. Take care. Good to know you care for your mother.

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 name is rohan I m 21 .single. weight is 55 kg and height is 510...never had a sexual vaginal or oral inter course....masturbating from 1year and 9 months.earlier I first saw porn when Internet broadband connection was taken at my home on jan 2012 aftr few mnths I first masturbated.i was so amused by the feeling of orgasm that I started doing it daily.sometimes more than 1 time.while watching porn.i got porn addicted. and during watching porn I use to masturbate.times went on.after 3 months the frequency decreased.2 times a week.in may.but during October starting.i got a huge depression in my personal life.so when ever I feel depress I masturbate to feel relief this continued till october this year when I realised its no longer that mental pleasure I used to have its just all physically rubbing of penis to ejaculate.no orgasm.as I got used to it I keep doing it. not enjoying the act anymore.earlier I used to HAVE ORGASM EVERY TIME I EJACULATE ......not having pleasure of orgasm anymore.very worried. plz help.will I be able to enjoy a normal sex life with partner.i read its called. Sexual anhedonia. but plz note I just use to ejaculate only once.even if its still erect.because earlier I used to have orgasm every single time I ejaculate.i also having wet dreams from past fee months.in the begining of my porn masturbation stage in 2012 jan I sometimes used to rub nd stroke my penis hard and give vigorous strokes...plzzz I m very depressed by the thought that I destroyed my sex life because of bad habbit of over and vigorous masturbation.THINGS CAUSE ME DEPRESSION AND MASTURBATION BECAME A WAY TO ESCAPE.I WAS NOT HAVING ANY PRIOR INFORMATION ABOUT IT.ITS TECHNIQUE AND SIDE EFFECT.MY QUESTIONS ARE IS MASTURBATION PRACTISED BY HARD STROKING OF PENIS HARMFUL.MY PENIS FORESKIN BECAME DULL IS IT CURABLE.?HOW I CAN END MY SEXANHEDONIA?WILL I EVER HAVE A NORMAL SEX ?LIFE WITH PARTNER.?had I made a permanent damage.?how can i make bring my penis sensation back?yesterday i watched porn but my penis not having proper erecting and porn was like another video of songs or movie.just a very little arousal.PLZ I M VERY WORRIED SIR..HELP ME PLZ.plz give ur persnal email id I feel suicidal coz of earlier drpression and now this sex thing.also tell me cn masturbation cause me weak body.?can I recover my sex power lost in masturbation and damage caused to penis. ### output:

Hi Rohan, I read you problem in detail and can understand what you are going through. Let's start with some basic facts. Masturbation is a normal physiological process and masturbating on a daily basis doesn't lead to any physical, mental or sexual weakness. However, from what you have mentioned, it seems that you are suffering from depression and that is leading to you having a lot of negative thoughts. You're feeling of sexual Macedonia can very well be part of depression. Your situation is highly amenable to treatment. What I would recommend is that you should immediately consult a local psychiatrist. You need to be started on some anti-depressants together with regular supportive therapy sessions. Wishing you speedy recovery. Best wishes.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear doctor, I never written to any doctor, never taken any consultation through online. I know its tough for you to describe medicine. All I want a suggestion from your side, let me describe my problem here... Since Sep 2011 onwards I have following symptoms on my body, 1.Burning sensation in both the foot 2. Burning sensation in different body parts, may be for small instance or for few mins 3. Muscle twitching in different body parts 4.Tingling sensation in legs and hands (Mostly on right side) some times slight numbness, mostly happens while sleeping or sitting for long time 5. twitching of bottom eye lid mostly in right side 6 Pain in leg thies and hand arm, its getting change everyday ( pain is changing from one portion to other) When I observed all these, I went for a complete health check up and everything was normal , Only LDL was at 115. I told all these symptoms to physician, He suggested if the symptoms last for more than two weeks then consult a neurologist. I consulted neurologist and he done all sensational testing he told everything is normal and asked about any stress or anxiety. Told him that I m ok in always but because of all these symptoms i m worried. He given some anxiety medicine for a week. In that months itself my right side of the face gone little numb and I took strain to open my right eye lid. it lasts for 2-3 days and gone, after that it didnt came.. After a month in October, I started observing eye floaters, I can say I was under big stess at that time, and I was thinking something wrong going to happen. Consulted many doctors no one found any problems, finally done an MRI the result was normal, I become very cool my stess has almost gone. based on the consultation with different doctors , in ayurvedha and homeo, Most of them has comes up that I might some allergy due to cold weather in Bangalore Ya.. In some points there were correct. I was don t care to chilles and cold food, When I tried to control all these.. I felt better. But those symptoms are not completely gone. Now I m bit worried about eye floaters. I know that there is no proven treatment for this other than surgeries. I m ready to accept what I have now and ready to live with it Only one pray it should not get worse anymore. 1.Do you have any suggestion for me ? 2.Should I do any kind of treatment? 3.Does the whether has a role on it ? few more points ------------------------ In all other ways I m healthy and rare to prone illness. never met any accidents or head injury. I have only one allergy from childhood, that is related to winter season. In every winter season my palms get dried and skin peeled off, I do get some itching and small boils in palms it happens in feet also but not severe , no itching or boils. I don t know why its happens and I tried all the medicines but never cured. I don t know what kind of changes happens in my body, any kind of vitamin imbalance .. No idea. Does this have any relation with the above symptoms ? Since I was in different location before (2010jan -2011 Jan In chennai ) (2006Dec-2009jan In delhi). I m not sure whether Bangalore climate has a role on it. ### output:

Hello, Its seems you are very much stresses about your symptoms.It's multiplying your problems. So,first stop worrying. Symptoms as described above by you are very non-specific and could be related to your excessive worry habit. So I would suggest some relaxation techniques like meditation. A consultation with psychiatric specialist would be helpful. 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: Hi Dr. Henry.first i want to apologize in advance for the questions Im about to ask merely because i see how often you must get asked about problems pertaining to lymph nodes. i really am at a dead end though and feel helpless about it. i want to know whats going on with me :(diagnosed march 2010 though Im sure i got well before that. been on haart (atripla) since April. numbers have been perfect since. high cd4 800-1000 range. and UD viral load. had some issues with my lymph nodes that required biopsy of 2 of them on separate occasions. all benign. since march 2011 started having intestinal complications, constant constant diarrhea blood in about 6+ bowel movements a week very thick white blobs of mucous in my stool. attached to the stool as well as being passed by its self. mucous was thick compared to the diarrhea. stool sample turned up blood in my stool and confirmed mucous but nothing else no disease or parasites or what not. ALL OF MY LYMPH NODES literally every single one you could think to feel you can feel. are not only large but 90% of them all are solid. rock hard. not like they used to be... (large but still squishy.) most alarming for me are the ones in my left groin. though last yr i had the ones on my right groin biopsied. my biggest concern with these are i not only feel the node its self but the entire lymphatic structure in my groin to be enlarged and very solid. i feel the stem system of one leading to the other. and they have only grown larger never do they shrink..ever. i read that most people vary depending on how their body responds to it, but should mine still be responding like this? i know it sounds as though Ive begun obsessing over my lymph nodes but i assure you believe it or not i really dont. for the most part i pay no mind to them at all except for public/social situations they come to mind only because they are quite visible on my neck when having a conversation with me. lately Ive been experiencing a random burning sensation at different times throughout the course of a day which feels like someone placing the head of a match on my skin. tolerable in pain but a very awkward sensation i can only describe as a burning. could the colon problem and the lymph nodes be related? should my nodes have gone down? should haart have made any difference by now? what could be going on with my butt :( lol ? is this common? should i really go for another biopsy again? am i just one of the unfortunate who will always suffer from enlarged lymph nodes even ones obvious to other people looking at me? my numbers are fine what else can i do to not look sick? sorry for all the questions my infectious disease doctor is awful with answers. they attempted to do a colonoscopy but my insurance denied the first request, its been resubmitted... what could the mucous be i havent had sex in ages... dont know how i ever could :(please.. give me your answers... i need them. im going nuts. thanks in advance,S- ### output:

Thanks for asking at Chat Doctor. I read your question and I understand your concern. Enlarged lymph nodes, hard in consistency has two possibilities 1.lymphoma as non Hodgkin lymphoma is common in your case which has very slow growth2. Immunological reaction to ART. It will be differentiated by biopsy. Mucous in stool means infection as in your case cryptosporidiasis is common that May be the culprit. Just check your CD4 count and liaise with your doctor. Take Nitazoxanide 500 mg Two times a Day for three days. Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi I am anna 1947...I have every symptom of lymes & feel that I contracted it when I was a young girl.my brain has scarring with neurological syptoms...also heart...eyes...this past year extreme pain in left leg...moderate pain in lower back & sciatic in right leg. is this much pain normal for lymes? I am so much worse during the full moon. lymph are affected & rash under armpits & inner thigh near groin in left leg. my body is having trouble handling the die off...went into kidney failure...lowered my dose of ceftin to 500mg 2X a day ### output:

Hello Dear. Lyme disease is related to painful rashes on armpit and thigh, but may not be related to brain scarring. Lyme disease is usually curable with antibiotics. This is so true that some authors of Lyme disease research have stated that the most common cause of lack of response of Lyme disease to antibiotics is a lack of Lyme disease to begin with! The type of antibiotic depends on the stage of the disease (early or late) and what areas of the body are affected. Early illness is usually effectively treated with medications taken by mouth, for example, doxycycline (Tobramycin), amoxicillin (Mobil), or cefuroxime acetic (Certain). These generally result in a rapid cure of Lyme disease. Therefore, if a person finds a typical bulls-eye skin rash (described above) developing in an area of a tick bite, they should seek medical attention as soon as possible. Generally, antibiotic treatment resolves the rash within one or two weeks with no long-term consequences. Later illness such as nervous-system disease might require intravenous Chat Doctor. There are no home remedies to treat Lyme disease. In those people with two or more episodes of erythema migrant rash, even years apart, it is felt that the episodes represent different infections or reinfection rather than persistence of the original infection. For relief of Lyme disease symptoms, pain-relieving medicines might be added. Swollen joints can be reduced by the doctor removing fluid from them (arthrocentesis). An arthrocentesis is a procedure whereby fluid is removed from a joint using a needle and syringe under sterile conditions. It is usually performed in a doctor's office. Rarely, even with appropriate antibiotics, the arthritis continues. It has been suggested by researchers that sometimes joint inflammation can persist even after eradication of the Lyme bacteria. This complication has been explained as an ongoing autoimmune response causing inflammation of the joint that was initially stimulated by the original bacterial infection. Oral medications such as ibuprofen (Motrin, Turin) can also be used to reduce inflammation and improve function. There is no evidence that nonspecific fatigue that persists after treatment for Lyme disease is related to persistent infection. The risks of prolonged treatments with antibiotics are far greater than any benefit in this situation. Of note, recent research was done to study whether longer-term antibiotic treatment of persistent symptoms of Lyme disease led to any better outcomes than shorter-term treatment. The study found that longer-term antibiotic treatment did not have additional beneficial effects on health-related quality of life beyond those with shorter-term treatment. Specifically, the researchers determined that this longer-term antibiotic treatment had no more beneficial effect on fatigue, or musculoskeletal, neuropsychological, or cognitive symptoms and disorders from Lyme disease than placebo Hope I have answered your question. Feel free to contact me if you have any more questions. I'll be glad to help you. All the besting warm regards

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am 52 years male with height of 165cm and weight of 72 kg.My lab test results are serum creatnine 1.28 mg/dl, Uric Acid 6.5 mg/dl, Albumin 4.81g/dl, Chloride 102.6mmol/l, Bicarbonate 26.8mmol/l, Potassium 5.02mmol/l, Sodium 142mmol/l, Calcium 10.78, Cholesterol 211.3mg/dl, HDL37.1mg/dl, LDL 149.3mg/dl, Triglycerides 107.3mg/dl, Total Protein 24 h Urine 90.2mg/24h.Following is my ultrasound report that was done after Lab test:Clinical Information: Increased creatinine serum plasmaFindings: Right and left kidneys are normal in size position and echogenicity without focal lesions or cysts and there is no gross stones or dilation in the pelvicalyceal system.The cortical thickness is normal and measures about 1cm but there is increased in the cortical echogenicity and the corticomedullary differentiation is accepted.Urinary bladder appears normal and contains 375 ml, without stones, filling defects or diverticula and the wall thickness unremarkable.Prostate measures about 24ml, normal in size, shape and echonenicity. The residual urine postvoiding is 38ml.Conclusion; Increased cortical echogenicity with accepted corticomedullary differentiation in both kidneys. Residual urine potvoiding 38 ml.otherwise unremarkable study.I do check BP & Random Glucose every month and always it is found in normal range. BP in the range of 70,80/110,120 and Glucose As I am suffering from malabsorption with B12, D3 and Calcium deficiency (Osteo Arthritis) for the last two years I have been taking metacobal inj monthly, 1 calcium carbonate tablet 600mg daily, 15ml drops in a month for vit D, 1 Omni ocas 0.4mg for prostate and a daily supplement of Glucosamine+Cod Liver Oil+Omega3 for knee pain. Need your professional advice for further management/rather to bring improvement in Kidney Function. I would like to know the reason of changes in the kidney and its function while I am neither a Diabetic nor a patient of hyper tension which as per my limited knowledge could affect kidney. Could it be my eating habit or any of the medicine which I take for over two years. I am a non-veg, non-smoker and never had alcohol in my life.Please accept my sincere thanks in advance for sparing time and your professional guidance. ### output:

Hi, It is possible that you could develop a kidney issue in the future, but as now the reports which you have uploaded suggest no major issue. On the other hand, one of the easy tests to identify features of early kidney damage would be to get an estimation of urine microalbumin, preferably early in the morning. If this is normal, you are unlikely to have a major kidney problem. The mild increase in cortical echogenicity that was noted on scan earlier would then be an artifact, which can be followed up on ultrasounds periodically. Irrespective of whether there is kidney problem or not, you can certainly restrict salt in your diet - usually the most helpful suggestion that we offer! Hope I have been able to help you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, I have been reading your site for a few weeks and find it to be one of the few sites that don t terrify me, but provide insight and understanding. Backstory: my dad died 2/2/17 (just a few weeks ago) from complications from amneodorane induced cirrhosis. He was dx with end strange liver disease in December and on 2/1/17 began vomiting blood, and well...they tried an edoscopy to band the bleed (he was put on a vent for this) that didn t work so he was brought down to have a TIPS procedure which lasted 6 hrs, maybe longer- once back in icu he was hypotensive and eventually bled out- 10 professionals worked on him. It was the most horrific sight, an hour and a half earlier he looked like my dad and after he died there was so much blood, he was so swollen and further bruised from the doctors valiant efforts to save him but is a sight I will never forget. I m writing you because I m scared about my own well being. I was anorexic/ eating disorder not specified/ anorexic with purging (self induced, lax, diuretic - all of it) for almost 20 year. The only negative physical ramification was a slightly elevated ast when on certain meds. I have stopped almost all medication and maintain a weight of 117 at 5 5 (take adderall 10 Mg 2-3x day, clonipan mg 1-2 time a day and occasionally 10 mg hydroxozine to sleep). On Jan 27 had my physical which I had put off and my ast was 225, alt 110, ferritin over 400 but everything else normal and no physical findings. I will drink a few glasses of wine a week, sometimes more sometimes less, and before those test had my period and took 4 Advil 4 times over two days. A week later (no alcohol, no otc) ast was to 70, alt 60....four weeks later my doctor retested again (I had wine during those four weeks, basically so many events for my dad s memory I wasn t paying attention to my own health) and on 2/16 ast was up to 125, alt stayed the same. Told my doctor about alcohol and cold medicine taken in the weeks leading up to the test. Neg for all hepatitis, hemochromatosis, all other blood levels still normal. She ran a ggt and it was 225! I was terrified- and I think she thinks I m lying bout alcohol intake. Nutrition hasn t been great but trying. I m getting an ultra sound Wednesday and see her again march 17 to retest all levels. Am I going to die like my dad? I m only 43. I am not an alcoholic but did enjoy wine, I am trying to eat better and drinking lots of warm water and lemon. I know you can t tell me for sure but I needed to reach out given the entire story. Many thanks ### output:

Hi, GTT is found in many parts of body, including the kidneys, liver, pancreas, intestine, spleen, heart, brain etc. So GGT alone is nonspecific Increased GGT levels can be seen in many conditions--many liver diseases, Pancreatitis, many cancers, Alcoholism, heart diseases. GGT levels may be increased due to medications also. Smoking may also cause elevated GGT levels. So, if you have no other investigation suggestive of any diseases, no need to worry. Do not run after a single investigation which is non-specific. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. Rammstein, General Surgeon

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, I observed a friend who called me for help who has a history of alcoholism since age 16 who has battled this addiction off and on for 39 years. He lost his father and went through a horrific divorce while having issues at work with his manager and started with panic attacks which he was hospitalized for around 4 years ago. He is a retired veteran with 20 plus years serving in the Air Force. He only has Tricare insurance and has been unable to get into alcohol rehab. He has never been to rehab to date. Now he is on Claritin 10 mg qd for allergies, Propranolol ER 60 mg qd for HTN and Venlofaxine ER (Effexor SR) 150 mg and 75 mg each qd for major depression despite drinking vodka heavily. I observed him today and he was coherent and interacting appropriately without slurring of words. He stepped into another room to retrieve some paperwork for possible alcohol rehab and returned and I observed him rapidly decompensate in front of me within 10 minutes to the point he was unable to converse and became incoherent staggering and tearful and fearful loosing all rationality and on the verge of paranoia. Unable to be reasoned with and verbally hostile and blaming me his best friend for messing up his life. I suspected he gulped some vodka because I found empty vodka bottles in the room where he retrieved the papers from. I have never seen anyone go from sanity to beyond intoxicated that quickly. Could the Effexor be contributing to the potentiated effect? His PCP was informed of his alcohol consumption on more than one occasion by his son and told my friend s son who accompanied him to his PCP visits. The Nurse Practitioner (NP) said that the patient s alcohol consumption it was not an issue to be concerned about relating to the Effexor and any interactions. the patient was encouraged to decrease his consumption , but I believe the anxiety is worsening therefore he is increasing his self medication (vodka consumption) which is a depressant. The NP also said she had done some sort of special mail out blood test that indicated that Effexor was the proper medication for the patient. I believe this to be hogwash. He is now missing work and risks his livelihood because he has progressively become worse since starting on the Effexor which his PCP continues to increase. Can Effexor exacerbate alcohols depressive effect and increase anxiety and contribute to a near hallucinatory condition to the point he babbles, repeats himself, talks nonsensical and acts like he is going insane? No ability to process information or interact with another person, lashing out at those closest to him? I almost called 911 today, but instead after 2 hour got him called down to wear he fell asleep. I watched him until he awoke nearly an hour later and got up and then laid back down to sleep. I called his son s who one is staying with him and another who looks in on him daily. If this happens again we, his son s and I plan to take him to the ED for an emergency assessment. Also we plan to get him under the care of a physician PCP with appropriate training, a MD or DO. Is this a reasonable plan? Thanks, RJ ### output:

Dear serve understand your concerns went through your details. Effector is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. This does not cause anxiety. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. 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: my SGOT & SGPT were found high.dr desired to make it normal level.what medicine and diet are recomendable pl. ### output:

HELLO & WELCOME TO Chat Doctor FORUM ITS VERY ESSENTIAL TO MAKE SURE THAT YOU ARE SUFFERING FROM LIVER DISEASE. YOU HAVE ELEVATED GOT & SEPT WHILES GOT MAY BE ELEVATED IN DISEASE OF OTHER ORGANS, SEPT IS VERY SPECIFIC AND COMES FROM LIVER. OTHER TEST WHICH IS ALSO SPECIFIC FOR LIVER DISEASE IS GAMMA GET, YOU SHOULD GO FOR THIS TEST. CAUSE OF ELEVATED GOT/ SEPT SHOULD BE Found AS YOU MAY ASYMPTOMATIC PRESENTLY AND MAY FACE SEVERE LIVER COMPROMISE IN THE COMING DAYS. GOT/ SEPT MAY BE ELEVATED IN VARYING GRADE:MAY BE IN HUN Chat Doctor. MILD RISE IS SEEN IN ALCOHOLIC LIVER DISEASE, RESOLVING AND PROGRESSIVE VIRAL HEPATITIS, MALARIAL HEPATITIS, GALL STONES, ACUTE PANCREATITIS, COMMON BILE DUCT STONE, FATTY LIVER, CIRRHOSIS, ETC. REGARDING MEDICINE URSODEOXYCHOLIC ACID 15MG/KG MAY BE HELPFUL FOR YOU. OTHER MEDICINE DOCUMENTED HELPFUL IN LIVER DISEASE ARE SILYMARIN, METABOLIZE, L-ORNITHINE ASPARTAME. DIET :1) YOU CAN TAKE EACH & EVERY THING. YOU DON'T HAVE TO TAKE ANY PRECAUTION. 2) YOU CAN TAKE TURMERIC (HALDE) ALSO. ALTHOUGH YOU AND MY OTHER DOCTORS ARE NOT SATISFIED BY MY THIS STATEMENT BUT LISTEN TURMERIC IS NOT CONCERNED WITH THE Color OF BODY IN JAUNDICE.3) FEW MISCONCEPTIONS ARE IN OUR SOCIETY: DON'T WEAR YELLOW CLOTHS, DON'T TAKE TURMERIC, DON'T TAKE OIL ND GHEE 4) WEAKNESS DURING JAUNDICE AND AFTER DISEASE DEPENDS ON THE DIET DURING YOUR ILLNESS AND IF YOU TAKE RESTRICTED DIET THEN YOU HAVE TO FACE WEAKNESS DURING RECOVERY PERIOD. 5) REGARDING TURMERIC YOU CAN UNDERSTAND BY THIS EXAMPLE: IF WE TAKE TOMATO, CHILLY, ONION AND WE DON'T BECOME RED, GREEN AND VIOLET THEN HOW OUR Color ALL CHANGE AFTER TAKING TURMERIC 6) SO BETTER TO TAKE FULL DIET WITH TURMERIC, OIL & GHEE NO WHERE HAS BEEN DOCUMENTED REGARDING LIMITATION IN DIET MISCONCEPTION IS ALSO ADOPTED BY INDIAN PUBLIC AND DOCTORS VERY EASILY AND THIS IS QUITE WRONG 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: Good day and greetings from Manila, Philippines! i recently had a check up with a Gulf country accredited clinic (but not ISO 9001 clinic) as a requirement for my Qatar work visa. my first thought that would put me into light is if i have UTI infection. When the result came out i was surprised that the problem with my medical result is an Elevated Alkaline Phostotase but all other results that is connected to the liver is normal. I was very skeptical with their medical result considering that my older had a history with them that she was diagnosed with Granuloma, but she has no history of TB, Bronchitis, asthma and most of all she doesn t smoke or had long exposures with secondary smoke. After a month with consulting with the Philippine Department of Health her Granuloma was diagnosed instead of an expanded artery in her lung thus she was clear for a fit to work clearance. On my case, when i consulted clinic s doctor, I asked him what could have caused my elevated ALP but instead he directed me to paying another set of tests. When i shared my knowledge on the normal levels of the ALP which i believe is 44-147 IU/L or 30-120 IU/L, the doctor again refused to acknowledge my question and instead directed again to paying another set of tests and he said that in their clinic, the normal level of ALP is 114. I even asked if its in IU/L and still he didnt answer me though he told me that the result is based on what kind of test it was given and when i asked if they do the standard procedure i didn t get any answer from him. i had a medical check up with my employer which a day apart from taking my medical with Gulf accredited clinic with also the same kind of tests. the results of both medical check-ups were given on the same day and the result was i was cleared and fit to work on my employer s medical check up with no elevated ALP as it was normal but it puzzled when the result of my ALP in the Gulf accredited clinic was different. i am hoping for your quick, and detailed response as i am very puzzle because honestly, i don t really trust their doctor on house. i may sound harsh but upon hearing other people who have healthy living but given sickness because of their results, it really bothers me a lot. thank you for your time and hoping to hear from you soon. ### output:

HIS UNDERSTAND YOUR CONCERNS.First I WILL SUGGEST YOU TO REPEAT YOUR ALKALINE PHOSPHATASE TEST IN A STANDARD RELIABLE LAB.IF IT IS CONFIRMED THAT YOU HAVE RAISED ALKALINE PHOSPHATASE THEN I Would SUGGEST FOLLOWING APPROACH.ALKALINE PHOSPHATASE IS PRODUCED FROM MAINLY 2 SOURCES LIVER AND BONE.LIVER CONDITIONS CAN EASILY BE EXCLUDED BY ULTRASONOGRAPHY WHICH YOU ALREADY MIGHT HAVE DONE.TO RULE OUT BONE DISEASE BLOOD TEST TO BE DONE ARE SERUM CALCIUM, VIT D LEVELS AND PARATHYROID HORMONE LEVELS.THE MOST COMMON CONDITION CAUSING RAISED ALKALINE PHOSPHATASE IS VITAMIN D DEFICIENCY WHICH CAN BE EASILY TREATED. I HOPE I TRIED TO PUT IT IN A SIMPLE MANNERISM U GOOD HEALTH!!PLY GIVE RATINGS IF YOU FIND THIS USEFULTHANKS 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: In 2007 I had a lumbar fusion L4-L5 with donor bone not my own and hardware with a laminectomy at L4 I had a MVA in 2005 and fractured my spine and spondylolisthesis. I have been having so many problems with my back and throughout my whole body ever since. I was treated with PT, narcotics, injections, exercises, OTC medicines. I starting detoxing off all pain medications and prescriptions June 27, 2014. I could feel my body getting worse. I am having burning up and down my spine that radiated every where. My lungs were on fire and chest pain with inflammation. I had fluid building up through out my body, basal temp is 96.5. I have to constantly battle to get it up to 97.5 and above to keep my kidneys working. I have continual spasms of all my organs, eyes, throat, back and chest, legs. My spine feels like it is on fire. All labs come back normal, including T3 and T4 and TSH. My tongue is huge, my face swells at will, I have stiffness in my legs and back. I have increasing low back and leg weakness. My legs go completely numb, tingling, cold from the knees down. I think its the hardware or the donor bone. I have multiple chemical sensitivity to alcohol, alcohol by-products or medical products that alcohol is used to process it. Also any medications or medical implants that may be enteric coated. I think those little bone chip things might have been! It feels like my body is attacking itself. I had an appt with an allergist/immunologist oct 1, 2014. He didn t do any tests just took my medical information and promised to contact me. No return call. I called him twice. I afraid I am going to lose my ability to walk before I can get help. The I have to go to the ER for temporary paralysis, hypertensive crisis, and allergic for shortness of breath due to the severity of the spasms. My eye doctor put me on Prednisone 20 mg for the inflammation in my eyes and fluid build up, another doctor gave me Clonidine 0.1mg to manage the hypertensive episodes from the continual spasms. Medications that would normally be used to treat spasms my body reacts with increased spasms and hypertension with syncope. Crazy. This has been going on since July 24, 2014 after all the narcotics and prescription drugs were out of my system. Will an MRI give better detail what s going on in my back? When you see the image of the hardware on the CT Scan part of the metal has a bent gap and crooked and is glowing white. I know it s a lot of stuff to hear. I am living with it. I am 98% home-bound. My legs are too weak to control. I can t drive any more. ### output:

Hi, Thanks for writing in. MRI is an investigation of choice to study the spinal cord, intervertebral discs and nerves. It is important that you confirm that the metal hardware is MRI compatible. This is because the MRI machine is a huge magnet and if the hardware is not MRI compatible then you might have serious injury during MRI scan. This happens when there is ferromagnetic properties in the metal which will attract the hardware. This might cause the hardware to get pulled from its fixed location and cause injury to surrounding structures. It is also possible that you have an MRI compatible hardware and if this holds good then there is no need to worry about any problems in MRI scan. Then your MRI imaging will be safe and the causes for your pain and discomfort can be evaluated in more detail than a CT scan.

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: Six years ago I went to the er. Always been super healthy crediting hard work and healthy living. Had a blood pressure of 220/117. Had a ringing in my left ear so much so it was hard to make out what people were saying to me. Blood pressure went down to 190/98 so they sent me home. Went to family doctor a couple days later. She examined me and said she did no know why my blood pressure was so high, the noise now seemed to be in my head than just my ear, and why I then could not turn my neck. She added that she noticed that it had been over 5 years since my last prostate exam and she could check that, that day. And I went home. Realizing it was up to me to survive whatever it was and try to get better. I have always believed I would wake up morning and the battle would be won. I lost my job and took some contract work. As of last year the pain is such that contract work is no longer possible. I don t nor have I ever taken drugs. To my question today. My left shoulder and arm really hurt, and I am good with pain. To the point, if I hold a phone to my ear for more than 5 minutes balancing my elbow on the arm of the chair, my arm locks up. I have to use the other arm to bend it straight and the bicep burns. The right arm will sometimes do the same but not at such a low threshold. In my heart I believe I have some sort of autoimmune thing. There are other symptoms that I believe support what I think but I am in no way an expert. I went to one person a couple years ago, expensive yes but boasted he was an expert. Turned out he was a chiropractor and would you believe if I went to him twice a week he could help me. I don t want to go back to my GP as I feel it would be a waste of her time and my money. I just don t know where the closest place to Southern Indiana that one could go to see a true expert in Autoimmune stuff and such. Do you? I would normally bother anyone with questions but these last couple weeks are getting rougher. ### output:

Here in your major explanation you have told you have problem with your left shoulder and arm along with range restriction. Here your problem could be related to 4 things,1. It can be frozen shoulder.2. It can be soft tissue (rotator cuff) damage covering your shoulder joint.3. Furthermore, it can be something related to heart problem.4. Shoulder joint often arthritis. Now if you see you have pain while lifting hand up and resisting movement and not allowing any movement. That means only with muscle contraction (tightening) if pain is present then it is soft tissue pain. If there is no pain while lifting hand up and resisting movement. But there is pain when movement is allowed. That means pain while moving the joint then it is frozen shoulder. If you feel pain in chest along with breathing difficulty while walking up hill or running or jogging then it can be due to heart weakness and heart related issues. Here whatever is your condition the conformation between frozen shoulder and soft tissue damage can be done by MRI of shoulder as well with or tho and physio specialist examination too. Now based on that there will be treatment given. For severe damage in shoulder joint there will be arthroscopy repair can be done. And if joint is deform due to often arthritis then shoulder replacement has to be done. And if there is mild to moderate problem then you will be fine with physiotherapy treatment and exercises. You can also use hot pack on your shoulder for some more pain relief. Now if there is problem with heart then your doctor will ask you to do ECG and treadmill test and based on that there will be treatment plan. It can be medical or surgical again. Here also in the end physio therapy will help for getting you back to normal life. 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 have never had allergies before, up until this year (some sinus issues on and off, but nothing major). About 4 months ago I had a few episodes were my eyes got very itchy and dry on and off and a few times I had some eye symptoms...minor swelling of the right upper eyelid , twice had a bubble which looked like a mosquito bite form under the eye (one time each eye) and another time I woke up with small to medium size bag under my left eye. Each time I felt fine other than the small amount of swelling and each time it was only in one eye, never both. In fact, most times I didn t realize until I went and looked in the mirror and then got scared after seeing the small amount of swelling. I also saw an eye doctor last fall after the first issue with it and the covering of my left eyeball was slightly fluid filled, which he said was due to an irritant and nothing to worry about. We had also found some black mold in our basement at that time that a plumber opened up the ceiling (so conceivably, some of these mold spores may have come out into the air...I had had no issues before this). I am now about 120 pounds (was 140 before I lost the weight) and female and 45 years old. I am a very nervous person and had been under severe stress for several months. It was during this time I started getting the eye symptoms. So stress, the mold issue and most likely the start of peri- menopause may all be contributing. Two of times I got the eye symptoms I had eaten peanut butter....but many hours beforehand. One time it was probably between 4-6 hours earlier and the second time, it was about 10-12 hours earlier. I had also had peanut butter in between with no symptoms. Each time I felt fine other than later on getting some eye symptoms. I had also, due to the stress, had lost 20 pounds during those months and once became dehydrated. Both times I had gotten the little bump under my eye (like a mosquito bite), I had been under acute stress both those days. Those are the only 2 times that ever happened. My general physician feels it s all stress-related and also seasonal allergies (I seem to have a little bit of hayfever). He said my symptoms are not consistent with food allergy or peanut butter allergy. Since not having any peanut products, I ve had no eye swelling, bags or bumps, but my stress level is also a LOT lower now. Should I get a blood allergy test for peanuts or is it most likely stress-related or hormone-related? Is it just a coincidence? Whenever I ve eaten peanut butter I always feel absolutely fine afterwards...even relaxed. No other symptoms...no rash, no breathing issues, nothing else. Being the nervous person I am though, I have worried that if the eye symptoms were related to the peanut butter, then my reaction could be worse next time. That s my main fear in trying the peanut butter again (as I said, I had been suffering anxiety and panic for several months, so my thought process became a little skewed). Would love to know if it s safe to just try the peanut butter again or if I should have the blood test. Thank you. ### output:

Hi, Thanks for writing in. I think you should get yourself tested for an allergy to peanuts. Its unlikely that stress or hormonal issues are contributing to these allergies. I would suggest that you steer clear of peanuts for the time being as allergic reactions can be very severe at times (fatal reactions have also been reported)Try and reduce your anxiety levels with deep breathing and yoga. This should benefit you a great deal. Hope this helps.

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 small bulge in the front of my neck for about 12 years which the doctor descdribed as a non toxic thyroid gland which he said needed to be removed to prevent it from becoming cancerous. Meanwhile In 2012 after massaging the back of my neck with an electric hand held massager to reduce a neck pain, I got a stiff neck which landed me in the hospital. This other Doctor ordered an MRI. The result read thus: OBSERVATION:-The study shows loss of cervical lordosis due to muscle spasm. Minor marginal osteophytes are seen at multiple levels . The vertebral bodies show normal height and marrow signal intensity. No evidence of fracture or dislocation seen. No evidence of destructive or sclerotic lesions present. The bony spinal canal appears normal at each level. Intervertebral disc saces shows reduced T2 signal intensity is suggestive of desiccation changes. C3-C4 intervertebral disc shows diffuse circumferential bulge and causally directed central extrusion causing indentation over thecal sac. There is both lateral recess and bilateral neural foraminal compromise with mass effect on bilateral traversing nerve roots and spinal cord. subtle T2 hypersensitivity is seen in the the spinal cord suggestive of myelomalcia . C4-C5 intervertebral disc shows diffuse circumferential bulge and focal central protrusion causing indentation over thecal sac and bilateral neural for amine compromise. The cord at ather levels shows normal signal intensity. CSF spaces are normal and show no evidence of mass lesion.. The Atlas and axis are normal with no atlantoaxial subluxation. The posterior elements and spinous processes are normal. Facet joints and unconvertebral joints are normal. No soft prevertebral //para vertebral collection is seen. IMPRESSION :MRI features - Degenerative cervical spondylosis as described above... I have always had shoulder and upper back pain since year 2000. Since 2009, after an anxiety attack I sometimes experience muscle tension in both sides of the back of my neck near the skull and it causes head aches and pains. When massaged the pain extends to my shoulders and my upper back muscles and my arms. I have also started feeling some pains and discomfort in my legs, hip and bottom joints and in my fingers. I have also observed loss of muscle tone in my arm and legs. During these episodes I also have blurred vision. All these symptoms are occurring more often now. What is the best thing I can do now. I m worried about my children and my future. Please help me. I am 50 years old. I had about three different traumas to the back of my head. One occurred during a dance routine in the university when I was 18, I lost consciousness. The second happened when I slipped on a slippery surface in my compound. I was about 36, I had a laceration and received about 4 stitches in the back of my skull. The third was a domestic violence. I was 38. My ex husband hit my head continuously against a wooden wardrobe about 3 or 4 times. Please help me ### output:

For cervical spondylitis use a collar in daytime, do isometric cervical exercises, take moral tab twice a day after meals, panto DSR one tab empty stomach once a day. Lyrica 75 mg and methycobalamin one each consult a spine specialist if he agrees with above treatment. A physical therapist may give cervical traction for 10 days, 10 minutes daily, if your spine expert doctor agrees. Hopefully all this shall help you. Refer to spine surgeon for further management.

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 morning doctor, I m a MBBS student.on 7th january i finished my 2nd MB exam.i want to clear some doubts about a problem which my mother is facing for which doctor prescribed her a medicine VERTIN 24 two times daily.My mother has high blood pressure so she is taking anti hypertensives for many years.2 years before she had urosepsis for which she was admitted in hospital and E.coli was found and it was seen in a test report that her creatinine became 2.4.so doctor thought it to be some problem with the kidney.but when USG was done it was seen that both the kidneys are normal and no hydronephrosis was seen.then within 1 month her creatinine became normal and doctor suggested her to show a nephrologist for further advice.i took her to the nephrologist and he saw the USG and told no problem with the kidneys but there may be some slight problem which cant be seen in the USG and its not at all serious so he gave my mother a medicine TELMA 20.my mother continued it for 4 months then again went to doctor and doctor told her to test creatinine which was normal.then he again prescribed my mother TELMA 40 which was adviced to continue for 2 months after which she was adviced to go the doctor but due to some work she went out of station and couldnt meet the doctor and she remained without medicine for 2 months.there she became sick as she had tremendous headache,nausea and she sometimes felt that she would faint but she didnt faint.after she returned the problem was gone and due to my MB exams she couldnt meet doctor and the problem again started.so after my exams i took her to a medicine doctor and he told her BP is very high and all these was only due to her not taking antihypertensives.so he prescribed her TELMA 40 two times daily along with VERTIN 24 which is for VERTIGO as she feels like that everything is moving around her and she cant see properly when she had headache.my mother is now ok but i want to know whether this medicine was given for that purpose only or not because after taking TELMA 40 she is not facing that problem.so should she take VERTIN 24 as she is not facing the problem anymore? ### output:

Hi reverting contains betahistine salt which is meant to treat chronic labyrinthine disorder I am briefing you the mechanism of action of beta histineBetahistine has two modes of action. Primarily, it has a direct stimulating (agonistic) effect on H₁ receptors located on blood vessels in the inner ear. This gives rise to local vasodilation and increased permeability, which helps to reverse the underlying problem of endolymphatic HY Chat Doctor. More importantly, betahistine has a powerful antagonistic effect at H₃ receptors, thereby increasing the levels of neurotransmitters histamine, acetylcholine, norepinephrine, serotonin, and GAZA released from the nerve endings. The increased amounts of histamine released from histaminergic nerve endings can stimulate receptors. This stimulation explains the potent vasodilator effects of betahistine in the inner ear, that are well documented. Betahistine seems to dilate the blood vessels within the inner ear which can relieve pressure from excess fluid and act on the smooth muscle. It is postulated that betahistines increase in the level of serotonin in the brain stem inhibits the activity of vestibular nuclei. So for acute phase of dizziness vermin was ok but now as primary problem of your mother was hypertension, not labyrinthine disorder betahistine should be stopped, and she should be maintained on a dose of telmisartan on which her b.p is normal 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: while sleeping I will be woken with dizziness. literally the dizziness is what wakes me. and sometimes as I am falling asleep the dizziness will affect me. Usually while sleeping on my right side. if I turn onto my back the dizziness will usually stop. I do have severe nerve damage in my neck so I thought this may be the reason. ### output:

Hi welcome to ChatDoctorI have gone through your query regarding dizziness. Dizziness refers to a sensation of lightheadedness or weakness. When dizziness makes you feel as if you or your surroundings are spinning. It may be a symptom of a disorder that affects the whole body, or systems within the body. And may also be the result of systemic toxicity to substances such as medications and Chat Doctor. Gulping on medicines indiscriminately, is not the solution for your problem. . In fact, Your body is always fighting something -- an infection, a toxin, an allergen, a food or the stress response -- and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin, your kidneys or sometimes your whole body. It weakens your immune system. You have fewer white blood cells in circulation to fight off germs. This leaves you susceptible to infections. Your immune system is your defense against invaders. But when the immune system becomes weak, due to fault food habits and derailed lifestyle, and frequent sufferings, disease cells can grow out of control, the disease overpowers. Here you have to work to strengthen your immune system by following a certain regimen by regular exercise and Balanced diet containing essential nutrients, So include essential nutrients in your diet --FIBER RICH, LOW SALT - LOW FAT DIET, fruit, green veges ginger, garlic to balance Air factor-- Vāyu Dosh -- in our body, vitamins and minerals in natural form -, coconut water,, nuts, almonds, and supplements full of antioxidants as Aloe vera juice + AMLA juice 2 spoons, Lemon juice with water and a pinch of salt and black pepper gives immediate relief . Fish oil and flax seeds for Omega-3 and Turmeric powder + Almond oil is very important for our sound mental and physical health and strengthen immune response naturally Avoid fried fast foods, sugar, tea, coffee, alcohol, smoking, stress, worry, anger, Constipation Proper regular walk, -, Adopt For proper blood circulation. Exercise, yoga , gently do neck rotation, clockwise anticlockwise, Kapalbhatti Panama -deep breathing, Anglo Film, Calamari are help full for soothing nerves & relieving your stress inducing sleep and eliminating toxins from our body and help the natural hormones work, Meditation also helps sooth the mind helps in detoxifying and strengthening the immune system to enhance resistance from diseases and pave way for healthy disease free life. Your symptoms may be caused by various health problems. Some conditions can also disrupt the communication between the sensory systems in the body (such as the eyes, inner ears, sensory nerves) and the brain. It is important to seek medical attention if you experience frequent dizzy spells and lightheadedness. Also consult your doctor if you experience any of the following dizziness symptoms:Sudden dizzy spells, A head injury, Severe stiffness in the neck, Disturbances in vision, High fever, Loss of hearing, weakness in limbs slow heart rate. Take Homeopathic Belgium 30 / Twice a day / Take 4 hourly / . Can repeat if required. Hope this helps solves your query. Take care. 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: 18 year old male weight 176 lbs. Active, works out, and plays summer AAU basketball.Woke early morning 5:30 AM June 18, 2013, with enlarged and moderately painful upper abdomen.Doctor took blood sample and found liver enzymes elevated 6X normal.Next day ultra sound indicated no problems, but gall bladder wall slightly thicker.Wed June 26: Performed Upper endosocopy of stomach and upper small intestine -- biopsy did not find anything. Gastroenterologist said mild ulcers in stomach and lower esophagus found. Prescribed omeprosole for 6 months. Ordered colonoscopy for July 10.Blood work June 25 showed liver enzymes now back to normal.Played basketball on Thursday, June 27, and had mild headache.Played again on Friday morning, June 28, resting in late afternoon and asked me (dad) to look at his right eye because he thought something was in it. Right eye blood vessels very dilated -- so took him to ophthalmologist who prescribed Dextromycin-Dexameth Ophth susp drops.Saturday morning he woke up at 8:00 AM and vomited yellowish bile before breakfast and had a bad headache.Called on-call gastroenterologist and he said because of headache take him to emergency room.They drew more blood and said he did not have mono or dehydration -- throat started to get real sore and emergency room doctor prescribed hydrocodone and something else for nausea -- departed hospital.Took hydrocodone on limited basis unless pain was severe, only took nausea medicine on Sat afternoon.Slept from 4:00 Pm on Sat June 29 to 8:00 AM (16 hours) on Sunday, June 30.Sunday still had headaches and very sore throat. Monday, July 1, eye very good, but upper body covered in red rash.Took him to doctor -- doctor thought maybe allergy or unknown virus causing all symtoms.Tuesday, July 2, rash diminished. Wednesday morning, July 3, took to doctor due to continued headaches.Doctor thought might have bacterial sinus infection due to virus and doctor prescribed Amoxicillin. Took more blood to check for West Nile virus (negative). That afternoon headache started to get bad again, so gave hydrocodone -- hour later started giving the prescribed Amoxicillin.Did not have any headaches after taking medicine on Wednesday afternoon, July 3.During this 2 week time he lost 7 pounds.Colonoscopy on Wed, July 10. Doctor checked large intestine for Graves and other stuff, alsochecked lower small intestine. Did not find anything. Thought it could be Graves but would have to do more tests of small intestines. Decided to wait and thought maybe virus was cause of all the symptoms.Said to let him know if symtoms returned or anything happened. Son has only regained about 3 pounds.Thanks ### output:

Hi dearWelcome to the Board of Chat Doctor Gone through your elaborated history and came to conclusion that you had a mild attack of hepatitis and along with that you also developed some gastritis. Hepatitis is usually self limiting disease. It subsided of its own without causing much trouble to you. All the symptoms' headache, pain in abdomen bloated abdomen can be explained with hepatitis. For the gastritis part you have already prescribed omeprazole for 6 weeks which you should continue. Hope you should recover with due course of time with this treatment only. Thanks

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello sir .. plz help me out .this is my father USG ABDOMEN report ...3 things mention in the report but i can t undertsnd ... 1-free fluid noted in adbomen .no pleural effusion noticed. 2-cirrhotic liver with ascitis. 3-left renal calculus . no significant calyectasis.....and one more thg he s diabetic .... doctor recommended these medicines liv52d/s tab lasilectone tab ursocol 150 USG ABDOMEN REPORT - Liver: is normal in size &shows coarse echopattern with irregular margains.no foca lesion is seen in the hepatic parenchyma .intrahepatic biliary channel are not dilated.. Gall bladder:-is normal in site ,size,shape & wall thickness.GB lumen is normally treansonic.No definite calcuus or any definite mass lesion is observed in the GB lumen.. CBD:-Is not detailed.no definite calculus is seen in CBD. SPLEEN:-Reveals normal size ,outline & parenchymal echotexture. Nofocal lesion is observed .no perispleenic collection is seen. PANCERAS:-Show normal size,shape,outline and echotexture .no focal mass lesion or any classification is observed in pancreatic parenchyma .main pancreatic duct is not dilated. KIDNEY:-Both kidneys shows normal site,size ,shape ,cortical thickness and corticomedullary differentiation .LEFT KIDNEY SHOWS A 5-6MMS CALCULUS IN ITS LOWER POLE. NO DEFINITE FOCAL MASS OR ANY BACKPRESSURE CHANGE IS OBSERVED IN THE KIDNEYS.... URINARY BLADDER:-Show nrmal contour &wall thickness no intravesical mass or calculus is seen.lower ureers are not dilated. PROSTATE:-Measure normal size and in size and in weight ..prostatic parenchyma is uniformly normal..median lobe is not enlarged.no breech is seen in prostatic capsule...... no significant retroperitioneal lymphadenopathy is observed.. FREE FLUID NOTED IN ABDOMEN.NO PLEURAL EFFUSION NOTICED.. IMPRESSION:-*cirrhotic liver with ascitis.. left renal calculus.no significant calyectasis......... plz sir tellme is it any danger in report .and how his liver working properly ... and things ### output:

The major concern with this ultrasound is the cirrhotic liver with ascites. When the liver is badly damaged with scarring (cirrhosis), it doesn't work very well. Blood flowing through the scarred liver gets backed up and creates high pressure in the liver, which in turn results in fluid leaking in to the abdomen (ascites). Unfortunately, cirrhosis with ascites may be an indication that his liver is starting to fail. The kidney shows that a stone is present, but that does not seem to be causing any problems. No other findings are of significance. What needs to be done now is to take a sample of the ascites fluid and determine if it is truly related to the liver cirrhosis or something else. Liver disease is the most common cause of ascites, but other conditions may cause it as well, and treatment may differ. Further investigation of the liver status may also be needed, such as a biopsy. Usually the spleen is enlarged when ascites develops with a cirrhotic liver, and his spleen is normal, so perhaps another more treatable condition is present. Liver failure from cirrhosis is the worst case scenario. Further evaluation should help define his situation better. Hope this helps.

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 I am a male of 24 Years working in an IT service industry in south India. I am staying alone in a mansion at my work town. I am having a height of 163cm and Weight of about 80kg.I go everyday to play badminton or to health club for some regular excise. I have a problem of getting angry quickly if i hear a small issue against me or is done by others. I get also tensed in small issues and even for some thing change from what i did not expects. I want the result or thing done fast for some cases. I cannot control my feeling or cannot control my anger. I just fear of me bursting out to someone when i get angry or i actually feel in smashing something but i try to control doing these thing or will talk to my parents who tries to calm me down but still i become worried too much. I some time feel seriously depressed when i couldn t get some thing done or achieve some thing. Where as I see there are many people in my family and friends who just take thing very easy and is always cool. When i talk to my family on these thing they said It may be because i am having high BP. I also have problem of forgetting words while i am speaking even if i know or even some time forget what i had to ask or say when actually i am going to ask or say something to a person which i just thought and i just stand there thinking what i actually came to ask. I also get confused while i am saying some thing or get mixed up with the sentences when speaking which even confuses my friends or family. I speak loudly when I talk to someone which actually i may have started with a low Voice (I am not able to control my voice.) I also have problem or getting very less sleep. I rarely sleep more the an 5 to 6 hrs only if am really tired and even while sleeping i have lot of dreams coming which actually feels real and after getting up i feel still tired. I am try to control my anger and other problem but still end up in the same place. Can I know should I take some medication or see a doctor or change in my routine activity.Please suggest on what i can do. Thanking You in advance. ### output:

Dear Sarah Baby, Thank you for choosing this platform to get answer to your queries. I appreciate your ability to analyze yourself so well and being able to pinpoint the problem area. It definitely is a step towards health living when we are able to realize our difficult areas and are willing to work on them. People working in the IT industry often have emotional difficulties due to their work routine, spending more time with the machine than with people and staying away from home when on projects. Its wonderful that you spend time exercising as it's a good way to burn out ones aggressive energies literally . How long have you been having these symptoms...sleeplessness, lack of impulse control and anger issues ... Issues related to work and performance as you have mentioned as in expecting fast results and dealing with small failures or setbacks could be personality based difficulties. I suggest you meet a clinical psychologist for a thorough assessment of your situation to identify if it's resulting because of your traits or situation and if it's a diagnosable condition like a depressive disorder or anxiety disorder. You may not require medication if your assessment shows the need for lifestyle and behavior modification like anger and stress management but if there is a diagnosable condition then you may require medication which would assist you in seeking solutions to your difficulties. Please do let me know how you followed up on your case from here on...some tips:1) recognize the physical signs your body shows before you get angry like feeling tension or faster breathing and remove yourself from the situation, Chat Doctor. .that would give you time to rethink 2) maintain good sleep hygiene as in try and sleep at the same time every day and stop watching TV or reading at least 30 min before lying on your bed.you could listen to soothing instrumental music.

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 Angie and I m a 30 year old single mom of 3 kids. I was in a car accident about 6 years ago where I sprained my neck and my shoulder. While that injury is not terrible, the accident as well as events following have created a lot of problems for me. I was diagnosed with 2 bulging discs in my lower neck (I don t remember exactly where they are) and I went to a chiropractor for some relief. After that visit I ended up in the ER unable to twist or bend my neck/back and since then I have had chronic pain. I ve gone through physical therapy, done cold and heat therapy, etc.. Every time I talk to a doctor I hear the same thing You re too young to have this many problems. Um..I KNOW! I m tired of getting treated like a drug seeker, yes, I AM looking for pain medicine because I AM IN PAIN! No one will listen to me, no one will help me! It s not just my back though..it s virtually all of my joints. My knees hurt so bad at times walking up and down my stairs in a problem, my lower back pain has caused me tremendous problems at work because I can t stand for long periods of time, and I m a waitress/chef, or I was, I just lost my job because of this. My fingers hurt, my wrists, my elbows in the morning..and my big toe. I have medicaid so I don t have many options when it comes to medical care and I can t find a doctor to listen to my concerns and help me without judging me. I m sick of this. I can t keep living this way! I m missing out on so much with my kids because I can t play with them the way that I should. My quality of life is terrible! Please help! ### output:

Hello, I am sorry to hear that you are kind of upset with what you are going through. It is sad and frustrating that the medical team is not able to help you have a good lifestyle in ADL. Coming to the point, there will be injuries due to accidents. Some will be shown that time and some will come to a later stage of life Now bringing the fact that you have spine issues and also the pain in multiple joints which includes the knee, shoulder, elbow, fingers etc., I can tell you that you need to first start your day while taking a good hot water bath in the morning. Post that you should start doing basic and simple exercise to keep the muscle active as much as you can. Something like Pilates, aerobic exercise and some basic strengthening exercise. Also, will advise you to buy one pocket TENS machine, which can help you reduce pain without taking much of the painkillers. Having too much of painkillers will only make you more trouble in the upper stages of life. So the non-trouble option will be buying the Pocket TENS machine which is widely available for commercial and personal use. Now as your job profile is about standing and working more, that means you need to improve your stamina to withstand the day. Well, currently we do not have any medication to improve the stamina, but exercise is the option which can help you regain the stamina to pass the day. As you had an injury with an accident and having too many muscle weakness with pain, the only solution I See is to keep the body as much possible active you can with exercise. I have seen many cases with such issues and most of them are better with regular exercises. Having accept to the fact that every human has their limitations and so does medical. Hope you understand that the solution is with you, and you need to do regular exercise and make your muscles strong and stronger. I assure you that if you follow a regular general exercise then your pains will come down, and you can have an active lifestyle. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Sorry about this being so long, I dont know where to turn right now other than here.I have had kidney issues since I was 3 years old, that infection I remember it like it was yesterday, the pain was so bad that I couldnt stand. Have had many kidney stones, had one blasted out, blood in my urine quite often, several times so much blood that you wouldnt even know that the substance was urine, it looked like pure blood, many UTIs, kidney failure 3 times on blood tests and 2 times resulted in hospital stays, many times unexplained side pains at the emergency room to find nothing wrong. When I was pregnant, my blood pressure and sugars were horrible, I had to give myself insulin shots 4 times a day, eventually I was taken to the hospital to control it, my kidneys were failing, they took them out early, at 33 weeks. My kidneys are scarred pretty badly, it says on most of my tests over the years, I have been to a urologist here, he could never find the reason this kept happening to me. He would be in the room and out as fast as he came in, I asked him numerous times to help me find out why this kept happening to me! Well last weekend I went in the the emergency room and the doctor told me two times that I had Polycystic kidney disease and that there wasnt anything they could do for me that wasnt already being done. I have polycystic ovarian disease, at first I thought that was what he said. He blamed my pain on gas and constipation ( which I know for sure is NOT true) and told me to get ahold of a kidney specialist, that he would put the number etc. on my paperwork. He did an abdominal cat scan, said there was a 3 mm kidney stone in my kidney and that my pain was caused from gas and constipation. I asked him about the PKD, because by then it had sunk in and he was very confused that I had no idea what he was talking about. He again said yes, you have PCOS and PKD. He wouldnt answer any questions I had about it after that. When I got home, I checked the paperwork, but it said nothing about my kidneys at all. No number to a doctor he recommends... nothing! He put on it that I was treated for constipation and gas! I went to get all of my records since I am tired of getting no answers and I want to take them to a specialist. Since the emergency room papers say nothing about PKD my doctor office wont refer me to a specialist. While I was reading cat scans and Ultrasounds, they said twice that I have medullary Sponge Kidney and mentions numerous times about Echogenic renal pyramids, lots of stones etc, but nothing about tumors on my kidney. I am still having left sided pain and occasionally the right side also. I see blood a few times a week and this been has been going for months! There is PKD in my family, the only one that we know of was my great grandmother, she died from complications at 37. My younger sister has kidney issues also. I am very confused as to what to do now!? I cant get recommended to a specialist for this, I need answers! What can I do? ### output:

Hi and thanks for the query, early diagnosis and appropriate management is important. A careful review by a nephrologist is required. PKD predisposes to chronic kidney disease. It is therefore important as of now for you to measure serum urea and creatinine levels, as well as serum Calcium and Potassium levels. This shall give clear information about kidney function. I suggest you book an appointment with a nephrologist. An abdominal ultrasound is needed to exclude cysts in the liver since these two conditions usually go together. 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: Dear Dr. Two days back my Son got sudden fever, which also resulted in febril seizure Please find below the series of event before and after the fever 1. On the day of fever, we gave him enough water to help him for the summer heat of Chennai. 2. He was normal through out the day. Evening he had 1 whole raw tomato (normal size) 3. Suddenly around 8 pm he got high temp which rose up to 103 F. 4. We took him to hospital and Doc advised us to give Normal para dosage at regular intervals. no injection was adminstrated. 5. That night my Son s body temp was normal after giving him para syrup. 6. Next day morning the temp was normal. After his breakfast around 10am again suddenly the temp rose up to 102 F. 7.My wife suddenly thought of giving him Meftal-P tab (without the Doc s advise). We gave him 1/2 tab of Meftal-p tab 8. Afte 30 mins of the dosage, we noticed his body gave a sudden big jurk, which for us was not a normal severing. We immediatly took him to hospital expecting the unexpected. 9. After reaching hospital for 15-20 mins he behaved very normally. Suddenly he got seizures, which lated for 30 seconds. The Doc immediatly gave him two shots and told us to sponging to reduce the tab. He further told us this kind of Febril seizure is common duing high fever. My question. 1. Earlier also my Son had high fever with 104 F temp but never had febril seizure. Was that due to any durg infection (as we gave him para the whole night and suddnely in the morning gave Meftal-P). 2. What could be the reason for sudden fever. Also note today morning we notice that a new teeth was comming. I am confused. Also advise on how to proceed further to know more about by Son s seizure. Many Thanks Gopinath M E-mail id: YYYY@YYYY and YYYY@YYYY ### output:

Hi, I am Chat Doctor. I have read your question and understand your concerns. Let me try to help you Question 1 : Earlier also my Son had high fever with 104 F temp but never had febrile seizure. Was that due to any drug infection (as we gave him para the whole night and suddenly in the morning gave Metal). Answer 1 : There are lots of factors which determine febrile seizures other than the temperature. So please don't get confused. Even with Temperature, the Rate of increase of temperature is more important than the actual temperature at the time of seizure. Question 2 : What could be the reason for sudden fever. Also note this morning we notice that a new tooth was coming. I am confused. Answer 2 : It can be a simple viral fever. If the fever has settled by now, you need not worry. If the fever is continuing, you have to do some investigations Question 3 : Also advise on how to proceed further to know more about by Son s seizure. Answer 3 : Just give him Sponging with Ice Water and keep few cubes of Ice in his Maxilla when he gets fever. Please don't hear to your parents of other seniors saying that Ice Water or Ice cubes will produce Cold. Seizures are more harmful than cold. You have to prevent them. So Always Ice Cold Water and Ice Cubes even when the temperature rises a bit Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. 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: I started having pain on my lower right side of my back a few weeks ago. I have been tested for stones, UTIs, vaginal infections, STDs, and appendicitis, and all were normal. Because I was also having bladder urgency problems and retention and right abdominal pain. A few nights ago I started getting really sharp, intense pain at the top of my left toe, it only lasts a few seconds and then stops . I then started having back pain on both side of my lower and upper back so severe I find it hard to breath, and it wakes me up at night, but goes away after a short time and then comes back. Then yesterday, I started having really horrible tailbone pain and found it hard to sit or stand or lay down. I feel the urge to go to the bathroom and I have no luck getting anything out and it hurts my back like crazy to try. I looked at my bottom in a mirror and it doesnt look like a hemorrhoid, it looks more like skin grew over my anus and now there is no view of a hole anymore and there is a red streak that started out small this morning and now it has spread up to my spine from the aaus and I feel excruciating pain when I sit, stand, lay or even try to go to the bathroom in my spine and hips. I also have been experiencing muscle spasm type feeling through my legs whenever I get up from sitting, it is also very painful and it has been going on for about 3 weeks,and the pain can last for hours. I have no idea what to think any of this is. I know I am not pregnant, I have been tested and I have started bleeding a few minutes ago from what I hope is my period. I have fibromyalgia, IBS, Interstitial cystitis, Migraines, and Bipolar as my history. I have been taking Neurontin and elavil though for those things. ### output:

Here you have told as per your past and current history you have irritable bowel syn Chat Doctor. Now recently you have started developing back pain along with muscle spasm feeling in your leg. Here your back pain can be related with multiple issues. It can be due to fibromyalgia where it is affecting your spinal muscles, it can be due to IBS where due to over strain on soft tissue it is causing pain, it can be due to problem at lumbosacral spinal level where there might be issue at lumbar spinal curve or disc related problems disturbing the nerves coming from. That particular level, it can also be due to interstitial cystitis which is disturbing the soft tissue and creating more inflammation in soft tissue.However the conformation can be done by MRI of lumbosacral spine and physical test examination by orthopedic doctor. As per the report and orthopedic examination, or tho doctor will suggest you either surgical correction for severe damage in spine and disc or conservative management with physiotherapy treatment and exercises for mild to moderate issues. Here if you have any issue with your digestive system as well for passing motion then you can also check once with Castro neurologist. For back pain you can also use hot and cold pack to have some more relief at home itself. As well do take suggestion on postural correction and physiotherapy spinal exercises properly. This will help to improve strength and stamina of your spine. If your MRI is normal, and it gets conform that back pain is due to fibromyalgia. I suggest first keep some rest to body and mind, do Panama and yoga to heal body from inside. Along with this again physiotherapy treatment and suggestion will help you a lot. Also do changes in your lifestyle like keep food habit regular and have simple food with Lora of fruits and fiber, maintain sleeping time etc. 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, I am 27 year old female, married, working as a researcher in india, weighs 49kg and 157cm tall. I have all my periods regular and on time. Hairs and nails are growing fine but facing severe hair fall and hair greying intensely. Coming to my basic character, i am very reserved type of person, talks very less but talks openly and frankly to those who i do. I have very less friends but whoever i have i trust them as my shadow. eventhough everybody see me as a matured independent person, i always owe to be supported morally by someone whom i trust as my breath. detailing about my problem, i cant control my temper. one thing is i am short tempered as well as i dont know what all i speak out when i am angry. after sometime when i realise i regret and cry a lot for the situation i have created. now the problem is very worse that i got married to a very nice calm, understandable and down to earth person. our marrigae happened one year ago and i know him for past two years. he tries to support me whenever i am angry, but now he started losing expectation from me. due to the career reason eventhough we are living physically separated, we always keep in touch through phone or other media. he visits me atleast once in two months. due to anger he is afraid that how it will be when we start a life together which we planned to start by next year end. moreover i have a feeling that my in- laws are not happy with me as i am living separated from their son and i am a reserved person. this created a block for them in my brain and i just manages them and dont feel anything for them from heart. i spoke this openly to my husband and he is supporting me and consoling me. never blamed me. but problem arises when i get angry i take names of my in laws for which he will tensed and crestfallen. eventhough everytime i try to control that it goes off my tongue. moreover he always tells me that i have attitude problem and i judge others too much. now the condition is that whenever he takes the words attitude and judgement i burst out like a volcano. this creates a barrier between us now as he is afraid to share his worries regarding family issues and also he is afraid when the smile from my face will change. now i get a feel that my husband doesnt love and care me as before and started losing faith in me. i want my family back and his happiness back as before. please help me in this. please.... ### output:

With your query, it's clearly understood that you are a straight forward person with independent character, and you want your own career that's good no problem but always remember straight tress are cut first not the bent ones. So whoever straight they always face this issue. Now coming to your family issue 1. You are living separately from your husband from the beginning of your marriage I believe so what happens here is understanding between both of you won't stand for longer though both of you feel that you know each other in very aspect. Openly in the beginning of any marriage living relation is must understand each other open heartedly2. Now coming into your in-laws anyone even you when you become in-law think in the same manner no one is exceptional for this so always try to understand them by keeping your legs in their shoes.3. Everybody talks uncontrollable when they are in anger, but it is our own consciousness we should be aware before we deliver our words.Finally, I would suggest you to be calm and think what to do to control your anger and make your husband to understand you better only this helps you. I believe this is not a serious issue to be considered since I see everything is in your hands you have already mentioned your husband is so understanding he will be ready to accept you for his lifetime if you can control your anger and words. Do meditation for mental peace and to get control over your anger which helps you better. Hope this helps you

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi,Dr. Samuel Grief, I hate to bother you, but I really appreciate you, and I have a lot on my mind. It s just that, there are some decisions in my life that are simple to make. For example, I never had dental insurance, so now I m finally getting around to going to the dental college several times to get a deep cleaning, several fillings, etc. That s an easy decision to make. I m saving my teeth before they get too bad. But here s the hard decision: I was diagnosed with bipolar disorder three years ago right after I finished my math bachelor s degree and while I was working on my teacher s certificate. I never finished the teacher s certificate, so I ve been living with my parents since I graduated college because I couldn t get a real job. When I was in the mental hospital for two weeks, I thought I had schizophrenia because I said some weird things. I m actually bipolar, but I need some support. I know friends and family help. I don t have a girlfriend, but I don t know if I should. What I really wonder about is the spiritual aspect of things. I was an atheist who was angry that his parents went to Bible Colleges and ended up working in low jobs. That was why I went to a top university and majored in math. When I was at the mental hospital, a girl was into me and wanted to be my girlfriend, I tried yoga, I read the Bible a lot, and I was given a book that I ve been studying called The Power of Now by Eckhart Tolle, which later led to studying the philosophy of Alan Watts. I know that it s important to know exactly what you want in life before you pursue it, or you ll keep changing your mind and waste your time. I have been given advice by some people I respect that I should try to pass some actuarial exams (basically becoming a statistician for an insurance company). I could earn good money that way and use my math background. But I m afraid of working hard, which I will need to do in order to get anywhere, and then ending up having another nervous breakdown and being institutionalized. My psychiatrist is just a drug dealer who gets as many patients (who are poor) as he can so that he can just give them prescriptions but not any advice or therapy. The point I want to make is that I just need a support system that I can put all my faith in, like Jesus Christ (but I m too much of a skeptic), so that I can stop worrying so much. Once I stop worrying, I can find out exactly what I love as a career (I m not even sure what that should be), and then I will pursue it. I was able to earn my college degree without having support, but it led to mental illness because of stress with nowhere to turn. Right now, I just wish I knew what my religion or source of spirituality would be for psychological strength so that I can achieve goals in the real world. Also, I never took a psychology class, but I may have something called paralysis of analysis. ### output:

Hi, Welcome to Chat Doctor .com I am Chat Doctor. Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. That was a very good history I wish that all patients are so descriptive There are lots of reasons for Bipolar disorder and Schizophrenia?. Some are chemical and some are structural. We need to evaluate you further. I would suggest to you consult a Neurosurgeon at the earliest Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in Chat Doctor at http://bit.ly/ask

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Dr Age: 36 Gender: Male Constant feeling of urination after abusive, lengthy masturbation and persistent mild burning in male urethea. Any nerve/tissue damage? I am having a sensation of constant/always urination; with a weired kind of burning senation in peline urethera and penile head. This situtation occurs after i did abusive/lengthy masturbation 10 MONTHS ago. After masterbation or having intercource with my wife it used to come for only 2 - 3 hours and after sleep in the morning used to feel alright. But due to a lenghty/abusing masterbation session 10 MONTHS ago feeling of urination have become constant and not going away The following test are done so far. 1. Urine Culture - All Normal. 2. Renal Ultrasound - All Normal (prostate size is normal about 24) 3. CBC - All Nomral. (Dr Says very slight Iron Deficiency Anemia; dr put me on iron tablets for a month) 4. LFT - All Normal. 5. Diabetic - Normal 5. Vitamin D - I am deficient (Dr put me on tablets for a month) 6. Vitamin B - Before the onset of these symptoms i was deficient in vtamin B and had few injections of cynacoblamin were given. All the doctors are clue less as of now; these symptoms are really really killing me everyday. I have seen a few urologists with the following diagnosis and treatment but with no relief. 1. A urologist diagnosed it as non-specific non-inflammatory prostatitis and put me on Cipro for 4 weeks but to no avail after that he put me on levofloxacin for a week with no relief at all. 2. Another urologist marked it as NSU and put me on numbing jell and a tablet which turns your urine dark yellow for 5 days with no avail. I also took a TCA Tofranil (Imipramine) for about 2 weeks for no avail at all. After being exhaused from thease treatments i have also tried alternative treatments as follows. 1. Homeopathic for 2 months with no avail. 2. TCM (Traditional chinese medicines for few months with no avail) As I am running out of ideas may be the following can be considered. 1. parasitic infection. 2. Pudendal nerve entrpement or perinal nerve pinching etc. Dorsal nerve etc. Or any other nerve disorder. 3. IC 4. MS Please help me to get rid of these annoying symptoms. ### output:

HelloThanks for query. Based on the facts that you have narrated you have a long-standing history of pain in urethra and constant sensation to pass urine which followed after prolonged abusive masturbation which has not responded to treatment with multiple antibiotics and none of the various relevant test are conclusive as regards the diagnosis and cause of your symptoms. In view of all these symptoms started after prolonged abusive masturbation I think the prolonged masturbation has caused trivial damage to urethra resulting to form a scarring and flimsy stricture of urethra. I would suggest you to consult your urologist again and explore need for doing endoscopic examination of urethral passage (Ureteroscopy). This procedure of visualization of urethral passage directly perhaps may help to diagnose the precise cause for your symptoms. Further treatment will be decided by him on final diagnosis. There is no possibility of pinching of any nerve as it never happens in reality. 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 my name is Kelli Jo...Last July I was involved in a (hit & run) accident. I was struck by a truck motorist and broke my left tibia. Underwent surgery receiving a metal plate with 8 screws. About a month after surgery my right ankle started to swell. Surgeon encouraged me to see primary physician. I did, and because I did not have health insurance at the time, and my doctor did not believe it was accident related, returned to work and waited 8 months until I received insurance to. go in and get tested. The first test I was given was a Doppler ultrasound, blood & urine samples. What came back under UA Micro Panel: positive for Leuk sm1. (i was told thyroid problems..my thyroid has to work xtra hard to work). My doctor s nurse contacted me with the results and scheduled a phone meeting with my doctor. Unfortunately, I woke up late and missed the meeting. Called the clinic right away to reschedule but not able to get in until 6/23. I m upset because...I m tired of suffering. I ve gone back to work after my accident but have had to work on my feet all day with swollen ankles. I have swelling in both feet, but more so in my right ankle. By the end of the day from work I can t even walk. It so bad. I travel to and from work by bus and have to walk to and from bus stops. I ve missed some work because of it too. (more lately). I ve been having a lot of charley horse cramps in my legs. They re more like ATTACKS. So brutal and so hard to subside. Last night I was awaken at 3:00am..started with 1 in my right back of the upper leg, then got another one same area in my left leg. (So had the both together). They re so bad I think I wake up the whole apt. complex...crying with agony and pain. I m mentally & physically exhausted having to go through this. I m depressed. I do take depression medicine celexa and have been for many years. (with the exception having no medical, went off it cold turkey for 8 months). I ve dealt with this long enough and I m tired of it affecting my job performance wise and absenteeism. I ve told my doctor about this and I have followed everything she s recommended to help while I m working..(compression socks, extra breaks putting my feet up, anti inflammatory pills). My doctor is on vacation now. Even though I missed the phone meeting..could t she of recommended something in the meantime? I don t want to lose my job over this. But I m afraid I may be getting close. I ve been at my employment for 4 years. I do housekeeping & laundry for a nursing home facility. I am 48 yrs old. will be 49 in August. Please can you provide some suggestions.. Thank you. (sorry about the note length). I APOLOGIZE I THOUGHT THIS WAS FREE ADVICE. I DON T HAVE A CREDIT CARD. THANK YOU ANYWAYS. I APPRECIATE YOU READING THIS. I LL FIGURE SOMETHING ELSE OUT. (i hope). ### output:

Don't worry. .this swelling is common after fracture fixation and prolonged period of immobilization of the joint. Do full laboratory investigation(CBC.liver and kidney enzymes. Blood sugar. Serum uric acid). Do X-Ray on your leg and your swollen ankle. Don't hang your leg down. Always keep them produce your physical activity and reduce mental stress as it may exaggerate the pain. Be sure you Will practice your work as before

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 37 year old female that works full time for an Internal Medicine Doctor s office. It gets very stressful at times as I am the only Clinical Nurse in the office that sees 25-40 patients a day. On 10/14/11 all of the the sudden I had tremendous (1-10 pain scale it was at least a 9 or 10) pain under the mid section of the rib cage.At the time of the onset of this attack I was in an exam room taking a patient s vitals & going through the normal routine of allergy, medications, etc. updates with the patient, nothing stressful. I had these attacks before but never as bad as this one, and the last attack was about 4-6 months ago & again, was doing nothing stressful at the time. The pain finally subsided after about 15-20 minutes (down to about a 3-4 out of 10). I excused myself from work & drove myself to the hospital (the hospital is 1/8 mi. away from my work). I went into the E.R. & explained to them what was going on, they immediately took an EKG & CXR that showed nothing. After talking with the E.R. Dr. & telling her about the last attack but that there was pain in my back associated with that one. The E.R. Dr. said it sounded like a classic case of gallbladder stones. They performed an U/S of the Gallbladder & it showed no stones however it was enlarged & dilated from what they said. Next, they performed an MRI w/o contrast that showed the gallbladder as distended for the patient s age , again no gallstones. I was D/C from the hospital & was told to follow up with a G.I for an Upper GI Endoscopy and to go from there. I have a history on my mother s side of her sibling s having their gallbladder s removed but at a much older age. I wanted to speak with a hematologist in regards of my lab results but on the same token give a bit of history as to which led up to the lab work being performed. All of the results came back in normal range except the following: WBC: 11.6 H ; RBC: 3.86 L ; MCH: 33.4 H ; Neutrophils: 80.0 H ; Lymphs: 15.4 L ; Monocytes: 3.7 L ; Neutro Absolute: 9.3 H & Glucose: 100 H Should I be worried about anything regarding the lab results & what do you recommend about the gallbladder situation? I extend a big Thank You in advance for your time and help in regarding my situation! -Theresa P. ### output:

Hello,1. Gallbladder with small calculi should be removed by laparoscopy as small stones bring risk of bile ducts obstruction and acute pancreatitis.2. Chronic liver parenchymal disease most likely means that you have fatty liver. You should avoid alcohol, fatty foods, spicy foods, medicines involving liver to reverse fatty liver process.3. Mild degree of splenomegaly should be consulted with hematologist as this can be a symptom of many diseases including leukemia, liver hypertension, infectious diseases.4. CBD borderline dilated can be caused by sludge or small stones inside. I suggest you to have liver tests (AST, ALT,GTP, AP), lipase, amylase, bilirubin checked. You should be operated anyway as small stones are more prone to move to bile ducts and cause acute pancreas disease. Hope I have answered your question. 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: Hi Doc, I am 30 years old, I had a history of right and left ovarian cysts, right adnexal cyst measures - 4.0 x 3.2 x 4.1 cm and left adnexal cyst measures - 6.9 x 5.2 x 3.4 cm (on 01/10/2011). Left Ovarian cystectomy and adhesiolysis done on 24/10/2011. Biopsy reports suggest - Endometriotic cyst. After that I had taken Inj.Lupride Depot 7.5 mg im x 3 such in 28 days interval (Nov 11 , Dec 11 and Jan 12). My menstrual cycle was stopped due to Injection otherwise it was regular. After 1st mentruation on April 12, Doc prescribed Tab.Ovaral G 1 tab for 100 days then stopped for 7 days again continued for 100 days for 4 cycles (till July 13). Since after we are trying for baby and I am in Follice acid and my menstrual cycle is regular (27th to 29th days). My gynecologist adv for follicles study , on 4th day - follicle was 14mm , 9th day growth multiple follicles - 17mm and 14mm each , 11th day - 2mm, 18 mm, 13mm , 13th day - 23mm, 22mm, 18mm, 14th day - 26mm, 24mm, 18mm , 15th day - 27mm , 25mm, 20mm , 16th day - 29mm, 27mm, 20mm , 17th day - one is 31 mm , other two are partially ruptured , (today)18th day - 35 mm , other two are partially ruptured. i have taken Tab. Fertyl 50 mg from 4th day to 8th day , then to rupture the folllicle , Inj. Hucog 5000 IU on 14th day and now on Cap. Susten 100 mg since 16th day for 10 days. My question is with this partially ruptured follicles can I conceive this month or not ? If not what is next step for me. Please suggest. ### output:

It i there, thanks for writing in. There are few things I would like to suggest.1. When we do follicular scan we can assess ovulation by noting that the follicle has collapsed and not visible and the fluid inside the follicle can sometimes be seen in the pelvis on scan. At times the follicle gets filled with blood and other tissues that it becomes difficult to know if ovulation has occurred. A good monologist makes use of other techniques like Doppler to assess ovulation. Having said that It's not always possible to tell certainly if the egg has been effectively released which applies to your scenario as well. But the possibility of pregnancy cannot be negated.2. Current evidence suggests in endometriosis of stage 1 and 2, mild, if the fallopian tubes are open, the best results are obtained when ovulation is achieved by gonadotropin (injections for achieving many follicles) and combining with intrauterine insemination provided your husbands' semen is normal.3. Make sure your fallopian tubes are open by getting tube test done. (Hysterosalpingogram). This is necessary for GUI. Please remember in fertility issues we only talk about probability and likelihood. It's good to be hopeful. 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: Hello, I have been dealing with a rash on hands, legs, back, arms and now bottom of my feet for the last 7yrs. I was prescribed 2 steroid creams and they have not worked for 7yrs. I asked my doctor to test me for lupus and she put me on prednisone which I was on 2 times before and it makes the rash go away for a little while. I was sent to a skin specialist 5yrs ago and they gave me the same 2 creams and still nothing works. I do have a copy of my blood test in which it says --- SEDWEST is 42, CRP is 2.5, RF is <4 , ANA is positive, ANAT1 is 1:320 and ANAP1 homogenous. So I guess my question is do I have lupus? my rash starts out like a blister and then itches then turns yellowish green then brown. I do not have a blister rash on my face but, I do have redness on cheeks and nose. sometimes I do run a low grade fever, tired, achy and my eyes are always dry. ### output:

Hello there! The classic presentation of a triad of fever, joint pain, and rash all points towards the lupus. So does the positive homogeneous Anyhow many of these complaints you have? Constitutional (e.g., fatigue, fever, arthralgia, weight changes)Musculoskeletal (e.g., arthralgia, arthropathy, myalgic, frank arthritis, avascular necrosis)Dermatologist (e.g., Malay rash, photosensitivity, discoid lupus)Renal (e.g., acute or chronic renal failure, acute nephritic disease)Neuropsychiatric (e.g., seizure, psychosis)Pulmonary (e.g., pleurisy, pleural effusion, pneumonitis, pulmonary hypertension, interstitial lung disease)Gastrointestinal (e.g., nausea, dyspepsia, abdominal pain)Cardiac (e.g., pericarditis, myocarditis)Hematologic (e.g., cyclopedias such as leukemia, nymphomania, anemia, or thrombocytopenia)the more you have, the more the Odds for lupus. As your ANA is positive Homogeneous It has pointed lupus further, but ANA is not that specific. You need to do Anti-Double stranded DNA and Anti Smith antibodies to confirm. You need a detailed workup for SHE, Anticardiolipin, Lupus AnticoagulantComplete blood count (CBC) with differentialSerum creatinineUrinalysis with microscopyErythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)Complement levelsLiver function testsCreatine kinase assays protein/spot creatinine ratio Brain MR scans joint effusions arthrocentesis and last but not the least RENAL BIOPSY to Assess the severity of lupus nephritis. You need a whole panel of RheumatologistInfectious disease specialistNeurologistPulmonologistCardiologistGastroenterologistNephrologistDermatologistHematologistHigh-risk obstetrician(if female with plan to pregnancy)A simple steroid won't help. So what are you waiting for. Grab your coat and see the nearby rheumatologist to start it. You need to control the progression and care for your vital organs if you need to survive. Take care of yourselfRegards 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: Sequence of events: Day 1: Burning, painful urination; pink urine detected; lower abdominal tenderness and bloating and frequent urination; this is also accompanied by urgency to defecate, loose stools nausea and some dizziness (had the latter before with sinus infection - have been taken pseudofed and Astropro for the sinus congestion and dizziness) Day 2: Urethral discomfort, blood still detected; cramping/pain in back just under the rib - both sides; no more loose stools, but nausea and dizziness continues; see NP in Internist office who orders urine dipstick and urine culture; prescribes Cipro under the assumption that I have a UTI; because of back pain, orders abdominal CT w/o contrast; I take 1 dose Cipro at night Day 3: Symptoms with urinary tract appear alleviated, though back discomfort continues; continue Cipro; start period? Day 4: Start period? attribute back pain to menstrual cramping Day 6: See Urologist on suggestion of my retired General Surgeon father; Urologist asks questions but doesn t physically check me; calls in results from urine culture and reports that nothing was detected so she is concerned about kidney stones; did do a urine test, blood detected, but at the tail end of period so means nothing; changes my abdominal CT to w/ and w/o contrast; tells me to stop taking Cipro because it is not doing anything Day 8 (exactly 1 week after symptoms began): do abdominal CT w/ and w/o contrast Day 9: NP receives results: abdominal CT does not detect kidney stones nor anything unusual with the urinary tract , though does detect a 1.6 cm cyst within the left ovary (which is where the more pronounced pain is felt); recommendation is to see OB/GYN regarding further exploration; called OB and nurse for ultrasound appointment; received urine culture results directly which states: Polymicrobes detected consistent with urethral flora and/or colonizing bacteria . Apparently, it was a nonspecific test, but appears I did, in fact, have a UTI. I resume the Cipro after a 3 day hiatus on the recommendation of the Urologist! Day 10: Coincidentally, UTI symptoms reappear with burning urination and discomfort, but no visible blood detected; frequent defecation and loose stool again accompanies symptoms; back discomfort continues, in addition to intermittent nausea What the hell is going on????!!!! There appears to be at least 3 different organ systems involved. ### output:

Hi, please don't be so upset. A 1.6 cm cyst in the ovary is of no clinical value we don't even call it a cyst, it may just indicate an unruptured follicle which may be painful. Even then, if this is bothering you, all you have to do is repeat an ultrasound pelvis after 6 weeks to make sure it has disappeared. All the other symptoms are likely to be related to your UTI. This infection may cause nausea, vomiting, lower abdominal pain, back pain etc. The antibiotic you are taking may also be responsible for all that nausea. Your dizziness may be due to the medications you are taking for sinus problem. Your diarrhea may be a consequence of antibiotic therapy or due to an ongoing infection. Just complete your antibiotic course and take any much medicine to stop your nausea after discussing with your physician. Please repeat urine culture some time after your treatment and period is over to make sure all has cleared up. May God help you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Dr, I was addicted to masturbation and because of that i feel extremely weak, tired and suffers lack of memory. I have taken the treatment of ayurvedic medicines in year 2002. But at that time i came to know that these ayurvedic medicines can easily be available at some ayurvedic stores so i take them from the stores and continue to take them for upto year 2004. During that period i didnt feel anything wrong. But in year 2005 i have suffered from jaundice. After recovering from the jaundice in year 2006 i go to a ayurvedic doctor for the treatment of premature ejaculation. At that time he gave me some ayurvedic medicines but on taking those medicines i suffered from the excessively lack of memory and brain fog. I told these symptoms to the doctor but he surpisingly said it rare how it happens in my case as those medicines doesnt have any side effects. So i decided to go to seek another better doctor. the problem persists again with that doctor too. At that moment of time i cant understand why this happen to me. I cant understand. After some time in the june 2007 i suffered from very bad health condition. Doctors doesnt know the exact problem. I suffered from excessive body heat causing me insomnia, lack of concentration and memory, headaches like burst out the veins of brain with jaundice like symptoms. I got inflammation in liver area too. I that time some local doctor said that i suffered from khushki like symptoms. He treated me with DNS and give some sleeping pills. After that my conditions remains like that upto now it passed 4 years but my condition still remains same. I feel extremely tired, lack of energy, lack of concentration and memory with a little jaundice like symptoms. My LFT reports said the same. bilrubin 1.4, Sgot - 58, sgpt - 69. The liver area under right ribcage have bulging which seems like liver inflames due to excessive heat caused by taking those ayurvedic medicines. I consulted lots of doctors, took lots of medicines for last 4 years but all in vain. After 4 years when i searched a lot on internet about my health i came to know that the ayurvedic medicines i take in past are stimulating herbs and that causes all these problems. Is there any treatment for this. Can i become healthly again. help me i am in deep trouble. My life become living hell. Some times even i think for suicide. what can i do please help ### output:

Hi there,First, I'd like to reassure you that your liver enzymes are only slightly elevated, and this doesn't mean that you have liver failure or your liver is in any immediately danger. I think some medications you've taken in the past are probably contributing to your elevated liver numbers, but I think they can go back to normal with the proper care. The first thing I would do is stop all your ayurvedic medications, which I think you have done. Time is the treatment here, and your liver will heal itself with time. I also would stay away from alcohol, fatty foods, and stay well HY Chat Doctor. I'd also limit red meat if possible. I wouldn't lose hope here. I see plenty of people with liver problems, and many times the liver can heal itself by clean living. Furthermore, I don't think you're in any big trouble here. I'd just stay away from the medications, eat and live clean, and take care of yourself with diet and exercise. I really do think you'll get better with this advice. I hope this answers your questions. Please feel free to contact me should you have any further 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: My Grandfather is aged 82. He had blood vomit due to one of the oral antidiabetic medicine. The haemoglobin levels had dropped to 6.6 and he was transfused with 2 units of whole blood raising the levels to 7.8. Doc had stopped his delayed release asprin to prevent any internal bleeding . It was further descontinued for 4 months unknowingly. He later had a bruise in the toe which developed a dry gangrene and periferal angioplasty was conducted to restore the blood flow. The toe fell off on its own and additional anticloting medicines were started ( Clopidogrel , asprin and cilostazol) post angioplasty. The blood haemoglobin levels had risen to 9.5 during the course (about 8 months post-vomitting) and now it dropped again to 8.7. He is currenly taking Multivit tab Supradyn (Morning), cilostazol (morning), Asprin-clopidet (afternoon), atorvastatin + fenofibrate (night), escitalopram (night) and Folic acid + B6 +B12 tab (night). The diabetes is managed with insulin 8-8-8 units/day. The sugar reports are 103 and 138mg/dl (fasting and PP respectively) and never above 180 (PP). When he was on antidiabetic tabs (voglibose, glimepiride, metformin, glipizide and some other) sugar was between 130-150 (F) and 170-240 (PP). The recent CBC has Erythrocytes 2.9 mil/cumm Hb 8.7 gms/dl Lecocytes 6000/cumm Platelet 2.15 lac/cmm PCV 26.9 % MCV 92.8 Femto lt MCH 30.2 pico-gm MCHC 15.1 % Neutrophils 42% Lymphocytes 56 % Eosino 02 % Monocytes 00 Baso 00 RBC morphology Hypochromia + Microcytosis+ / Anisocytosis+ Creatinin 1.6 Sugar (F) 103.6 mg/dl Sugar (PP) 138 mg/dl I wold like to know if there is any correlation withe drugs related haemoglobin drop and what should be the solution? ### output:

Hello Vishal and thanks for writing in at ChatDoctorFirst of all thanks for giving complete and detail history of the patient which is required by any physician for a better advise. I have studied your mail in detail. The cause of anemia is many, but in your case and the detail provided by you, it can be due to:1. Kidney disease related anemia: S. creatinine is 1.6 which is higher than the normal value. Kidney releases Erythropoietin which is required for formation of RBC's.2. May be due to anticoagulant Chat Doctor. Try to investigate it by urine R/E, stool for occult blood, Done your INR test which will confirm your blood thinning and helps in managing your dose of anticoagulants. 3. As you are taking all the supplements which cause anemia, so it is not nutrition deficiency anemia.4. Other causes to be ruled out for anemia are bone marrow related anemia, G6GD deficiency anemia or Hemolytic anemia. Please consult your medicine doctor and get rid of it. Best Wishes

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Sir, I am Gopal, we are trying to have a child since 5 five years. My wife side everything looks normal(other than one cyst with size 2.6 X 2.6 in L.t overy. Last month we have done one cycle of IUI , but failed. Again this month RE asked us to come on 14th day of cycle. that day my wife had two eggs with (2.6X2.5 and 1.9X1.8) in Rt. overy and two eggs with (1.8 X 1.6 and 1.7 X 1.6) in Lt. overy. RE given injection for egg(s) rupture and asked us to have normal intercourse on next day(15th day) and come for IUI on 16th day. We had two times normail IC on 15th day. On 16th day scanning before IUI shows 2 eggs in Lt.overy and 1 egg in Rt overy already ruptured. They have done IUI. IUI seman sample was 20 millions, 50% SM, PC- Plenty. Since one more egg rupture was pending after IUI we had sex for two days and each day twice. Can you please clarify me how is my SA report looks, is motality & morphology ok? if not how to improve motality. Can we expect conceiving in this cycle. Also for some pooja(prayer), after IUI my wife had fasting for 1 day morning to evening. does it effect IUI. MY AGE: 32 Y MY WIFE AGE: 34 Y I had left vericocelctomy in 4 years back. My SA report ============ PHYSICAL CHARACTERISTICS 1. LIQUIFICATION TIME : 50 Minutes 2. COLOR : WHITISH GREY 3. VISCOSITY: NORMAL 4. VOLUME : 1.9 ML 5. REACTION: ALKALINE MICROSCOPIC CHARACTERISTICS 1. SPERM CONCENTRATION : 20 MILLINONS/ML 2.FAST FORWARD : - 3.MODERATE : 10% 4.SLUGGISH : 50% 5.NON-MOTILE : 40% MORPHOLOGY 1. NORMAL : 64% 2. AMORPHOUS HEAD : 04% 3. PIN HEAD : 04% 4. ROUND HEAD: -- 5. GIANT HEAD : 04% 6. DOUBLE HEAD: -- 7. NECK DEFECT : 08% 8. TAIL DEFECT : 12% 9. DOUBLE TAIL: 04% 10. NO OF PUS CELLS: 2-3 /HPF 11. NO. OF EPITHELIAL CELLS : 1-2 /HPF IMPRESSION: ASTHENOZOOSPERMIA ============ ### output:

Hi Goal, Chances of conception in one cycle of GUI with multimolecular ovulation after 5 years of infertility are around 20%. Your semen analysis appears fine. Fasting has no effect on success or failure of GUI. You can safely try around 4 cycles of super ovulation with GUI for maximizing chance of pregnancy. After 4 cycles, if you don't conceive, chance of success in GUI decreases & better to go for IVF. As there are good chances of conception in this cycle don't think of future & relax. That might help. Wish you good health.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, my name is Angela and I am 33. A brief history, I have fibromyalgia, migrains, & degenerative disk disease.i also have unexplainable vision loss. I have had many head and neck traumas starting at 19months, none in the past 2 or 3 years!! And MRIs and CT 2 years ago show some old injury to my occipital lobe and a couple other spots they weren t sure of but said weren t a concern. 3 weeks ago I was told by the ER I was experiencing vertigo but before when I had it (2other times, and over 10 years ago) I was unable to have any balance or walk. This time the symptoms were loss of memory for 3 days(or very foggy) lack of hand eye coordination, foot and eye coordination, dizziness, headache, blurry vision, ringing and nausea. **Everything got better for about a week then I woke up one morning very confused, nothing really made sense, everything was very loud in a deeps bass like time, everything smelled like chemicals (the rain, snow, shampoo, water, perfume, food) All foods tasted rotten or like chemicals except candies or high sugary foods! I had a huge headache and blurry vision which has yet to go away completely. This induced some panic. I also have had an increased heart rate, almost painful and could not eat or sleep for about 4 days because of it all. Things are better now, smells and taste has returned but only like 90% and the vision issues comes and goes, no dizziness, and the headache has changed to a dull thick one. My doctor is out of town and we were scared to go to the ER again. Thought they might think I was crazy talking about the tastes and smells and sounds. I have since talked to some friends that think it could be very serious. When my doctor gets back I will be making an apt but I am pretty worried about this. None of my meds have changed. I take 1 8mg tab bid of subutext and have for 2 or more years. It replaced a long list of meds I have been off for years now :) The following are prn and have been used for years as well: I take 1 cyclobenzqprine hs prn, 1 800mg IBProphin tid prn, and a low dose of prednisone prn. None of the above symptoms seemed to have been effected by any of my meds and I haven t needed to take prednisone in about 4 months. Thank you for your input!! Any advice would be nice and greatly appreciated! I m not one to really worry and I usually try working through things but seems like this one may be a little different! And I m a bit scared to be honest! ### output:

hello In all probability, a neurosurgeon or neurophysician may advise an CT scan or MRI of brain, as symptoms point towards some lesion in the occipital area of the brain, either space occupying or some kind of vascular impairment, aneurysm etc., also anemia and vision loss give a clue towards that. Consultation with neurospecialist is a must therefore, as with modern know how, the lesion could be removed by operation or by angioplasty of vascular lesion if any and cure rate too as, surgeons say, is good in majority cases, so seek the earliest appointment for scans and consultation. I am sure this shall help you to get cured. The physician will make broad assessment of your Chat Doctor. Migraines can also cause varied symptoms, but anemia and vision problems herald to look for organic causes in occipito-parital region of brain substance 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 have two types of pain, and I m not sure if one is related to the other or not, if they are a gastro- intestinal problem or a GYN problem. The first I will discuss is the lower abdominal pain . Located in the center of my abdomen, right in the pelvic region, deep, not superficial. It s not even a pain really, more like an uncomfortable pressure. It never ceases, but at times its barely noticeable, and at other times, it s painful, but not sharp pain at all, but dull heavy almost-pain but isn t. Easy to endure, easy to ignore. Coughing and sneezing cause painful pressure. Sex is often painful somewhere deep inside, near my uterus. Almost never get constipation, usually have loose bowels and alot of painful gas... I have regular periods, which are medium / heavy flow with alot of cramping and passing blood clots, sometimes as big as dimes. My cycles have always been regular, except 2 years ago. I was also 140 lbs overweight (topped the scales at 270 lbs. on home scale), I was working and going to school full time. My periods stopped for about 6 months. Later, when I back on a normal schedule, and lost some weight, periods went back to normal. I have since lost 70 lbs. I also believe myself to have a hormone imbalance of some sort, cause I grow facial hair (lip and chin , male pattern hair growth), and quite a lot of body hair as well. I have to shave facial hair daily. I don t know if this info has any relevance here, but I thought I d throw it in anyway... Now for the rectal pain. It comes about once every few months. The only way I can describe it is like this : it s like having a lightning bolt shoved straight up my butt! A bolt of white hot electricity shooting straight through my rectum... It is so painful, so intense, it has literally knocked me of my feet, I was walking and I fell on the floor in pain. It hit me while I was driving once, and I remember lifting my whole behind off the seat and arching my back, and my foot stomped down on the excellerator and I couldn t move my leg to stop. I can usually feel this pain about to happen, it gives a warning, and I have to brace myself before it happens, or else I will fall. It s what I would imagine it feels like to be electricuted. These intense pains last about 10 - 20 seconds, and then they re gone for months, like they never existed, forgotten about until months down the line when hit again. ### output:

Hi welcome to Chat Doctor forum. Thanks for calling Chat Doctor. Forum. You have got pain in the middle of the lower central area. Hurts on sneezing, or coughing, or in sex. Periods are bulky, painfull. You got loose motions sometimes, and rectal pain. The rectal pain is so sharp like electric shock, and passes to the legs to get fall to the ground. For few months periods stopped, and resumed again. You have also got masculine distribution of hair growth on the chin, etc. I suspect it to be the pelvic inflammatory disease, and can cause all the symptoms. I advise you to consult a gynecologist for diagnosis and treatment. You may need to have M.R.I. besides other routine tests for confirmation. Abnormal hair growth could be due to increase in maleharmone testosterone in place of estrogen the female harmony. For this you have to consult an endocrinologist. Or you can get rid of by laser treatment. Wishing for a quick and complete recovery. Best regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Thank You! I lost one of my kidneys at 63 years old due to a very small non-malignant tumor called an oncocytoma. Everything I read said they are slow growing and never spread, the surgeon stated the same thing. It grew only slightly after waiting a year. He decided we needed to get it out anyway through surgery. However, after surgery, he told me that due to seeing more cells in the margins around the tumor, he decided to act aggressively and removed my entire kidney.?? So they do spread!! I was in surgery 6 hours and doctor came out and told my waiting family she has renal cell carcinoma as I m sure you know a deadly form of kidney cancer. The next day he came into my room smiling and said guess what.....it was a non-malignant tumor. Why was it spreading after he had even said they never spread, but can grow larger but are slow growing. I m mad as hell, because of late, I m reading that it is possible to find out if a kidney mass is malignant by pinching a small piece of it off by going through the skin with a long probe to reach kidney to remove a piece of mass, before invasive surgery. The tumor was very small, we waited one year and it grew only slightly. It has ruined my life. I m always worried my single kidney will fail. I know that there are many people living with only one kidney, but it has ruined my life. Doctor admitted when I asked, could I get another oncocytoma in my single kidney left. He said it is more likely now since you had one in left kidney. I cannot happily go on living because of constant worry about what I eat, drink, preservatives in some foods, vitamins, prescriptions I must take. I absolutely will not go on dialysis if this happens. I just turned 70 and no one will donate a kidney to me due to age. In retrospect, I should have sued the hell out of the doctor for how he handled my case. There was a pathologist in the surgery room who apparently looked under the scope and told the doctor he believed it was renal cell, so told doctor to proceed aggressively. He told me later that by the time he cleared the margins, that there was not enough of my kidney left, so he removed the entire kidney. I m depressed all the time, can t sleep well anymore and truthfully ready to meet my maker. I ve seen therapists of all sorts, been on medications to ease my anxiety, but to no avail. Now I m in chronic pain all over my body and taking oxycodone which I m sure will take out my only kidney, (prescribing doctor) didn t mention how it is metabolized, and I didn t ask. I m at a point that I don t care anymore and have become a complete recluse in my small house. I don t really don t know what I am asking of you. I guess to validate that you would feel the same way or something along that line. Don t wish to submit reports at this time, but will if you need them. Respectfully, Leslie, Independence, Missouri ### output:

Hello and welcome to Chat Doctor. Well, I fully understand your concern about being on a single kidney. As a Urologist, let me assure you, there's really nothing to worry. Many child Chat Doctor. Many live-donor kidney transplants are being done daily worldwide, from kidneys of people having two normal kidneys. And the fact is you had only a benign or non-malignant tumor, then what are you tense about. Thank God daily in your prayers for not having had a cancerous kidney. Hope your doubts are cleared. Feel free to contact me by name, if you feel like.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: iam having blood tests done ,been told iam anemic 7. something ,ihave been anemic most of my adult life as i dont eat well ,now i am worried because they are l ooking in to reason and one of the reasons being cancer .i can not stop worring as in the past iron tablets have worked. ### output:

HI WELCOME TO ChatDoctorI have gone through your query about your anemia. I am anxious to know, first : Your AGE ? , Second : Gender? , Third :Your Lifestyle ? Any way, It is good the you have realized the importance of eating. 7 HE is too low. It should be 11-15 F / 13 -16 Deficiency of hemoglobin would decrease the oxygen-carrying capacity of the blood. This also decreases the number of red blood cells resulting in a condition called anemia. Causes of low levels of hemoglobin levels include poor nutrition Never mind, it is never too late. There are ways & means to good health. Magnitude of the survival advantage from improved nutrition, can even be greater than the magnitude of the treatment effects being targeted in current clinical Chat Doctor. Only gulping on medicines will not help to secure your perfect health. I would like to suggest you to modify lifestyle to fight your health problems is one of the most effective treatment options in my view. Vitamin and mineral supplementation. There are several minerals and vitamins that can increase hemoglobin levels. Most important of these are iron, vitamins B6, B9 (folic acid), and B12, and vitamin C, which is important for enhancing the absorption of iron. Our health depends mostly upon our lifestyle & what how & when we eat. A diet full of processed foods will produce biochemical and metabolic conditions in your body that will decrease your immunity, so avoiding fried, fast, processed foods is definitely the first step in the right direction. One of the important strategies to achieve healthy body is a diet containing essential nutrients -- fresh, raw whole foods. Fiber letup, onion, potato, fruit -banana, grapefruit, plums apple, pomegrenade, beet root, egg fish, fish oil for Omega-3, green leafy veges, Iodine, artemisinin and green tea. Take beneficial natural supplements full of antioxidants serve as antibiotics serve as important defense mechanism to support immune health while fighting cancer and all diseases cells. Coconut water, Aloe vera juice 20ml juice & 2 TBL spoon AMLA juice Twice a bitter gourd juice25-30 kills bacteria on mass basesLemon juice with water twice before meals, Turmeric powder, level spoon with a cup of hot milk at bedtime, All are great antioxidantsWith all above, Adopt Physical activity in order to renew healthy cell and rebuild itself, to, eliminates toxins in the body and boosts the immune system, and enhance assimilation of food which also cleanses the lymphatic. You should make exercise a lifelong commitment. Do 30 mins walk/ exercise - from head to toe, yoga, Panama - deep breathing, Kapalbhatti / Laughing aloud and meditation to detoxify your system to accelerate the process of recovery. . The condition is REGULARITYContipation is the mother of all illnesses so is mental stress /worry /anger. Avoid them further suggest you not to worry and take action fast, Above regimen will surely gradually, help you to lead happy worry free healthy life ahead Magnets &

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, 36 years, married. Me and my wife have been going through a case of infedility from her end. we have had some very troubled times in the last 3 years, however the last 2 years have been most turbulent. Initially when I got to know about my wife s extra marital, I was very disturbed but I tried talking to her and gradually after the feeling sank in, I have tried innumerous times to talk to her. I have been performing well in the sexual sphere of life since we got married, but it never affected us as my wife was very co operative. but of late since the extra marital came to light, I am more keen on performing well that is no. 1, and no. 2 is that I want the relationship that has gone sour to get back on track. The last 2 years have seen me fall from an annual salary of 11lacs to below 7 lacs.She doesn t trust me, love me or consider me an important part of her life anymore, she also is secretive and doesn t reveal what happened or what went wrong, which is proving to be very difficult for me to deal with. On one hand I am dealing with professional loss, on the other sort of a personal loss & on the third front, am a disaster right now in terms of my self confidence & trying too hard to please her emotionally, mentally & physically. I feel I am good for nothing and we have a 5 year old son. I lost my parents at a very early age and have no siblings, my family starts with my wife and ends at my son.My in laws are separated so it s no help either & our s was a love marriage. Kindly advise and help. ### output:

Hello, Thanks for writing in. Dealing Infidelity is definitely very stressful. It would measure you patience, make you angry and upset. Creates a lot of uncertainty as well. I totally appreciate the effort you have taken from your side to understand and convince your wife. It looks like you have lost hope in yourself and you marriage. Keep up the faith. Try to understand where it all went wrong. With that you will be able to figure out probably the exact reason. Confronting your wife, can to an extent help your wife to open up. You may already be aware of everything but give her confidence by reassuring that nothing would go wrong even after her confrontation. Look at all the aspects of a marriage right from trust, faith, emotional stability, financial matters. Ask her about her expectations in all of these aspects. If you think your wife is still not ready to open up give her sometime. Blaming would do no good but spoil the relationship all the more. Stay with her throughout but do not question her or try to please/convince her emotionally. With that (mostly)guilt will make her confess everything to you. Reminding her and yourself about all the good things and positive things like your son, that happened in your entire marriage would also give you and your wife the confidence to gain it all back again. If you think you and your wife have both equally understood where things have gone wrong(if especially your wife is willing to) start it all over again by forgetting the past. Do not remind her or remind yourself about the infidelity once its over. Forget about it and move on to your future. As of now take a break! Go for a small vacation with your son and your wife(if she is willing to). Carry on with your other responsibilities like work and looking after your son. This will distress you. Joining any of the sports/music or youth clubs will increase your friends circle and encouraging healthy habits like indoor games will you have a better social life which in turn will not make you feel lonely and left out. Possibly visit a marriage counselor with your wife or for yourself. They will help you deal better with your crisis. Hope this helps you. Stay Healthy!

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 43 years old. I have a syrinx within my spinal cord from C5-6 - T1, currently 8cm in size. It was believed to be originated from Arnold Chiari 0 due to the protrusion level of my cerebellum tonsils. As it turns out, my surgeon is now convinced that the syrinx developed as a result of a spinal injury I received in an auto accident at the age of 16 where I sustained a severe case of whip lash. I had a Suboccipitial Craniectomy done in December 2011 to decompress the spinal cord with the hope of decreasing; if not, diminishing my syrinx. One year later, it s time to do an MRI to see the progress...it shrank a little. I became somewhat optimistic but, frustrated at the slow progress and the symptoms and problems that I had prior to surgery have gotten worse. Nearly two years later, I ve already had an MRI done and the syrinx has not changed at all!! I m beyond frustrated and now I have carpal tunnel syndrome & De Quervain s Tenosynovitis in my right wrist/thumb; in need of both surgeries AND I have 2 herniated discs, L3-4 & L4-5, that I need to have surgery on as well. The neurosurgeon that I was seeing, who had me go through multiple tests; including a lumbar discogram w/no sedation, to reach his diagnosis (not the same neurosurgeon who performed my suboccipitial craniectomy, he dealt strictly with syrinx). He told me that he believed that the symptoms that I have been having with my arms, hands & wrist issues, muscle, & shoulder weakness was due to the pressure within the syinx and it had to be drained. So, his course of action was (3) SURGIES and it started as follows: 1) carpal tunnel & De Quervain s, three weeks later... 2) Syringo-Subarachnoid-Peritoneal Shunt ....3) Lumbar Disc Fusion I told him that I did not want to have the Syrinx Shunt surgery done and he now refuses to do the other 2 surgeries. He said that I can go to an Orthopaedic Surgeon for my wrists but that he believed I would still have complications resulting from the syrinx. As far as the lumbar surgery, he said that, With the narrow space around the syrinx in your spinal cord and you lying on your stomach for 2 - 2 1/2 hours with your blood pressure lowered while under sedation; you have to keep in mind, Mrs. ......., your blood pressure needs to stay elevated when dealing with a syrinx. ....it s just not safe to do the surgery and I just can t do it. So, that brings me to my question....Is that true about the syrinx during surgery? Will having this syrinx keep me from having my back surgery? Also, he said that having surgery on my right wrist and thumb might still have complications later due to the syrinx. Is that true? -Distressed ### output:

Hi, Thank you for posting your query. I can understand your discomfort due to the symptoms, lack of good success of spring surgery and the need to undergo three surgeries in future too. However, I would suggest that you undergo the surgeries for lumbar disc and carpal tunnel syn Chat Doctor. This is because you have already had one surgery for spring without good success. If your symptoms do not improve much, then a second surgery for spring may be planned. I hope it helps. Please get back if you require any further information. Best wishes,

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: dear sir i done semen analysis after 3 month (jan 2010) & now i done semen analysis in may end 2010 i found very changes, how it possible ? first i get 55% motility now i get 0 % MOTILITY HOW? ### output:

DEAR SIR / MADAM HERE IS REPORT OF MY SEMEN ANALYSIS AGE- 34 MALEMETHOD COLLECTION-AT LABABSTENENCE OF - 4 DAYS PHYSICAL EXAMINATIONQUANTITY - 1.5 COLOR -OPAQUE WHITELIQUIFICATION - WITHIN 20 MINS CHEMICAL EXAMINATION pH - ALKALINE MICROSCOPIC EXAMINATION (PER HIGH POWER FIELD)TOTAL SPERM COUNT - 25 MILL/ML MOTILITYACTIVELY MOTILE - 00%SLUGGISHLY MOTILE- 50%IMMOTILE - 50% SPERM MORPHOLOGYABNORMAL FORMS - 7%A. HEAD - 4%B. BODY -2%C. TAIL -1% PREMATURE GERMS CELLS - FEW PUS CELLS - IN FAIR NUMBERS CULTURE & SENSITIVITY SPECIMEN - SEMENORGANISM ISOLATED + NO PATHOGEN ISOLATED GERM & ZN STAIN ANALYSIS TEST NAME - RESULTSPECIMEN SEMEN PHYSICAL EXAMINATION QUANTITY 1.5 COLOR OPAQUE HISTOGRAMS STAIN NO ORGANISM SEEN. DEAR SIR PLS REPLY ME SOON, WHAT CAN I DO FOR IT THIS IS DT 26/05/2010 SEMEN ANALYSIS LATEST.-----------------------------------------------------------------------------------------------------------BEFORE 4 MONTH SEMEN AS ABOVE SEMEN COLLECTION AT LAB.COLLECTION TIME 10-00 A.M.EXAMINATION TIME 10-30 A.M.DAYS OF ABSTINENCE 10 DAYS QUANTITY - 2.00 COLOR - OPALESCENT WHITEOUT - MUSTYVISCOSITY - NORMALLIQUIFICATION TIME - 25 MIN TOTAL SPERM COUNT 38.00 MILLION / ML.ACTIVE MOTILE 55 %SLUGGILISHY MOTILE 5 %NON-MOTILE 40 TOTAL ACTIVE MOTILE SPERMS 42 MILLION MORPHOLOGY-NORMAL 75 %, AB NORMAL 25 %. CELLS-PUS CELL - 25-30 CELLS / HIRED CELL - 7-8 CELLS / EPITHELIAL cell FRUCTOSE TEST - POSITIVESPERM ANGULATION TEST - POSITIVE. IN BETWEEN FOUR Months I LEFT TABLET 1. OLIVER, 2. COQ 10 COENZYME & 3.STEPHEN M. MY COUNT LOSS IN BETWEEN THIS TIME, PLS REPLY ME I M VERY SAD. CAN I BECAME A FATHERS.PLS REPLY MY EMAIL AD Chat Doctor? Com PLS HELP ME.

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 shot through the right ankle area from inside to outside with 22 magnum bullet on Nov22 2014. It missed the artery, the bones, and most of the tendons. The doctor removed the parts of the bullet that was at the skin on the outside of the leg and left the small bits of shrapnel inside the leg. The wound has healed quickly and cleanly. The bullet seems to have hit or at least damaged the tibial plantar nerve. I am experiencing an interesting assortment of sensations in my foot. The area forward of the instep on the bottom of the foot has no feeling to touch but fizzes, bubbles, burns, tingles, stabs, and electric shocks causing me no shortage of miserable hours. It is generally worse evenings and unbearable at bedtime. My big toe and the one next to it are bending to the right and bend downward if I lift my toes toward my shins. My first question is: If the nerve is severed why am I having all these sensations in my foot? If it s not severed is it likely to heal and give me the feeling back in my foot? Can nerve damage cause my toes to bend and twist or does it sound like some other hidden damage. Even though I have no feeling in the foot, I m walking, with some difficulty, since I do have to earn a living. Will walking on it benefit circulation or is it detrimental? Thanks for allowing me to pile on the questions. M ### output:

Hello. Thanks for asking from Chat Doctor. I can understand your concern. As bullet injury occurred from inside out, it might have caused medial plantar nerve injury or tibial nerve injury just before bifurcation. It can only be confirmed by examination of your foot. Medial plantar nerve damage cause sensory loss or tingling/burning sensation on medial plantar area between big toe and adjacent toe. There will be weakness of big toe and adjacent toe plantar flexion. In your case, most symptoms are resembling medial plantar nerve damage. Now coming to your queries. 1. Severance or disconnection of nerve can be complete or partial. Partial disconnection can cause abnormal connection between nerve ends (neuroma). This can cause irritation symptoms like burning/tingling/insect crawling like sensations. Complete disconnection leads to loss of all sensations in affected region. Confirmation of it can be made by NCV/EMG studies.2. It is right that partial injury has more chances of healing than complete injury. Presence of some sensation is considered a good sign. Nerve regeneration and healing in such cases can occur unto 18 months, but maximum healing occurs in first 12 months. Even surgical repair of nerve shows some good results in first 12 months. But there is one problem. If irritation symptoms are severe and not decreasing even after medication, sometimes nerve is severed by doctor to relieve discomfort. 3. Walking or physical activity has nothing to do with healing of nerve. But it helps in stretching of muscles and acts like physiotherapy, which is good for muscles supplied by the nerve. You can passively stretch your toes up and down. It also prevents permanent spasm or contracture of joints and thus deformity. Do not overdo it. It can damage muscle. Some tips-Do not take any medications for healing of nerves as after 1 year of injury, Chat Doctor. -You are having small sized peripheral nerve injury. Repair of such type nerve is very difficult and results are not very promising.-You can take help of physiotherapist to learn about toe exercise. Thanks. Hope it 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: hello, i went to my primary care doctor because my throat was tight, i thought that it was my thyroid, since I take medicine for it. We ran blood tests and it was in the low range, but she chose not to increase my medicine, even though my skin is dry, my hair is drying and falling out and I m tired. She read my chart and said it was gerd, which I hadn t had in about 5 years, she prescribed two types of acid reflux medicine., and told me to take it. I ve been on them acid reflux meds for 8 weeks and have been complaining of stomach acid. I went to my GI doctor and he took me off the ranitidine saying it was too strong for my stomach, so he took me off of it and kept me on the omeprazole. I ve been off of it for a week and my stomach is feeling better, however he wanted me to have an ultrasound to check my gallbladder. I had the ultrasound and found that the renal cyst that i had discovered 5 years ago has now increased in size. It was about the size of a quarter then and now its the size of a water balloon. I ve been complaining of back pain and stiffness, but I thought that it was from me working out. My question, is if a water balloon size cyst would cause that kind of pain in my back and in my stomach and if so, what can be done to relieve the discomfort? ### output:

Hi Welcome to ChatDoctorI have gone through your query and can understand your concern. Dear first, I would like to know your age, height, weight your lifestyle so that you can be given appropriate advice for your problems. Since you are suffering from so many of them, it is not ethical & safe to consume, & to prescribe number of remedies at a time. So we have to look for minimum medication which can cater to solve maximum of your sufferings . . In fact, Your body is always fighting something -- an infection, a toxin, an allergen, a food or the stress response -- and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin, or sometimes your whole body.invaders. Your immune system is your defense against invaders. But when the immune system becomes weak, the disease cells can grow out of control, the disease overpowers. Gulping on medicines & antibiotics , will not help cure, unless we care to modify our food habits and mind our lifestyle .your total health depends on what we eat, when we eat and how we eat I would like to suggest you to take vitamin D from sun exposure daily, as vitamin D helps keep your bones, including your spine & back stronger. Take balanced diet, having all essential nutrients, fibers, proteins, minerals, vitamins - fruit, veges, nuts in natural form. Also ginger, garlic great antioxidants helps balance air , heat, phlegm (Vast, Pitt, Kph) factors which are one of the basic health problems, causes of pains. Imbalance of these all 3 create bad health. So regular exercise and Balanced diet containing essential nutrients and supplements as fiber, fruit green veges vitamins and minerals in natural form - coconut water, lemon juice with water, nuts, almonds, and supplements full of antioxidants as Aloe vera juice + AMLA juice 2 spoons, Coconut water, A level spoon Turmeric powder + Almond oil is very important for our sound mental and physical health and strengthen immune response naturally Chat Doctor. Since your body is composed mostly of water, staying 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: Hello doctors please could you advise me on this urgently. I have had cysts and fibroids for the past 25 years. I am waiting to see consulltant shortly. I am now having lots of pain in my arms back and legs. I am having problems with my bowels sometimes I go to the toilet about 3 to 4 times a day and other times I am constipated and need to take laxatives. I was on provera because I was bleeding alot and the bleeding would not stop after two weeks.I also take votorol and co-codamol for pain . I take iron tablets and I was given menefenic acid tablets as I had heavy bleeding and clots. I have stopped taken the provera and I had a period for a week this time. I had swellen on my neck and I have now got swellen on my wrists. My blood pressure is extremely high.I feel low in energy.. The swellen on my wrists is happened all of a sudden.Iam taking one piriton tablet which I was given at the Emercency unit. I was not given any to take home with me . I was told to see my G P. I am not able to see him till Monday and I am getting increasingly worried I am not sure if I have had a reaction from the chocolates. I don t normally suffer nut allergies. I am not sure what is going on I have pain in my shoulders and neck. The swellen on my wrists is tender and painful to touch and has not gone down after two days. Please help me with advise Thank you. ### output:

Hello friend, Thank you for posting your query through Chat Doctor. Strange for me- you appear to be very anxious and worried on Sunday because you cannot wait till Monday! And that too about a trail of symptoms you have for 25 years! You knew you had cysts and fibroid for 25 years. You did not sit for a moment to ask yourself or even to your doctors why you are getting the lot of symptoms while most of the other ladies of your age do not get them. Furthermore, you have mentioned irritable bowel syn Chat Doctor. I am a Homeopath and so there will be thoughts in my answer that are apparently strange for you, because you have been under the conventional method of treatment for a prolonged period. You took proverb for bleeding, Motorola and co-codamol for pain, iron tablets and mnemonic acid tabs for heavy bleeding and clots, prior for arthritis etc. I have to say that you are on a wrong path. After the consultation on Monday also, you will be getting some more medicines to relieve some of the symptoms you tell to the doctor. You have confessed "I am not sure what is going on". Yes I am going to give you some food for your thoughts. Till date nobody has told you why you are suffering and going from bad to worse in spite of taking treatments. First understand that all these happened and are happening because you have a genetic tendency to develop this sort of diseases. Genetic manifestation is not only in your body but also in your mind. Just look back to the query, you have not mentioned a single word about your life situations and your mental reactions to them. Because you are made to understand that your health is only physical. We Homeopaths hold that your health and so your sickness also is both physical and mental. The cure also has to occur in both mind and body. Instead of getting cured, you are continuously becoming more and more seriously sick under the present method of treatment. You become more and more worried also. Because your genetics is not considered. Your constitution is not taken care of. Only the symptoms are managed just as the tip of the iceberg. You were not cured in any instance in the past. Your symptoms were only suppressed with strong chemical

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been diagnosed yet again with another UTI with Klebsiella being the bug that is always found in my urine. The dr says it is not caught from my partner but every time I have sex with him I am back to the Drs again complaining of the same symptoms. Sometimes the urine samples show nothing but most of the time it does. Why is it that I no sooner get rid of the infection then have sex and the infection starts all over again. I m beginning to wonder if my partner is the cause of all of this. Never ever had this issue before with any other partner. I m in my 40 s and have been with my partner for 2 years and am completely monogamous (never have numerous partners). I m so over this please help me ### output:

Hello, Klebsiella is mostly and primarily found in not immunocompetent individuals, usually in hospital settings and cause the so-called hospital-acquired infections (HAI). They could cause opportunistic urinary tract infections, pneumonia and other respiratory infections, bacteremia, infection of surgical wounds, etcetera. In diabetics, people with chronic obstructive pulmonary disease, etcetera. Due to their particular structure, Klebsiella species are naturally resistant to penicillin-type antibiotics, some Aminoglycosides (Gentamicin, Kanamycin, Streptomycin, etcetera.). Often their treatment is possible only through the use of Carbapenems and Fluoroquinolones (Ciprofloxacin, Levofloxacin, etcetera.). Klebsiella is considered part of the normal flora in various parts of intestine and colon. Recent studies have reported that recurrent Klebsiella urinary tract infections are caused by persistent Klebsiella found in the urinary tract even after appropriate antibiotic treatment and all persons with recurrent infections were elderly and diabetics. Recurrent strains of Klebsiella also had increased adhesion and invasiveness compared to colonization strains (those causing infection for the first time) and this might explain their tendency to cause repeated infections. Now, it is known that frequent sexual intercourse is the strongest risk factor for recurrent urinary tract infections in healthy women, and it is why your disease comes back each time you have sex with your partner. The fact that the disease comes back after you have sex with your partner puts in high risk of future urinary tract infections. In your case the following measures could be of benefit: 1. Continuous antibiotic prophylaxis for six months, by using low doses of the antibiotic that is more effective in your case. You have to consult with your doctor about which antibiotic you will use and for how long.2. Post-coital therapy, by applying a single dose of the most effective antibiotic each time after having sex. You again have to consult with your doctor about the dose and type of antibiotic. 3. Apply the so-called post-coital voiding that is: urinating immediately after sex.4. You should maintain high genital hygiene as it could help as well. It is also important that you have a thorough evaluation by radiological examinations in order to rule out abnormalities of the urinary tract (anatomical or functional) that could boost infection recurrence. Lastly, Klebsiella is not transmitted sexually, thus clearly your partner has nothing to do with your recurrent infections. But, during each intercourse, it is easier for the bacteria to get contact with your urinary tract (remember that Klebsiella is a normal part of intestinal tract and colon). Hope I have answered your query. Let me know if I can assist you further.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello! I have a big troubles. Everything started 10 years ago, when I was diagnosed with cancer, but lucky or unlucky, it was just a hernia. A year later, I started having problems like waking up in the middle of the night, cant breathe etc. Just an easy problems. After time, the things went wrong. I was affraid to go to a doctor, because I dont want to hear, that I am sick of Cancer. That is still the good part. Few Years later, I started having more serious problems. Currently, almost everyday at anytime I am in a different moods. Once I am happy, everything is fine, next minute I am depressed, and nothing is valuable to me. It happens after I lost one girlfriend though. But the problems are: 1. Cant focus on almost nothing2. Brain Fatigue3. Sleeping more then 8 hours and wake up tired.4. Always thinking of something in the past, cant concentrate on the present.5. Social Phobia - recently I found , that I am having it6. Hard time to organize my day. When I sleep less, like 4 hoursI am feeling more organized and easy going. But on the next day, I need to sleep more , like 10 hours and when I wake up, I am confused, stressed, tired, and the day is just passing by me.7. Sometimes, I am feeling, like I am out of my body and my life is just passing near myself.8. Avoiding reading documents and doing work, where brain is involved more then normal. That s a big problem, because thequality of my life is getting worse and worse. Currently, I am 30 years old, finished my law school, but dont want to tell you how hard I took my exams, because, when I read something, I do forget it very fast9. It is hard for me to remember many things from my day. Everyday, I am not having many memories. For Example,not sure what I ate, not sure what movie I watched, not sure with whom and when I have a meeting. Cant organize myself, and the biggest problem ever is, that when I have all those symphoms, I start stearing in the mirrow and I see, that somehow, my eyeis changed. The way my eyes looks is a bit scary even for me. When I dont feel this pressure in my eye, they seems well, but often they skin where my eyelash is located is purple to red colour. this is only on one of my eye.10. Tired during the day. Need a sleep often in the early afternoon for at least 30 mins.11. Cant focus on many things, even if I want to. I would like to ask you, please, give me a clue, because when I go to doctor, everyone says, that I am ok, and this is just a depression. It is not, I am sure. I read forums, about Bipoliar Disorder, Concentration Disorder, and almost every desiase, I have the sympthoms. I need to know, what I am seek of, so I can take the propper treatment and have at least more normal life.Thank you very much , and hope to read from you!!! ### output:

Respected user, HiT hanks for using Chat Doctor.come have evaluated your query thoroughly.* This is not due to simple depression, it consists of pyramid of anxiety, phobia, stress, personality disorder with behavior changes at major extent.* Only cure is getting hospital treatment with expert Psychiatrist in form of behavior therapy, counselling sessions and if required may have to opt for Electron convulsive therapy, other IV treatments.* This is curable , needs extensive treatment , patience on the part of doctor and patient. Hope this clears your query. Welcome for further assistance . 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 m having suicidle thoughts all the time,keep having really bad mood swings, crying 24/7 not wanting to go to school. Loosing intrest in the things I enjoy, Stopped eating due to thinking im fat doing things to wreck my body like cut my self.Cut my hair off.. shave my eye brows off. I listen to music that makes me cry, i cant do anything I enjoy anymore, I cant look at myself in the mirror without nearly crying all the time, never orginised never sure what to do with myself, nobodys here to speak to me when I need it, cry that much I keep shaking, cant sleep properly, keep halusilating, strong head aches, periods keep coming late, locking myself away in my room. Looking up loads of stuff on the internet, writting suicidle notes and theres so much more i could tell you im crying right now typing this too you, failing in my school life,not being able to think. My life is hell and I was wondering if you could help me? As I cant seem to talk to anyone about this and I cant go to the doctors with out my mum being there, im 13 years old and live in the uk get bullied quite alot, my mum also suffers from deperssion which is why i find it hard to tell her things with out her getting really bad. I have no one to talk to teachers at school hate me I have anger issues not seen my dad since i was five i hate him he tried killing me and my mum latley ive tried things like weed, smoking and drinking im getting really bad and cant contolle my actions anymore.. and was wondering does it seem like I have Bipolar or bad depression or anything too you? and do I need to speak to someone about this? PLEASE ANSWER THIS?! ### output:

HI megantriggertiny. THANKS FOR YOUR QUESTION. YOUR SYMPTOMS SUGGEST YOU ARE SUFFERING FROM DEPRESSION LIKE LOW MOOD, FATIGUABILITY, LOSS OF INTEREST IN ALL ACTIVITY AND SUICIDAL THOUGHT AND AS YOU HAVE A FAMILY HISTORY OF DEPRESSION (IN YOUR MOTHER) SO YOU ARE MORE PRONE TO DEVELOP DEPRESSION AND A EARLY AGE LIKE YOU IN JUST 13 YEARS AND IN YOUR CASES PROGNOSIS ALSO NOT GOOD IF YOU DONOR START TREATMENT. DO YOU HAVE EVER FEEL VERY TALKATIVE, INCREASE ENERGY, INCREASE APPETITE, FEELING Perfect IF SO THEN YOU HAVE ALSO INTERMEDIATE MANIC/HYPOMANIC SYMPTOMS SO YOU QUALIFY FOR A BIPOLAR DISORDER? THIRD THAT I AM THINKING IN YOUR CASES THIS RECURRENT SUICIDAL THOUGHT MAY BE A OBSESSION I MEAN YOU HAVE COMORBID OBSESSIVE COMPULSIVE DISORDER TOO AND PROBABLY HAVE SOME PERSONALITY PROBLEM. SO THERE ARE A LOT OF ISSUE IN YOUR QUESTION.SO PLEASE GO TO A PSYCHIATRIST URGENTLY, DISCUSS EVERYTHING YOU MAY NEED A DIAGNOSTIC PSYCHOMETRIC AND PERSONALITY ASSESSMENT THEN BASED ON ALL REPORTS PSYCHIATRIST WILL PRESCRIBE Chat Doctor. 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: HI, My name is Shikha and I am 26 years old. I have never got any kind of acne or pimples on my face in earlier life and my skin is normal but little dry sometimes with a very sensitive nature. Therefore, I don t use any harsh cream or go through any facials regularly. All I do for my skin is cleansing. We had a function on 07.06.2014 and I went for a facial on 05.06.2014 for the first time. I had a little itchy skin that time and two or three pustules on my face before that facial. But I vanished them by putting Soframycin overnight. But as of now, I have been allergic on my face. I got lot many pimples and they are too scratchy and red in color. I have been to a dermatologist. He gave me allergic tabs plus a lotion and one other cream to put on those pimples. Today is the first day I will start using them for next ten days. I need to know that what could be the reason for this allergy so that I would remain cautious for next time. The reasons which I believe that could be: 1. From 25th may, I started applying daily a mixture of milk (boiled) with turmeric on my face, neck and arms as well before I take bath which was supposed to be applied for a natural glow. 2. I was using an old cleansing milk too from last 15 days, which I saw today, that the same has already been expired in 2013. 3. That facial could be a reason as I have gone through the same for the first time. But I have had a few pustules before the same. 4. Another thing is, on the very next day I have gone through the facial, i.e. on 06.06.2014, We had some breakage work at home, and the time the labor completed their work and the cleaning of cement and dust was started, I started getting my skin more itchy and even flammable. Then I washed my face with cold water and mild soap & was feeling better after doing so. It was all fine with my skin during 07.06.2014. I done mild makeup too on my skin but got no rashes, itching or any kind of inflammation but all of a sudden on 09.06.2014 I got allergic reaction and went for a doctor today. I was using that cleansing milk during these two days for makeup removal too. Kindly let me know the exact reason or the most probable one so that I can take care of my skin in future. Regards Shikha Sharma ### output:

Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concerns. As per your complaint it seems that you have Allergic Contact Dermatitis causing inflammation and bumps over the face due to allergic reaction to any of the cosmetic product that you have used. It is a bit difficult to explain that what is causing the allergic reaction without proper evaluation and investigations as dust, turmeric as well as expired cosmetic product all are potent agents that can cause allergy. Consulting an Allergist and getting evaluated will help you to rule out the exact cause of reaction. You should continue taking the anti allergic and other topical agents advised to you by your physician. For lubrication of skin you can use algebra gel. For facials use only dermatological tested branded products. Wash face frequently with cool water. Avoid exposure of skin to dust as well as over exposure to sun should be prevented. Hope this information helps. Thanks and regards. 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: Ive been in 2 car accidents. Since then I ve been in severe pain.Mri of the lumbar spine show L4/5 mild left paracentral posterior.Even though this is causing me sever chronic pain, the Neurologist doesnt think this should be a problem. I ve since then had a mri on my neck and cervical spine; which mri show L5/6 diffused disc bulgeeffaces the anterior subarachnoid space.facet joint hypertrophy greater on the left with moderate to marked left neural foraminal narrowing. at L4/5 posterior spondylosis greater pn the right with mild flattening of the right ventral cord. I ve see 2 Neurologist and one Neurosurgeon , Ive told them all im in severe pain constantly every day . ive tried several spinal injections which did not help only ending having to have a blood patch from a spinal headache. I m taking Lortabs 10 ; which one of the Neurologist prescribed and flexrell 10 muscle relaxers, they don t ease this pain because ove been on them for a while the doctor refuses to change any of these because he claims that it should relieve the pain which at first when I first start taking them I did get some relief and was able to hold my full time job. I ve also had decompress therapy for spine , nerve and back. which 13 out of 20 treatments that made me worse because when I come out of treatment I feel worse coming out than going in so, based on the medical stress of the pain, and medical debt, and the fact that I have no ease pain is chronic and severe medical debt that I can t no longer afford, In stop going. These Neurologist , and Neurosurgeon say that these findings of these 2 mri results can cause a little pain but they don t feel they are causing severe pain, but they are.based on the fact of me have been in two car accidents, my back back started from the first one and the second one increased the symptoms that I already had and added as well because from the first accident I did not have a problem with my neck , cervical spine but I do now test show diffuse disc at L5/6 and flattening and narrowing of space in other areas of L4/5. My question is , can these problems in different areas cause sever pain? everyone body is different,therefore things affect people different, What is your advice or opinion on what I should do. Now because of my sever pain I am unable to work. ### output:

DEAR FRIEND, I UNDERSTOOD YOUR CONCERNS, SEE AS PER YOUR MRI REPORT WE CAN ASSUME THAT THERE IS PROBLEM WITH YOU VERTEBRAL DISC AND NERVE COMPRESSION RIGHT? NOW WHAT IS The SOLUTION? BY GIVING INJECTION IS NOT PERMANENT TREATMENT SO AS YOU SAID "everyone body is different, therefore things affect people different" SEE IN THIS TYPE OF CASE PAIN IS THE MAIN FACTOR WHICH TROUBLES YOU DUE TO CREATION OF NERVE ROOTS. NO NEED TO WORRY, YOU NEED TO TAKE IT AND TRACTION THERAPY FOR YOUR BACK IN PHYSIOTHERAPY CLINIC... IF ANY LOCALIZE PAIN IS PRESENT THEN TAKE ULTRASONIC THERAPY.... YOU NEED 15 days TO THIS THERAPY!! THEN ONLY START WITH VARIOUS EXERCISE... TILL THAT TIME WAIT FOR PAIN TO REDUCE....

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 please help me. my name is lisa..I am 23 years old, and ever since i can remember i have always had stomach problems, constipation always, lactose intolarante, gas, abdominal pain, I got diagnosed with IBS at age 20 . now that im 23, 6 months ago i went to subway and ate chiken and dumplings, witch i had never had before, as soon as I got home i started itching later that day my whole body was covered in big red welts. then my foot became swollen, I took benaeryl and the next day my other foot was swollen my hands and my eyes i coulnt even walk.. i went to the emergency room and they game me shots that made the swelling a little better.. it took about 2 weeks for all the marks on my body to go away.. NOW i have this uncontrolable iching with little bumps all over my arms legs thighs... I went to a allergist specialist and after preforming about 40 diffrent foods pricks on my back right away ALL OF THEM TURNED RED ,BIG RED MARKS. I have been searching and searching on the web and CANNOT find anything about the tests coming out ALL positive... The doctor game me 2 sheets showing the numbers and most of them are 5.5 some 6.5 some 7.5.. and he said I have DERMAOGRAPHIC ... I really dont understand.. I cant stop itching. am I allergic to all foods... ??? please someone help me.. ### output:

Hello Lisa, Thank you for asking at Chat Doctor. There are two types of allergy tests - skin prick test (which you have been undergone) and serum tests (Immunogen or LAST). I suggest you not to be worried by test results. These tests are not 100%. They only complement a clinicians decision about diagnosis of your food allergy. If you are demographic, skin testing will give you what we call false positives (means even if test is positive you are not allergic to it). So in a demographic person, skin testing is not a reliable test. So forget the results of skin test if you are demographic!! Diagnosis of food allergy requires a very detailed history about your symptoms & your diet, right from very beginning when you had your first allergy symptoms. This requires a detailed consultation. After suspecting the foods you may be allergic to, you may be advised serum allergy tests to support the diagnosis. The best diagnosis of food allergy is by food challenge which is done at specialized allergy centers. I would suggest you to keep a food diary in which you can keep note of food taken (including ingredients) and every symptom you developed, with time & date. This will help you and your doctor to suspect what is it that may be causing symptoms. Common food allergies are milk, wheat, peanut, tree nuts, soy, eggs, fish & shellfish. But one can be allergic to any other food substances from routine diet. Also, I should tell you that there are other gastrointestinal disorders which may mimic food allergy and there is food intolerance (in simple words it means one cannot tolerate some foods) also. A gastroenterologist consultation would be helpful to you if you don't have food allergy. So I would suggest you not to think that you are allergic to all foods! Also, I would suggest you to take an antihistamine (levocetirizine or cetirizine or fexofenadine) and montelukast daily to control your symptoms. Wish you 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 diagnosed with bone necrosis of the left jaw joint. Basically I have no ability to chew or open my mouth, brushing my teeth requires holding open with my fingers. It s extremely painful and I am losing my battle of hiding this condition from the people around me. I have been to several doctors and not one will help me because there is no cure. There are three surgeons in the US that treat this condition but it requires complete removal of jaw joints and lower jaw bone. Disfigurement and the lost of teeth is the future with the disease. The pain is so bad that I have to be on a pain patch but it does not touch the sharp and nauseous pain I have all the time. Who can I go to for help? I am fighting to not give up but I can t find anyone that will provide medical support while I prepare for the loss of my jaw. My family Dr provides the patch but I fear that this too will be another turn away because she can t just give me a patch without some type of treatment. I have seen dentists, oral surgeons, dental college here...not one has the medical field on replacing or repairing the jaw joints. I have 3 abcesses in the jaw bone at this time and one has broken through to leak infection into my mouth. This may be fixed by an endo Dr but he will not touch the other 2 abcesses, doesn t touch jaw bone disease. If you have any suggestions on where I can find help besides Europe, then please share. I can t be the only person with this disease and I can t believe that others have no doctor to turn to for medical care. We have great insurance but regardless of where I go, no doctor can provide the help needed to allow me some comfort for this horrible problem. History- car accident, shattered face. Broken jaws in 14 places and jaw joints were sheared upon impact. I had jaw bone surgery to repair breaks. Jaw joint surgery to remove worthless discs and remove broken bones out of the joints. 20 years later brain surgery to remove ex-large brain tumor. Numerous teeth shattered, lots of fake ones now. Sinus surgery to repair damage and gangrene infections that set in after accident. Was told that left sinuses will never drain to nose again unless I approved a hole placed in roof of mouth. Declined because I have no interest in blowing my nose through my mouth, now I just don t have a working nose on the left side. It is completely impossible to sneeze. Fun stuff. So at this point I am clueless on what options are available. No one wants a patient with a disease that has no cure. I will be on some kind of medicine for life. If I could get help with this, I would be able to have a somewhat normal existence until a dr who specializes in this particular problem is found. My problem is where are these doctors that help the facial bones? I can find a knee Dr all day long, but anything above the neck that isn t the brain...good luck on finding anyone. Thanks for your attention and help. I will look forward to seeing what you suggest and hope that you have been down this road with another patient. ### output:

Thanks for contacting Chat Doctor. You mention that you have problem of bone necrosis in jaw and history of facial trauma also. After seeing a jaw x-ray perfect diagnosis can occur. Generally in this case primary therapy start with antibiotics course and 100 percent oxygen therapy. Without proper seeing a jaw x-ray and other clinical symptoms difficult to treat. Surgery that one is last option. Consent an experienced oromaxilofacial surgery for treatment. I hope my guidance is helpful to you. Take care. 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: Anitta 14/f clinical notes- b/l congenital SNHL for cochlear implant MRI of brain including cochlea and CT of temporal bones technique- plain axial: t1,t2, FLAIR,DWI,FIESTA coronal :t2 cochlear imaging 3d FIESTA ct temporal bone, axial 2mm sections findings cerebralparenchyma is normal in bulk & signal intensity pattern with maintained grey white matter differentiation. multiple small/t2 hyperintense lesions are seen in b/l cerebral white matter- likely ischemic lesions no acute infarcts.no hemorrhagic areas. no intra cranial mass lesions no SDH ventricular system is normal b/l basal ganglia and thalami are normal cerebellum midbrain pons and medulla are normal megacisternamanga is noted sella, super sellar & para sellar regions are normal b/l orbital structures are normal no CPA mass lesions b/l inner ear structures b/l cochlea show normal 21/2 turns with apparently normal modiolus b/l vestibule are normal b/l semilunar canal are normal no dialated endolymphatic duct or sac b/l 7/8th nerve complexes are normal in b/l IAMs ct temporal bone b/l EAC s normal b/l middle ear cavity including ossicular chain normal b/l inner ear structures are normal; no definite calcifications in cochlea b/l facial nerveroot canals normal in course b/l mastoid air cells are well pneumatised, no e/o mastoiditis impression/finding summary multiple small or tiny t2 hyperintense lesions in b/l cerebral white matter in b/l cerebral white matter- likely ischemic lesions no acute infarcts. no hemorrhagic areas. no intra cranial mass lesions. no SDH no CPA lesions normal b/l inner ear structures ELECTROPHYSIOLOGICAL STUDIES BERA right ear- brain stem auditory evoked potentials was absent at 99dBnHL left ear- diagnosis- bilateral profound SN hearing loss ASSR - bilateral profound SN hearing loss DPOAE - absent in both ears tympanometry - bilateral A type, reflexes absent, no indication of any MEP PTA- bilateral profound SN hearing loss Recommendations ENT review regular use of hearing aid counselling - (realistic views of CI given, limited outcomes) follow up ASSR Response Audiogram Thresholds A/C left 1000Hz 99dB HLcg A/C left 2000Hz 97 dBHLcg OAE report test condition - satisfactory recommendation abnormal functioning of OHE s in both ears Tympanometry results bilateral A type tympanogram with reflexes absent no indications of any ME pathology Aided Audiogram stimulus used - pure tone instrument used - siemens cirlo sp test condition - satisfactory can u tell me the successfulness of cochlear implant. ### output:

This is a case of sensory neural hearing loss which is caused by the damage to the nerve fibers which carry/process auditory signals. Cochlear implants are generally useful in such condition however if you choose not to go for this then there is no other therapeutic option available. You may try stem cell therapy for this condition as an experimental alternate therapy which has shown some encouraging results however this is not a proven form of therapy(It does not require surgery)

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 Doctor said im having F.20 What is F20? Kindly help me Hi, I am 30 years male. I always had some kind of problems from my childhood and i consult a psychologist after then a psychiatrist at the age of 18-20 [i cannot recall the exact year]. I easily forget and i am unable to understand what is happening with me, like what is real and what is unreal. I used to think i have extra ordinary powers, like i can fly, some kind of power releasing from my eyes or body and a problem staring eyes. I stared at a woman in a feast at a church, i was unable to take my eyes from her, my brain was so free-zed and some friends helped me, pushed me to get out from that place. I saw a flash light when i close and open my eyes, like when we take picture using a camera. I was unable to move my body, unable to move my legs or hands to get away my eyes from her. I was cursed for that, nobody understood what was happening with me. I was staring at all woman and suddenly i heard a voice asking me to suicide . I wanted to jump in front of train and suicide but somehow i reach a meditation center, i spent few days there. I felt like i am St.George and i still have many thoughts like that. After a few days i start to stare at both woman and men, i stare at legs, i still cant help myself, so i don t appear in any public places. I tried to wear sunglasses but nothing helped me. I always hear people talking to me, i see them like i watching a movie, i talk to them continuously all day and night. I had frightening dreams while taking pills . Some times they curse me and ask me to suicide. I consult another doctor and he said it is something F20 psychosis . What is it? Is it anything related to schizophrenia? I am still having the problem for last 10 or more years, hearing voices of people, i see them, staring problem and also i see objects that are not really there. Like i see someone standing in a place but when i ask to my friends if you see him, they say they don t see it. l was unable to continue my education because i was unable to concentrate when i hear people talking to me, asking me to run out from the class rooms, also staring at people to their private parts or legs was a big problem as society doesn t accept it and many stay away from me. I was alone and i was isolated, i am working from home for a living, i am unable to understand whats happening with me, what is real and what is unreal. At present i am taking Sizodon Plus[Resperidone and Trihexyphenidyl Hydrochloride Tablets] before i took Palido OD 6 [paliperidone extended tablets]. Also, i took many other medicines, but nothing is helping me. Can anyone help me to know whats happening with my eyes? Is it anything related to schizophrenia? My Doctor said im having F.20 What is F20? Kindly help me, thanks ### output:

Hello. F20 is the code for Schizophrenia. This code is used in the International Classification of Diseases (ICD) version 10. Your symptoms do suggest that you are suffering from Schizophrenia. Your eyes are not the problem, but the thoughts, delusion and hallucination make it appear as if there is some problem with the eyes. Even though no medicine seems to be helping you currently, you should follow up regularly with your treating Psychiatrist and try different doses, medicines and combinations, whichever shows adequate clinical efficacy. Hope this helps. Best Regards Abhijeet Deshmukh, MD

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 65 yrs. old female. For about 20 yrs. Ive known Ive had a mitral valve prolapse, with just a flutter once in a while. Id cough and it would go away. About 3 yrs. ago I went through breast cancer, mastectomy and a tram reconstruction, nothing in my lymph nodes, so I had no further treatment needed, thankfully. About 1 1/2 yrs. ago my doctor at my regular check up said she heard more gushing in my chest and advised me to get an echo. I didnt really feel anything and put it off until I needed to have more reconstuction surgery last Dec.and my plastic surgeon said the same thing, so I had it done. My cardiologist said it was moderate to severe stenosis of the aeortic valve, and another new cardiologist gave me a card that I have a bicuspid aeortic valve. He did another echo and confirmed the first report. It was a little hard to see, but he thought I had this from birth, but it looked like I only had 2 cusps instead of 3 and now have some calcium buildup there was why it had gotten more prounounced. I had to have some more breast reconstruction done in December, but had it done under local. I still need another procedure of some fat transfer done in the next months to help fill in a small sunken area above the breast. Anyway my last cardiologist appt. in June said to wait for 6 months and have another echo, unless I have any bad symptoms before. When I think about it it seems I have more fluttering. Stress seems to upset it a little. I really feel good, no pain, maybe a little shortness of breath when I climb stairways, but besides a little pounding every now and then I wouldnt know it. BP is low. But because I know it, and it was a big shock as I feel like Im falling apart and I do worry about it. I sometimes maybe feel a little rushing in my head but thats pretty mild. Im pretty healthy or thought I always was til now. Im 58 weigh 148 # have some joint issues with my hips, knees and recently my shoulders, and Im more comfortable on a bike than walking because of this. Seems to be easier on my joints. I went to Curves for 9 years and both in our area closed in the last 6 mos., so i try to do some form of exercise at home. Thought I could wait til I could have a non invasive approach to the valve, I just find it really hard to think of having my chest split, especially now since Ive had all my reconstruction and am in fair order there. My cardiolgist doesnt recommend the non invasive approach. And I hear the valves dont last that long and dont want to think of more surgeries down the road. I take one drug arimidex for the breast cancer for another 2 years. Im ready to get rid of it, as I think it has precipitated some of my joint problems. So far my dexi scans are o.k What are my options and warnings. ### output:

You are having aortic stenosis. First you need to regularize your heart check up and regular echo to know the heart functions. If cardiologist recommend you the surgery then you should undergo it. Best option available is valve replacement. Metallic valve have good life and bioprosthetic ones have short life span. However after metallic valve replacement will need blood thinners post operative. But in short if you surgery you should undergo it because without surgery prognosis is bad and survival is short

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 25 years old. Had an amazing job , been there 6 years. One sunday after coming home from church I just collapsed in our bedroom. It was as if I was in a trance. Sat that way for several hours. Then went into a type of siesure. Arms moving in all directions , eyes going to the back of my head. Head drawing back. Legs acting if I was a string doll. Lasted for 2 to 3 hours. In a little while it started over again. Next day arrived at the emergency room . They didnt know what to do with me so sent me home. Told me to go to a physicologist. I did. Went to several of them. They said it was not a mental problem that it was physical. Visit 3 Neurologist, they said nothing showed up. And all the while they could see the episodes for themselves. MRIS Several Scans, Blood work tested for everythink you can imagine. After 4 months of visiting Ga Doctors My parents decided to take me to the Mayo Clinic in Fla. We stayed a week. One test, One Dr. after another. 2 visits to the emergency room with severe episodes. 2weeks later returned for results of the test. ... Nothing showed up. They had no answers for me. Had to get around in a wheel chair and a walker. Came home very discouraged and still having the siesures. 2 or 3 a day. Many times my husband had to call the EMTs out because I would pass out.Finally went to a Physocologist and he prescribe a nerve pill for me to help with the strong hold the episodes had on me when I was drawing for hours. He said all he could do was to treat the symptoms. Thank God for such a kind man. I had been going to Dr. for months and they had given me nothing to help get me through this horrible.By now my family leave had ran out and I lost my job. I cannot drive a car, and have not since that first episode.I cannot walk around the block. knowing I could pass out. My grandmother stayed during the daytime and my husband took care of me at night even tho he was given out from a 12 hour job. We went to another Neuroglist and to another Rhematologist, as well as other Drs. that were suggested. None of them knew how to help me. The Neurologist did start me on a low dose of siesure meds. I am still experiencing episodes and causing my husband many heartaches. Can you tell me what could be wrong or what type of Dr. do I go to next. Which way do we turn now. Please help. My insurance will run out in may. What do I do then? May God guide your thoughts as you ponder this. Thank you. ### output:

Hi, Thank you for posting your query. I have noted your symptoms in detail. Thank you for providing detailed information regarding your case. Based on the description, there are two possibilities. The first would be epilepsy and the second would be non-epileptic seizures. You need to undergo a prolonged (24-72 hours) video EEG telemetry. Sometimes, the epileptiform activity is not picked up on the routine EEG, but gets picked up on prolonged EEG.PET scan of the brain would also be helpful in making a diagnosis. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, Chat Doctor. Ly/

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Good morning Doctor, I Ms. Tanushree das, am 30+ yrs old. I got pregnant in the month of May, as I did a Preg test in the same month and took the required precautions. In the next month too I did the preg test to confirm my pregnancy, as before this I got a miscarriage in the month of March 2009 after 6 weeks of pregnancy. As I m working I took leave from the workplace. But on 6th July 2010, I felt some sticky things coming out and hence consult with the Doctor. She prescribed me Tedenal, Follic acid, Polybion syrup and a USG done immediately. I did the same. But when my USG was done I got a pain in my lower abdomen and hence she suggested me to take complete bed rest. At the very next day, ie on 8th July I got severe pain in the lower abdomen and the blood started flowing. At midnight a pinkish sac ( very small) came out andthere is slight relief from the pain. In the next morning a big sac like structure came out with slight blood clot on it. I consult with my gynae, she toldme to wait and watch if at all any blood clot iscoming or not and wait for 3-4 weeks and get a USG. Sir, I just want to know that whether my pregnancy is still there or not. I m afraid of the USG test as it seems to be painful to me. What should I do. I don t want to happen this again and again. And one more thing I got a Progestrone injection on 8th July. Sir please help me to know whether I m still pregnant or not . what are the other precautions I should take in my future to concieve a healthy baby. Thanking you, Yours truly, Tanushree Das ### output:

HI, Thank you for the query. - From your history, you had bleeding in early weeks of pregnancy followed by abortion. Yes it seems to be complete abortion, as the bleeding completely stopped after passing the big pink sac. (suggests expulsion of fetus.). It can be confirmed by USG abdomen. If you feel USG is a painful experience for you, try USG scanning per abdomen is not painful at all. Only thing is you have to retain urine till bladder is distended before the scan. - Injection proton depot is a hormone preparation given to avoid abortion. But probably it was given after the harm was already made. - Precautions for next pregnancy- - get complete health check up of both partners including blood grouping/ V Chat Doctor. Any problem found must be treated before getting next conception. With an expert gynecologist/ urologists advise. _ Try to have good health (with no health issues) before planning for a baby. - Take folic acid pill/ capsule vitamin E 200 mg once a day (both partners. - Take oral contraceptive for 3 cycles before trying for a pregnancy. After 3rd course, stop the contraception & try around ovulation day (tested by LH surge test . Home kit.) - Get pregnancy test done after 8 days delay in period & once the pregnancy is confirmed, start with medicine like Proton depot (hormone for fetal development & continuation of pregnancy)weekly with your gynecologists advise. - Continue hormones as advised by your doctor. Avoid stress (physical/psychological) up to 14 weeks of pregnancy. - Have regular pregnancy check-ups This will take you to a successful motherhood! 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, may Dear Sir Sir my father is a patient of Dr Syamasis Bandyopadhyay since 3 years but uhfortunately the deases of my father is on control but not cured like my father is suffering from rheumatoid arthritis,anemia,diabetes and high blood pressure since 5 years.Before 1 year when my father was at assam suddenly he fainted in the morning and next day also he fainted like that it goes for some days while he was fainted his eyes were wide open and his lips were pale.We checked the random sugar level and it was normal nearly 120.After that we went to chennai apollo for checkup where he was done a lots of tests including MRI ,colour dopler, ct scan,etc but failed to find the actual reason of faintaing.After that we came back to kolkata and after few months he again fall ill and was admitted to Apollo Gleneagles kolkata and was diagnosed pneumonia and staphylococcal septicaemia.Dr Syamasis Bandyopadhyay saaid that my Dad had a minor attack of stroke and also he was talking like a mad,non meningful talks constently. Dr Syamasis Bandyopadhyay stopped all the medicine prescribed by chennai Apollo hospital.Now for long 6 months he is taking the medicines prescribed by Dr Syamasis Bandyopadhyay the medicine are tablet Pantocid it,Minipres-xl 5mg ,wysolone 2.5mg tablet cetapin xr 500 ,amaryl 2mg,nexito 5mg ,stamlo 2.5mg, tablet folvite,p650,lonazep 0.5mg.He also has a eye problem on right eye cataract,and glaucoma and the medicine for eye is gatilox eye drop, homarin forte eye drop, prednisolone acetate eye drop ,combigan eye drop.Now my Dad cant stand without the help of Walker nor he can stand by his own without our help even he has to do toilet on the bed. Now the matter of concern is that today on 11/02/2010 at nearly 2pm while he was sitting in a chair near the dining table he was feeling sleepy and ill.He asked my mom to give him lunch and immediately asked for water but before she could give it he fainted.His eyes became wide open and lips pale.We sprinkled lots of water gave him water to drink and after trying for 2 minutes or so he regained his senses.As he was hungry we gave him buiscuits and water.After almost 20 minutes of that we gave him his lunch but after swallowing it once he vomited.After that we again gave him his lunch about 45 minutes later and he could consume it then. So Sir Please do help us by providing the best treatment to make our father move and make him healthy and get rid from the fainting problem your advice is highly appreciated thanking you your sincearly from Anirban dey I answer your health queries right now ? Please type your query here... ### output:

Welcome to Chat Doctor, your question refers to multiple problems faced by your father. But, the most important problem, it seems, are the fainting spells, what he is facing. The most common problem faced with diabetic patients is definitely hypoglycemic episodes. Another causative factor, what comes to my mind, is some sort of arrhythmia. I would suggest you to go for continuous blood glucose monitoring as well as holder monitoring. Both can be done at home .hope this helps to find a cause for his problem.

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 son is Mr. Surya Narayan. Date of birth: 15-01-1992. Because of my younger brother, he learns video games, TV games and mobile and also my son told me that my younger brother do some physical abeyance to his body. Because of that he is not interested to go to school and study, violent, expensable. We are refusing any thing what ever he wants, he starts violent and throw out the cooking items. It started 2007. We have given treatment in Spandhana Hospital, Rajajinagar under treatment given by Mr. Srinivas. We have given to my son computer, mobile. But suddenly he is telling games not suitable this computer or mobile. Please change these things and purchase new one. We have given tablets Zisper Plus 1-0-1, diva od 500 1-0-1, MazorilSR 200 1-0-1, Thyronorm 50 1-0-0, Trancodol dt 10 mg 0-1/2-1/2, Paradise12.5 mg 1 daily. But 40% improvement is there. We are worrying mainly his studying. We have joined him in ramaiah college diploma in electronics and communications. First 4 months regularly gone. After he discontinue himself. 1st Semester exam not attend. Now he is in the house. We are sending him tution for above course not regulary going. Please give your advise about medicines and course studying. Now also some violent is there. Some times he is beating his mother. Many counseling done by Spandana Hospital, Bangalore. The counsel person also told to doctor no use to counsel. Now, he is not completely cure. We refuse to any thing whatever wants he is beating his mother, throw the food items or some other whatever he gets. Now also he is feeling he wants to discontinue college. Another thing he written 1st Semester exam written. 3 subjects failed. Again 2nd Semester he starts going to college. He is not going properly. Against he is feeling to discontinue. Mainly he required games. He told us to buy costly mobile and put games every time. Sir, My email ID is YYYY@YYYY . My house phone no. 080-0000 / (My wife R. Girija is available) My mobile no. 0000 Sir, Please advise to take care of my son strictly sending to college and make study the subjects, if any body is there? Is it useful to us. Now he is in ramaiah college, Mathikere. Regards, N.SIVSUBRAMANIAN My email id: YYYY@YYYY ### output:

Hello thanks for askingYour son of 22 years have complaints of violent abusive behavior, not following commands, demandingness, poor performance in studies, hitting family members. He is currently on Risperidone 4 mg, Sodium valproate 1000, Haloperidol 10, Paradise 12.5 per day. He is not getting much relief and there is only 40% improvement. Furthermore, he is still demanding big games and mobiles. As per my opinion he is suffering from bipolar disorder with manic episode or second possibility is Conduct disorder. He is on right medicines, but the relief is less. Consult his psychiatrist again for reevaluation. Other option is electroconvulsive therapy. This treatment is usually reserved for resistant cases. You can discuss with his doctor for ECT. The therapy is given weekly or every 2 weeks interval, and it has good results as compared to medicines. Thanks, hope this helps you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Doctor, My daughter, in her 30s, slipped on carpeted staris and fell. She hurt her left lower back around the SI joint area. It was 10 days ago. X-ray taken next day, found no acute fracture and no dislocation in sacrum area. She has been taken 1800mg ibuprofen for 8 days. Since then she is taken IB 2 days a day, each time 600mg. She slided her feet forward in order to move around at home by holding the back of a chair with very slow motion and a bent forward position at 70 degree angle. She could make small steps with same body position and help of a chair, just like a senior in the past 3 days. She has not been standing up straight nor lie down to sleep as there will be extreme sharp pain shoot up from injured area. She has been in a sit-up position to take naps at night. She has not been able to walk up or down stair so to take showers or bath. She has no problem on calls of nature. Her both legs muscles have been very hard and they look much fatter than before the injury. She has very sharp pain sometimes in the SI area by just lifting up her right arm to reach something. She dares not to move any part of the body fast as it might trigger sharp pain from injured area. Questions are: Does it seem like she has pinched nerve. If yes, what does that mean? If yes, how long will it get healed? Are her muscles or bone bruised? She only iced her lower back area in the first 48 hours. She stopped using heat pad for about 2 days ago. Should she continue to use ice pad or heat pad? Is it safe for her to continue to take IB? If yes, how many more days and the dosage please? She wants to know what actually is wrong with her and what should she do to help improve the healing? I asked on her behalf as she has been pretty upset with no sign of obivous improvement. Kindly let me know what she could do for better and fast healing. Thank you. Catherine ### output:

Hi, Your daughter really had a very bad fall which is ought to give her a bad injury on her back. The answers are as following:1) Yes there are chances of having a pinched nerve. A pinched nerve means the nerve fibers that exits from the vertebral Gorman is trapped by a disc bulge (most of the cases) or a broken bony fragment.2) The duration of healing will depend on the severity of entrapment and at what levels have it taken place.3) The body gives a protective mechanism by developing a muscle spasm to prevent further damage, so not to worry about muscle pain also a bone injury can be only confirmed on x-ray or MRI.4) Yes it will be good if she continues taking Ice and hot packs both as it will provide some relief from the pain and stiffness5) No I would not suggest taking Ibuprofen for a longer duration as it will not help in treating the basic injury that she is having. Moreover, I would like to suggest visiting an Orthopedic for a detailed examination. For proper healing she needs to take rest, avoid activities as much as possible and take the medicines regularly as prescribed by her Orthopedic based on detailed examination. Hope this helps you to some extent and release your daughter of some stress that she is having due to this injury. Please convince her to go to a doctor and stop taking any home remedies as this will only worsen her condition. Again worrying will only lead to delayed healing. Hoping her to get well soon. Let me know if I can assist you further. 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 been in a real bad accident a couple years ago...i fractured c1 and 2 minorly...destroyed my ribs, almost had eye surgery and i have a metal rod in my leg. i chose to stay away from opiates the whole time i was healing. i used gabapentin instead. after about 1 1/2 years i decided to add tramadol to the list cause i was in more pain. then i also started to have horribe muscle twitching in my calf and debilitating painful muscle spasms at night when i try to relax. so i had the doctor try diff muscle relaxers....i have had znaflex, flexerall, baclofen and noe methocarbamol. all of them make me feel sick and disoriented in a bad way. when the first couple failed i demanded that she prescribe me diazepam. then bam i could finally sleep...i felt way better...less pain and it did not bother me the next day. i am poor, have no real insurance and i have to pay out of pocket. Soma is the only muscle relaxer i know that ACTUALLY works for me and does not make me wanna be sick. I know its habit forming but since i now my condition is for life...i am not so concerned about addiction as long as i can live my life better without pain and with sleep. i proposed a small dose of the valium in the day and a higher one at night to sleep and she said no...she seems all against soma all together....what other options are there for me?? diazepam cost me $5 a month and all those others are $30 plus a month for prescriptions. For a person in my condition does it not make sense to give me the valium at a higher dose so i can use it in the day and at night or at least prescribe a day time does of soma to go with the valium??? those are the only options i see..... ### output:

Hi, thank-you for providing the brief history of you. As you mentioned the fracture of ribs, c1&C2 region and also implant in leg, and now you are in pain. Since the incidence is 1-1/2 years old now you should focus on doing regular exercises as to get back to function. The types of exercises you can perform is -1. Breathing exercises - performing breathing exercises will help improve the capacity of lungs. It will even improve the strength of the respiratory muscles both primary and accessory. Also, this will improve the oxygen in the blood and the cellular mechanism in the body will be maintained well.2. Core stability exercises - this exercises will provide and assistance to the respiratory system and also improve the digestive system by improving the metabolism. This will also provide the stability of the spine.3. Lower limb exercises - this will be performed to help gain strength in the lower limbs. It will also improve the stability to the joints of the hip, knee l, ankle and foot. Also, by performing exercise there will be removal of metabolic waste through the excretory system.4. Neck strengthening exercises - this will help stabilize the neck muscles and the cervical spine. This has to be performed slowly as to avoid any excessive pressure on the old fractured cervical vertebrae. Now since you know what exercise you can perform, you can even take a guidance from the physical therapist as they will be able to teach the way it is to be done. Post that the exercises can be performed at home without any strain. Slow and steady wins the race. With the grace of God I wish you a good health. 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 been experiencing some pain in my upper butt crack. This started about a week ago during a shower when I was sitting down and I thought I d just torn the skin a bit while adjusting my position (scrubbing my feet). I get slight tears in any of my soft tissue or cracks quite often, so I thought that this was the same case here and figured it would as it usually does, just go away after a while. However, the pain has been getting worse not better. I have Crohn s disease because of the types of vit deficiencies that I suffer from most, is why I say that I get tears often and I also get ulcers sometimes pretty bad in my mouth, throat, and once in a while I even get them vaginally. Sometimes if I am shaving and I move wrong I will tear the skin between my pelvic area and upper leg. Probably not describing it correctly. And maybe this happens to lots of people sometimes, however when I do tear the skin even just a little it tends to take sometimes up to months to heal. That is why I didn t think about this one too much. Until tonight I decided to take a close look, I expected just to see a red mark in between the crack but instead I found what look like small lesions or ulcers or whatever they might be. I will say right now that I am free and clear of any STDS, I do know this for a fact as I have been married for 10 yrs and due to my current health conditions even if he were cheating on me we aren t currently active together so that is not a possibility. Besides I m routinely tested anyway just because I have moved a lot lately and any Doctor I see tends to want to rule that out. The redness starts at the top of my crack or right at tail bone and goes down probably about 2 inches. It s pretty skinny, doesn t span more than a half an inch width wise. Most of it is just red and looks irritated almost like a diaper rash. There s just a small section about the size of a quarter that has what look like as I said before lesions or ulcers. They look a lot like the ones I get in my mouth just smaller. They re roundish to oval shaped and it s white in the middle like it s puss but I don t know if that s what it is or not. I have been suffering from Crohn s since 2005. before that I was diagnosed with cancer rhabdomyosarcoma at age 4, I am almost 31 now. I ve seen a lot of stuff with my health and been through a lot. This is new to me. It s got me concerned. I just moved so I don t have a new DR yet and I don t want to go to ER over this unless I really think I need to. I m a little lost. ### output:

Hi, At this area, it may indicate several issues and most common are a colonial cyst or perianal abscesses. These are inflammatory processes in the sacral and perianal area usually manifested with pain, redness, swelling, fever and pus discharge. Cellulitis is less common and may be present in the sacral area as well. This is mostly caused by beta-hemolytic streptococcus, and it necessitates antibiotic treatment with Augmenting, or combination of Capitol+ metronidazole. You should also, apply cold compresses, take nonsteroid painkillers such as ibuprofen 400 mg and rest. If there is no improvement within 2 days, you should see a doctor and have intravenous antibiotics. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. Rammstein, General Surgeon

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hey guys, I was wondering if anybody can shed any light on Wheaton earth is going on with me.I have recently visited a&e a fair few times in the last few months for these symptoms as well as my doctor but nothing is getting me anywhere.It seems that I cannot request the doctors to refer me for certain things unless they have due cause.I do suffer with asthma and anxiety but 100%, its not related which the doctors just keep writing it off as.For the last 3 years, Ive suffered with a tight chest and a really strong heart beat.Not necessarily a fast heartbeat but a strong thumping instead, so much so that I can feel it vibrate throughout my body.Tight chest I have all the time, worse when I eat, drink, do anything physical.I literally carried an empty cardboard box up the stairs the other day, maybe 2kgs maximum and had to have a rest immediately due to not being able to breathe properly.That isnt normal for somebody who is only 27 years old.I get this tight chest feeling then in turn have a bloated, hard feeling stomach.Im having to use the toilet immediately after eating, again, that shouldnt be the case.Its as if its going straight through me with no digestion process.I feel weak, dizzy, blurred vision, I genuinely feel like Im falling apart.The doctor said that it may just be anxiety but its not, whats making me feel anxious is feeling so ill.I occasionally bring up blood and phlegm after coughing (the coughing has only developed recently)I have a hands on job, my own business intact but I havent been able to work for the last 2 months due to feeling so rotten.It seems the doctors simply assess my asthma, ask me about anxiety, listen to my heartbeat and tell me in ok.But im not, and I know Im not.Im running out of options and physically cant continue feeling like this.My doctor makes me feel awkward for requesting services like a 24 hour tape / brain scans / CAT scans but surely if I feel this is necessary, I should be able to ask for this surely?My chest is sort to touch in places, very tender.I go very red in the face if I eat too much, I go very pale if I do too much physical stuff, even running up the stairs or climbing in and out of my van.Im not diabetic, I dont have any STIs, there is no foreign bodies in my blood, ECGs are ok apparently, echos are fine.Im at a loose end here and need help.Also, has anybody every been through private healthcare on a pay per use plan.I was thinking about using bupa for the relevant tests and scans etc but unsure if its worthwhile / too expensive.Any info, much appreciatedMany thanks ### output:

Hello, Thanks for the query to Chat Doctor. Forum. Chest tightness, cough, exertion breathlessness, sometimes blood in phlegm, mucus, general weakness, strong heart beats (vibration type). In my opinion you may have Mitral stenosis ?However, without physical examination & complete history it is very difficult to diagnose any disease. But as you mentioned these symptoms relates to MITRAL STENOSIS. 2nd possibility may be due to asthmatic allergic bronchitis. 3 may be due to anemia, (complaining pale & breathlessness).4 may be due to esophagitis (causes are tension and stress).ECHO & chest X-ray as well physical examination by a physician will reveal the cause. Hope I have answered your question. If further any question, I will help. 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 m 23 years old southeast asian and have had Eczema my whole life. For the past 6 months now I ve been dealing with some sudden intense, severe itching and rashes. The itching has been UNCONTROLLABLE to the point where I can t go seconds without itching and it gets worst at night and has prevented me from getting any sleep, it s driving me crazy. I feel as if I m a crazy person itching myself all the time. This has never happened before of my whole life dealing with Eczema and just started in April when I first began dating my boyfriend who smokes.The rashes are all over my body, severely on top of my hands, wrists, arms, corners of my armpits, all over my legs worst underneath the corners of my legs and on top of my thighs. My skin suddenly gets SEVERELY dry, flaking and itchy to the point where I can t move without it hurting whenever I wake up or don t have Vasaline on. The lotions that I use to use on my skin are no longer working and that includes Cetaphil. It stings when I shower, especially if I use soap.The soap I use is Dove sensitive unscented soap bar. I wash my sheets and clothes all the time with unscented soap and detergent. I ve gone through two doctors now: First doctor said she wasn t sure what it was and just prescribed me allergy pills which didn t help at all so I stopped that. Second doctor said it was tinea corporis and prescribed me a one week worth of pills for tinea corporis to stop it on top of some pills to prevent itching and to help me sleep at night and those did not do anything whatsoever. I m getting really desperate now. I really want this to stop, its driving me crazy and has never happened before in my whole life until this year. I ve had to go to the hospital because I ve itched to the point where I would ooze and bleed. Even before when my skin gets smooth and normal, I still get this UNCONTROLLABLE URGE TO ITCH ALL OVER, which brings back the rashes. Current medications prescribed and using: Hydroxyzine HCL 25 MG Tablet and Triamcinolone 0.1% Current store bough medications: Advil and Benadryl Current product using to keep skin from being dry: Vaseline (which still doesn t help stop the itching) Current soap: Dove sensitive unscented soap bar. Skin looks and feels SCALY, FLAKY, ROUGH, HARD, PATCHY, UNCONTROLLABLY ITCHY, RED, EXTREMELY DR, PAINFUL. Rashes are all over my body, severely on top of my hands, wrists, arms, corners of my armpits, all over my legs worst underneath the corners of my legs and on top of my thighs. ### output:

Hi, It seems that probably you may be having atomic dermatitis. There may many causes in the form of allergens... inhalants contact ants and dietary allergens. You should keep yourself away from all types of allergens. Avoid contact with all suspected allergens. Avoid food which is likely to cause allergy. I would suggest...- antihistamines like cetirizine-antibiotic like cephalexin- oral steroid like deflazacort in a tapering dose-apply mild to moderate steroid cream - avoid soap at bath-take treatment under observation of dermatologist for a long time 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 adenoid cystic carcinoma with numerous large lung mets. The original site (bartholin gland) has not had any recurrent disease. I have had a chronic cough for a long time. Recently, coughing jags are followed by an unexpected small vomit. The first vomit seems to be almost burped up, then the gagging/coughing continues. I am end stage and am short of breath when I go up stairs or walk any distance. Is the vomiting a result of progressive disease or more likely have another cause. I am not undergoing any treatment at this point. Thank you, in advance, for your response. ### output:

Hi welcome to Chat Doctor, I have gone through your query regarding frequent vomiting and cough. It is a matter of concern. You have adenoid cystic carcinoma, ant yet started any medication ? It is great negligence on your part ? I would like to know your age, since when you have come to know that you are suffering?. I like to suggest you to visit your physician and find the possibility of your treatment . You can get cured. Don't loose heart . Today every thing is curable . A cough is a reflex action to clear your airways of mucus and irritants such as dust or smoke. The mucus production is related to a body that is overly sensitive to its environment due to these problems and, thus, constantly inflamed and causes deep cough that brings up thick mucus or phlegm and if not able to be expelled , leads to vomiting, WHICH IN A WAY BOON IN DISGUISE as it clears your system from mucus. More or less our lifestyle is also responsible for that. In the early stages you may experience shortness of breath when exercising or moving and, in the later stages, shortness of breath while at rest. Hemoptysis (coughing up of blood) may also be present especially when an infection is present. As you know prevention is better than cure, Meanwhile, you have to follow a balanced food habits and regular lifestyle . 1. Make sure to include all essential nutrients in diet as fiber whole wheat grain, soups vitamins, minerals in natural form - fruit, veges, Almonds , ginger, garlic, honey, black pepper .long pepper cinnamon, and other antioxidants as turmeric powder with warm water or a cup of hot milk at bedtime , Lemon juice twice with warm water before meals, Aloe vera juice 25 ml +AMLA juice 2 spoons in the morning , after salt water gargles 2. Avoid fried, fast foods, tea, coffee , smoking, alcohol, mental stress, worry. Anger and constipation which is mother of all ills. 3. Make exercise, walk, yoga. Pranayam, deep breathing an essential part of your regimen for detoxifying your body and enhance strength to immune system. 4. Meditation, rest and proper sleep is necessary for total health. 5. To cleansing, Gargling with warm salt water loosens phlegm in the airways and bronchioles. Simply add a spoonful of salt to lukewarm water and gargle with in the morning and again in the evening.6. Meals should be light, easily digestible ,small meals at frequent intervals --after 2 hours gap or so .7. Ayurvedic Punjab is also helping to cleanse internally to make the system free of mucus -- After evacuating your bowls , Chat Doctor. Then vomit and force vomit the water 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, On February 23, 2013 I was assaulted during a party. A guy punch me in the face around the lower jaw area and blood instantly came from under the lower left canine tooth. I didnt think much of it because the area was not swollen nor painful until three days after the incident. I went to a dentist and they took x rays of the area. They said that the root of my 22nd tooth was fractured from the injury and referred me to a oral surgeon. When I went to the oral surgeon they took a panoramic x ray of my mouth/ jaw and they said from the looks of the x ray that the tooth wasnt fractured but the bone surrounding the tooth was fractured (alveolar bone). They consider the injury to be a green-stick fracture, minor and curable by a soft diet and pain medication. For two weeks straight I experienced unbearable pain. I had a clear, sometimes yellow, discharge coming from under the gums of the 22nd tooth. Furthermore, the lower left side of my jaw was swollen badly! During those two weeks I took my medication and had follow up visits to the oral surgeon because I was afraid that the yellowish/ clear discharge was a sign of an oncoming abscess. They told me that since I had a cut around the inner and outer gums of the canine tooth, that food and debris could be getting trapped with the cut and causing the discharge. From their the oral surgeon put me on an oral rinse called Peridex and took me to complete the course of my medication. Three weeks after the initial fracture date, the swelling begin to decrease and a soft lump begin to form around the lower part of my jaw/ chin area Also, a bump begin to form behind the 22nd tooth. Both formation are painless unless I irritate it. It hurts to chew on both the 22nd and 21st tooth. When you tap both of those teeth, it is sensitive. I have tried to burst the pimple like bump behind the tooth but nothing came out but blood. I applied antiseptic rinse to the area after I popped the bump. Also, I applied hot and cold compresses to the lump on my lower jaw/ chin but nothing seems to relieve the swelling. I research possible answer to my symptoms and some of the results I were given were question. Being that my jaw is fractured, the lump on my lower jaw/ chin area could be a soft callus which is a part of the bone healing process. My biggest fear is that the lower is enclosed pus that is leading to an abscess. I REALLY need someones opinion on this because all of the doctors I have went to have given me different diagnosis. If it is an abscess, Which I HOPE IT IS NOT, I need to get it taken care of as soon as possible so my adjacent teeth and jaw bone wont become infected. Please Help ### output:

Hi, Thanks for asking query, According to your explanation it seems that you have develop abscess in relation to tooth injured during the trauma. It can be the possibility that it has spread to adjacent teeth also. I suggest you to visit dentist get the fresh Iowa and OPG done. Get the root canal treatment done of the affected tooth followed by crown to the particular tooth, abscess should be properly Chat Doctor. Take proper broad spectrum antibiotic and non-steroidal analgesic as prescribed by dentist, gargle with warm saline water 3 to 4 times a day, use antiseptic mouth wash. Hope this will help you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Doctor, I am Arun Karthik from Coimbatore, Free Lance VFX Artist.For the Past four years my life is out my control, My family consists of of my dad, mom, and younger sister, Dad as an Electrician mom as house wife, sis working in a private concern. A Normal Middle class family My Problems are as follows 1.Fear of Death, 2.OCD 3.Fear that i would have a disease like cancer, Brain Tumor, Heart Attack, Colon Cancer, Stroke, i often think that i would have some disease, i fear a lot, i am always in a confused state, if i get out my computer thats all i feel like i am going to have some disease or i am going to faint, vision blurriness, these are my past and present problems, often i go to a doctor and check my health, even my doctors say nothing to worry i will always think about that and reserach about it, now coming to the present problem. I had an appendectomy before 2 months, after that i had right stomach pain which lasted for three days my doctor said it would be an infection, i did a USG, it reported that there is mesentric nodes and study of RIF needed, i was treated with IV Fluids for three days then i discharged, after that i had the same pain, again i went to my doctor he said that a CT will reveal the problems, My CT was a normal study, again i took a USG , the report said no mesentric nodes or free fluids in abodemn, it was a normal study, my doctor said there is nothing to worry, i lost 2 Kgs of Weight,i was 42 before my surgery and now just 40, if i eat there is indigestion and i feel that i have fever, but temp and BP is normal, my blood tests said its an infection, (wbc of 120000), now when i eat after an hour i feel urgency to have a bowel, but i can control it, what is my problem, should i do a colonscopy or endoscopy? i fear a lot? no blood in stools, but somewhat blackish, is it a serious problem like colon cancer or stomach cancer, i went to one Psychiatrist Called Dr.Moni in Coimbatore, i cannot explain my problems to him because he was so busy only he took ten mins of time and put me on a counselling session, i did not go there again. There they said me that i have depression and OCD.I do yoga Shambhavi Maha Mudra Dyan from Isha Yoga, daily it gives me some relief for one or two hours then back to the game.Lots and Lots to say everything is....... Seeing my situation Doctor my dad had an Heart Attack Last Week, i am more depressed and i am always worrying, ### output:

Hi Martin, Your description of your problems suggests that you are suffering from OC spectrum disorders. You can get well with either medicines or psychotherapy or a combination of both. You can contact any psychiatrist they will help you for sure. Don't worry about the time they spend with you, your problems could be understood even before you tell everything in detail. So have faith in any doctor or contact a doctor you can build trust upon and get proper treatment. If you are interested in medicines you can ask the doctor, and you will be prescribed with medicines which are basically classified as antidepressants but works perfectly well with your problems. Remember these problems are too common, and I see many patients suffering from similar problems who gets improved in few weeks of treatment. So don't hesitate and ask for help from a psychiatrist.

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 Dear I would be very pleased if you could help me in this case. I am suffering from extreme anxiety and I want to live a normal life! I can t describe it, I ve never had a scare like this before. I think every strange thing is going on with my body is related to pregnancy! I think it s because I don t have enough sex information and don t know how pregnancy actually happen, so whenever I get negative search result from Google, I start to think bad thoughts , it will increase my anxiety and I feel panic again. you know, I am living in a culture where sex before marriage is frowned upon. I know nobody can diagnose whether I am pregnant over the internet but I just need to know how likely it could be that I might or might not be pregnant. So I would be very grateful if you could help me and let me know how I can be 100% sure if I am not pregnant. I will briefly mention to the points I guess you need to know. my 3 last period was on August 31. we had an unprotected foreplaying (No sex) , he ejaculated so we re afraid if my labia touched his sperm or not. I should mention that I am still virgin and had no sex before. I also took a shower immediately and used Plan B after 2-3 hours. as I was so stressful and afraid that the stress delays my period, I started to drink Saffron tea and Cinnamon tea, two weeks before my next period and I only drank 1 or maybe 2 cups a day. because I d heard these can make the period come. I got my period on time on October 1st with a normal flow as the same as before. I did the home pregnancy test a week after my period finished and It was negative. I started to drink those teas again 2 weeks before my next period. I m afraid if these teas can cause a fake period!! I got my period on November 1st. I feel the blood was changed to dark-color on 4-6th day of my period. I also should mention that I had a white or grayish jelly-like vaginal discharge with itching which was increased right after my period ended. I did hpt again on November 14 and it was negative. even it seems I have pretty much zero chance of being pregnant but I am still anxious. google search results said some women confuse the irregular bleeding during pregnancy for their period and the irregular bleeding can come even right around the time you are expecting for your normal period. or the other point was that some women had even 6 negative blood test before the finally had a positive cause some women do not carry enough hormones to detect till later. so I can not trust even on blood test!!! could you please let me know what I need to do right now and how I can be sure if I am not pregnant, before I miss the time for abortion!!! I I get my next period on time, can I still be pregnant after 3 normal and on time period?!!! I m looking forward your answer.Thank you in advance. ### output:

Hello there I have read through your question and would like to tell you that you are not pregnant. Firstly you didn't have an intercourse and that itself makes it unlikely for you to be pregnant. Secondly you had a plan B and got your periods after that whicChatDoctorpletely erases all the chances of you being pregnant. You already had three cycles after that and irregular bleeding during pregnancy does not involve Frank bleeding. I would advise you to relax and stop stressing about this as you are not pregnant. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have panic disorder. (1)I tend to panic while traveling in any vehicle especially planes. If I am driving or controlling the mode of transportation I have no fears. Especially at greater speeds.(2) I always want to see the different places but sometimes on doing so seeing unfamiliar races and areas I get too excited leading to constant swallowing, choking and panicking. I am not afraid of crowds or public speaking, I don t care about what people think of me one bit so having a panic attack with friends and family also tends to happen. It s like I retreat into myself and panic. Also no tragic incident led to the panic attacks. I was on a bus trying some deep breathing when all of a sudden I felt shortage of oxygen. I panicked and this was my first experience. After that I guess I shouldn t have dwelt on this episode for too long. Because then it led to general anxiety. Now I can feel anxious with any new and different thing. And traveling. How can I stop fearing a breathing issI have panic disorder. (1)I tend to panic while traveling in any vehicle especially planes. If I am driving or controlling the mode of transportation I have no fears. Especially at greater speeds.(2) I always want to see the different places but sometimes on doing so seeing unfamiliar races and areas I get too excited leading to constant swallowing, choking and panicking. I am not afraid of crowds or public speaking, I don t care about what people think of me one bit so having a panic attack with friends and family also tends to happen. It s like I retreat into myself and panic. Also no tragic incident led to the panic attacks. I was on a bus trying some deep breathing when all of a sudden I felt shortage of oxygen. I panicked and this was my first experience. After that I guess I shouldn t have dwelt on this episode for too long. Because then it led to general anxiety. Now I can feel anxious with any new and different thing. And traveling. How can I stop fearing a breathing issue. No asthma or thyroid. I have gone for all the check ups. Just not being able to keep my mind off breathing, burping, shortage of breath as a result, choking, and wanting to feel courageous instead of negative attitude towards lifeue. No asthma or thyroid. I have gone for all the check ups. Just not being able to keep my mind off breathing, burping, shortage of breath as a result, choking, and wanting to feel courageous instead of negative attitude towards life ### output:

Dear friend, I can understand the height of your suffering. But you have every chance of getting adjusted with any situation and lead a fruitful life. All the above episodes, symptoms and situations are generally called Anxiety issues. We are all social animals. The animal instinct of "Fight or in any situation is largely influenced by the interactions and experiences we have with the environmental factors. We decide on either "Fight" or "Flight" based on our perception of the threatening factor and relating the experiences almost to a certain extent. You may not be able to recall or bring back to memory some of the experiences you had with regard to any situation or this situation in hand. We have some chemicals in the brain which regulate the animal instinct of FIGHT or FLIGHT. The irregularities in the secretion of these chemicals can be disturbing too. At present, it is my advice to avail the services of a Psychiatrist for some medications to bring back the equilibrium of the chemicals in the brain along with the services of a qualified Psychologist who can be able to patiently listen, interpret and render some therapy for a behavioral change. Good days ahead ! 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, my boyfriend works out of town so when he was back i wanted to skip my period. on the wednesday i was suposed to start taking the placebo pills on my birthcontrol but i took a new batch instead. i had started bleeding a tiny bit before i actually took the pill but i thought it might stop it anyway. it put it off for a few days but started spotting again on that saturday. he left that sunday and is gone for 3 weeks.i continued regularly taking my birth control but i spotted for about 2 weeks straight and then it kinda stopped. yesterday was the day to take my placebo pills again. i did but i still havent gotten my period but ive felt cramps. is there any chance i could be pregnant? ### output:

Hello, thanks for trusting Chat Doctor doctors for your health related queries.I guess your concern is-are u at present pregnant or not???right???actually to pinpoint n say u r not 100% pregnant is difficult CZ u haven't taken pills properly.....but don't worry every problem has a solution...I will try to help u in short way can try out my suggestions:1.have patience,wait for another 3-4days for menses to occur. If menses happen you are not pregnant,2.if menses doesn't happen after 3-4days/or you're in very much hurry to get rid of tensionfull mind-am i pregnant....u do urinary pregnancy test.this test kit is avail bl at affordable prices in your nearby medical stores...buy it, do it by ourself. If its negative you are not pregnant,,,if positive visit a nearby gynecologist for further help3.if still u in dilemma of pregnancy then a scan(ultrasound of abdomen n pelvis)can be done, in scan its possible to see an embryo/baby is there or not...but NOT NECESSARY DEAR...RELAX....4.when a husband/wife are meeting after a long time of gap then it's better to use condoms...whiz d logic behind I will explain.let's say u people meet up once in 15 days, so max 2 times in a month u do sex/coitus.to avoid pregnancy for this two times in month meeting you are on medicines for almost 28 days...of course result of medicine-u won't b pregnant but u will b exposed more no of days for side effects of medicines....I hope u understood...so usually Jen husband/wife meet up occasionally as they live at long distances...we advise condoms. Condom has result(prevents pregnancy)but has no side effects.whereas medicines had result along with side effect.some husband/guys say we don't feel exact natural sensation, so we can't use it....n some say we used condom, but as we did zhabardhassttt sex condom ruptured!!!!!!!for this also solution is there, its i-pill.available at your medical stores at affordable prices....if you are taking I pill, then lets say u meet your husband/bf once in 15days.so in a month u take only two I pills.....so not exposed to many side effects...u agree with me madam????I hope this was informative enough, helpful,useful for your query.regards- Chat Doctor. (having regular healthy sex lifestyle Bowen couples is very good and advisable too...but a small presence of mind, u can use condom n can make girl free of medicine side effect n boy from being in psychological tension whether his GF has become pregnant)

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: History: I am a 60 yrs old. A duodenal ulcer was diagnosed about 25 years ago, but I have taken full course.I am patients of hyperacidity, which is being controlled by my diet. Four years ago I feel diziness, rapid heart beat, several times off & on and pain on left side chest. My angeogram was done and doctor told me that my heart and arteries are quite normal. There is no problem upto next 20 or 25 years. But my symptoms are still remain. Several times I feel stabbing pain in lateral part of my left side ribs shooting towards armpit with increase heart beat dizziness and confusion. A gland of my thigh was prominented.& examined, diagnosed tubercular. I am taking ATT from last 8 months regularly. But my symptoms of pain, rising from left lobe of liver to armpit is still stand occassionally with diziness and confusion. Sir I am eager to know that is it due to duodenal ulcer, heart disease, gas or gastric disease or due to ATT drugs ? ### output:

coronary angiogram is the gold standard test for diagnosis of coronary artery disease with a sensitivity level as high as 99.9% .so the chest pain and burning sensation is not because of cardiac cause. There are some other causes which can present with the same symptoms and can mimic pain of cardiac origin few of them are gastritis heart burn acid peptic disorders you say, you have acid reflux for several years, you were diagnosed with duodenal ulcer, ATT therapy also increases formation of acid and causes severe gastritis, most likely cause of your chest heaviness and pain is HERD(Castro esophageal reflux disease). Gastroesophageal reflux disease (HERD), Also known as acid reflux. HERD occurs when stomach contents move back into the throat. This may cause a burning sensation in the chest known as heartburn. Once cardiac condition has been excluded, the most common cause of chest pain is HERD. I would like to say that treatment of HERD is done according to the following guidelinesPatients are often prescribed a proton pump inhibitor (PPI) also called a PPI trial(e.g. omeprazole). They must be taken at least 30-60 minutes before breakfast. If the patient responds, the treatment can be continued for at least 8 weeks. For patients not responding to a PPI(as in your case) alone a combination of PPI with Levosulpiride should be tried for 4 weeks. Low doses from the class of Chat Doctor. These medications are felt to produce their favorable effect by reducing pain transmission from the esophagus to the brain. The two most commonly used agents are migraine and trazodone. For patients not responding to either acid inhibition trial or TCA, esophageal motility testing (a study done to evaluate the muscle contractions of the swallowing pipe) may be done to look for other uncommon causes of chest pain such as Andalusia. Esophageal Andalusia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter (LES), Andalusia is characterized by difficulty in swallowing, regurgitation, and sometimes severe chest pain and burning sensation. A peptic ulcer is one of the most important cause of dizziness, chest heaviness and explains all your symptoms.it's not your heart it's because of gastritis and ATT increases it

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 been experiencing bouts of severe abdominal pain over the past 7 months and admitted to the hospital four times. I ve been given different diagnoses of diverticulitis , irritable bowel , typhlitis and colities. The pain initially presented on my right side and also intermittently included back pain. The stomach pain on a scale of 1-10 is usually 7-8. I ve had an ultrasound, a abdominal CT scan with and without contrast, an EGD, a HIDA scan and most recently a colonoscopy and I m scheduled for a CT scan with and without contrast with a pancreatic window. My History: 49 year old African American female, 5 2 , 220lbs (lost 30 pounds in the last 6 months). I currently take cardizem cd 120mg, losartan 50mg, ferrous sulfate 325 twice a day, protonix 40mg, singulair at night and just finished 500mg of levoquin after my last hospital stay July 21-23. I had H Pylori back in 1989, had my gall bladder removed in 2006, had ovarian masses/tumors removed in 2008 along with a complete historectomy. I also have a mass and cysts on my right kidney (which I was informed was perfectly harmless--been there since 2008). My last 2 hospital stays were because of hypertension, heart palpitations, tightness in my chest, headaches, sweats, pains in the left arm, lightheaded/dizziness. Tests showed a normal EKG, but some tachycardia. The EGD showed a hiatal hernia and a growth that was sent out for a biopsy. Lab reports showed among other things, anemia. The ct scan showed typhlitis , whatever that is. The colonoscopy showed stenotic ileocecal valve. The doctors have come to a concensus...they don t know what it is. Here are the majority of the pieces of the puzzle, any light you can shed would be greatly appreciated. ### output:

Hi MEANS, Welcome to Chat Doctor ! Your problem is really very complex. So many possible causes are there. Two of your medicines need to be switched, Singular needs to be stopped you can take other inhalations anti-asthmatic which are equally effective, You are taking excessive doses of iron- I would suggest 100 mg thrice a day after meals, which is most tolerated dose. You might have post-surgical bands which result in intermittent obstruction and pain, that is more so a case if you are totally well in between the episodes. Another prominent possibilities is tuberculosis of abdomen. If your problem does not get resolved soon please review with your gastro-surgeon, and possibly you would need an exploratory laparotomy for a diagnosis and intraoperative intervention if possible. You need a physical examination by your physician and get baseline investigations like Chest X-Ray, Electrocardiogram, Complete Blood Counts, Renal Function Test, Liver Function Test, Fasting and Postprandial Blood Sugar, Thyroid Profile, Lipid Profile, Ultrasound Abdomen, Urine Compete Examination. This work up is expected to detect the underlying problem, so a definite treatment could be started. I hope this advice would be helpful for you. Still if you have any queries or doubts, please write me back, I would be happy to solve them. Wish you a great 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 29 year old/ male, an occupational health nurse working in UAE on a construction site. I was recently married and rejoined here 2 months ago. Suddenly one day I was having sciatica pain on the left leg for 2 days and it shifted its location to right side after 2 days and it continued for another 5 more days. I underwent an MRI as per my orthopedic doctors advice and the report shows that i am having degenerative disc disease on the lumbar region. This is the MRI report:- MRI OF LUMBAR SPINE Indication: Low backache radiating to bilateral lower limbs (R>L) Technique: MRI of Lumbar spine was done on 1.5 Tesla Scanner in multiple planes and using multisequence technique. Patient given Soft copy of MRI study Findings: Straightening of lumbar spine noted. Marginal osteophytes noted at L3-4 level. Transitional vertebra noted (sacralization of L5). The vertebral body heights are maintained with normal marrow signal intensity pattern. Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. Rest of the intervertebral disc normal. Facetal joints normal. Pedicles, laminae and spinous processes are normal. Visualized spinal cord, conus medullaris and thecal sac are normal. Both psoas muscles are normal. Both sacro-iliac joints are normal. Pre and paravertebral soft tissues are normal. Opinion: Degenerative lumbar spine disease with Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. I am not on any medication because the pain was lasted only for 7 days. Now i am absolutely pain free and i am able to do anything. I am over weight and it is 112 Kg with 60 height. But I would like to know more about - 1) the problem what i have..??? 2) what will be managements ..?? 3) what are things i should take in consideration to avoid further damage..??? 4) Is there any cure for the disease..??? 5) What are the things i should keep in mind before intercourse...??? 6) Will sexual intercourse make further damage to the said problem...?? Please help.... ### output:

I read your query carefully, and I understand your concern. The report indicates diffuse degenerative changes of the lumbar spine and a herniated disc at the L3-L4 level which causes narrowing of the neural foramina thus compressing the nerve roots bilaterally, data which corresponds to your symptoms. The first step in treatment is physical therapy and painkillers like Ibuprofen. If symptoms don't subside local injections with corticosteroids and anesthetics are the next step. If still no success surgery could be considered, at times even earlier if there are new signs like motor weakness, saddle-like distribution sensory changes and micturition problems which could indicate caudal equine compression. You should also avoid heavy weight lifting if that is the case in your line of work. I hope to have been of help.

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 64 years old. Despite a low risk profile: no familial history of heart issues, don t smoke, exercise regularly, good diet, no fat around girth, cholesterol in the normal desirable range, and normal blood pressure, two years ago i experienced severe chest pains which resulted in me having a stent installed in one artery. The others were clear. I was prescribed: Perindopril 2mg Atorvastatin 20mg Asprin 75mg Sometimes, I suspect my blood pressure may be a little low, although when my GP checks it routinely on my occasional visits it has been normal. Recently, I sensed my blood sugar was a little low and perhaps combined with low blood pressure, I experienced some worrying memory disturbance, which however, resolved within a couple of hours. I consulted a doctor about this but with inconclusive outcome. I have since been fine and back to functioning with full cognitive capacity (I work in the mental health field). I have also experience for some time now low libido, and occasional problems with mild impotence. Also, my doctor diagnosed me with benign tremor, which again is mild, and at this stage not too noticeable. My question is: could changing my medication address these issues better? I m wondering if nebivolol (given the good data on it now and its superiority over other beta blockers for heart conditions) could be used to replace perindopril, slightly lowering my blood pressure, and perhaps helping the benign tremor. I am aware that it is the only beta blocker of its kind that has been found not associated with a decline in libido and the problem of impotence. My last cardiologist in Australia suggested that perindopril was best for me because of its specific properties relative to my condition. I am wondering if this is the case now in the light of new data on the effectiveness of nebivolol. Lastly, I have not felt fully myself ever since the stent was installed and I started on the medications, despite daily exercise, excellent diet, meditation, and no alcohol. I forgot to mention, my cholesterol is now sitting around 3 (it never did exceed 4.5 even before I commenced on atorvastatin). Because I am in the UK getting sound advice without waiting many weeks is frustrating. Hope I can receive good advice, that will improve my quality of life and give me the very best prognosis given my history. ### output:

Hi, Nevibilol and perindopril belong to two different class of blood pressure medication had its own benefit and side effect profile. As per my understanding, there are certain aspects of why you want to shift to Nevibilol. Let me explain each. 1) Fall in pressure, maybe titration of perindopril dose would be more appropriate. Decreasing the same may help. 2) Tremors, Nevibilol is a beta blocker with intrinsic sympathetic activity, so though beta blocker as a class helps reduce essential tremors, Nevibilol may not help much.3) Libido, though Nevibilol is marketed as causing the least loss in libido, for sure it doesn't improve it. Also, it's a company-sponsored trial, so how much to rely on is a problem. Lastly, Perindopril has never been associated with loss of libido, so your problem may be completely unrelated and so changing medication may not make that big a difference. For sure Nevibilol is heart protective but so is Perindopril. So I think your doctor would be in the best position to select which medication would be best considering your individual characteristics. 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: About 2 and a half years ago I started to have headaches and overwhelming tiredness.I was sent for an MRI and everything appeared normal. A couple of months later I started to suffer from recurrent infections and illnesses. In the last 2 years I have had many infections including:Recurrent UTIs, kidney infection, recurrent uvulitis, ear infections, recurrent thrush, lymphadenitis and cellulitis (the last 2 requiring hospitalisation). I have also had lots of viruses, colds and flu symptoms. I also suffer from a lot of sores, on my mouth and in my nose, and get lots of mouth ulcers. On a regular basis I suffer from migraines/headaches, aching limbs, neck, shoulders and backache, numbness in arms and hands, with loss of dexterity in the fingers, fatigue, skipped heart-beats and chest pain, brain fog (confusion and memory problems, sometimes slurred speech) and occasional blurred vision, occasional low grade fever, and more recently muscle twitching, spasms and cramps. I eat a healthy diet although I am unable to exercise due to chronic pain. I have put on 2 stone in 2 years but this may be due to lack of exercise and my age - 40 years. ( I am now about a stone overweight) I have also had bouts of depression, usually as a result of being so fed up of it all. I was referred to an Infectious Diseases Specialist about 18 months ago, and initially it was suggested possible CFS. She has run many blood tests to rule out things like thyroid, diabetes and HIV, and I have also had an ECG and cardiac scan. Although my blood tests are usually relatively normal (apart from when I am really ill), the one thing that does crop up almost every time is a low white blood cell count. Neutropenia and leukopenia have been noted on several occasions.I recently had another test and all was normal apart from a low absolute leukocyte count (normal range 1.5 - 4.......mine was 1.1). As yet I still dont have a diagnosis.Am I right in assuming that the reason I am always getting ill is because of the leukopenia? Or is the leukopenia a result of always being ill? Do you have any ideas of what could be the cause?Or any suggestions of a diagnosis?Or can you suggest or recommend any more tests? I would be very grateful for any assistance, thanks. ### output:

Hi! You are absolutely correct! You often get infections, and you say, On a regular basis I suffer from migraines/headaches, aching limbs, neck, shoulders and backache, numbness in arms and hands, with loss of dexterity in the fingers, fatigue, skipped heart-beats and chest pain, brain fog (confusion and memory problems, sometimes slurred speech) and occasional blurred vision, occasional low grade fever, and more recently muscle twitching, spasms and cramps...WHAT IS YOUR DIFFERENTIAL COUNT OF WBC?WHAT IS THE STATUS OF IMMUNOGLOBULINS?PLATELET COUNT NORMAL? RBC MORPHOLOGY NORMAL? I need these also, to stamp your case as king of combined immunodeficiency BUT in the same time I would like to consider bone marrow failure and try to find out its cause; bone marrow examination is a must in such cases of cyclopedias...! Therefore, I would like to see you again with these reports. 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 persistant cough for 2 years now after a about of pneumonia and bronchitis. At first I thought it is just lingering after the illness because it was a bad one. I do have asthma but no allergies. My asthma is the type where ones body produces extra mucous. I cough up white thick sticky gunk and sometimes it has a pale yellow color. I have noticed at times my voice gets hoarse, not bad but I can tell its differant at times. I have had multiply chest xrays, i have had a chest CT scan and the only thing it said in the report was this: Few upper limits normal sized mediastinal lymhph nodes slight increase in size from the Octoaber 2010 CT. I know when they run the inflamation CRP test its like around 11 something and I know the normal is below 1. No one is giving me an expanation. Could this be just my next stage of asthma or something else. my family history is my dad died at age 51 of a heart attack, My mom had her 1st heart attack at age 41 and died of congested heart failure at age 68, my half brother died at age 58. I am 50, I dont smoke, drink, i am morbidly obese and just got diagnosed with sleep apnea and RLS. I have had so many respitory illness such as bronchitis and pnuemonia I cant even begin to count. I have had 2 sinus surgeries. My cough is embarresing and I want to know why I am coughing. In 2010 I believe was the year, I received a brand new prescription that had Methascopolomine Hydrobromide in it, after 20 minutes of taking my 1st pill of this prescription I was having stroke like syptoms and ended up in the ER room and hospital overnight. A pharmacy accidently overdosed me with methascopolomine is what the ER doctor said is what happened. It was about 1 month after this episode i came down with a very bad bout of bronchitis which turned into pneumonia. Could this play into my persistent cough? I have seen several doctors over this and no one seems to care to find out the cause. Should i let it go and just deal with it or shall I keep searching for a reason. My thought was-if it is like cancer-lets nip it in the butt but so far i learned nothing. ### output:

Hi, Thanks for using Chat Doctor. With the history, it does not look like asthma. Asthma is a type of allergic reaction, presents with wheezing, breath less less with cough. I advise you to get done spirometry, as this will help you find whether you are suffering from asthma or COPD. In your case you have RLS and also may be chronic pharyngitis extending even to larynx. Your CRP shows you are being infected somewhere. Get examined by direct & indirect laryngoscopy and get done once early morning sputum (yellow color) / throat swab culture and sensitivity to treat the infection. You should reduce your weight, do regular 30 min outdoor exercises along with breathing exercises and have only required amount of calorie. Hope this answered your question. Get back with the reports and also detailed explanation on your symptoms for future discussion on your management. Consult your doctor for further examination and management. Feel free to ask me if you have any further queries. Wish you good health. Take care. 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 m Sarah I m 20 years old and I ve been experiencing seizure like activity and I went to the Er multiple times and they called the neurologist down to consult with me and see what s going on So he order a CT Scan Of My Head. The CT Scan of my head Came Back Normal And He said that I wasn t having true seizures and that my brain was just stressed out and I need to go get help from my psychiatrist and sent me home. Three days later I came back to the same er for the same thing again but this time they wouldn t stop and didn t recover from them. So the same neurologist saw me and he did another CT scan of my head and it came back normal and be told me that I need to stop coming to the er because I m not having true seizures and sent me home so I just stop coming to the er for my SEIZURES unless hurt my head or substain any other injuries to any other parts of my body. So a month later on 08-3-17 I had a seizure and I was out and about with my grandpa so be called 911 and met them their at the Hospital. So I had two SEIZURES in the back of the ambulance before I arrived at the er they gave me versed to stop my seizures and it for about 3hours. I got to the er they checked me in and took my vitals and everything bout 3mintues after my intake I had 6 SEIZURES they gave me Ativan to stop my SEIZURES it worked bout for 2 hours then I started having more Seizures so they admitted to the neuro unit for further evaluation and testing. My 3rd day their they did an 1hour V-EEG Test and it came back negative so they ruled out epilepsy. So they looked back at my history and saw that I have a Psychiatric history so they based my diagnosis off of that so they Diagnosed Me With Psychogenic NonEpileptic Seizures. But the thing is I continue to have SEIZURES where I m very confused post itcal foam at the mouth and loose BLADDER CONTROL and every time I go to the er they say my SEIZURES are fake and not real SEIZURES and I need to stop FAKING and grow up But I m not FAKING so I stopped coming to the er again. So i recently just started my JR. Year of high school and i continue to have SEIZURES at school. My school sent me to the er 4 times and I told them u didn t need to go but they sent me anyway so the hospital doctors are getting tired and mad at me for coming to the er for my SEIZURES. So my school says I can t come back to school until i am medically cleared by my neurologist to come back to school. I don t know what to do because I m still having seizures. ### output:

Hi, I can't blame your school, either the ER doctors since they have a written neurological opinion that yours aren't seizures. If you are convinced that you have seizures then you should seek a second neurological opinion. Another EEG must be obtained. A single EEG may miss on epileptic activity, but it is unlikely that repeat EEG's miss epileptiform activity. If repeat EEG's turn out normal (or even more conclusively if the EEG is obtained during the seizure, and it shows no epileptic discharges) then I am afraid that psychogenic origin must be accepted, and you should consult a psychiatrist for management. 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 had severe pain in my back spine and lower waste.the orto doc.gave several medicine including cartigen 1500 and injection for nerves strengthening .But my physician advises not to take cartgen as bones will be effected n deshaped in the long run . Please advise ? As finally after my pet scan and MRI TEST every thing found o.k. In my report except the B 12 level / vitamin is above 2000 count is found which caused me pain in my whole leg I.e. From thigh to feet as whole .Please suggest whether I should stop cartgen . ### output:

Hi welcome to ChatDoctorI gone through your query regarding your lower back pain & its department . It is matter of concern. Regarding cart gen, Would like to suggest you, not to stop or start any medication without you doctors advice 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. For your info Every day, we are bombarded with toxins in our environment and in our food which is why detoxification is such a critical process in your body & weakened immunity. If the detox process is hindered, toxins will build up in your body eventually causing acidity and toxemia. These are the root causes of nearly all diseases, requiring modification of lifestyle and food habits. Gulping on only medicines will not help if you don't modify your lifestyle and food habits. By following some simple steps, you can be back in the swing of things in just a few days. Slow motion action is permitted till the problem persists. There is no better option than physical exercise. Walking is the best exercise to begin with also gives you well shaped body. 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. Slow motion action is permitted till the problem persists. There is no better option than physical exercise. Walking is the best exercise to begin with also gives you well shaped body. 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 Sandeep 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 .will produce biochemical and metabolic conditions in your body that will decrease your immunity, so avoiding is definitely the first step in the right direction to detoxing the body, boosting the immune system. All are the pillars of our strong immune system responsible for healthy disease free life. Always remember, if pain is severe or incapacitating, please see your doctor / professional 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: Hello.....Women on both of my parents sides have had breast cancer for years, and on my Dads side, cancer runs very high....my Dad just passed away from brain cancer, and his two sisters have had breast cancer, only 1 of them died from it. My mom gets benign breast cysts all the time. Also, my maternal grandmother has just been getting treatment for uterine cancer. Are my chances very high of getting some form of cancer? Should I get a DNA test done? ### output:

Hi Welcome to ChatDoctorI have gone through you query and found your concern about chances of getting some form of cancer? Dear, It is not mandatory that if someone has family history of cancer ought to get infected. Chances can be there. You have to have stronger immune system to be free of the disease. You have to be aware of the fact that everyone has cancer cells in their body, so why does one person never get diagnosed with cancer and another person is diagnosed with cancer? Because ---Nasty microbes and parasites get inside the organs and make their homes there. The cells in the organ become weak due to the activity 0f microbes and weaken the immune system & cause growth of cancer cells indiscriminately, The cancer will not come back as long as the patient watches their diet and strengthen their immune system, so that it can fight out the microbes and parasites causing cancer or other diseases. If you think you may be at risk for cancer, you should discuss this concern with your doctor. You may want to ask about reducing your risk and about a schedule for checkups. Meanwhile, for your IMU system I would like to suggest you to Adopt regularity in your lifestyle. --Simple, healthy nutritious food including more of fibers, proteins, vitamins & minerals than starches like rice, potatoes. Also avoid tea, coffee, alcohol fried and fast foods PROPER regular EXERCISE, WALK, YOGA, pranayam-deep breathing proper rest HELP YOU TO STRENGTHEN YOUR IMMUNE SYSTEM and help you lead disease free life. Turmeric powder a Spoon with a cup of hot milk before bedtime help many types of bacteria under control. A Spoon of fenugreek seed powder with water in the morning to control sugar level. Antioxidants like raw garlic, ginger, onion in every meal. Use of lemon in water before meals and butter milk in lunch help the body keep going Mixture of extract of Lemon, Garlic, Ginger, Vinegar of Coconut water Bark of Maringá tree & Homey , Take 25-35 ml for 21 days to 41 days , with equal amount of water for 3-4 days and pure mixture for rest of the days.PROPER regular EXERCISE, WALK, YOGA, pranayam-deep breathing proper rest HELP YOU TO STRENGTHEN YOUR IMMUNE SYSTEM and help you lead disease free life. All the above is full of antioxidants having no side effects giving you immunity to live life without such disease and can go with any therapy. Condition is to be regular with this regime. You can advise this regimen also to your mom , grand mom or anybody who is undergoing treatment to save them from recurrence of the disease by STRENGTHENING THEIR IMMUNE SYSTEM. Hope this helps solve your query. If you have any doubt pls mail at Chat Doctor. compare 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: had vomiting 2-13-2014 could keep nothing down, went to local family doctor, he gave me a shot of ondansetron. Then developed extremely bad cough, earth shattering, seems like that flu with cough was really effecing nw ohio. So then doctor gave me Z-pack (zithromycin), and predisone for cough 10 pills to take 2x a day for 5 days. I felt terrible, grumpy, could not sleep, words can not describe how bad I felt. I only took 7.5 of the predisone. I had a vacation of which was scheduled in January and never thought this flu would last this long, I back in oct 2013 had flu shot. So 3-21-2014 I went to local emergency room, thinking I could get codine cough syrup...but NO.............er doctor told me an x-ray was in place, it showed a couple blood spots. Upon entering er if was immediately put on wrist bands with allergy alert and of course identification, the allergy was sulfa and pennecillin. er doctor on call, not one of our regular ones, ask if I was allergic to anything I informed her as stated above affirmative. Well she insisted on amoxicillin, and I had informed her 40 years ago I broke out form amoxicillin. I should have walked out of er, but she said that before I leave I was going to take l amoxicillin. I had a terrible reaction in am aprox 8 hrs later, hands 4X size and red, I called er they told me to either come in or they would call family doctor. Doctor called me asap, told me to proceed with vacation, and take 12.5 childrens benedryl. 2 days later, ankles swelled up, rapid heart beat, short of breath, and both legs knees down beet red. Got thru 5 days, only to see my former family doctor with family boarding airplane, for I was short of breath and so thankful he was there. Two days later, I broke out on chest and back, mind u 10 calendar days after amoxicillin. So went to former doctor and got another x-ray, and cortisone shot . the rash went away. however went to get chest x-ray today and findings ....The mediastinum is unremarkable. The cardiac silhouette is enlarged. Perihilar vascular congestion is seenbilaterally. Small bilateral pleural effusions are noted. Impression: Congestive heart failure. Could you advise me of your opinion ....I have appointment scheduled on tues. of next week with doctor who ordered last x-ray. thank you ### output:

Having gone through all the information you have provided, I would have advised, to my own patients, to get support of anti-allergic herbals which will not only enhance your immunity but would also correct the problem. This herbal medicine do not have interaction with any other Chat Doctor. However, we give some gap between allopatry and herbals. For more open discussion to make decision to opt for Ayurvedic herbals in your own interest, please converse through direct question. In my clinical career of three decades, many complicated allergies have been solved by simple means and principles of Ayurveda. If you agree, please make sure you will abide by dos and don'ts of food protocols (simple ones) while taking Ayurveda medicine as advised by me or for such reason by any Ayurveda doctor. Hope it helps. Please write direct question.

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 AGE IS 26.I WAS DIAGNOSED WITH HYPERTENSION.MY BP IS 160/100.THEN I CONSULTED WITH A CARDIOLOGIST. THEN HE PRESCRIBED TWO MEDICINE,HOPACE H 5 & NODON 5MG PER DAY.SO THAT TIME I HAD SOME CHEST PAIN,SOME TIMES PAIN IN LEFT HAND,NECK & LEFT SHOULDER. THAT TIME DOCTOR CHECKED MY LIPID PROFILE,URINE ROUTINE TEST,SUGAR LEVEL,ECG & TMT. BUT IN REPORT ALL THINGS ARE NORMAL.THEN HE TESTED MY HEART ECHO TEST,EF VALUE WAS 62% AND ALL VALVES ARE WORKING PROPERLY. BUT STILL I AM HAVING SOME CHEST PAIN THEN RECENTLY I CONSULT WITH ONE MORE DOCTOR. NOE HE CHANGED MY TABLET TO OLMEZEST BETA 20/25,ALPRAX.25 PER DAY. THEN FOR LEFT HAND PAIN & NECK PAIN I CONSULTED WITH ORTHO DOCTOR & HE TOOK MY CT FOR NECK & BOTH SHOULDRES, HE IS TELLING MY NECK HAVING PROBLEM WITH CERVICAL SPONDYLOSIS. DOCTOR ONE YEAR BACK MY WEIGHT WAS 96KG &WEIGHT 175CM. SO NOW I REDUCED MY WEIGHT TO 78KG. THEN FOR MY CHEST PAIN I CONSULTED WITH A CHEST PHYSICIAN, HE CHECKED MY LUNGS,CHEST DEEPLY.BUT DOCTOR TELLING THAT ITS A ATYPICAL CHEST PAIN.DOCTOR NOW BY BLOOD PRESSURE IS 110/70mmhg.sugar level before food 80& after food it is 90.MY CARDIOLOGIST DOCTOR TESTED MY KIDNEY FUNCTION AND VERIFIED THAT BOTH KIDNIES ARE WORKING PROPERLY. DOCTOR MY WORK NATURE IS SERVICING OF MEDICAL EQUIPMENT,IAM A BIO MEDICAL ENGINEER & DAILY IAM TAKING A SHOULDER BAG WITH A WEIGHT OF 9 KG.AND IAM TRAVELLING MINIMUM 200KM PER DAY.SO PLEASE GIVE A EXACT ANSWER FOR MY CHEST PAIN & BLOOD PRESSURE ### output:

Hello, It can be a gastritis and reflux problem leading pain in chest. Do you have any bloating, burping, upper abdominal pain, nausea associated, if yes it further supports the diagnosis? You should avoid spicy and fatty food, avoid smoking, alcohol if any and have some antacid like pantoprazole. Does this pain increase on pressing the chest, if yes it supports musculoskeletal pain as a cause of chest pain. If yes you need some NSAIDs like Ibuprofen and Diclofenac gel for local application. 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 developed a lump on the side of my gum the size of a pea the last two days which is hard and painful. Should I be concerned? I tried to squeeze it but have irritated it. Should I be concerned? My grandfather had jaw cancer from smoking. and had part of his jaw removed and has since passed. I am not a smoker. ### output:

Any bump in the mouth is of concern. Inflamed tissue can require simple treatment such as a cleaning or be an indication of a more severe condition such as a cancer. A visit to the dentist for an exam and cleaning or a limited exam with a possible X-ray of that location is advised. Suggest you rinse area and gentle dental care. Avoid area when chewing with a soft diet. Anti-inflammatory medication may help. Common conditions:Inflamed gums-Swollen, red tissue, sensitive, tender. Action required professional cleaning, plaque and tartar removal, evaluation of periodontal health. Irritation under gums - swelling, pain, broken tooth under gum, something caught between teeth, periodontal abscess. Dental cleaning with numbing under gum, remove object, possible medications include anti-inflammatory, pain and antibiotic, rinsing. Exotosis, Tori or excess Fibrous tissue - hard bump, not moveable becomes sensitive if subject to trauma. Thin tissue covering bone is prone irritation. Treat with warm salt water rinsing, avoid area, non-irritating diet. Allow time to heal. No action required and may have been present prior just never noticed. Condition is just extra normal tissue. Only concern if distinct, abrupt change or interfere with daily function or dental treatment planned. Infection - swelling localized to a tooth may develop from bottom of the root. Pain from pressure and spread of infection is common. Tooth can be very sensitive to pressure. Bubble on gum with tract from tooth may develop and release pus. Action by dentist may include Chat Doctor. Anti-inflammatory medications helpful to reduce discomfort. Infection - swelling large with hard feeling tissue may be prone to spreading to face and neck. It can indicate a systemic reaction that can become severe. It may still be a reaction to a single tooth that requires antibiotic treatment, but you need to control the spread of the infection. Seek Emergency Room care if dental office is not available. Stronger anti-inflammatory medications may be required. Cancer - bumps, sores, pain, areas that do not heal with irregular borders, history of smoking, chewing tobacco, high alcohol beverage consumer, family illness history all can be signs of concern. Certain locations are of greater concern. Further testing can include a biopsy and referral to a specialist. Ulcerated areas can often be viral and need a short time to heal while patient can rinse, avoid area, and keep to a non-irritating diet. Biting your tongue or cheek can also cause bumps. Healing time and rinsing area again will help this condition to resolve. A dental exam is recommended if questionable areas are noticed in the mouth. In my office, I commonly see teeth with infections causing swelling. The initial complaint is often described as a lump on the gum. If the area is moveable and does not appear to be attached to the bone, it is often the initial stage of an infection starting to spread. Schedule a dental visit to put your mind at ease and prevent your condition from getting worse. Hope you feel better 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: I am a 64-yo female with longstanding PMH of hypertension (28 years), well controlled on meds for the most part. I was diagnosed with diabetes in 11/2010, having been intermittently symptomatic for at least 3 years prior. Since DX, A1c levels have trended down from 7.0 to current level of 5.8, taking metformin and with dietary changes. Chronic depression/anxiety/stress of 20+ years is also adequately controlled with meds, but has been subject to ongoing unemployment woes since 11/2009 and consequential financial problems. Over the past 2 years I have noticed initially subtle, now gradually progressive mental status changes such as loss of focus and concentration, cognitive deficits affecting thinking, reasoning, decision-making and memory , plus mild expressive and receptive dysphasia signs. I asked my FP/PCP to order a brain scan w/wo contrast. The results I received last week are as follows: 1. Scattered nonspecific punctate bilateral frontal, bilateral parietal and left subinsular white matter T2/FLAIR hyperintensities may represent chronic microvascular ischemic changes, described in the impression as supratentorial and age-appropriate. 2. Bilateral old lentiform nuclei lacunar infarcts, the extent of which was not described. Having been a medical transcriptionist for 30+ years, I ve read a bit about both findings, and am vaguely familiar with the functions of these cerebral regions and the described processes, but I have two questions. I am assuming that either or both conditions are contributing to the mental status changes....particularly the bilateral lacunar infarcts. I originally thought these symptoms were attributable to chronic depression/anxiety/stress and the unemployment/financial problems. In your opinion, am I over-reacting to this news by making that assumption? Also, in view of these newly diagnosed deficits, would it be beneficial for me to consult with a neuropsychiatrist? I am asking because I am planning to seek counseling/ therapy for these problems since I need to re-enter the workforce. I am wondering if and how these conditions change the therapeutic approach. Specifically, I believe tests to evaluate the degree of cognitive deficits is in order, as it would stand to reason they would impact the modalities used in a therapeutic treatment plan. Any insight you can offer would be greatly appreciated. ### output:

Hello, I have noted all your complaints, imaging data. The imaging findings that you have can be seen in patients with high blood pressure and diabetes. The infarcts that you have described is also seen in patients with these problems. The most important thing to note is that whether you had any stroke in the past or not. People with high BP and diabetes can have these MRI changes without much problem also. So it is unwise to interpret this data without any clinical correlation. Regarding the cognitive problems as well as anxiety etc., this may represent a type of executive dysfunction which may/may not have relation with the current MRI findings. Interestingly some people can have both depression/anxiety and cognitive problem due to organic disease. Please undergo a joint evaluation by a neuropsychiatric, clinical neurologist as well as by a psychiatrist. Their clinical evaluation will tell us if you have any organic cognitive problem or not so that we can plan our treatment accordingly. Hope this helps

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 really worried that I have golden staoh/msra and that i am going to transmit it and cause someone a lifethreatening illness that could eventuate in death. My father is in a aged care facility and on a recent stay in hospital was found to have golden staph. The doctor said that everyone can carry golden staph from time to time. I went to visit him a few time since on the last visit we were given now contact precautions by the staff. I cleaned my hands when arriving but cannot remember doing so on leaving.I have read since how serious this can be and I am worried that I may have become colonized by the bacteria even though I have no evidence to suggest it. i have read where it can live in the nose and now I am afraid to rub and touch my nose as I am afraid that I will spread the bacteria to someone vunerable. Would that be possible or would you have to insert your fingers into the nostril where the bacteria is located? Does every one have it in their nose or only those colonized in that area? or is to do with the bacterial count in a particular area? I see lots of people rubbing and touching as well as picking their noses with no intentions of washing their hands, if it was such a risk why wouldnt there be health alerts.Other members of my family do not seem to be too concerned and said you shouldnt worry unless there is evidence that I may be colonized, but they havent read what I have read and what the consequences could be if you were carrying it and infected someone unknowingly.I have always been concerned with hygiene, but now I know this is lurking everywhere I find I am constantly aware and becoming obsessive about it as we are told to constantly wash our hands to avoid it. I am worried I will be somewhere without the facility to wash after I have touched something that could be contaiminated I know you can us e antibacterial wipes or gel but you would also contaminate your purse delving for them. Should I take my families advice and just use normal hygiene procedures as before until proven that I am indeed colonized or should I be over cautious and assume that I may be colonized. Is the rationale behind hand washing to do with reducing overload of bacterial counts? Is infection dependant on bacterial count as well? ### output:

K so let me tell you about what have mentioned as golden staph/MRSA (Methicillin Resistant Staphylococcus aureus). Staphylococcus aureus is a bacterium and is capable of causing mild to severe life-threatening infections. Initially it was susceptible to penicillin that is it could be killed by it but over a period of time it has acquired the property of not getting killed by penicillin that is it has become resistant. This property of acquiring resistance by organisms to various antibiotics is a cause of concern worldwide as infection caused by such organisms is difficult to treat. Hence, measures to control the spread of such organisms is followed worldwide. MRSA is one such bacteria which is resistant to many antibiotics including Methicillin and oxacillin restricting treatment options. MRSA carriage is seen in anterior nears commonly. So if you want screen yourself for MRSA carriage, do a culture sensitivity for MRSA screen from anterior nears. If its positive you have to use mupirocin ointment in your nostrils thrice a day for 5 days. Following this do a MRSA Screen again to make sure that its gone. We should definitely think about 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 father is 75 years old and on dialysis s both of kidneys of him are not functioning well. He has been diabetic patient for last 38 years. He is CRF ans presently the frequency of dialysis is biweekly. I want to know: 1. What should be the preferred frequency of dialysis. 2.Whether dialysis can be termed as good ao bad based on some criteria. 3.What should be the levels of creatinine and urea just after dialysis. 4. How much reduction in creatinine and urea is expacted in single attempt of dialysis. 5. What are the chances of reduction of frequecny of dialysis for such patient. 6.WHether some other treatment ( Ayurvedic, Homeopathic etc) shouldbe taken along with Allopathy. 7. Whether this diseases can be cured in allopathy. ### output:

As per history the condition is presumed to be End stage renal disease with Diabetic Nephropathy on Biweekly dialysis. Chronic renal failure (CRF) requiring dialysis or transplantation is known as end-stage renal disease (ESD). 1) The preferred frequency of dialysis depends on the blood urea and creatinine levels. If the Glomerular Filtration Rate falls to less than ~20% of normal, symptoms of uremia may begin to occur. They almost are invariably present when the GFR decreases to less than 10% of normal. If these values are on a higher range, dialysis frequency may be more. If its moderate then the frequency reduces. 2). Since dialysis does what is supposed to be done by kidneys(an essential organ for disposing waste), it is more a good than seeing bad in it. 3) As it is the problem of CRF the levels can't come to normal or subnormal, maximum reduction in creatinine and blood urea levels should be tried at each session without interrupting the comfort of the patient. 4) The reduction of creatinine and urea after dialysis depends on the pre dialysis creatinine and urea levels, the nephrologist takes the final decision on this, even if the values are on a higher range.5) Allopatry medicine never recommends ayurvedic and homeopathic treatment. 6) The disease cant be cured as it's damage to both kidneys, kidney transplantation is the other option. The problems are age of the patient, availability of donors to donate kidney, the transplantation surgery after that, complications of transplanted kidney. To summarize, Dialysis is the longer, the better, the slower, the better, more often the better, the gentler, the better. Let me give few good medical tips regarding diet for CRF patients on dialysis. Dieticians consult is crucial.a) The diet should maintain a balance of electrolytes, minerals, and fluid in patients who are on dialysis. b) Diet includes high in protein and low in sodium, potassium, and phosphorus. c) Fluid intake is also restricted’d) Before dialysis, you may be asked to limit protein to slow the progression of kidney disease. At the start of dialysis, you will need much more protein. Many patients need to take vitamin supplements. e) Diet alone can usually meet the requirements for the fat-soluble vitamins (A, D, E, and K). Vitamin D may be supplemented, depending on your calcium, phosphorus, and parathyroid hormone levels.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been having the simular problem my circumvallate papillae & Foliate papillae hveboth swollen for over a year. I was told it was thrush and have been treated three times for thrush have been tested three time for herpes(HSV), siphis,HPV, cancer,liver ,kidneys, HIV i had her test everything all negitive results my doctor said my immune system is low though. I have rinsed with salt water sucked on pieces of garlic, probiotics, vinagar i have tried everything i could!! they well not go away! I smoke about 10 smokes a day i drink coffee constantly with international delight creamers and have noticed that by the second cup my throat starts to hurt or feel irritated of i drink coffee with just milk and sugar it doesnt seem to bother me at all. when i brush my tongue there are little white pieces or tabs of skin on my tongue after. before i brush everyday my tongue has a film some is yellow brownish from smoking and where my circumvallate papillae is where it looks thrush like. I also think the are ulcers in my throat it seem like it my tonsils that hurt and if i stop drinking coffe and switch to jucie pop or water my throat doesnt bother me at all.Its just not going away. I also have had issues with my skin breakout everywhere that according to my doctor may be gluten but it is mostly my lower legs,face(nose),back of upper arms and hips these are bumps dry skin, blood blisters some heal in two day others stay for months i hive when i use expholiating stuff or anything oil of olay(posion) causes me to hive.and it all seem to be some thing to do with my folicals i think. anyway my doctor sent me to a dermy for my skin and she gave me six months precription of NU-DOXYCYCLINE Yes this is the same thing they use for some stds for you that want to jump the gun i well repeat have been tested 3 times in the past year not to mention once a year every year before that. and have had the same partner for the past year who also has nothing cause he was at the doctor about two weeks ago and my last appointment was just this past january. Anyway the NU-DOXYCYCLINE seems to be clearing the skin issues and seemed like it was clearing what is happening in my mouth but it has been a month im on my second month of the meds and it seems like its healing my mouth too but really slowly. i am going back to my doctor agian soon see if she thinks i need more oral thrush meds don t know what else to do I also have noticed fruits like peaches pinnapples and strawberries tend cause me to feel like i am sweating in my t zone mostly right between the eyes where my nose meets up at the forehead don t know if this is connected. ### output:

Hello Dear. First you reduce smoking and also the number of beverages per day. Brush twice daily. Eat a lot of citrus fruits which are rich in it c like oranges, Red peppers, Brussels sprouts, Broccoli, Strawberries, Grapefruit, Guava. In addition to it, you can apply candid mouth paint inside your mouth around the sore areas three times a day. Avoid Chat Doctor. Sweating around the T zone may not be anything related. May be just a normal phenomenon. Kindly follow these things till you meet your doctor. Hope I have answered your question. Feel free to contact me if you have any more questions. I'll be glad to help you. All the besting warm 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: SIR WE HAVE DONE FOLLOWING TESTS (CASE HISTORY) PATIENT NAME-PREMALATA BISWAL,AGE -76 YRS,(FEMALE)HAVING LONG STANDING DIEBETIC TYPE-2,COMPLAINED ABT ASCITIC FLUID RETENTION.1ST WE DID U S OF ABDOMEN & PELVIS .RESULT OR IMPRESSION:CHRONIC MEDICAL RENAL DISEASE GRADE -III,MILD SPLENOMEGALY ,MILD TO MODERATE ASCITES ,THEN WE DID FLUID EXAMINATION-FLUID EXAMINATION(22.09.2012) : SPECIMEN-ASCITIC FLUID,COLOR-PALW YELLOW,VOLUME-08 ML,CLOT-NIL,SUGAR(GLUCOSE)-1588 MG/DL,PROTEIN-1.2MG/DL, ADENOSINE DEAMINASE ACTIVITY-08 U/L,GRAM STAIN-NO BACTERIA SEEN,Z.N STAIN OF AFB-NEGATIVE,CYTOLOGY TOTAL COUNT-225 CELLS/CUMM,DIFFERENTIAL COUNT:CYTOSMEAR FROM CENTRIFUGED DEPOSITS SHOWS: LYMPHOCYTES-70%,MESOTHELIAL CELL-25%,POLYMORPHS-5%,NO MALIGNANT CELL SEEN.AFTER WE DID CA 125,RESULTS 42.00 U/ML,CA-19.9 RESULTS-126.91 U/ML,AFTER THIS WE PERFORMED PLAIN & CONTRAST(BOTH ORAL & IV)ENHANCED CT SCAN OF WHOLE (29.09.2012)ABDOMEN,IMPRESSION:FEATURES ARE SUGGESTIVE OF 1)MODERATE ASCITES,2)MILD THICKENED ANTERO-PYELORIC WALL OF STOMACH,3)RIGHT RENAL CYST.4)MINIMAL RIGHT SIDE PLEURAL EFFUSION.SUGGESTED :UPPER GI ENDOSCOPY.AFTER THIS WE DID ENDOSCOPY ON 30.09.12 IMPRESSION- FEATURES OF GASTRO-DUODENITIS.KINDLY SUGGEST WHAT TO DO? ### output:

Her ultrasound findings are suggestive of chronic kidney disease (CKD) however there are many tests which are needed to confirm it.1) Hemoglobin and CBC2) Kidney Function Tests3) Urine routine and 24 hours urinary proteins4) HbA1c levels5) ECG6) EchocardilographyAlso the sugar levels in ascetic fluid are very high indicating that her diabetes is uncontrolled. Accumulation of fluid in abdomen can be a part of diabetic kidney disease as well as of associated heart disease. All these reports are required to know that. Meanwhile, she should reduce her sugar, salt and water intake and take medicines like Las ix or Dy tor if not taking already. Should get in touch of a nephrologist in your city.

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 17 years old. I have major depressive disorder. I get headaches almost everyday (not my eyesight). I am ALWAYS tired. I do have a history of anemia but whenever I get blood tests now my iron level is fine. I also used to have low blood pressure but that is also fine now too. I am taking pristiq (for my depression). Ive been on it for almost a year now. i used to take iron pills and I currently also take birth control to regulate my periods. Recently (for the past month) every time i stand up and start walking I cannot see for a second or so and then i can only see through the centre of my eye for another next few seconds (the perimeter of my vision is black). my eyesight is very unfocused and i get very dizzy everytime i stand up. it focuses and im fine after about 5-7 seconds. Another problem I have (and have been having for years now) is trouble breathing. Every second of the day I feel like something is in my chest and throat blocking my breathing. I take a deep breath every minute or so and that lasts me till the next deep breath. i dont know if that makes sense or is even possible since im still alive but my mum doesnt really take me seriously. however, im constantly having breathing problems, heart aches and my doctor says its because of depression. i literally feel like my throat is blocking air from going in and coming out but i know its obviously not. I am tired all 24 hours of the day and i have no motivation to study for university, no energy and no concentration. whenever i try to concentrate my head hurts (I learnt that after trying a concentration meditation exercise. it just made my head hurt and didnt help my breathing). thanks. sorry for the long message.. ### output:

! I have read your question carefully, and must say that it is very well written. From what you wrote and from my clinical experience, I can say that you have symptoms of lethargy, depression, breathing problems (most probably due to anxiety), visual problems. You used to be anemic but now fine. Now, according to me - you have two sets of problems ---1. Psychological and 2. Organic. The psychological or psychiatric illness looks like combination of anxiety and depression. You have been on desvenalafaxine (prestige) but looking at your symptom profile, I must say that it is not working at all. Had I been treating you, I would have gone for some other Chat Doctor. ...there are many better and effective choices available, which also donor carry any major side effect. Second problem is organic / physical problem. It looks like that you have postural hypotension, as you feel almost black out, dizziness occasionally, and weak. Every time you get up, you take few minutes to gain some balance. You need to get some test done like-blood pressure reading both sitting and lying down position, thyroid, hemoglobin. They would check the cause behind this symptom. Your breathing difficulty and heart aches is actually due to psychiatric problems, as your doctor says. I can understand that you really problem in breathing and you feel choked, but it has a psychological basis rather than physical one. Such breathing problems are frequently seen in such patients in our clinic. With proper medicine this will certainly go away. ### You could not proceed with medication as it needs a silent state of mind, and it is not concentrating on something.....meditation is relaxing....when you have so many issues, you have breathing difficulty, etc., how can you relax? This result in strained meditation and there is headache....ok, so first get better with

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 Anneli. Ill just explain shortly whats troubling me and i hope that you will be able to give me your opinion of what should i do about it. About a month and few weeks ago i got infected with the ringworm. First i had a little itchy spot on one side of my body just below breast, i wasnt sure what was it until it developed and looked like a big ring. I went to doctor and was advised to use anti-fungal cream Lamisil, it didnt go away but spread. So all my neck was infected, full of smaller rings, they developed kinda differently though, as i could see the light reddish/pink ring from start, not a spot. Gone back to doctor and got another cream, Daktacort and travocort cream, it stopped the existing ringworms growing but after 3 weeks , all my body is infected by the ringworm. As is my boyfriends, but he seems to have it less. After closer looking (as i know by now what im looking) most of his arms and back is full of flaky rashes..Its wierd that on his skin they wont be as classic ringworm looking, more like batches of flaky skin, they only appear as ring-shaped rashes after the shower, so its really easy to miss them and to show doctor. Now my hands are affected with small tiny rings, hard to see @ first, once ive applied cream to them( they are red at first, but then change to darker rings after) but they still wont go away and never stopped spreading. My head is itching as well, so i quess my scalp is infected as well. My doctor havent prescribed anything else then creams, but the truth is that one 30 gr ( thats the normal size for those creams or smaller) will be gone within a day as its now developed all over my body. After so long time creaming my self and boyfriend its getting very frustrating, time consuming and expensive. One big point i wanna make is that, ive seen them flaky batches on my boyfriend since i met him, and they were only pinky looking after shower, could he be a carrier, like i said the symptoms are rather lighter on him? barely unnoticeable until after shower. Its most of his body just have to look really close... are we wasting the time with cream? my doctor seems to have a very little knowledge about it, and hopes to see the classic big ringworm what i have on the side and on my neck, missing all other body parts as they are so small ringworms and like i said applying cream kinda stops them, but not really, they still remain just wont grow bigger, and look darker and harder to notice, so hes not convinced that anything else is needed to treat the infection but cream, but 1 and half month and my body is fully infected. Should i ask him a bit more aggressive treatment? I know that my writing is kinda long, so im sorry, but id really appreciate your honest opinion. Thanks in advance ### output:

Hi Annelid, Thanks for writing in Chat Doctor. The condition can be dermatophytes, satyriasis tricolor etc. Diagnosis cannot be made without visual clue. Your boyfriend can in fact be carrier of organism. Both of you should be treated with oral antifungals for complete cure rather than only topical creams. A visit to dermatologist will confirm the diagnosis. Till the time you can take tab. Cetirizine 10 mg twice daily. It will decrease itching. Hope this helps. Regards Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I m 5 4 and 24 years old..according to my age and height, I just found out I should have a weight of 150lbs and BMI between 20-25, with 18.5 being the lowest (or so I m told). HOWEVER, I weight about 104 pounds (47kg) and have probably seen 117lbs as my MAX weight ever. BMI is 18.13 now. I m down to 1 light meal a day, and have been like that for 6-8 months or so. I do not eat my greens nor meat..have even cut out chicken over the past 4 months. Generally survive on mini snacks, frozen food, or junk food. I went for blood tests in October, and I was told I have iron deficient anemia. I was at level 7 or 9 with my iron stores, should be at 12 minimum. I was given iron pills to take twice daily (Feramax 150) but I ve rarely been taking them (I forget!). I do not take or have ever been on birth control. Lately, I ve been noticing my nail are blue-ish purple and I generally DO NOT get hungry or am not motivated enough to eat at all. My meals have been as big as my snacks used to be in the past. I have been stressed lately and emotional too, dealing with anxiety (usually want to crawl away and hide, or sometimes forget how to breath and have to force myself) and haven t had motivation or inspiration to live..been looking for a reason to live at the moment and find meaning to life...still getting there slowly... This month I did not FEEL like I was getting my period (no feeling, no cramp, nothing). I had unprotective sex when I was 1 day overdue my period. He pulled out, and did not *** inside me. I worried about the sperms in the precum from foreplay. I took the Plan B after 18 hours of sex. I still have had no spotting, nor any cramps at all. It s been 2 full days since the unprotective sex, and 3 days overdue on my period. I usually always get my period on time, with a 26-28 day cycle. I had a 37 day cycle two months ago and last month was 25 day cycle. I ve taken the Plan B once before in September. Could it be that I generally just missed my period? What s the likelihood of getting pregnant when you re a day late on period with iron deficient anemia and possibly being anorexic, and he pulled out? Should I be worried? What should I do? ### output:

Hello, Thanks for your query. Without adequate iron, the body is unable to produce normal red blood cells. In young women, iron deficiency anemia can result from heavy menstrual bleeding. Non-menstruating women or men who develop iron deficiency need to have a colon exam to help identify the source of chronic bleeding. With iron deficiency anemia, your doctor will probably recommend iron supplements that contain the ferrous form of iron, which your body can absorb easily. If you use iron supplements, remember the following cautions:Always consult with your doctor before taking iron supplements. Iron supplements -- like all supplements and any medication -- should be kept out of the reach of child Chat Doctor. Taking iron supplements with food can help prevent common side effects, which may include nausea, diarrhea, constipation, and stomach pain. Watch for

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 m Michael, my question is I work at a powder coating plant, here in the past few weeks I have broken out really bad all over my face and body.and with that I also swell on my face, arms and legs.and my throat. And itch really bad all over what can this be. ### output:

Hi sir/madam, Thanks for your question on Chat Doctor. Home Remedies for Rashes:-1. Apple Cider Vinegar:-Raw and organic apple cider vinegar is another excellent home remedy to treat skin rashes and calm the itching. Moreover, its acetic acid content helps fight skin infections that could be causing or aggravating the problem. Dip a cotton ball in apple cider vinegar and place it on the affected area. Leave it on for a few minutes, and then remove the cotton ball. Do this several times a day for a few days or until your rash clears. Note: If apple cider vinegar causes irritation, try diluting it with water before applying it. If the irritation persists, then try another remedy.2. Cold Compress:-A cold compress can be beneficial in reducing rashes, especially those caused by heat, insect bites, poison ivy and shingles. It helps ease itching, swelling and inflammation, and can be particularly useful if a rash begins to develop into blisters. Put ice cubes in a sealed plastic bag and place it on the affected area for a few minutes. Repeat a few times daily for a few days. Alternatively, you can simply soak a clean washcloth in ice-cold water and place it on the rash for about 10 minutes.(Do not put ice cubes directly on the skin)3. Aloe Vera:-Due to its anti-inflammatory, emollient, antibacterial and antifungal properties, aloe vera is excellent for treating a number of skin ailments including rashes. Apart from healing, it also soothes the skin, relieves itching and reduces redness. Extract fresh aloe vera gel from an aloe leaf. Apply it on the affected area. Leave it on for at least 20 minutes, and then rinse it off. Do this at least three times a day until the rash clears.4. Oatmeal:-Oatmeal is great for alleviating skin irritation and inflammation due to its soothing and anti-inflammatory properties. It is excellent for rashes caused by poison ivy, eczema, sunburn, chicken pox and allergies. Grind oatmeal in a blender, food processor or coffee grinder. Mix one cup of finely ground oatmeal in warm bath water. Soak in it for at least 15 or 20 minutes. Do this daily until the rash is gone. Alternatively, combine one-half cup of oatmeal, one-quarter cup of milk powder and two teaspoons of honey. Put this mixture in a muslin cloth, tie it strongly with a string, ribbon or rubber band, and place it in a bath tub filled with warm water. Soak in the milky bath water for at least 15 minutes. Finally, pat Chat Doctor. Repeat daily for a few days. For rashes on your face, apply a thick paste of equal amounts of oatmeal and plain yogurt mixed with a little honey. Leave it on for about half an hour before washing it off. Do this daily until you see improvement.5. Baking Soda:-Baking soda helps

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 chronic back complaint and have been on Norspan patches for 9 years and and am reducing down to 20mg patch per week. I have taken Endone tablets for about 5 years and in December had Denervation surgey on my back. Since then I have reduced Endone tablets completely. About a week ago I had to take one a day. Now I have all the systoms of withdrawal. What can I do to help get through this WD time? ### output:

Hi welcome to ChatDoctorI have gone through your query regarding treatment for chronic back pain. I can understand your concern. Dear, back pain can occur due to many reasons, is often caused by an over exertion and weakening & over-stretching of the muscles between the shoulder blades. This is often as a result of spending too long, too often with your head in the position akin to reading a book that is on your lap. One of them is supposed to be, lack of water content in our body. It is suggested to include a lot of water in your daily regime besides all essential nutrients and supplements full of antioxidants for stronger immunity with all. It seems that your problem may be due to your inactive lifestyle and faulty food habits. For your info Every day, we are bombarded with toxins in our environment and in our food which is why detoxification is such a critical process in your body & weakened immunity. If the detox process is hindered, toxins will build up in your body eventually causing acidity and toxemia. These are the root causes of nearly all diseases, requiring modification of lifestyle and food habits. Gulping on only medicines or surgeries will not help permanently if you don't modify your lifestyle and food habits. There is no better option than physical exercise. Walking is the best exercise to begin with also gives you well shaped body. Slow motion action is permitted till the problem persists. Modification in your lifestyle, food habits -include healthy diet as fiber, vitamins minerals, cheese, milk, supplements full of antioxidants, in natural form --fruit, green veges, lemon juice with water and salt and pepper before meals, ginger, garlic, Aloe vera 30 ml, AMLA, Turmeric powder a level spoon + almond oil a Spoon with hot milk, at bedtime, with required work out ---- Regular walk, Back bending Exercises & Yoga posture, Dhanurassan, Bhujjangassan, Vajjarassan, from left to right stretching, while standing & lying on the ground, or any posture which gives you relief. Front bending not allowed. Avoid processed foods carbs, sugar, fried, fast foods, Tea, coffee, alcohol and smoking, Sleeplessness , stress and Constipation all will produce biochemical and metabolic conditions in your body that will decrease your immunity So avoiding is definitely the first step in the right direction to detoxing the body, boosting the immune system and for resistance from diseases . Take Homeopathic Arica 30 dose in the evening and Chamomile 30 / 1 dose at bedtime. Nux Com 30 / 3 doses / 4 hourly 3 days. Repeat the sequence if required Always remember, if pain is severe or incapacitating, please see your doctor / professional 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: Dear sir, Iam Latha aged 40 years. My hemoglobin count is 7. it is same for the past 2 years. But I didn t take any treatment . Recently I am feeling too tiredness. My hemetology report says Rbcs: show moderate to severe degree of anisopoikilocytosis with hypochromia . substanial no of annulocytes with few mycrocytes are seen wbcs: appear normal in number with normal morphology & neutrophilic preponderance. platelets: within normal limits no haemoparasites seen impression: microcytic hypochromic anaemia (early) mail id: YYYY@YYYY ### output:

Hi Welcome to Chat Doctor I have gone through your query. Dear your so low hemoglobin count is -7 for the last 2 years is matter of great concern. Hypodermic anemia is a generic term for any type of anemia in which the red blood cells are paler than normal. The most common causes of this kind of anemia are iron deficiency and thalassemia, vitamin B6 deficiency from a low iron intake, diminished iron absorption, or excessive iron loss. It can also be caused by infections (e.g. hookworms) or other diseases, Chat Doctor. Dear, I must suggest, whatever the name of the disease you suffer, is outcome of your weakened immune system , For your info Every day, we are bombarded with mental stress and toxins in our environment and in our food which is why detoxification is such a critical process IS HINDERED, toxins will build up in your body eventually causing acidity and toxemia & weaken immunity, so we fall prey to diseases every off and on, require modification of lifestyle and food habits. Include regular healthy diet as fiber, vitamins minerals, cheese, milk, supplements full of antioxidants, in natural form --fruit, green veges, lemon juice with water and salt and pepper before meals, coconut water, ginger, garlic, Aloe vera 30 ml, AMLA, Turmeric powder a level spoon + almond oil+ honey, a Spoon with hot milk, at bedtime, all will help boost your Immune system & alley your pains gradually with required work out ---- To detoxify your system, do regular walk, and increase your activity level. Exercises from head to toe & Yoga postures, Dhanurassan, Bhujjangassan, Vajjarassan Panama -- deep breathing Avoid processed foods carbs, sugar, fried, fast foods, Tea, coffee, alcohol and smoking, stress, sleeplessness and Constipation all will produce biochemical and metabolic conditions in your body that will decrease your immunity. So avoiding is definitely the first step in the right direction to detoxing the body, boosting the immune system. Medical treatment suggested by your doctor can be complemented using a variety of alternative therapies. Most of these therapies or home remedies focus on strengthening your immune system so that you may overcome the infection quicker. Take Homeopathic Cascara Pros 6 and Fer rum Pros 6 / Alternate / 2 doses each / 3 hourly / 15 days.always remember, if problem persists, please see your doctor / professional 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: My history is: Antoroseptal MI on 14.02.11, thrombolysed with STK. Angiography (24.02.11) results: LMCA-Nor.; LAD-40% Ostial Segment Stenosis & 90% mid Segment Stenosis; D2-80% Ostial Segment Stenosis; LCx- 30% mid Segment Stenosis. PDA-RCA Ostial Segment Stenosis. Coronary Angioplasty Report (24.02.11): PTCA / Stent (XIENCE Vascular) to LAD + Inj. Faximab with good end results & no residue stenosis or flap.Discharge Summary (26.02.11): Acute Anterior Wall Myocardial Infraction, Double Vessel Disease, PTCA + Stent to LAD, LV Dysfunction (LVFE 45%).Stress Echo (16.06.11) Report: LVFE 50% at rest & 60% at Impost. Trace MR at rest & No MR at Impost. Impression: Negative for reversible Myocardial Ischaemia.Myocardial Perfusion Scintigraphy Report (19.01.12): Test done following i/v Inj. of 110 MBq of TI201 at rest & 444 MBq of Tc99m Tetrofosmin at Bruce. Exercised for 06.51 Min. & attained heart rate of 148 BPM (89% MPHR). Test Reveals: Post stress images show reduced tracer uptake in septal / anteroseptal & apical wall of LV myocardium. Refilling kinetics is seen in above mentioned area at rest thallium images.Impression: Features of SPECT myocardial perfusion scintigrapghic study are showing evidence of exercise induced reversible ischaemia in Septal / anteroseptal and apical wall of LV myocardium.Personal observations: Post angioplasty I used to have throat irritation on exertion. Even during stress echo on 16.06.11 & on 19.01.12 the throat irritation / chocking feeling increased & exercise had to be stooped.Now what do you conclude & suggest future course of action.I shall be highly obliged for your expert consultations / suggestions. Thanking You & RegardsAnil Goel+91 0000 YYYY@YYYY ; YYYY@YYYY ### output:

Dear Anil Goer, On your angiography in 2011, there were significant narrowing of two coronary arteries and some non-significant narrowing which couldn't cause any ischemia and complaints. One significant narrowing was treated with stent, but the other one remained. I think they didn't perform stenting of the other artery as the stress test results were good in 2011, but of you have positive stress test results in a year, then there is a need to repeat coronary angiography to evaluate arteries again, there may be two possibilities, either the other narrowing became more and are significant now or it is the D2 from the first angiography causing the problems. In both cases angioplasty (stenting) may be needed. Take fearsome back if you have any further 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 have been experiencing various strage symptoms this past month. I was put on flecanide 50 last Dec. And propanolol 40 to take with it to prevent arrythmias. I have had lone afib a few times a year for a few hrs and have had all the work ups done with normal results. I also have had svt on a d off all my life with no problems except inconvenience. So they tried to ablate it in Dec and it was not successful. So that is why I am on flecanide and propanolol. This has worked well until last month. I has a routine d&c for what they thought was a polyp and turned out to be nothing. During the procedure my heart rate went down to 30 and they gave me robinal. A week after that I was started on protocol for a cholesterol of 278. My cholesterol has always been ok before that. 7 days later and 10 days after the d&c I began experiencing lightheadedness and a bp of 90/60 and a pulse in the 40s. I went to the hospital and was kept overnight on tele. All was ok hr in 40s-50s. Had normal echo in am and sent home. I hadnt taken propanolol since the night in hospital and began to experience pounding heart rate headache shakiness and over all terrible. Cardiologist said it was beta blocker withdrawal. They put me on half dose, back on flecanide,off protocol, and did stress echo and 24 hr halter and said it may have been vago vasel related. I went back to the gun for post op f/u and c/o lower and cramps. Found to have vaginal infection, on abs now. What bothers me is that I am still having these strange lightheaded moments and I dont know why. Everything seems to check out ok. It is not like fainting or dizziness. My pulse and bp is ok except that my pulse does get somewhat faint during it. Sometimes I get a cold feeling on the side of my head with and lingering after it. I am normally very very healthy and I dont know what is happening with me. Is there something I can do to find an answer? I am 62 and a little overweight. Thankyou ### output:

DEAR OVERTHINKS FOR CONSULTING AT ChatDoctorI UNDERSTAND YOUR CONCERN. BUT FROM YOUR HISTORY THAT YOU PROVIDED PAST HISTORY OF LONE AD AND PSV WITH FAILURE OF ABLATION THERAPY POINTS THAT YOU HAVE THESE DIZZINESS SYMPTOMS ARE A PART OF CARDIAC SYNCOPE LIKE FEATURESTHOUGH YOU HAVE NO LOSS OF CONSCIOUSNESS It's PROBABLY BECAUSE OF UNDERLYING CARDIAC ARRHYTHMIA I SUGGEST YOU TO GO FOR A 24HR HOLDER MONITORING GET A ECHOCARDIOGRAPHY DONECONSULT A CARDIOLOGIST SO THAT YOU CAN BE PUT ON A PROPHYLACTIC INTRACARDIAC DEFIBRILLATOR THAT CAN PREVENT FURTHER RISK OF ARRYTHMIAHOPE I HAVE ANSWERED YOUR QUESTION. 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: Hi, I have an uncomfortable sensation in my right forearm. It feels somewhat like fiberglass irritation although I have had no exposure to fiberglass. This started some months ago, and was only felt when my bare skin was resting on my desk or table. Now the sensation is more frequent and more intensified. Pressure of any kind or from clothing touching my forearm will aggravate the sensation. Any ideas? ### output:

Hello! Welcome to Chat Doctor ! Irritation in forearm may occur either due to- 1. Brachioradiales Pruritic: Brachioradiales pruritic can make you feel itchy, tingling or stinging or a changed sensation on the skin of either or both armor forearm. Brachioradiales pruritic develops due to damage to nerves in the cervical spine (neck). This may be caused by: a) Cervical spine tumors b) Cervical rib c) Compression of the nerves d) Cervical vertebral osteoarthritis e) Other spinal cord conditions. Continuous pressure on the spinal neurons conveying itch impulses can activate sensitization processes. When nerves transmitting light touch and pinprick sensations are over-stimulated, the patient may develop sensitive or sore skin, with intense responses to touch and pain (conditions known respectively as paresthesia and hyperplasia). Brachioradiales pruritic will typically affect one particular area of the skin (a dermatome), but may spread to other regions. The condition is more common in sunnier climates, as prolonged exposure to sunlight may harm nerve fibers in the skin. Brachioradiales pruritic is usually diagnosed by taking a biopsy of a small piece of skin. This is then examined under a microscope, and doctors may see reduced skin tissue (skin atrophy) and damaged nerves. 2. Other Causes: a) Eczema-is a long-term non-infectious condition resulting in itchy inflamed skin, which gets worse at night. Eczema can develop anywhere, but is most frequent behind the knees and on the arms. It appears as red, Chat Doctor. b) Lichen plans -is a chronic non-infectious inflammatory skin ailment. Patients usually get itchy forearms and inner wrists. There may be groups of lesions that are purple-colored, flat, have defined borders, and are covered with white lines, known as Wickham striae. The skin may look shiny and become scaly. c) Contact dermatitis-is a common skin condition caused by contact with irritants or allergens. It appears as an itchy rash, and you may also experience blisters, red bumps, thick scaly skin, and soreness in the affected region. d) Ringworm infection-appears as a circular itchy rash that is inflamed and reddened at the borders and normal skin-colored in the center. The rash is usually raised, and you may experience sores and blisters. Ringworm infection is very contagious. Hives is a common non-infectious condition with a welt-like rash, which may be extensive. The rash is red or pink, with raised itchy spots, and can last anything from a day up to 6 weeks. The itching can be intense, and occasionally patients experience burning or stinging. e) Certain

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: In 2009 I was diagnosed with MS. I have had several courses of treatment that made me significantly ill. In 2010, I made a quality of life decision to discontinue treatments, as I was having no success with any of them. This was a horribly emotional decision, but I made it and have been living with symptoms, changed my lifestyle, my job, my address, everything to eliminate stress, as stress is a main contributor to relapses. I went last week for an MRI, and the doctor told me I was misdiagnosed in 2009, and there is no evidence of lesions or plaquing. He wants me to go through testing for auto immune diseases, etc. From 2002 through 2009, I had gone through every test imaginable. Starting over has me swirling emotionally. I should mention that this is a new doctor. My doctor says that this should be good news, that I dont have MS. and it is. but, I am back to stage one. My symptoms are exactly like ms. I have had double vision, i lost sight in one eye for 3 months. I have had black spots in my field of vision that caused me to be unable to drive for nearly a month, I drag the right foot, I am in pain all day every day. I get very weak muscles that at times, cause me to use a cane. I have also gone completely unable to stand, to the point where my daughter had to carry me to the bathroom. I have memory problems, cognitive thinking issues, My skin often feels like it is sunburn, but there is nothing there. It also gets very itchy, but is not at all dry. There are times I can not even lift my arms over my head, they are too weak to do anything. I was unable to hold my granddaughter when she was born in fear that I would drop her. My biggest problem is the pain and weakness. The pain makes me so exhausted that by the end of the day, I go to bed by 7:30 to lay and watch a movie or something. I am not an over-weight person, and try to stay busy through hiking, kayaking, fishing. I am limited as to the type of exercise I am capable of doing due to my lack of good balance. So, My question is, does any rare medical condition come to mind that can manifest itself as MS does? I have been tested for many more notable autoimmune diseases such as lupus. I am desperate to not have this take another 10 years. I have been through so much! ### output:

Hi, I am sorry to hear that you are suffering from pain and weakness. I agree it must be very difficult having been told you have MS for nearly a decade and now being told it may be something else. I would recommend a few things1. Get your old records - everything including tests, progress notes, imaging results and medications from your previous doctor's office. 2. I would suggest getting a second opinion-the reason is that if you were treated for MS for so many years there must have been a reason to diagnose you with the condition. If your new doctor thinks it's not MS and wants to embark on a whole new set of investigations, I think its worthwhile getting a second opinion before spending thousands of dollars on costly tests3. Since pain and weakness are your main symptoms, I would recommend seeing a Physical therapist. Physical therapy is often very helpful to improve strength and endurance. Also, consider seeing a pain specialist to discuss other ways to manage pain. Consider alternative ways to reduce stress including meditation and yoga. Please let me know if that was helpful. 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: OK so here is the deal, my whole life as far as i can remember i have been an emotionless, shallow, uncaring person. Nothing to do with my child hood, it was great. This has just been the way I am for some reason. I mean seriously you could blow someones head off in front of me an my response would be that sucks and walk away, my father always told me i would make the perfect soldier in the military.. I m not crazy, depressed or any of that dumb stuff. Just empty/emotionless inside. But the one day my friend hands me this pill, well it was a pain killer that changed me like no other. I loved my job, my friends, was very open, caring, had emotions, I was a completely different person, i felt......human. Well it lasted a month an was like forget this i m not gonna be a junkie. So back to the blah me, month later another friend hands me a Valium. Well, it didn t make me as happy/outgoing as the painkillers but little things wouldn t bother me, controlled my temper, i was very relaxed and easy going. Gave up on that for same reason then maybe 2 months later a friend said try this, it was Xanax. Well it gave me some feelings/emotions, was pretty happy, relaxed, could hold conversations and hang out with friends again. So once again i said screw this now almost 2 months later i m back to the same emotionless asshole. Out of all 3, the painkillers worked the best, they made me feel a lot more amazing versus the other 2. Oh also, when not on any of those i am a very quite person, i try to avoid conversation and when hanging out with friends i usually just sit there, all 3 meds made me pretty talkative. And one other thing, this one could be because ive done it for a few years now, but i can not fall asleep unless i smoke about half a bowl of weed before bed, which is fine. About me a little bit, I have a very good job, im actually quite happy with my life, I have done quite well for myself, so why am I like this, what is wrong me. Like i said im not depressed or anything, im just a quite person that doesn t really care about much of anything or want to do much of anything unless im on some kind of drugs (i was this way before the drugs). And not being on any of those drugs days seem to last forever, my 8 hour shifts at work seem like 15. Is there something mentally wrong with me, is this normal in a lot of people. What kind of doctor would i see about this kind of thing and what do i tell them and what kinda crazy shit are they gonna try and give. Ive seen all those commericals for antidepressant meds and that kinda junk but like i said im not depressed. So whats out there for whatever i am. ### output:

His admire your positive outlook and congratulate you for the attitude. Now I guess you have underline depression, and it could be due to some stress in your personal life. That would be the reason of taking weed, Xanax and painkillers. In that case, you need some help. However, let me give my opinion here. I think a combination therapy of antidepressant and low benzodiazepine would help you. That would help you to come out of this depressive phase. You can try some relaxation exercise like JPMR or deep breathing exercise. That would keep you calm and relax. For this you need experts guidance by psychiatrist or psychologist. Hope this helps.

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 trying to cut back on some of my medications -- because I have been having an increasingly high liver enzyme count. I have Narcolepsy w/ Cataplexy, so I do have to take lots of medications, therefore my Doctor has me do bloodwork every three months. But, then I started having increased pain in my abdomen, vomiting bile, upset stomach, and severe burning! After many tests - they found that I have gall bladder polyps / not stones! And my liver is swollen and is probably the reason for all the pain (right side, under my breast area, sometimes radiating to my back, under my shoulder blade.) I have been taking atenolol for years now...for mitral valve prolapse with regurg,(but I ve cut back on it this week, since I ran out...can that affect nothing significantly?) I had stopped taking Diazide for a while -- because I kept becoming too dehydrated / and passed out! But I have that under control now -- drinking tons of water! And I also take AdderAl for Narcolepsy. I take Synthroid for hypothyroidism. I recently started taking proton is for the stomach pain and acid, as well as Carafate for the burning (just took my last one)! I had an upper gi -- they found H-Pylori, I took all the strong medications to treat it & completed the course! I it helped for about 2-3 days, and as soon as I had something acidic to drink, the pin started all over again! I also have ulcers, which have been bleeding from time to time (throwing up blood & in bowel movements). My urine and bowel movements are very yellow...I guess from all the bike! For about three months I was throwing up bile every day...and about 2-3 weeks of non stop vomiting...no matter what I ate or drank! I have been taking atenolol for years now...for mitral valve prolapse with regurg..., but I ve been out of it for about a week, so should I start it back up...or just wait? Additionally, I have had severe head trauma in the past from all of my falls / accidents / injuries -- from the narcolepsy! I m concerned -- because I seem to be falling allot more than normal lately -- and I keep injuring myself! Last year I broke 4 vertebra in my back (rising my horse), I fell they a porch the other day, and have bruises everywhere & think I broke my toe! Then two days later, while working in my closet, I went to turn / after being on a ladder, and fell, catching my big toe on the other foot - and I m sure I broke it as well! What the heck is up with all of this!???? Plus, I m having in going headaches every day (I ve had migraines in the past too). What do you think of all of the confusing issues / meds / symptoms / etc? Thank you for your response! Glenda Hunter James DOB 5/7/55 ### output:

Hello! Welcome to Chat Doctor ! Better you have to take Ayurvedic medicine which are safe. I will suggest you take : 1) Tab Magnitude Vat 2 tablets, 3 times. It cures your liver and gall bladder problem.2) Tab Gokshuradi Juggle 2 tablets, 2 times daily for hypothyroidism and swelling.3) Tab Arjuna Vat 2 tablets, 3 times a day for heart and blood pressure problems. Thank you for contacting us. Hope this clarifies your concerns. 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 doc, myself aged 23 years old height 5 3 and my weight is 69kg. I recently had an natural miscarriage at 9 weeks. It was my first baby. I got this after 2 years of trying with pills. My menstrual cycle also used to be normal.But now after the miscarriage my cycles are all up and down. my first cycle came after 28days which began in spotting for 2 days and then normal flow for seven days. Den the second cycle i.e my last period came early which also began in spotting but not for two days continuous 15 days or so which was not stopping. So i went to the doc who took for me pregnancy test plus vaginal ultrasound . Everything seemed to be ok. my pregnancy test turned out negative and vag ultd showed that i had little cysts and i need to loose weight.yeah, and the doctor prescribed me dicynone to stop the bleeding. I had the tablet for 5 days but still it dint stop. Alternatively as i was having this tablet i was having very bad unbearable shooting pains inside my vagina. In my next appointment the doc then prescribed me primolut nor 10mg for 21 days two times a day. And a pain killer ponstan forte to stop the pain in the vagina as the doctor told the pain was due to bleeding for long days .Now the bleeding have stopped after 3 days taking the tablets but still i am continuing it for 21 days.And the pain had dissappeared after 2days.What i want to know is this pain only becoz of bleeding or will der be some other problems associated with it?? after taking this tablet i am having currently withdrawal bleeding on the 3rd day.but my withdrawal bleeds are in clots.a huge clot had come.is this normal period or just withdrawal bleeding???do i have to take concern in this matter?doc have said me to take hormonal tests on 2nd day of periods.since now i am having heavy withdrawal bleed should i take the tests now or should i wait till my regular menstural flows come later????can i concieve after this withdrawal bleed by checking when i will be ovulating by doing a scan with the doc or should i again wait till my regualar menstural flow.. i am very stressed becoz i badly want a baby soon.i want to know when can i conceive???can i at this stage?will my periods me normal in the next cycle?will there be chances of an empty sac again as it was the case before.and also it was lying in the corner of the uterus.will such things happen again?my hubby was also taking ubiphene eariler but not now.do he have to take those tablets again to conceive.And ya if i am planning to conceive can i use ovulation kits to know when i will be ovulating.will that work out becoz i am having cysts.otherwise doc can u prescribe something better to know wen i would be ovulating.thank u dats all. thanks for taking concern .waiting for ur help. ### output:

Hellowelcome to Chat Doctor thanks for your brief medical history,,,yes you can conceive surely try to visit the best gynecologist near you,contraceptive you used for 21 days are God as a line of treatment.follow advice of your doctor,yes of course ovulation kit will surely help you ,as you need baby madly, so you can't wait your menstrual to be regular.don't worry there is nothing serious,have healthy diet .take carpal

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Dr. , I am in the philippines. I went to to my doctor OB Gyne because for almost ten years in my married life, I was not pregrant even once. I am worried. I decided to consult a doctor. My doctor told me to take a panfor metformin three times a day. After two mos cycle and fter my 5 day menstruation period she give me a clomane twice a day in 5 days, then have TVS. The result was that my left ovary produced a follicle measured as 1.77 x 1.81 x 1.58 cm as my day 12 stimulated cycle. After that, my doctor give me progynova 2 times a day as my endometrium is thin only 0.46 cm, intact isoechoic. Two days after, my doctor instructed me to have TVS on my day 14, with results of 0.57cm, thin, my endometrium and my follicle F1 measured as 2.55 x 2.03 cm. Then, i came back to my OB with the results. She said it is time to do the iui a day after the injection of prygnil for ovulation. After 24 hours, IUI was performed. She instructed me to have 30 minutes rest before I am going home. She give a duphaston 30 tablets good for 15 days and taking those tablet twice a day. I started taking duphaston after 2 days iui. Aside from that, i continue taking the progynova for 10 days aftee my iui. My questions are the following; My first time iui, is it possible to get pregnant for all of these treatments?How many days should i take the pregnancy test after iui?I am waiting my menstruation this 25th in august. And i iui was done last aug 8. What will i do now? I took a vacation leave from my office work for 7 days after iui. I am so excited to kniw the results. By the way, my husband sperm count is 33.6m per ml before pre-washing and after washing resulted to 39 m per ml and other remarks stated normozoospermia. Today, I stop taking progynova as instructed and continue taking duphaston.I need more advices from the doctor, infertility specualist. ### output:

Hello, Thanks for the query to Chat Doctor. Forum. Your question is, is it possible to get pregnant? Yes, you can get pregnancy. Ovulation date was 9-10 August, so now if ovum fertilized i.e.pregnancy, you can test blood for Human Chorionic Gonadotrophin (Chat Doctor), level should be 300-500 NG/DL, if pregnancy. If you want home pregnancy tester than wait 7 days after delay of period date. Both tests are reliable, but in my opinion this is good to wait for home pregnancy test. Your husbands sperm count is low. Normal fertility is associated with sperm count of >48 million /mL. Endometrium thick of uterus is also below than normal. In my opinion consult one more infertility specialist and get his opinion. As you are taking metformin, this is usually taken in POD (PCs) cases, so please upload ultrasound report of both ovaries(if cyst). Hope I have answered your question. If further any question I will help. Good luck.