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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: My Husband just stated with what he belived was gout (not had it for 2 yrs) soon he had high temp and going cold then realy bad swetting, his big tow was quite red and his hole foot was going red and even a darker with a small blister that was quite large time we arrived back to new Zealand from AUS. The puss and the infection got hold, to the point after we had seen 3 Doctors in AE and even out off Hours, by this time is tow was now going black!! with lots of puss out brake, in a few parts THEN AT LAST with bloods taken, full scan, plus swobs he was taken for his op!! to just clean the wound out by a 3ins cut to get in deep, and after a good clean he was back on the ward to be told the he could still have to have the tow taken off......... still with one more wash done he has just been advised it is Streptococcus type G he is fit and well lost eats a balanced diet after fitted with a Stent in 2011 would n we need to take more care and should I have him go back to a hart Physician when he gets out of Hosp. They have said he will come home with a pump and a drip to feed his meds for up to three weeks. We have taken photos stage by satge. Thanks Linda ### output:

Hello, Welcome to Chat Doctor, Foot Infection is difficult to manage because of its weight-bearing chances of getting repeated injury & soiling. Usually it starts with a trauma or abrasion or puncture wound, skin involvements like edematous lesion, misfitting shoes. These get secondarily infected to form inflammation, ulcers, getting deep in the skin, soft tissue, may be sometimes up to the bones. You seem to have an ulcerative circular lesion with scaling of skin on your foot. Looking at its chronic standing I would like you to exclude few conditions-Diabetes-In diabetes due to raised blood sugar, infections do not respond to routine treatment. You should get your fasting & post meal blood & urine sugar tested & in case it is raised-consult a Planetologist for further investigations & specific treatment. A controlled blood sugar along with proper management of infection will heal completely. Peripheral vascular disease-This causes narrowing of peripheral blood vessels & condition needs to be excluded, as it causes chronic infections, more so in lower limb. The diagnosis is made by USG-Doppler, angiography, computerized Tomography. Please consult a surgeon for his expert advise For management of the wound as well as peripheral vascular disease. A detailed CBC, HBO & culture & sensitivity of the exudate from the infection site are usually done to define the exact causative organism & the sensitive antibiotic, medicine will be selected. Local management of the infection ulcer with proper cleaning, removal of dead tissue & application of healing agent is to be followed regularly till complete healing. This should be done under expert surgeons care. Wearing of proper shoes/socks to protect foot from further injury of new healing tissue should be followed after the treatment. Thank you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I was very desperate for a job and had unprotected sex with a guy who promised me a job on the 7th of March 2014, I took morning after pills on the 8th March, first day of my last period was on 16 March (of which I was convinced the pill worked). I then had unprotected sex again (after my period) with my boyfriend several times but don t recall the dates (somewhere from March 10) . I found out I was pregnant on the 10th of April and went for an ultrasound on the 30th of April, my Doc said I am 7wks 5dys preg. How accurate could that be as I believed at the back of my mind that I am between 5-6wks pregnant. Could it be possible that the pill didn t work? I m scared and confused that it might not be my boyfriends. Please help. I am losing my mind and can t seem to not stress about this mess I put myself in. I also have one more concern please, my period was normal as it lasted for 4-5days, *sigh* my boyfriend and my mother know about the pregnancy as we (my boyfriend and I) were pretty much planning to have a child together but the ultrasound dates just really gave me a huge slap on my face. The ultrasound based on the measurement of the embryo showed that my due date is on December 12, 2014 (my doctor didn t ask me when my last period was) I am also a bit confused about two other things as well - the first one being when I use the due date calculator by sonogram (reverse calculation) it says that I conceived on March 21, (how long does it take to conceive after sex) then the second calculation based on my first day of LMP which was March 16, shows that conception date was March 30. Am I chasing empty pavements or none of this changes anything? I had a miscarriage last year and really wanted a baby but not that of a man I don t even love. ### output:

Degree understand your concerns went through your details. Sperm life within moist vagina is up to 48 hours. If sperm cell could not find a way into the ovum, within this 48 hours, the sperm cell dies. Sonogram shows the growth of the embryo, and it could be possible that the embryo had grown a bit faster than usual. That happens in many cases. The tentative delivery date is calculated based on the general arithmetic and assumption, but there are techniques like this too. I don't think you have anything to worry about the current scenario. Doctor said 7 weeks and your calculation is 6 weeks. The matter of 7 to 10 days tolerance is normal. Note that almost all pregnant women give birth at least a week or more before the tentative delivery date. Don't worry. You may talk to your doctor in detail. Don't be shy and afraid to talk to your doctor and clarify your doubts. Take care. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Available for further clarifications. Good luck.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear Doc,3 1/2 years ago I had a deviated septum w/ allergies, had an operation and life was awesome for 6months. After the 6months it felt back to square one, Im allergic to dust and grass, Nasonex helps slightly (I can breathe through 60% of my nostril) and fexofenadine stops my eyes from being super sore, but Im so desperate to get the same feeling I had after the operation, occasionally I do have days of bliss, Id say once every couple months (doing nothing differently), Is it worth going back and having the operation again, even though I know full well its going to come back? I have read about this injection being made in Switzerland, a cure for all allergies, but 4 years is a long time! Looking forward to any help you can provide,Regards,PoP.S. Ive tried everything, on prescription and a neti pot, can work for 2-3 days but nothing for me as of yet (apart from the op) has been a long term fix. ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. It is important to remember that sinus surgery corrects structural problems related to nose/sinuses, it cannot "cure" allergies as basically, allergies are related to immune system. So, unless your ENT surgeon suggests you need to have a repeated surgery (he will advise you only after examination of inside your nose and after some investigations), you may not actually require a surgery.2. Were I treating you, I would suggest you to continue intranasal corticosteroids (alone), I would add regular montelukast and an antihistamine like fexofenadine, cetirizine or levocetirizine.3. I would suggest you regular steam inhalation (please be cautious to avoid burns) and net. It will help.4. Should you have reflux symptoms, i.e., regurgitation of foods after meals or burning pain in chest, especially after hot/spicy/oily meals, I would prescribe you antacid like omeprazole for at least 6 weeks? It can worsen sinusitis.5. I would also suggest you allergy testing and consult an Allergist-Immunologist with the report. After reviewing your symptoms and reports, he may prescribe you allergen specific immunotherapy. The "injections" you have heard of might be actually immunotherapy. Nowadays, there are both injections and Chat Doctor. Of course, it should be continued for 3-5 years, but improvement in symptoms usually begins within first 6 months of beginning of immunotherapy. It works on your immune system to modify response towards the substances one is allergic to and hence improves allergies gradually.6. A diet rich in vitamins and minerals as well as avoidance of dusts, smokes and air pollution will also help you. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health. Thank you & Regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am an Asthma patient from my childhood. I am 68 now. I am regulaly practicing Yoga, Pranayam, Surya Namaskaram and Meditation for the past 3-4 years and am able to be active throughout the day. I havent got an attack recently. I have also reduced my dosage of Ketasma(Ketotifen 1mg.) 1tab and Unicontin-400- 1tab taken in the night daily to 1/2 tabs. each now for the past app.six months. I use Asthaline inhaler for the suport. I have a feeling that the Inhaler is not working effectively.(using it for more than 2 decades) My consumption is three inhalers of 200 metered doses. Can you suggest an alternative and effective inhaler. Ultimately I want to be out of tablets first and inhalers following it. ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. First, I personally congratulate you for adopting lifestyle changes including Yoga, Panama, Surya Namaskaram, Meditation, which help to reduce medicine requirements in chronic disorders such as asthma. Please continue efforts towards improving your body & mind.2. As an Allergist-Immunologist, I would suggest you allergy testing for airborne allergens such as house dust mites, molds, pollen, insect proteins, etc. It will help you to identify the substances causing allergies to you and also to know the measures to avoid them.3. Based on allergy testing, an Allergist-Immunologist may suggest you allergen specific immunotherapy which works gradually on immune system to improve allergy symptoms over a long time duration.4. If your requirement of Stalin inhaler is 3 inhalers (600 metered doses), I would rate it as high. As you have mentioned that it is not working for you recently, I would suggest you a test named Spirometry with post bronchodilator reversibility testing. This test is usually best performed by pulmonologists, and it measures your lung capacity and amount of airway obstruction, also the reversibility of the airway obstruction.5. Such testing will help your doctor to decide whether you need rescue inhalers such as Stalin (albuterol) or "preventer" inhalers (such as inhaled corticosteroids) to dilate your constricted airways.6. There are many alternatives to Stalin inhaler such as levosalbutamol or other brands of albuterol, but at present, from your history, I doubt whether they will be really helpful to you. So I would not suggest them prior to spirometry testing.7. Please try to avoid exposure to dusts, smokes and air pollution as much as possible.8. A healthy diet rich in vitamins, minerals and antioxidants as well as adequate fluids during day to maintain HY Chat Doctor. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, thank you for your help! I am a generally healthy 19 year old male with a height of 6 0 and a weight of 145. I have been a cross-country runner for over 5 years, and have remained physically active into my college years. My diet reflects that of typical American teenager; however, it may be slightly healthier considering the fact that the only beverage I drink is water and I generally try to be conscious of my diet (less processed foods, balanced, etc...) I am concerned about my blood pressure. Two years ago I had my blood pressure checked, on multiple occasions, at 142/90. Yesterday I had it checked at 143/88. And today, at my town s clinic I had it checked at 138/88, although I was exceptionally clam today because I am on vacation. This is highly concerning to me because I believe that my blood pressure would be even higher while in classes. In college, I often consume caffeine (about 100mg daily) and occasionally (1X/week) take stronger stimulants such as nicotine, provigil or methylphenidate, although I do not have a diagnosis of ADHD or narcolepsy. I do this to accommodate my work schedule as I am enrolled in a highly demanding elite university. I know that I have a family history of hypertension; however, none of my known family members have had hypertension at such an early age. In fact, I had my blood pressure checked alongside my 71 year old grandfather and his proved to be lower than mine (141/86). I love life and I cherish the experiences that I am able to have as an average American Joe. I am interested in prolonging my life for as long as possible, and I take this threat to my health very seriously. I haven t yet tried drastically lowering my salt intake, and I am reluctant to abate my stimulant usage, however I am certainly willing to to protect my health. I feel as though I already exercise enough, and it is quite difficult for me to permanently lower my cortisol levels. I also take my sleep habits very seriously and nearly always sleep 8-9 hours/day during the same relative time such that I maintain a stable circadian rhythm. This is why I am really at a loss as to what to do. My home clinician didn t seem to take this issue very seriously and he just told me that I shouldn t be worried and that he would check it again in a couple of months; however, I want to be taking actions to lower my blood pressure now! What do you recommend? Is this issue as serious as I am taking it? If so, what steps may I take? Is it inevitable that I will have to be prescribed a medication? Thank-you for your time! I look forward to hearing your valuable opinion. ### output:

Hi, if your blood pressure is high on successive occasion then u will check your blood pressure three times in week on one day gap in between. If it is higher than normal than u have to first go for serum lipid profile with cortisol level. If it is normal than start antihypertensive tablet for some time than measure your blood pressure again if controlled than gradually decrease dose of Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi, i am a 15 year old boy and have been having pain which i believe could be gallbladder pains. from what i have researched the symptoms seem to indacate it aswell. i regulaly get fairly yellow skin (as stated by a friend in maths lesson), ( Jaundice symptoms), not severe but friends have noticed although it is not constant and comes on every so often. i also have urticeria, which could explain for the itching, but the rashes dont come up when i do, so i am not sure if it is a symptom. with these symptoms i get pain and tenderness under the ribs on the right side that is made worse by movement or coughing. however it is not severe (i am not screaming in pain but am crouched over) and not long lasting normally (6 hours-1 day), (Acute cholecystitis symptoms). but i do not get the tempreture asosiated with it. in serious cases of it i do get long lasting pains but never a fever or anything like that. and also i feel like i get gallstones but i have no proof it has never been stated by a doctor, it just feels like people say it does. my parents both have problems with gallbladders, my mum had to have hers removed. what can i do to get rid of these pains, should i see a doctor about it, and is there something i can do to stop it permanently because it as occasionally effected my sporting performance, and that is not usuall because i have played with a ruptured hip flexer and sever cases of shin splints and osgood schlatters. many thanks ed ### output:

Hello there, I will answer to your question according to Ayurveda. Firstly, you should do abdominal sonography first to rule out your fear. If the report is ok, then don't worry, its a physiological problem that you have. Now what Ayurveda thinks regarding this problem? As you are also suffering from urticaria (sheet pitta) along with yellow skin. This is called tirykgamitva of dos has. My experience says if this is not due to gall bladder stone then It's related with blood(Rasta) +NASA(lymph) +mama(muscle) that. This is called samtajaneet pitta/kaphavrurtta pitta Doha in Ayurveda. The best medicines for this are Navajos Lola/punarnava manure/shank ha plasma/naval pistil etc. along with dhanvantar friar/mahatiktak friar/ADIMAD friar. I got excellent results with these medicines in my ayurvedic practice at my clinic.Also, maximum intake of ginger/thing/spinach/yam/beet root/turmeric/coriander seeds/black cardamom/oregano/mangosteen peel/Jagger/green gram deal is also recommended. Besides do various test like LFT, AST GG PT, AP,Urinalysis, BUL,ESR, BSL etc. If any problems occurs the above written treatment is also effective in gall bladder stone +in any liver diseases.

If you are a doctor, please answer the medical questions 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 rolled my right ankle about 4 weeks ago. After about 2-3 weeks of rest and icing my right ankle, it felt pretty good. Good enough to start jogging again. I could walk and jog with no pain. On the forth week I tried to get back into soccer. Before the game I laced up my shoes and ankle brace then stood straight up to go for a jog. Immediately when I stood up I noticed a sharp ripping pain, across the bottom of my shin maybe near the top of the extensor tendons (if that s the right name for it, the tendon attached to the tibia), moving from the outside to the inside of my foot. I tried loosening the ankle brace but still the ripping pain continued when I stood up. I completely loosened the ankle brace and the ripping pain left and I could jog again. I decided not to play and started to examine the pain. The ripping pain only occurs when I over-extend my right leg or when I am standing/extending my leg and touch/grab my lower shin/upper ankle area. I had an X-Ray done on my lower leg/ankle but I haven t heard back from the doctor so I figured there wasn t any issues with my bones or ligaments. That leads me to believe it is a partial tear(s) in the muscle or tendon. Could you please give me a general idea if I need to have it surgically repaired or will I be able to continue resting and wait it out and eventually it will heal properly all on its own? Thanks Adam Cyr ### output:

Hello, What I understand from the history is there is a probable ligament Injury and to rule out this we need to do some special clinical test and maybe an MRI to understand the extent of the ligament injury around the ankle which is very common. Now x-rays are something which cannot reveal anything about the ligaments or muscles but only the bones. For soft tissues, we need to depend upon the CT or MRI scan. If this is the ligament injury then post knowing the extent of the ligament injury we have to decide either surgery is needed or not. In most cases no surgery is advised. With proper physical therapy and sports retraining of the ankle the player can go back to the game. This method takes some time but definitely provide excellent results. Being a Sports therapy specialist I have seen cases, and they have recovered much better and still, in sports, they are now. Now you mentioned using a brace and trying to wear sports shoes and pain started this is common as the muscle will be restricted that will the major cause of the pain. Coming to muscles of the foot, we need to understand that muscles undergo physiological and mechanical changes due to injury to a ligament. Some are stronger and some are weaker. We need to figure out the weaker ones and find out the exercises which suit well for the entire group of muscles to equally function for stabilizing the ankle joint while in sports. Try to meet up some good sports therapist, or maybe you can provide me with more details, so I can help you much precisely. Hope I have answered your query. Let me know if I can assist you further. Take care 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: Hello Doctor,My Mother is 53 years old. She has been suffering from headaches since 10 years. whenever she used to get headache she used to take paracetamol 500 mg and it used to get reduced. she used to get headache twice a month during the last 2 years and she used to take paracetamol. But 3 month back, she has got severe headache along with vomitings. So we went to a neurologist and got a CT scan done which says like this "RIGHT PARASAGITTAL OCCIPETAL EXTRA AXIAL CALIFICATION IS SEEN". Impression of the report goes like this " ?MENINGEAL CALCIFICATION, CALCIFIED MENINGEOMA IN RIGHT OCCIPETAL REGION".Doctor has prescribed encorate chrono 200 mg(Twice a day), spenzo(0.5mg), Mylonerv D tablets. . she used them for 1 month . she did not get headache in this 1 month.After 1 month when we went for follow up, Doctor prescribed the following medicines - Franxit(composition-flupentixol 0.5mg, melitracen 10mg) , Vibrania D(composition-vitamin d3,methylcobalamin,pyridoxine hydrochloride) tablets. she used them for 2 months. she did not get headache in these two months also. 10 days back we went for follow up . Doctor checked her weight. within 2 months she increased her weight from 55 kgs to 60 kgs. Doctor told to stop gaining weight. i dont know why. In the recent follow up Doctor has prescribed Encorate chrono 200 mg(twice a day) and neurobion plus tablets (once a day) for another two months which she is using now. Doctor told to have MRI scan after 2 months. My questions as are follows:What is ?calcified Meningeoma?Why does it occur?Are we taking the right treatment?Are there any side effects in using the above mentioned medicines especially encorate chrono for such a long time?Is there any kind of natural remedy for this?What kind of diet is to be taken to get rid of this?What kind of precautions are to be taken by such patients?Request you to kindly give your opinion.Thanks and regards,Sudha ### output:

Her weight gain is probably secondary to Enc orate which contains Valerie acid and has increased appetite and weight gain as a side effect. Meningiomas are usually benign extra-axial tumors i.e. they do not arise from brain parenchymal. They arise from meninges which are sheaths covering brain and spinal cord. They are usually benign and slow growing with resultant calcification. Since they are causing symptoms I strongly suggest that the patient gets an MRI scan of brain and is seen by a neurosurgeon for possibility of safe excision. If the tumor is small it can also undergo radiosurgery with a Gamma Knife without having to undergo surgical procedure. Please discuss it with your doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi... ok... here it goes.... When I was 11yrs old, I had a bike accident. From 21yrs old on, I have had multiple procedures to deal with my urethra stricture. 5 yrs ago, I had surgery. From that point on, I have noticed that my perineum tends to get swelling when I get an erection. The swelling begins before the erection begins and lasts longer than the erection does. It does not usually hurt. My last procedure was in 11/13. It was a dilation. This Morning (6:30am), when I ejaculated it was v. painful... after I could not urinate, when I tried it was v. painful (tried 2xs 8am, 10am). The pain lasted a while (usually my painful urination stops when the urination stops, for some reason the pain today lasted between 30mins for the first urination and an hour 30minutes plus for the second). At 10:30am, I took a cab to the emergency room... during the ride, I noted that my perineum was still swollen and I had to hip sit and I also had to walk bow legged into the hospital. (the head of my penis was also hurting). At 12noon, I was able to urinate a little (dribble stream with pain). At 1:30pm, I again urinated but the flow was less, pain was same. I believe that perineum was still swollen but it was not on my radar. I told I would have to get a Suprapubic catheter and had decided to have the procedure the next morning. While I was waiting to get admitted, at 3pm, I urinated and my flow normal (my normal) and with pain (still my normal). I also noticed that the swelling in my perineum was also gone. I decided against the procedure. I have urinated once since being home. It was again my normal flow. Am I crazy to connect the two and any ideas on why it is swelling. I spoke with one of the urologists and he didn t seem to think they were connected. In truth, I have never brought the topic of the swelling up with any of the urologists I have worked with over the last few years because it never occurred to me. We are now talking about a urethra re-construction but if this perineum thing is contributing to my urethra problems and could be fixed with a less intrusive procedure... (and buy me some time)... that would be great... again thanks... ### output:

Hi. Thanks for to elucidate self-explanatory history. The perineal swelling along with the erection is suggestive that the part of the penis root has been herniating through the weakness of its covering. Secondly the other swelling you developed is suggestive of the diverticulum of the urethra, most probably developed due to stricture or the procedures blocked the out flow. I think the correction of this swelling is also a part of the next procedure. The easiest way to diagnose this is arthrography to outline the urethra. This will help plan the nest procedure well.

If you are a doctor, please answer the medical questions 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 38 year old woman and I was in a car accident in 2011, which led to compression burst fractures of T-4 and T-5. I had surgery a year later they put in rods, screws, a cage, and done a spinal fusion from T-2 through T-8. While testing before the surgery they found I also have osteoporosis of the spine, stenosis at multiple levels, degenerative disk disease and kyphosis. Anyway during surgery they found the spine wasnt straight and that it was worse then the MRI and X-rays showed. The Surgeon told my husband and family that he couldnt get the spine completely straight and the hardware could never be removed. I have been having lots of pain in the shoulders, chest, back, neck, hands and arms. At times my hands and arms feel like they are asleep and or I could be holding something in my hand and just drop it like my hand isnt even there. I can get cut doing dishes from a knife or burn my hands and not even feel it! When lifting my arms up or reaching something in my back, well the best way I can put it is, it feels as if something is pulling, snapping, and popping. I have been on Norco 7.5mg for 2 years now at first they were helpful but now they dont help at all. As of three weeks ago the doc decided to take the pain meds and told me to take Ibuprofen and over the counter Tylenol. Which I am having to take 1600mg of ibuprofen every 6 hours and 1500mg of Tylenol every 4 hours and that just puts me to sleep it does nothing for the pain. I think the surgeon believes it should all be better and refuses to listen. My back burns,pulls, feels like I am being stabbed from the inside out, and just plain hurts all the time, so I went back to my surgeon whom without any new x-rays or anything, in fact the last tests he done was 3 months after my surgery and they havent even tried sending me to physical Therapy. This same doctor now tells me they need to go in and take the hardware out. I reminded him of his previous statement about the hardware havin to stay in and he replays it will be fine. My questions are is this anywhere normal, what could happen if they remove the hardware? Will i be in worse shape then I already am? Should I even consider doing the surgery to have it removed? I am very confused and in so much pain that it effects everything in my life. Anyone with any Ideas? Anything Please! ### output:

Thanks for writing to us. I understand that you had thoracic spinal fusion for fracture vertebra. If possible please upload the X-rays pre- and post-surgery to know more about the spine. Spine implant usually not removed unless there is a complication related to it. First we need to know what is the pain generator? What's the situation of the implant? If your spine is fused then implant removal can be done provided it needs to establish that that's the pain generator. Please upload the X-rays and also get a fresh ct scan of spine. Thanks.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I am very worried about my 5 year old son. Since Friday night, he has been having a very bad cough which wakes him up either vomiting or short of breath. I have to give him his inhaler to help ease the cough. He was diagnosed with asthma, but doesn t use his inhaler on a regular basis. For the past weeks I have also noticed that he started to snore again after several months of not doing so. The snoring has gotten so bad to the point that he has times when he doesn t breathe. He also at times drools . My 6 month old has a cold as well, and she has a bad cough to the point where she also wakes up crying, vomiting and I have to give her her nebulizer. She had erythromycin ointment prescribed for her eyes since she had pink eye. Now my son has the same problem going on with his eyes. I don t know if they have the same thing going on, but I am greatly concerned about his breathing, lack of. In the day, he is fine, he doesn t even suffer from a cough nor are his eyes releasing any mucousy discharge. It is only at night like I said that he has a very bad cough accompanied by vomit he sweats and complains that his stomach hurts. also, in the day he tends to be hyperactive. I was told that his tonsils and adenoids are enlarged. I am very worried what do you recommend me to do. Also, at he was a preemie at 35 weeks gestation and suffered from RSV at 2 months old. ### output:

Hi welcome to ChatDoctorGone through your query about your child Chat Doctor. I can understand your concern. For your info, Coughing is a natural body reflex It keeps the lungs, throat and airway clear of foreign material and vomiting further helps in clearing. Sometimes, inflammation in throat, lungs and airways causes irritable cough. Constant coughing is irritable and requires treatment. Dear, one thing is sure to understand, that inhaler or sublimer is a very short term remedy. Indiscriminate use of it suppresses the mucous and worsens the condition. It should be used in emergency only. You have to find out remedies natural, non-invasive. Based on the principles of Ayurveda, the ancient Indian science of healing, are completely natural, non-invasive, and can be prepared at home.First you need to give him a glass or 2 of warm water with little salt mixed in it, and make them vomit, at least once a day, empty stomach, to detoxify the system. Give both of them little warm water 2-3 times a day. Don't give them cold beverages. Soak 7 almonds in water overnight Peel the skin in the morning Crush them to make a paste. Add a Spoon of honey and a little salt . Mix well Eat this every morning and evening. Using paste of basil leaves, ginger and honey for your son, gives relief in cough. As your daughter is too small, give her devotion of basil leaves mixed with honey 5-6

If you are a doctor, please answer the medical questions 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 Paul male 27 years of age. i was injured back on march 3 2013. i fell into a storm drain i injured my knee, and hit my back. Once i was on the crutches i seperated my right shoulder on them. I have had three knee surgeries over 10 years ago. No problems after the last acl reconstruction. Now i am having extreme pain in my right leg, mainly knee with shooting pain up and down my leg. I also have my shoulder that is killing me i can barely lift it above my head. I have been treated my an ortho who believed my knee to have rsd and sent me to a pain management specialist. They have done every test known, blood mri xrays bone scan. The pain management doc wants the ortho to do exploratory surgery on my knee. I am worried if i have rsd that will make it worse. How do i handle that. I also had problems about two months after the initial injury with my back hurting. I thought it was matress and after a month of pain it went away. The pain management doc asked if i had any back pain because he wanted to check for injuries that could affect my knee. i told him about the pain and he ordered an mri. After it came back it showed a fractured spine and a hemangioma. When i saw the spine specialist he said that the hamangioma had to be there since birth. My research shows that no one really knows how they happen some believe genetics others trauma to tissue. He also said wc will not cover that because the fracture was due to the hamngioma weakening my back. but he says that it doesnt need to come out. My back has been really hurting for about two weeks and he said hemagiomas do not cause pain, my research again shows that some do. Also wc has not approved my shoulder therapy for three months now and the pain is just as bad and sometimes feels worse. My questions should i seek a second opinion and how to find the right one to help me in my area. My knee pain is terrible if i put weight on my leg it bruises easily and swells up. I am just lost on what i should do. I feel these doctors have just traded me back and forth and just keep putting me on different meds. I am on opana 10mg which does not work all day. Lyrica 150mg, zipsor and flexiril. I am just so tired of being in pain. Please help. ### output:

Hello, I have studied your case. Hemangioma do not give pain, but fracture associated with it may give rise to pain. For these symptoms analgesic and neurotrophic medication can be started. I will advise consulting two specialist knee and spines again for proper opinionative time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. 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 Doctor,In 2004 i had constipation once and approached a gastro enterologist.He inserted his finger to examine and i remember stool comming out.He suggested fibrogel and usage of fibre rich food.Till 2007 July i didnt have any problem. That year i had bleeding at the time of defecation. I approached a gastro enterologist and he confirmed that i have fissure. He suggested to heal with medicine. If it repeats he suggested to have surgery. Again in April 2008 August i had problem.In all the above mentioned periods, the pain went off soon and i was normal.But in 2010 on New Year eve i had the problem again with bleeding. I still have the problem on and off. The doctor suggested surgery. I have only one fissure. He suggested to have surgery before the count increases.But i am not inclined to have surgery.Do you suggest Homeopathy or Sidha in this case. ### output:

Hi Welcome to ChatDoctorI have gone through your query regarding your fissure problem. Constipation is a boon of faulty lifestyle and wrong dietary pattern. Causes like unbalanced food habits, irregular sleeping pattern, low physical exercise are few of them. In elderly population, about 70% people are affecting or complaining about constipation. Constipation is mother of all illnesses. Fissure, piles are part of it. If you are severely constipated, the hard stools and strain during bowel movements will cause further harm to your condition by tearing - You may even bleed as the tear gets rubbed by the hard stools. You may feel an urge to itch the affected area. First thing you should keep in mind , Prevention is better than cure so try to eat a high-fiber & a low-carb Chat Doctor. Eat food rich in natural fibers to avoid this condition. Whole grains, beans, green leafy vegetables, carrots, figs, raisins and dates, prunes, papaya etc. are some of the best foods you can include in your daily diet. Fiber helps to increase volume and soften the stools, thus preventing constipation. Soft stools will put less pressure.- Avoid sour spicy foods, refined flours foods, as fried, fast foods cakes, pastries, white bread and biscuits. White rice and sugary food items tea, coffee alcohol corn, tortilla chips, and peanuts should also be avoided as they can cause constipation. Milk and milk products can cause diarrhea in some people, can also aggravate the pain in the anal fissures. A gentle instillation of olive oil into the rectum is an effective home remedy to treat anal fissures. You need to use around 50 ml of olive oil at a time. Repeat it daily whenever required, help to soften the hard stools. This prevents aggravation injury and helps heal the fissure quickly. Use of fresh aloe vera jelly compress on the anus will provide comfort from the painful symptoms and help heal the injury fast. Keep the affected area clean and

If you are a doctor, please answer the medical questions 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 type one diabetic with sever seasonal allergies. I have tried all over the counter (claritan, zyrtec, etc) as well as homeopatChatDoctoredications and nothing works. I have seen many allergists that tell me that taking steroids for the allergies would be worse due to elevated blood sugars but they are the only thing that works (i tried them many years ago after begging and pleading) I feel as though my sugars are more out of control due to the persistent chest, nose, eye, etc problems caused by the allergies. Do you think it would be impossible to find a doctor to prescribe a type one with an a1c of 7 some steroids for seasonal allergies? Also do you really think it is more dangerous to take steroids and have my allergy symptoms go away rather than live with highs due to the symptoms? thanks! ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. I would like to know about your symptoms in detail like since how long, how often, what are your nose, eye, chest symptoms, which medications you used, which forms of steroids you used, dose of insulin for type I diabetes, any other medical conditions, any other medicines, your previous reports, etc. etc. This will help me to understand your complaints better and to make more specific suggestions for you. As you have chest symptoms, I would definitely like to know whether you have asthma, since when, inhaler use, etc.2. As long as nose/eye symptoms are concerned, I usually prescribe my patients' combination of levocetirizine + montelukast regularly.3. Regular steam inhalation also helps in a long run.4. I would like to mention here that there are many forms of steroids available, tablet, intranasal sprays, inhalers, etc. Most side effects, including weight gain, increased blood sugar, etc. occur with tablet/oral form. Sprays and inhalers are very safe as compared to oral forms, and choosing appropriate form may help to ensure minimum side effects with maximum health benefit. 5. Of course, Chat Doctor. 6. For diagnosis of allergies, I would suggest you allergy testing for common air-borne allergens such as house dust mites, pollen, molds, insect proteins, animal dander, etc. This will help you to identify the substances causing allergies to you as well as to know the measures to avoid them.7. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms.8. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.9. Regular physical exercise including breathing exercise and a diet rich in vitamins & minerals also will help you in a long run by improving your lung capacity and immunity respectively. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been sick since the beginning of May. I started Puva chemo treatment for CTCL a form of Non- Hodgkin s Lymphoma , only made it through 2 weeks before becoming very sick with bronchitis and a bladder infection . CTCL is basically a cancer of the immune system , but I have always been able to complete my treatment before. Every time I finished my antibiotic treatment the bladder infection came back. I have now had nine back to back, UTI s and doctor seems family Doctor seems to not care. I had two Mondays ago a abdominal ultrasound with inter vaginal ultrasound. I have been suffering from stomach bloating and pain. I was aware the past two months that something was interfering with my urine flow. Finally made doctor write the lab orders. Which show a mild plural effusion of my right lung. A 2 cm cyst in my kidney, and a 11 mm change to my endometrial lining in my uterus. He only asked for more testing of my pelvis by MRI, and told me to see my GYN as soon as possible. I will have the results sometime today. But the pain wakes me in the middle of the night like right now. ### output:

Hello Cindylanger, Thank you for posting your query through Chat Doctor. As per your query, You have CTCL, Bronchitis, Cystitis, UTI, Stomach bloating, stomach pain, Pleural effusion, Cyst in kidney, Endometrial thickening, Some undiagnosed gynecological complaint, Sudden and severe pain that wakes you up in the middle of night etc. The sad thing about you is that you were and are treating all your physical complaints and none of these medicines cured YOU. I am a Homeopath and so speaking in a different language which you have not heard about so far. You are not sick because of all these diseases, but you get all these diseases because you are sick. By treating each one or other diseases you are in no way becoming healthier. On the other hand your health is becoming from bad to worse. This is because, so far YOU are not treated but only your diseases were treated. You got sick because your genetics made you sick. Your genetics made you to think, feel and react in a particular manner. These reactions made physical complaints along with your mental states. No doctor tried to explore your mind. Or for them your mind was not of any importance. In your long query you have not mentioned anything about your mind, your life situations, your mental and physical reactions to them, your family relationships, your social positions, your psychological conflicts through which you have traversed etc. These are the most important factors that made you sick. The chemical Chat Doctor. It is not too late to come back to natural line of treatment. You are advised to approach an expert Homeopathic physician at the earliest. If not available in your reachable locality, you can confidently get back to me. I can send to you a case taking format in which you can enter your case in detail and forward it to me. I will help you with the right genetic constitutional remedy. If you are convinced and opt for Homeopathy, Contact me with the details. With Best wishes,

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello..I face some sexul problem which is...my penis is not strong and stand when my wife come to my side..bUT..when 1st time of marriage then few days I face this problem then I take a sexul medicine vegorax .just few time ..after that s it s solve...but after 2 yes later ..at present 2 month my penis totally does stand and strong. when sexul time. ### output:

**Thanks for contacting Chat Doctor with your health concern1. As the problem has again resurfaced consult a Urologist for necessary examination and investigation of Reproductive System, till then:i. Start with perineal exercises: while urinating, stop the flow of urine, start again, stop & start again 4-5 times. ii. take: milk and milk products, ghee, Mahan, cheese, curd, black grapes, pears, raisins, dates, almonds, walnut, pomegranate, carrot, banana, apricots, musk melon, AMLA, coconut, pistachio, turnip, potato, onion, lady finger, radish, old brown rice, peas, garlic, bottle gourd. iii. Avoid: sour and cold substances, tobacco [in any form], brinjal, tandoori ROTC, red chilies, heavy and food which require long hours to digest, Jagger and its items, deep-fried food. iv. before starting treatment take:. Take trifle churn [3 gm] with lukewarm water before retiring to bed for 15 days. Singly you can use: [after 15 days]:- Ashwagandha: best regarded as adapted with aphrodisiac properties which may be due to testosterone like effects, thus prescription Chat Doctor. - In Compound form:i. Vigo max capsules [Charge]: 1 capsule daily with breakfast or at bedtime PS. Recent studies indicate Vigo max was effective in restoring sexual function in men with ED of varied etiologies. ii. Tented forte tablets [Himalaya]: 2 tablets twice daily for 3-4 weeks. Treatment may be prolonged depending upon the response.PS. is a non-hormonal and safe sexual stimulant and acts on higher brain centers to improve libido, the antis tress, adapted action of tented forte helps alleviate anxiety associated with sexual desire. iii. Take tablet mental [Himalaya] 2 tab twice a day [since ED is a psychosomatic disorder] thus tranquility of mind is important. iv. perineal exercise [pelvic floor program] is a noninvasive alternative for the treatment of patients with ED by clearing venous occlusion. [will help to achieve full erection afterwards] It also helps to strengthen the muscles and splinters involved in erection and ejaculation. PS. Before prescribing medication especially for ED, the patient should be evaluated for any cardio vascular diseases, thus have an appointment with a Cardiologist for any potential risk of a cardio vascular event, so that Ayurveda medicines/herbs can be incorporated in your daily routine.

If you are a doctor, please answer the medical questions 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 problem begin around April this year. I had visited my primary doctor for a few times and did not solve my problem. So I try to solve by myself by looking all of my blood test result and searching from internet. My beginning problem is waking up in the early morning (only sleep 3 hours) about 2:30 am when feel the shoulder joint bone reducing and it disappear right away after standing up no more sleep and it come again when I go to bed to sleep again. After one month it developed to litter pain on shoulder to wake me up in the early morning. My doctor said that my thyroid function is normal because TSH 2, T4 0.85 . the vitamin d 28.9 little lower but I already took the vitamind3 2000iu more per day and my doctor said it is about enough vitamin d3 now but my problem even become more serious. I then went to emergency room because feel stress sex needed , short breath, and high blood pressure . Doctor want me bring all of the blood test result back to see my primary doctor. He did not say anything but no infection . I feel I am dying and no help because the following days is independent day and holiday. By overview my blood test I had found Sodium 135 (lower), Potassium (3.3) lower, Chloride95(lower), CO2 (25) normal, Anion Gap 15 (higher). I think I am lack of electrolyte, and buy the electrolyte concentrate to dilute with water to drink. After I drink a big cup of electrolyte water I feel much better no more stress. I continue my internet search about why short electrolyte and found that I need take more sea salt food and potassium food and I continue to search why Anion Gap higher. I had found my blood pressure medicine losartan may cause RTA and cause Anion Gap higher. After I take off my blood pressure medicine losartan and take amlodipine in stead of it , my shoulder pain disappear that night (My blood pressure medicine is amlodipine 5mg and losartan 50mg generally, now I change to take amlodipine 10 mg ). I had solved my shoulder pain but I still wake up in the early morning can not sleep enough. I think I might have Hypothyroid problem. By self-test of early morning 1st wake up temperature of my body , 95.2 F , 95.1F, 95.F. From the book if the body temperature in this self test is lower than 97F is hypothyroid. So I think now my problem is hypothyroid . I am looking for how to solve my condition. Thank you for reading and looking forward to your advice. f ### output:

HiI would advise you don't study much on net as it would confuse you as a layman. Go to a physician with trust and get proper advise to follow. Electrolyte imbalances do occur time and again, so does body temp fall.97 is quite normal. Just eat routine diet and juices and fruits and take prescribed medicines. There is nothing to worry from medical point of view. Self-analysis is dangerous and depend only on your treating doctors opinion, you will live and shall be okay best wishes

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, I am wondering if I may have a mild form of tetanus. I impaled the sole of my foot about 3 weeks ago on a metal belt-buckle tine ( about 1/4 in in diameter and 3/4 in long). There was no bleeding so I initially didn t think it pierced the skin although I could feel and hear it enter, like an awl through leather. After looking at the wound under a microscope light I could see a clear + shaped entry. It produced a rather large bruise on the top of my foot for a week or so but that was it. I didn t think anything of it at the time but since have had weird symptoms including: sudden lump in throat and trouble swallowing ( went for dinner with my girlfriend last week and coudn t eat - thought I was going to choke so got a doggie bag) - I thought maybe strep so got anti-b s for that yesterday. Trouble is the swab won t be accurate as I self-medicated with some penicillin I had in the house for a couple of days prior trying to relieve my symptoms. Also, a severe and sudden onset of back pain lasting several days, x-rays showed nothing and it eventually subsided. Slight temp for several days now and also I have frequent ( every 15 - 30 min ) of flash heat/sweating and I know its not menopause as I just had my hormones checked and all is normal. I thought after 6 doses of anti-b s all would be fine but no. I feel like crap, can t get up in the morn and just want to know if I should be thinking of tetanus as the culprit. I don t think I ve had a tetanus shot for about 8 years or more. Had stitches about 7 years ago and remember telling the ER staff that I had had tetanus a couple of years prior so didn t get another at that time. Should I be concerned? The initial wound on the sole of my foot is pretty much healed, no infection that I can tell...a little tender but I am walking on it...just a 1/4 in scab under the skin. Do you think I should go back to the doc? I meant to ask about the foot injury at my last visit but thought it would sound silly. thanx ### output:

Hello. Tetanus is a fatal disease without life support caused by a bacterial toxin. Initially toxin is formed near wound area and later toxin spreads to whole body. Features are irritability, restlessness, locked jaw, fever, initial muscle spasm in the throat and jaw later spread to whole body including respiratory muscles. So until toxin is removed using antitoxins patient has to b put on respiratory support. According to your description difficulty of swallowing is only one episode. Tetanus is a progressive disease, so you can't have only one episode of muscle spasm. Fever and chills are may be due to the throat infection. Some of your symptoms are related with anxiousness too. Anyway it is better to get your blood tests done as soon as possible complaining your worries to the doctor. Hope this helps. Thank you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i have a history of kidney stones and latelty over the last 3 days or so i have become very sleepy nauseated and its hard to pee. i have had pain in both sides of my back near the kidneys mostly on my right side wraooing to the front a mild fever ...is this a kidney stone? ### output:

HI THANKS FOR POSTING YOUR QUERY.HAVING GONE THROUGH YOUR CONCERN, I WOULD LIKE TO TELL YOU THAT THESE SYMPTOMS OF YOURS ARE HIGHLY SUGGESTIVE OF RENAL CALCULI/KIDNEY STONES.YOUR PAST HISTORY IS SIGNIFICANT FOR KIDNEY STONES WHICH GIVES THE STRAIGHTFORWARD CLUE TO YOUR CURRENT ISSUE.KIDNEY STONES CAN GENERALLY ARISE AT DIFFERENT LEVELS -KIDNEY, URETER,BLADDER, BASED ON WHICH SYMPTOMS PRESENT.BACK PAIN RADIATING FROM BACK TO FRONT OF ABDOMEN IS QUITE SIGNIFICANT FOR STONE HIGH UP IN THE RENAL OUTLET OR PELVIS KNOWN AS "staghorn calculus" AS MOST LIKELY IN YOUR CASE.THIS KIND OF STONE CAN PRESENT WITH BACKACHE, WITH LOIN TO GROIN RADIATION, DIFFICULTY IN PASSING URINE, PAIN WHILE URINATING, COMPLETE CESSATION OF URINE FLOW, OCCASIONALLY NAUSEA AND VOMITING. I WOULD LIKE TO ALERT NOW AS YOUR STONE DISORDER CAN BE PREDISPOSED TO A SPECIFIC URINARY TRACT INFECTION-CALLED "ACUTE PYELONEPHRITIS".THIS CONDITION IS QUITE TOXIC TO PATIENT PRESENTING WITH CHILLS AND RIGORS.IT NEEDS INTENSIVE MANAGEMENT IN AN INTENSIVE CARPETING WITH PARENTERAL HIGH DOSE ANTIBIOTICS.ALL YOU NEED TO CURRENTLY DO IS TO GET A PLAIN CT(COMPACT TOMOGRAPHY) SCAN OF YOUR ABDOMEN TO CORRECTLY IDENTIFY THE STONE MORPHOLOGY AND ITS LOCATION WHICH CAN GUIDE THE TREATMENT PROTOCOL.STONE BREAKING MEASURES INCLUDE ESWL-EXTRACORPOREAL SHOCK WAVE LITHOGRAPHY OR SURGERY- PCNL-PERCUTANEOUS NEPHROLITHOTOMY.PAIN KILLERS LIKE TRAMADOL CAN BE HELPFUL IN YOUR CASE.CONSULT AN EXPERT NEUROSURGEON TO DEAL WITH YOUR ISSUE.THANK 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: Dr. Sadie, i hope that u can help me with my situation right now and give me the best advice as possible. My name is Adriana and im 23 years old. I have had 4 csections ( 3 live 1 deceased) in the past 5 years. I currently found out that i am pregnant but unsure of how far along i am. I did not want to get pregnant and was taking care of myself as much as possible. I am scared due to the fact that i was high risk in my last two pregnancies. As much as i love my kids i cannot have another one and the dr. that attended me on my last csection repeated to me that i could not have another one because it could be extremely dangerous. I do not know what to do, i have not told anybody and i feel like im in a hole that i cant get out of. What do you suggest i should do ? If you could please respond to me at YYYY@YYYY . Thank you for your time. ### output:

Dear A Chat Doctor. Pregnancy after 4 Cesarean sections does carry a very high risks of rupture of the uterus during delivery and even sometimes during pregnancy, retained placenta after delivery if it is implanted over the scar, post delivery bleeding, etc. If you are under 9 weeks of pregnancy and are sure that you do not want to continue with this pregnancy, you may opt for termination of pregnancy by medicines which carries very low risk even after cesarean section. WHO has recommended two regimes for such terminations:1. Tab. Mifepristone to be followed after 24-48 hours by Tab. Bisoprolol 2. Tab. Bisoprolol only regime: Tab. Bisoprolol every 3-12 hours for up to 3 dosesThese are very effective and safe methods for terminating pregnancy up to 9 weeks of gestation. It is advisable to ensure the completeness of abortion by ultrasonography. These medicines are prescription medicines and need to be procured by Gynecologists prescription only. They should be taken as per the instructions of Gynecologist. These medicines cause developmental abnormalities in the baby; hence the pregnancy should not be continued if the medicines fail to abort; then the pregnancy should be terminated by surgical methods like MVA aspiration. Since you are having 4 previous Cesarean sections, it will carry some extra risk; however under expert supervision, this can be carried out fairly safely. If you decide to continue with this pregnancy (which I would not advise), you will have to be under continuous supervision of Obstetrician. The integrity of the scan may be assessed by repeated frequent ultrasonography. Any discomfort over the lower abdomen should be reported to the Obstetrician immediately. You may have to be in the hospital during last month of your pregnancy. This will have to be a planned cesarean delivery. This delivery has to be a hospital delivery. Please maintain your health. Keep your hemoglobin within normal range by regular consumption of iron and high protein diet. Please visit the Obstetrician for antenatal care more frequently and follow the advice religiously. I hope you got the messages.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: , Im not under a doctors care, but back in Sept. of 2010 I was under the care of Dr. Noel P Lim, I went to him for neck pain and burning and tingling in right arm and left arm. He did an Exam and was very concerned so he had an MRI done, the findings were as followed: Technique: MRI of the cervical spine was performed at 1.5 Tesla per routine protocol.Comparison (s) none available. Findings: Images are markedly degraded by patients motion. Several imaging sequences were repeated without significant improvement in image quality. There is advanced degenerative disc disease throughout the cervical spine, most noted at C3/4, C5/6, and C6/7. Modic type degenerative endplate changes are noted within the C5, C6, and C7 vertebral bodies. There is focal increased T2 signal within the spinal cord at C3/4 and C4/5 levels. C2/3: Broad-based posterior disc osteophyte complex without significant spinal canal or neural foraminal narrowing. C3/4: Advanced degenerative disc disease witChatDoctorplete loss of disc space. Large broad-based posterior disc osteophyte complex resulting in severe bilateral C4 neuro foraminal narrowing. There is flattening along the ventral margin of the thecal sac and the AP diameter spinal canal is narrowed to 8 mm. C4/5: Degenerative disc disease. Central posterior disc herniation/protrusion with mass effect along the ventral aspect of the thecal sac and spinal cord. AP diameter of the spinal canal is near the 5-6 mm. C5/6: Advanced degenerative disc disease. Broad-based posterior disc osteophyte complex. Short pedicles. There is flattening of the thecal sac and spinal cord. AP diameter of the spinal canal is narrowed to 8 mm at this level. There is severe bilateral C6 neural foraminal stenosis. C6/7 Advanced degenerative disc disease. Broad-based posterior osteophyte complex. The diameter of the spinal canal measures 9 mm . There is mild to moderate bilateral C7 neural foraminal stenosis. C7/T1: No significant stenosis. Impression: There is multifactorial spinal stenosis and moderate or severe bilateral neural foramial stenosis from the C3/4 through C6/7 levels. There is abnormal signal within the cervical spinal cord at the C3/4 and C4/5 levels, probably representing mylomalacia secondary to chronic compression. ### output:

HIT hank for asking to ChatDoctorIn the beginning of report it said that image quality is not good due to the movement of patient, If I would be a doctor then I would ask for another imaging report with strict instruction not to move your head at all during the procedure, because such movement can not give good quality image and bad images greatly effect the interpretation, which may not be taken in to consideration, but still it can be said that the above report is suggestive of cervical spine degenerative disease may require medical attention better go for another MRI have nice day.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear Dr. am suffering of numbing in my feets since 25 years started in my toe coming up to my full left foot and now my right foot also begun since the last 3 ears . recently i feel like wearing tight shoes even pain in my joints knees and total hip joints i have no diabete so my doctor started since 2010 treating me while he made a test or me that shown inflammatory veins with medicine called Lyrica 150 mg bd plus (CYMBALTA 30mg duloxetine) for 3 years without getting improvement.but worst more pain in all my joints and can not stand without stick .. my knees having no power to carry me .pain in my total hip joints.i couldn t take CYMBALTA 30mg because it was very hard / strong on me which made me vomit and sick and i knew it was antidepressant drug useless but my doctor said its important for my treatment but could not take it . now since last 3 months he started to increase the medicine lyrica 300mg t.d.r plus injection SOLU-MEDROL IV 1000 mg @ 3 days for every 2 weeks.(three times) till to date. yes the pain in my joints has gone temporarily for 5-8 days i just knew that this medicine contain CORTISONE he also asked to take blood test but was very anxious for result because my ESR was 104 . immediately he asked for another test of blood & urine called serum ig electrophoresis i am so worried now and result will come out after one month as he ill see me .. but asked me to continue take the old medicine (Lyrica,THIOTACID 600mg b.d , Imuran 50 mg Azathioprine Tablets b.d, Caltrate 600-D Calcium Supplement.plus pain killers like Tramadol Arcoxia.pls xanax 1mg at night i am feeling very weakness in my legs can not move my feet forcely i feel my feet is hanged in my leg with numbing and very tightness also the pain start coming back but i use spry sedative and pain killer and can not walk without stick . i need to work and my age is 52 Kindly help me.... is there any dangerous situation waiting for me. and would lyrica help on longer time as higher does of lyrica making me feel drunk also ..but this injection is good for a while only relieving pain Kindly help me and would xanax affect the joints on long term use ??? Thanking you with best regards Abdulla yousif ### output:

Hello, It would be helpful if you look into your blood sugar for this is usually the cause and to include lumbosacral spine MRI with contrast to see if you have spinal stenosis. The motor weakness should be ad Chat Doctor. These modalities could identify, rule in rule out the problem and management will follow. Treatment entails escalation of pain medications to rehabilitative medicine and spinal surgery if warranted. 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: I am a 25 year old male. I have been experiencing certain symptoms whenever I get tensed / excited such as sensation of heart beat (pounding feel on the chest), fleeting breathlessness, chest pain,etc. The symptoms usually dissappear once I relax myself and do not usually last for more than 2 - 3 minutes. I have also experienced panic attacks and palpitations occassionally (3 - 4 times in the last 4 years or so). I recently met a doctor who asked me to get my ECG done. I got my ECG done and the doctor said I was having sinus tachycardia. But for the fast heart rate, he said my ECG was otherwise normal. I was asked to get my echocardiogram done (to rule out other complications like MVP,etc.) and also to undergo a thyroid test. In the mean time, I was prescribed Inderal 40 and Clonotril tablets. I am getting my echo and thyroid tests done shortly. But I am a little concerned as to whether I really need to take the medication he prescribed (Inderal 40 and Clonotril). The symptoms I have described above do not really bother me since they occur only occassionally when I get involved in a tense situation or so. Moreover, they don t last for more than a few minutes and as long they don t point to any serious trouble, the symptom itself is not a problem. I am worried if the above medication could cause side effects and would like to avoid them if possible. Can you please advise? ### output:

Welcome to Chat Doctor! I have gone through your problem and there is a possibility of anxiety and panic attack. It is less likely related to heart disease. Your ECG was normal apart from sinus tachycardia, which is just a finding when one is anxious. I don't think that ECHO and other tests will have anything abnormal in it. The doctor had given you right medicine, they will be very helpful. From my clinical experience I can say that these symptoms are more likely to increase if not given proper treatment and may lead to severe anxiety, which may require long term management. You are not worried about these symptoms doesn't undermine their significance....they reflect some kind of chemical disturbance, getting such attacks more frequently can pose stress to heart, may lead to increase in Blood pressure. I'm not trying to scare you, but one should not unnecessary increase/ neglect it. Taking medication will help you, and later you can stop them. I don't know if you have any stressor currently which is leading to this problem... federal may cause some lowering in blood pressure, sometimes anxiety /palpitation also, but largely is helpful. Clonotril is good antianxiety medicine but may lead to sedation to some people even in low doses. Control may cause addiction if taken for long time, especially without prescription. I have seen paroxetine 25 mg alone working very nicely in such problem, with control 0.25 mg when there is panic attack. If still you want to avoid medicine then please do breathing / relaxation exercises regularly, three to five times a day, this will help in reducing / stopping the anxiety. Hope the reply is usefulness free to ask more 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: Hello Doctor, I am Roma, 23, single and working. I come from a gujarathi family but born and brought up in Maharashtra. I am writing to you to seek help for my brother and parents. My brother and parents are having a strained relationship. Brother is 31, married and works in US. Parents (mom aged 55 and dad aged 59) stay in Dhule, Maharahtra. Dad is a physician (M.D., M.R.C.P.) and mom is a housewife. Brother has developed a feeling since childhood that no matter what he does, his parents are never happy with his achievements and they donot love him. He says that they have always pointed out only the negatives in him and never ever appreciated any of his poistives. He recalls many trivial incidents from his schoollife to graduation to current, wherein he thinks his parents never appreciated his success. Also he feels that MomDad try to micro-manage things ( as they want every small thing to happen as they want only) and donot appreciate independent thinking. (Though I know that mom dad have always been very proud of his achievements. It s just that their way of expression was way different from what brother expected). After his marraige, there have difference between his wife and parents. Parents feel that their son should take their side. But brother does not feel that right. Mom Dad are of a very traditional outlook. And this might be also because of the kind of society thet live in. They think they are always right. They think that after going to US and after marraige, their son has changed a lot. They think that their son is arrogant and not matured to the level expected. So now the case is Mom Dad are sad that their only son is being good to them inspite of they having been do so much for him all life. And brother is sad because he feels his parents have never been happy with him inspite of all his efforts and he is now frustated by their behavior/expectations. The situation is not at all good for a healthy family. I know i should not interfere in these conflicts as that would just tear me apart. But having know both the sides, feel a moral responsibilty to try to solve situations. Though they always all tell me not to worry about these things. Hence i want you to help them sort out things.Can u help here? The problem is brother is here for diwali right now and is going back to US on 10th of this month. So there is not much time. Would it be possible for you to have some phone-discussions and email conversations with all of them individually or on conference call? thanks Roma ### output:

Hello Roma, I agree that you face a very difficult situation within your family. Just to make the environment better, your parents as well your brother has to make efforts. Your parents should understand that their son is a grown UO now and has the capacity to take independent decisions. So they should try and not judge or interfere with him. On the other hand, your brother should also take pride in that his parents have worked for his success in life. They are his responsibility and he must work for their happiness. Hope the situation gets better. I would be pleased to help you further if I can in any way. Thanks.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi..i m Swati.I m of 21..suffering from lower back pain for last 4 months.few days before i did x-ray spine LS but everything was all right.dr gave me medicines Gemcal plus pure D3 Espra but i m not getting relief.it becomes painful in night i feel straining in spine and to my right leg i cant sit more than 10 min i feel good in walking but not in sitting or sleeping.what to do please suggest sir.. ### output:

Hi Welcome to ChatDoctorI have gone through your query for persistent lower back pain. It is a matter of concern . Dear, It is good that your X-ray came out normal & all is well. But At so young age you are facing this problem, is really worrisome. 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 will not help if you don't modify your lifestyle and food habits. 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. 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. Avoid processed foods carbs, sugar, fried, fast foods, Tea, coffee, alcohol and smoking, 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. All are the pillars of our strong immune system responsible for healthy disease free life. Take Homeopathic Lachesis 30 1 does in the evening and Chamomile 30 / 1 dose at bedtime. Thus to 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: my husband had arterial surgeery in august. they put in three grafts. also found out his liver is totally shot .hepatitis c.since the surgery he has lost 40 pounds. no appetite, lethargic, and no strength at all. also he had a staph infection in one of his incisions where one of the grafts where.. i think we are over the staph infection. but, my husband is almost like dead. he can barely walk cuz he is so weak, he will now -last 4 days -drink ensure to keep himself alive, also he is very weak- like i could push him over with a feather. he also started having chronic pain in his abdomen and lower back about three weeks ago. since this time thats when docs found the staph infection. but since then he is still having chronic pain in his lower back-so bad he would not eat or sleep for fivedays. doctors say he has muscles spasms. hard for me to believe. he also is going downhill- fever, sweats, very lethargic where he sleeps continuasly, and still in massive pain.saw the doctor today, and prescribed ambien. now he is sleeping, which is good, but the poor man is still feverish, and so ill he can barely stand up. would the doctor just not tell me or my husband that he is dying-expecting that the infectiuos doctor to tell us. i am at whits end. he is definatly deteriating- and i was the one to point out to doctors that he had lost 40 pounds since the surgery. please help ### output:

Hi there, If he is still having fevers and lethargic, I'd be worried that one of his grafts were infected. Sometimes, it takes many weeks or even months to get over a major surgery, but he should start to improve and not decline. Blood cultures would be the first place to start, as if he has blood cultures that show infection, I'd be very worried that his arterial grafts were infected. If he has negative blood cultures, that is more reassuring. If his incision is getting better, that's certainly a good sign. I would have a straight forward conversation with the surgeon who did the surgery and ask him why your husband hadn't fully recovered, and what his expectation for his recovery should be. If he's not eating well and having pain, then there are certain things that can be due such as a nasogastric feeding tube, or perhaps even IV nutrition. If he's having pain issues, then he should refer him to a chronic pain doctor. And finally, if he's having fevers, I'd ask the surgeon if he has an infection of the grafts, and if he says no, I'd ask him where he thought the fevers were coming from this far out of surgery. In this case, it sounds like you really have to push your surgeon for answers. No one will know the answers to these questions unless it's the surgeon who did the operation, who should be following him closely. I hope this is helpful. Please contact me 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: About one year ago I was diagnosed with PSC after a year of symptoms (did not seek treatment from a hospital due to the suspicion that it was a gall bladder issue, so I changed my diet and reduced my symptoms dramatically with only a few exceptions of serious pain). The hospital staff that diagnosed me did not inform me of much at all, simply what my condition was and how it worked. I was told to eat a low fat diet and sent on my way. Later I found out that I will most likely need a liver transplant within 10-15 years, and if I do not I will die within that time period. So now I really need to ask, how often do people whom need a liver get one based on economic status, location, liver availability ect. and how long is a person expected to live based on things such as living / deceased donor, condition, age of receiver and donor. ### output:

Hi, Regarding Liver Transplant: It is of two types one is Live donor and other is Deceased contrive donor in which half of liver from one person who is normal, is taken out and transplanted in the patient.Advantages-Liver is available immediately. Disadvantages - 1. You have to arrange for donor, and it should be your near relative preferably first degree relative and that after some paper work and completing the legal formalities.2. Both donor and recipient undergo major surgeries and donor also have more risk of complications (although it is very safe these days but due to major surgery risk is definitely high)Deceased Donor in which a person who is dead, or brain-dead is used to get full liver. Advantages - 1. Full liver is available.2. As donor is already dead, no risk to donor. Disadvantage -1. Wait list is very long as it depends on someone who died2. It also depends on that whether blood group of that person is matching with you or not. Different hospitals and different regions have their own preferences. In some places, mainly it is Live Donor while in others, it is mainly deceased donor, but live donor is also there. Cost - In private set-up it is quite expensive for surgery and later on for follow-up investigations and treatment (which is life long), you would need a monthly expenditure plan just for this. While in Govt. set-up, it would be lesser. Regarding 2nd part of your question - and how long is a person expected to live based on things such as living / deceased donor, condition, age of receiver and donor. The quality of life after liver transplant is excellent if everything goes well. However, there are many factors which effects the outcome both donor and recipient related. It is quite a complicated equation. It depends upon the co-morbidities in recipients like heart disease, DM, Hepatitis C or B, history of Alcohol or cigarette smoking etc., and quality of liver which you receive like how fatty or fibrotic it is. Any surgical related or post-operative complications like rejection, blockage of blood vessels or bile vessels, any post transplant infection etc. 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: Hello I am a 19 year old female. I have had reoccuring stomache problems for 4 years now. And been in and out of the hospital several times because of the pain. When I arrive at the hospital they take my blood and I have high white blood cell count. I have had every test possible done and come back all normal. When I have my attack or whatever it is, I usually feel like I have a gas bubble in my stomache that won t go away and it progressively gets worse after a couple hours tell soon I am vomiting from the pain and curled in a ball not able to walk. The only thing that seemed to help while in the hospital was Demerol and buscapen. The one surgeon I have been seeing is saying he will attempt to take out my gallbladder only if I want, because I have a 1 in three chance I will either get better, get worse or stay the same. I seem to always feel nauseas, and I m very gassy, especially burping. My pain when I have my attack is in the middle in my stomache, right below my ribs and goes to around my belly button and then sometimes shoots all over but hurts alot too press more to the right side for me. It is not my appendix though. I am so sick of suffering from this. I seem to constantly be sick. And I also don t like to take Demerol cause it makes me nauseas and feel weird. I sometimes will wake up in the middle of the night gassy, heart burn , and nauseas, and slightly in pain but nothing serious ( like right now for example ) I feel hot and cold . And so uncomfortable. I just want too sleep. I also wonder if its maybe the food I eat. I dont eat terribly but sometimes I eat bad food like chips. I feel hopeless cause many doctors have given up on me considering they can t find anything wrong with me. I know something is wrong for a fact. One doctor even thought it was all in my head, but I m sure it s not. I don t believe my white blood cell count would be high cause things all in my head. I also am not overweight . I am 140lbs and 5 4. I really hope someone somewhere can see this and help me. ### output:

Hi there, the symptoms that you have described do seem to point towards an appendicitis or cause related to gall bladder or due to chronic gastritis. I would suggest you to take a full course of antibiotics for Helicobacter infection along with antacids to receive you of the gastritis like symptoms and if it doesn't give you any respite, instead of getting the gall bladder removed it would be better to investigate for chronic appendicitis and get it removed. You could also take the small measures of have small frequent low fat and spice diet and going in for some kind of meditation or yoga to calm your mind and to get over the anxiety and tension that you seem to be suffering from due to this condition, It would also be worthwhile to get an x-ray PUB done to rule out any ureteric stones as they can mimic an acute appendicitis attack. Do not get disheartened and do try to get to the root of the problem. 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: Dear doctors, I hope you guys can advise my on my current condition. I am a 21 years old male with a girlfriend that once has cold sore on her lips but it has recovered. We had sex about 4 weeks ago but during intercourse I feel pain on the shaft of my penis so I ask her to stop. So after this there is no oral or intercourse. About 3 days later I realize that I feel a burning pain when I urine and there s a couple of pimple-like lumps showing on the shaft of my penis. I went to consult a normal clinic doctor about this and he told me that it could be genital warts. He gave me anti biotics for my burning pain during urine and a cream that contains steroid for the warts 3 days later I am not feeling any better so I decided to see a dermatologist. So she told me that it s herpes and gave me valtrex pills and Bactroban oilment and a anti-imflammation pill as the burning pain during my urine is not better As I took the medications, the herpes is healing up but the pain when I urinate is not any better . So I went to see a urologist and he gave me doxycycline and he say that the antibiotics I am having is not complete to fight the bacteria in my urinal tract. So now week 4 and I have completed a total of 3 types of antibiotics (1 of it is doxycycline while the other 2 I forget it s name) completed valtrex pills and got ASAP silver cream to apply my herpes. The herpes is gone and the buring pain has more or less gone away. But my semen is yellow-ish!!!! I went back to the clinic and the doctor say that it maybe a prostate infection. He gave me levofloxacin for 2 weeks 1 pill every morning. And now I have very serious of itchiness on my penis and my anus. This is what happened to me and I hope you guys can understand what I am trying to explain and advise me on my condition. I have a couple of questions though -is hsv1 and hsv2 the same? -is the decocort helps with the itchiness on my penis and my anus? -how to know whether is my prostate infection better or worse? -will all this affect me on having a baby? I really want to know what is happening as I have seen too many doctors and I start to be very confuse in my own condition. I want to be normal again. Thank you very much Thank you, Thor ### output:

Thanks for asking in Chat Doctor forum In Short: I understand your concern, have patience please. Explanation: It seems that you had herpes and Urinary tract infection together. Urinary tract infection may be prostatitis also. SO, prostatitis takes long time to heal. So, please visit your urologist once again with your same complaints and ask him for urine/semen/prostate secretion culture and sensitivity and change antibiotics according to the report. Please have patience, you will be alright but takes time. And also donor change doctor frequently. Hope you understood it. Please let me know.

If you are a doctor, please answer the medical questions 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 from Canada and had a few arguments with my neurologist and now I just want a few other opinion. I had in November 2012 a working accident, were I fell 8 of a roof straight on my feet and with my left foot I hit a rock and kinked my ankle and that s how I broke a few pieces of an inner bone off about 15mm x 10mm x 5mm was the biggest but that they found out a year and five month later because thats when they did the surgery . The rock I landed on with my foot was small but I guess I was stiff or something when I landed. I tried to walked but it was to pain full and I right away noticed that I got dizzy and tried to sit down but later woke up laying on the ground. I don t know for how long it all was but I then somehow got to my company van and drove to the shop which was just 2 miles away. There they dropped me off at the hospital and they did a x-ray but could t see anything just a big swelling and then they send me home. About 3 month after I started to have seizures and it got worse and worse till they did the surgery and then things went better and I was seizure free, but all with medication. It went good till September 2015, suddenly in the evening I was sitting down and I had a seizure and hard one. Till know I m not really recovered, lots of headaches, dizzy, bad hearing, beeping in the ears, hands and face is getting num. But I never had that before the last seizure. My questions are: as a child when I was 8 I had encephalitis but recovered 100% (that it shows in my documents) and there were no signs of seizures because I had to go for EEG s and MRI s every few month after I was diagnosed with encephalitis and later every few years and there was nothing. It all happened after the accident that the seizure started. Is there any possibility that the seizure come from the accident? Because I lost consciousness after the fall, is that normal? It was snow and icy and I was wearing a toque. Thanks ### output:

Hello, If I understand you right there was no hit to the head, no direct head injury from the fall, you say to have fallen straight on your feet. In that case, I don't see any link between the seizures and the fall unless there is a brain injury there is no reason for a fall to cause seizures. Loss of consciousness was most likely a vasovagal syncope, a common cause of loss of consciousness due to increased legal activity often related to stress and pain which I suppose were present after that fall. Tough to throw any hypothesis about the origin of the seizures as you provide no info on current brain imaging and EEG results, you mention only those after the childhood encephalitis. It is unclear why you had surgery for seizure as well, surgery is rarely used for seizures, usually when there is a tumor or some other type of brain lesion as a source. So please provide more info on that regard if you are to resume this discussion. 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 ve been diagnosed with multiple things. Dysthmia, Panic Disorder, ADHD and Borderline Personality Disorder. I think ADHD, and BPD are primary. I probably actually have both. Through great research I decided I wanted to try Abilify, and I asked a Medical Practitioner, and it works very well with certain symptoms. Especially it stops me from losing emotional control and having stress induced emotional outbursts where overwhelming surges of emotion (easily triggered) overpower my better reasoning. For this it is 100% effective, incredible. Literally I have been on it for a year now and not lost emotional control a single time. Part experimenting, part by flook (ie luck) I discovered that 400mg per day of Modafinil significantly augments the effects of the Abilify. I do not only not lose emotional control now, but I don t feel overwhelmed by stress and negative emotions in the first place. I feel well, positive and able to cope with life. For the first time I am also motivated, and my concentration has improved quiet dramatically. I have had various tests, and know that physically I am in good health (blood tests all fine etc). But I am not sure what to say to a doctor, that basically through experimentation (without informed medical supervision) I have stumbled across a miraculous combination of medications. Literally like I am basically cured of my problems on this combination. I have spend decades of my life FAILING to find such a combination, and finally I have it. I have been on Disability for these problems for 1.5 decades, now I believe I am fit enough mentally to consider working. As I have been keeping my Modafinil use a secret- what should I do? Its not an approved indication for it. My belief is both the Abilify and Modafinil are likely improving the functioning of various areas (especially the medial area) in my prefrontal cortex. Abilify modifies various serotonin receptor types in the PFC and Modafinil, apparently increases Dopamine, Noradrenalin, and indirectly Serotonin in the PFC. Basically they are both PFC enhancing medications (if you read the latest literature and research). I don t know how to explain it to him, but it was from reading THOUSANDS of pages of scientific literature that I suspected my problems likely occur due to Prefrontal Cortex under-activity , especially Medial and perhaps orbit-frontal areas in regards to the emotional and stress intolerance aspects of my problems Any advice you can offer would be appreciated. ### output:

HiT hanks for using Chat Doctor You are right behind your logic that your problem is related to prefrontal cortex, and you need medication that could maintain the balance between serotonin and dopamine. In that, you can use an antidepressant like paroxetine or stimulant like modafinil which would increase the level of dopamine at frontal cortex. Abilify consists of aripiprazole, and it is a partial agonist of dopamine. You can take it in low dose with modafinil and antidepressant. 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, my husband has been though much testing in the past 2 weeks. It all started with a swollen supraclavicular lymph node. Then a week later one on the other side became enlarged. After a week, he went to the doctor who put him on amoxicillin. During this stage, he got extremely tired, and began running low grade fevers. After the 10 day regime with no results, he went for blood work, which all came back normal. Next, a chest xray, which showed fluid in his lungs and something in his chest. A ct scan revealed the swollen lymph nodes in his neck and either a mass or swollen lymph nodes in his chest. He went to get the fluid drained off his lung. They took a gallon off and said they would take the other gallon within a week (he has an appt. Monday). This fluid was tested and lymphocyte cells were present. He had a biopsy of the first swollen lymph node a couple of days ago and they said the results would be in within 7-10 days. The doc. said something about a type of lymphoma after the initial look at the biopsy. We now have an appt. with an oncologist this week. I feel like we are not getting enough info. They say whatever is in his chest is pushing on an artery, which is causing the fluid. I dont understand why no one knows what this is. If this is lymphoma, is there any insight as to what type it might be? Is this something where he will need his lung drained every week? He has been feeling short of breath with back pain due to the fluid. He is 32 years old and other than this has always been in great health. Any detailed info. would be appreciated. Thanks ### output:

Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. IN the given situation, You seem to have suffered from-NHL Lymphoma with Mediastinal Lymph nodes with supraclavicular nodes first on one side and then on the other side. Other possibility could be-TB lymphadenitis with glandular lymphdadenitis / and Acidosis. But in view of the lymphocytes in the pleural effusion, chances of Lymphoma and or TB Lymphadenitis. Chances of Lymphoma are more in view of the supraclavicular lymph node swellings. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link-http://doctor.Chat Doctor .com/Funnel?page=askDoctorDirectly&docId=70229Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Almost constant discomfort in my lower-back and left leg. Sometimes it goes away - and sometimes it returns with excruciating shooting pains which keep me from being able to stand or walk.I am 55 and in fair health, though I don t exercise much. I was riding a bicycle the other day fairly strenuously - and then retired to a small restaurant with short stools to sit on. After about 20 minutes I stood and felt a little pain - then got into a taxi for a short drive to my apartment - and by time I reached there I was almost incapable of getting out of the cab. This was a month ago.I ve done chiropractic before and so went to a trusted practitioner, had several treatments with varying degrees of temporary relief but the pain keeps returning daily.I have also noticed a lump along the ridge of my left hip just off-center from my spine... and that I didn t have one on the right side (my initial pain was on my left side). I ve tried massage with heat and oils to reduce or eliminate the pain with no success.I m tired of putting up with the consistent pain, and also the worry of sitting wrong or for too long and not being able to walk when I stand up.If I experience pain when I stand I can get some relief if I sit back down and bend over stretching the area... I can at least stand up and walk even though there s still residual pain.Realizing it s impossible to diagnose accurately online - I d like recommendations. ### output:

Hi there, thanks for your question at Chat Doctor Most commonly Low backache can be attributed to bad posture or muscle pull/ strain due to abnormal stress on back like sudden twisting movements or lifting weights etc. But I think it needs further work up since. 1. you have back pained for after sitting for 20 minutes(not expected at your age). 2. you have start up pain(pain on getting up form sitting position-indicates some form of instability in the back, muscular or bone)3. New onset pain like sensation in one of your legs(might suggest pinching of nerves in back) 4. No significant improvement in pain after several treatments, heat and medicine(suggests severity of underlying etiology) and 5. You have relief of pain on bending forwards(can suggest arthritis of facet joints - joints in your back). The most basic work up will include a thorough physical exam and X-Ray of your spine. Further course of action will be decided based on them. Online solutions might help you in muscular strains and postural pain, but not if there is some pathology in your back. The lump like feeling in your back can be due to muscle spasm or bony instability, which further calls for a visit to your physician to be more sure. In the meantime, I would suggest you to go through websites on ergonomics. Ergonomics is branch of science which deals with posture adjustments according your livelihood. It will help you choose a posture most suited for your daily routine. Also core stabilization and back strengthening exercises will help support your back in the long run. Hope this helps. All the best. 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: My 16 year old son had 1 1/2 hours of soccer practice Mon. night. Next morning while sitting in a chair, waiting for breakfast he fainted sideways and fell on the tile with his head. There was a bruise mark, and swelling. He stayed home from school that day, and drank about 7 pints of water. HE was still dizzy, so I took him to Baptist Urgent med. They noticed the bruise, did an EKG , and a CAT scan. They also took blood and urine, and noted he was borderlline dehydrated. My son does have a history of vasovagal syncope , so bad at one time that he had to do school at home online. This stopped, but it is Friday now, and he is so dizzy still, and afraid he will faint again. My son Steven said that even though the bruise from his head was on the right side of the dome of the skull , the worse pain is below, or where it is more soft. His pediatrician ordered an MRI, not for this but rather for an adenoma that was on his pituitary found 3 years ago. His doctor believes that dehyration should not have caused this fainting . The Urgent med doctor believes it may have added with Steven s past syncope problem. I am also asking for follow up with a neurologist and cardiologist, recommended by Urgent Care MD. He saw these specialists before including and endocrinologist , all were NEGATIVE. I am concerned because he is so dizzy, light headed, ringing in the ears. He is missing school. He said that yesterday while at home, he felt a sharp pain in his head, ringing in the ears, so he got down and made it to the bed half way and passed out for about 5-10minutes. Any advice? It is 6:41 am Eastern time, and he is very dizzy. I am thinking of taking him to ER today if it does not improve. Concussion? ..possible sensititivity to this fall due to his history of syncope.. Any comment would help . Thank you. Elizabeth ( wrorried mom) ### output:

THIS MAY BE PROBABLY DUE TO HEAD INJURY.INITIALLY FALLING FROM CHAIR MAY BE DUE TO VAST VA GAL SYNCOPE N THEN HE FELL DOWN ON THE TILE WHICH CAUSED BRUISE N SWELLING.THOUGH THE INITIAL CAT SCAN DID NOT REVEAL ANY HEMATOMAS IN THE BRAIN, I FEEL IT IS BETTER TO REDO THE CAT SCAN BRAIN TO RULE OUT ANY DELAYED HEMATOMAS.if U R AFFORDABLE LATER GET A MRI BRAIN PLAIN N CONTRAST FOR BETTER DETAILS REGARDING PITUITARY STATUS.HE MAY ALSO HAVE POST TRAUMATIC VERTIGO WHICH MAY LAST UP TO 2-4 WEEKS TIME.BETTER CONSULT A NEUROSURGEON.

If you are a doctor, please answer the medical questions 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 vertical 4 red arc bordering my left ankle and was wondering what it may be. Here is a background on me. I had breast cancer in 2009 and was treated with 26 high dose radiation visits and have been on the 5-yr Tamoxifen treatment plan for 3 years now. I also had a foot wound in which I was diagnosed with Cellulitis , Strep infection and Scarlett Fever, 1 year ago. I flew a long distance 6 months later and both of my feet, ankles and legs swelled up again. My family doctor told me it was just the long flight and that I should get stockings and get up during the flight. I disagreed and thought it was related to my Cellulitis and wondered if my Strep infection was cured. I was originally given 3 antibiotics to treat Strep, Mersa and 1 other infection for the recommended length of time, my family doctor said the infection was treated but did not do a follow up blood test for strep. I still have a few red dots on my legs below my knees. I just got back from a trip to Hawaii from Alaska and my legs were fine! Currently, my latest blood test revealed high glucose and high calcium. My oncologist asked me to do another blood test to recheck my calcium and go from there. I also have an appointment with an internist for an office visit to report blood from rectum with more frequent and loose stools. My family history is cancer, heart disease. No diabetes. I have normal low blood pressure, 101/63 or so. I have also been going through menopause for the last 9 years. I also have frequent nighttime urination along with incontinence . I have to wear a daily panty liner because of discharge. I have had yearly exams and tests ran for all std s but all have come back negative. Sometimes I feel like I have a swollen gland in the outside vaginal area and once in a while feel maybe an ovary pang.? I have had a cough the last couple of months, running nose and a sneeze ever now and then. I have also had a couple of scans on my neck area because of bone grinding and neck tipping . My cartilage is gone between a couple of discs and I was diagnosed with osteopenia and told to take calcium supplements. ### output:

thanks for your query can feel your concern sits really hard to cope with so many problems you need to monitor your blood sugar. And you may need medications if it is continuously high. Modify your diet. Avoid junk food and bakery items. Use fresh fruits and vegetables. For your loose stools, you can use Español husk. You need a routeing urine examination to rule out any urinary infection. Moreover you can have pelvic exercises to overcome urinary incontinence. For cough, use honey and green tea. Steam inhalation is also effective. Avoid cold and soft Chat Doctor. You can use some antihistamine after consulting your doctor. Continue using calcium supplements and also use vitamin D Supplements.wishing you good health regards

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello doctor, I stopped smoking 6 months ago, since then I have not visited the club till 2weeks ago when I went twice and stayed for hours in an airtight place covered with smoke, after then I started feeling sick, firstly I had stuffy nose and blocked nose to fever, now I can t breathe properly, I m still awake cos I find it difficult to breathe and can t sleep, what can I do. ### output:

Hi welcome to Chat Doctor Dear solution is the main cause of falling sick and difficulty in breathing . By now you must have realized this fact ? Adopt Exercise to Breathe Easier. Weak muscles need more oxygen, so you can become short of breath just inhaling or just moving. Exercise changes that. When your muscles are stronger, daily activities are easier. Yoga & Panama - Deep Breathing Inhale - Hold - Exhale - Hold, for 2 seconds each , repeat 15 times. Always breath through nose. Anglo Film - close your right nostril with your thumb, inhale from left nostril, Hold for 2 seconds, Exhale from right nostril, close your left nostril with your thumb, Hold for 2 seconds and Inhale from right nostril . This Repeat 10 times. Kapalbhatti - Exhale with slow force, only throw out your breath, all doing regularly will further strengthen your muscles. If you haven't been active lately, check with your doctor before starting an exercise. A balanced diet which include all essential nutrients is equally important. Peanut butter can pump up your intake of both calories and protein. Protein is important at every meal for people with breathing problem. Good sources include eggs, lean meat, fish, poultry, legumes, and nuts. Crushed Garlic, ginger with honey, lemon juice with warm water with a pinch of salt and black pepper Vitamin B6 and Vitamin B12 are very important nutrients to treat asthma decreasing the inflammation in the lungs. Vitamin C Is needed to fight infection, increase the amount of oxygen and reduce inflammation. Lemon juice and AMLA are the best source of it C. And also a level spoon of turmeric powder with milk at bedtime help boosting immune system. Avoid milk and milk products, substituting other calcium sources. 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. Always Chat Doctor. 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 can overcome your problem. Regular check-ups from your professional are recommended. Hope this helps solves your query. Take care. All the best. Get well soon.Don't 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: Hi I am 48 yr male, 6 1 220lbs. I have a clean medical history. No issues or allergys. Heart disease does trun in my family. But I have no heart issues. Anyway my problem is on my forehead. I always had a slight what I would describe as a slight soft fatty tissue under my skin under my hairline the size of a penny. It was not noticebale except to me really. This created a small soft bump. Not really a problem physically or appearnce wise. Recently I got a haircut and couple people asked me if I bumped my head. I had not but they noticed the bump. I figured it was because of my shorter hair they noticed the bump. Well 2 weeks ago I noticed the area was inflamed & reddish. I assumed it was an acne eruption or I got a chemical reation to something at work. I treated area with heat pad & ice along with some cortizone cream. The skin broke and now their is a soft tissue that protrudes up slightly. It does not hurt when I press down but creates a bump and is reddish. I treated it with iodine and hydrogen peroxid. It is not infected. Just seems like what I thought maybe was a small cyst is on my forehead. I rubbed the cortizone cream on the wound whch is size of a penny. The wound is not really healing after over 2 weeks. It s not an open wound. Just the skin is very rawish looking and pink. When I rub on the sac like cysts it feels tough like cartliage rather than skin. I am going to see my primary care doctor a board certified internist. I was curious based on my description what you thought it might be and if in your opinion with proper care. That I might be able to get my forehead looking like it used to be. As for now I am walking around with a regular sized bandage on my forehead which is kinda embarrassing. As I said it s not bleeding, nor does it hurt. Just looks like I have a sore that has not healed on my forehead. My thinking is it s a cyst of some kind that needs either antibiotics or possible removal. As I said it s size of a penny. If it were not on my forehaed I would not be as concrned as I am. It s worrying me that I am permanently going to be disfigured or something. Thank You-----Tim In Indianapolis. ### output:

Hi, Tim. If you're not experiencing any other symptomatology, yes, its most probably a cyst, a fibrous or even a lipoma based from your description. And the definitive treatment for that is surgery or excision biopsy. If you're concerned aesthetically, you could opt for a plastic surgery consult. But it's a surgery that could easily be done by a general surgeon as well. Usually, the surgeon will cut along the lines of your skin, as minimal as possible, to remove the cyst. After the surgery, inflammation will be observed. But few days after, it will resolve and heal accordingly. Hope this helps. Good day!!~ 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: Is my daughter showing enough symptoms for me to take her to get diagnosed for autism or aspergers syndrome?I dont remember if she had a speech delay nor tantrums but she used to bang her head on the floor if shes upset or didnt get what she wanted (all her siblings did.) but she was smarter than kids her age when she was 3 and was a fast learner and did academically well, sh even speaks another language fluently! but Ive noticed that shes socially awkward and i thought that shes just too shy and i have to give her a push to go befriend kids her age, she barely talks with them and shes horrible at small talk and when I ask her did you have fun with them? she shakes her head and tells me she doesnt want tot do that again, ever.she has bizarre interests like Spiders, Spider-man, arachnids or rare unusual stuff like names or Cyprine for example, she told me she like its name and that is a precious stone and she also likes some gruesome and/or gross stuff and a normal interest like art, drawing, photographing, comic books, cartoons.. she can go on and on about color shading, blending, smooth lines, rough lines, thick lines, shapes..etc.things that made me suspicious:she notices car plates and tells me if one had a cool number like 0000 or 9000 or something like that, she notices patterns, details, smells, sounds and spaces out a lot she told me she goes to her world that she made, is it normal? she also plays the same strategy game she played 7 years ago on the internet, she locks herself in her room and just plays it or watch a movie or something. the way she acts is selfish and lazy and she says inappropriate things and when i scold her she knots her brows and say but its fine.. why is it inappropriate?she also gets angry or scared if someone yells or if theres a lot of loud noises and hates parties. she takes a while to register some things i tell her (like instruction or if i was being sarcastic.) shed be perplexed then she realizes what i meant and find most jokes Not funny.. also she used to stutter and find it hard to pronounce some words or express herself which often made me mistake her for lying..shes introverted but has a few close friends who share some of her interests. i just want to know, should i get her diagnosed or am i over-thinking? ### output:

Hello You have mentioned that your daughter has symptoms of poor social interaction, she spends her time in playing indoor games, she is intelligent than others in some domains, she can notice unusual number plates and she doesn't like that her routine get disturbed. Most likely these are symptoms of Asperger's Syn Chat Doctor. She can speak and has normal language development, so Autism is very less likely diagnosis. Other possibility that may occur is some form of Bipolar Disorder or some Psychotic Disorder. I would advise you to take her to a good Psychiatrist for expert evaluation and evaluation of IQ. IQ assessment is necessary to estimate her IQ and to rule out mental retardation. 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: Our son, Gregory Whitcomb was diagnsed with schizophrenia affective about 15 yeas ago or so. he spent some yearsin Royal Colony, Oakland,CA after being admitted to the Alta Bates Hospital Mental Department. We moved from Florida to Lincoln CA Sun City to try to be helpful. He was on medication for many years while at Royal Colony, Oakland,CA. He seemed to be improving a lot . He wanted to live on his own , which seemed fine at that time. After a short time, he went off the medication. Then, there was a decline in his health, He had more delusions, began writing on facebook unacceptable letters etc. Several times he went back to a mental hospital for a short time . He refused to take the medications . Then he was allowed to leave the mental hospital . His behavior declined and he was on the street several times. Most recently, he was in a mental hospital in Vallejo,CA . The doctora gave him the meds which we wee grateful for that. He was released to ahome that took in a few boarders, Once again, he went off the meds . His writings on facebook were degrading to his brother in Ashland ,Oregon (Duane Whitcomb) as well as to others in other episodes. He has a restraining order from his churdh which he attended for some 12 years or so.Family relattionships have deteriorated a great deal because of the problems here, He has spent thousands of dollars foolishly and continues to refuse medication or doctors help as he believes he is well. We feel he needs to have medical help but we are told that he must admit himself to have the meds and therapy necessary.. Please let us know how to deal with this to have help for gregg as he will not listen to us. Sincerely, Marion and Ernest Whitcomb and Duane W. and Loretta Jacobs (brother and sister) 1186 Hawthorne Lane Lincoln, CA 0000 phone 916-543-5399 ( YYYY@YYYY ) PS We, the parents , are in our mid eighties now and feel we cannot have him in our home or care for him because of our own health problems. Marion Whitcomb ### output:

His am sorry to learn about his illness. This seems to be a deteriorating course of illness. This is a psychotic disease where people have no insight into their state of physical or mental health. They are cutoff from reality. Giving medications is always a big challenge and a lot of these patients relapse because they stop taking medicinesThere are depot preparations available in the market which have to be given once in 10 to 30 days, depending on the dose requirement. You need to consult a psychiatrist of your area who after assessment, prescribe this injectable medicine. This injection will be given by the psychiatric nurse, and it will be taken care of by the psychiatric social worker. Some of them are in. Risperidone, In Aripiprazole and many others Take Care Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am having pressure and pain in my neck and it almost feels like blood is being cut off. Pressure in my ears, etc. It started about 24 hours ago and up higher behind my left ear and has moved down and toward the front of my neck. Wondering if it s swollen lymph nodes? Feels like really tight muscle cramping. ### output:

HI WELCOME TO Chat Doctor I can understand your concern regarding pain and pressure in neck Dear, it is very common problem occurring due to wrong posture, some throat problem, swollen tonsils or some ear infection. As all parts of our body are connected and work as a unit, infection in one part infects all connected parts and make you feel miserable . In general, lymph nodes become swollen when they are active either due to an infection, inflammation The most common cause of swollen lymph nodes is viral of upper respiratory infections such as the common cold. 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. 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 specially neck rotation , walk, yoga, Panama deep breathing to strengthen your immune system . 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 Apply heat pad on affected part, Do slow range-of-motion exercises, up and down, side to side, and from ear to ear. This helps to gently stretch the neck muscles. Have gently massage with Olive oil OE sesame oil before heat pack application. Take Homeopathic chamomile 30 / 2 Chat Doctor. Repeat if required. Hope this helps solves your query. Take care. All the best. Get well London 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: Hello, I have pain, like a burning sensation and numbness and then pulsing pain in my left arm, triceps and armpit, with a cold, ice like sensation, followed by a searing burning sensation, as if I am having saline solution put through my vein. If I put my hand on my left hip, the pain starts immediately from the armpit into the triceps but goes away as soon as I let my hand rest down parallel to my body. This is a second time I ve experienced this pain for nearly 3 weeks, right after I was examined my oncologist. Twice now he presses very hard, digs into my armpit until I am in pain to palpate the Sentinel node and really crunches it against my ribcage! After having a lumpectomy, I refused to have the sentinel node removed or to follow up on the standard protocol for breast cancer. It s been 8 months since my surgery and I never experienced pain until he dug for the sentinel node twice, very, very, very painful examination. Now, when I feel the node, it seems that it s been squashed and divided somewhat! Is this pain coming from trauma to the node or have I been protective of my left side. I do tend to lift and do heavy manual work...the oncologist told me that he s 85% sure the cancer is in that node and he really wants me to have a biopsy or have it removed! Why? Why am I being demoralized and pushed to think I m doomed? I am going in for another ultrasound on Monday. Every time I asked to see my ultrasounds before and the 3 after the surgery, I am not given access. Why? ### output:

Hi, thank you providing a brief history of you. Since you mentioned you get this kind of pain + you had once also + you do regular heavy lifting works.to come to an assessing part of the oncologist it is his job to figure out if anything is wrong. Chances of getting pain after the pressure might be symptomatic but not have damaged anything. Still you are going an ultrasound you will get some inputs as well.let's understand that when u keep hand behind the hip you get pain or else in normal anatomical position you don't get any pain. Why don't you try doing some regular exercises under the guidance of a physical therapist who can help assess your weaker muscle groups and help you strengthen them. You can even rule out any issue with the spine if any nerve is getting trapped. For which an NCV or MRI will be of great help. You can even take the HEL of a physical therapist who can use some therapeutic ultrasound and TENS for reducing the pain symptoms. Improving the metabolism of you body will help it to fight against infection too. With the exercises you will even have improved immune system which may rule out the nodal cancer issue which your once is suspecting as your exercises' indulgence will suppress all symptoms and make your once wrong and make you happy a lot. With the grace of God I wish you a speedy recovery. Never get demoralized by anyone. You should be a fighter and prove that you can make a change for your own self.

If you are a doctor, please answer the medical questions 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 taking drugs for Schizophrenia and mixed Depression-Anxiety. I am taking the following drugs for Schizophrenia a) Risperidone 2 mg 1-0-2 b) Quitiapine Fumerate 100 mg 1-1-1. I am taking the following drugs for mixed Depression-Anxiety a) Sertraline 50 mg 1-0-0 b) Mirtazepine 15 mg 0-0-1 c) Lithium Carbonate 400 mg (SR) 1-0-1 To counter the side effects, I am taking Pacitane 2 mg 1-1-0 and in spite of this I am having hand tremors and am not able to write at all. I am having stammering also. I am taking Neurobion Forte 0-0-1 to strength the nervous system. By taking Nerobion Forte bi-daily help in controlling the tremors? By taking Ashwagandha powder (1 tea spoon with milk) twice daily help in controlling the tremors? Also, I am Asthmatic and Diabetic for which I am taking Theo-Asthalin 1-0-1 and Glycephage 500 mg 1-0-1 respectively. I am a smoker also and I smoke only 5 cigarettes a day. Kindly advice. Also confirm whether psychotic drugs be taken along with Ashwagandha Powder. Kindly reply at the earliest. Thank You Yours Truly Jayanth ### output:

Hi Welcome to ChatDoctorDear Jay ant I am real concerned about you for having so many medicines but no relief. And over and above that, you want to add 1 more, Ashwagandha in your city First I want to know, how old are your problems ? What is your age, weft & height? As for as I can understand, you are not leading balanced, regular lifestyle. That is the reason, you have to keep on adding medicines. I am not avers of your taking any medicines prescribed by your physician But I would like to keep in mind one thing, that only medicines without a disciplined life will not do any good to you. Ashwagedha is good, no doubt and helps in many problems successfully. I will suggest you to take nourishing diet with fibers vitamins minerals, soup of Gullah / green DAL tiger, garlic in your all meals. Avoid sugar, fried fast foods' banana guava in fact all sour things and over indulgence of tea, coffee, alcohol and smoking A level Spoon of turmeric powder with a cup of hot milk at bedtime gives a good dose of antioxidants . Chaywanprash good tonic / remedy for asthma ang general health. Good night sleep is essential To Do Sufficient walk, exercise -yoga, Panama deep breathing . Constipation should be removed regularly. The above regimen can help you to slowly remove many of the symptoms you are suffering from and will help you fully recover, One day you lead happy life without Chat Doctor. Mail at

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I am 30 year old male and non-alcoholic. I am on medication for Jaundice for the past 2 months. First blood test on 11th Feb 2013 showed my Total Bilirubin: 4.9mg, SGOT:499U, SGPT:430U and hepatitis B as negative. I was advised to take Liv52 DS and Limarin 140mg twice a day for 1 week. The next blood test on 16th Feb showed my Total Bilirubin: 8.6mg, SGOT:71U, SGPT:51U. With the same medication the next blood test on 22nd Feb showed my Total Bilirubin: 10.6mg, SGOT:30U, SGPT:92U.So I was advised to take further blood tests and USG (Abdomen) on 22nd Feb. The results were Alkaline Phospatase 52IU/L and HCV negative. In Scan my liver size was CBD: 3mm and PV: 11mm and Gall Bladder contracted. Then I was prescribed URSOCOL 150 mg along with Liv52 DS twice a day and was asked to do blood test every 2 weeks. The results with the date is given below9th Mar showed my Total Bilirubin: 3.4mg, Direct Bilirubin: 1.9mg, SGOT:59U, SGPT:92U23th Mar showed my Total Bilirubin: 2.0mg, Direct Bilirubin: 0.9mg, SGOT:75U, SGPT:128U6th Apr showed my Total Bilirubin: 1.6mg, Direct Bilirubin: 0.5mg, SGOT:99U, SGPT:137UNow I am advised to take only Liv52 DS twice a day but I am having a small pain on the left side near my lower rib. Please advise whether any diet should be taken or any medication is required. ### output:

Hello, sujith.Ramakrishna, I am glad that your Hepatitis B and C tested negative. I am also glad that you are not an alcoholic. Sonogram shows a contracted gallbladder which could be from chronic inflammation. No mention of stones. I am not sure if the doctors have ruled out autoimmune hepatitis by doing special blood tests such as ANA, Anti-DNA, Smooth muscle antibodies, Complement levels, Anti Kitchen Chat Doctor. These are important because the treatment is different. As for your current enzyme levels and bilirubin levels, they are improving. SGPT is somewhat slow to come down and so is Alkalinephosphatase. Your current medications USO and Liv52 seem to reworking. As for diet, I suggest you avoid fatty, greasy and fried foods. A healthy high protein diet with enough carboy

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Im a 37 year old male. I drank heavily for about 5+ years. about 2 years ago I have a severe kidney ifection and let it go, this caused me to have full renal shutdown and like an idiot while this was happening I continued to drink to the point I turned jaundice. I was hospitalized for 2 months and recovered fully with no dialysis needed. A year ago I had a cholecystectomy, a few days later I was readmitted with pneumonia, left side pneumothorax, and MRSA. I recovered from that as well. I have continued to have severe right side abdominal pain right where the liver is. My GI Dr had me go for an MRI with contrast. Results are There is evidence of contour nodularity of the liver consistent with hepatic cirrosis and hepatocellular disease. I have been sober over a year. What does this mean?Full info from the MRI Results as I could not fit it into the original question: There is evidence of contour nodularity of the liver consistent with hepatic cirrosis and hepatocellular disease. The liver demonstrates heterogeneous enhancement with somewhat irregular lacy areas of enhancement scattered throughout the liver and the noduals may indicate some areas of regeneration (which that part is good). There is one area in the right lobe of the liver lateralally which demonstrates a wedge shaped area of greater enhancement but not have the appearance of a mass. The spleen is also enlarged and a ct/pets scan should be reformed for further evaluation. Over all impression is evidence for hepatosplenomegaly. Contour nodularity of the liver and heterogeneous enhancements felt secondary to hepatocellular disease the wedge shaped area although not believed to be a mass could be representative of some sort of transient vascular phenomenon rather then a mass. There is also evidence of perihepatic ascities. ### output:

Hello,1) Your diagnosis is Alcohol related liver cirrhosis with portal hypertension2) Alcohol damages liver by affecting work capacity of cells in liver. This damaged cells can not regenerate to produce more cells and as a result of that damaged liver cells are replaced by fibrous tissue. (Process is similar to healing of any deep wound on skin which would not be same skin)3) Because of damage to liver tissue and decreased ability to reproduce new liver cells, liver function gets deteriorated gradually (Once liver damage, this deterioration is irreversible)4) Because of these changes, not only liver function is affected but vessels which supply blood to liver (Portal vein) are also affected and develop high pressure within this vein which causes portal hypertension (causes enlargement of spleen). In severe cases' portal hypertension may cause blood vomiting. To prevent this periodic upper GI endoscopy is necessary.5) To evaluate condition periodically, USG abdomen for status of liver is mandatory6) To support liver function, you may require medical gastroenterologist consultation and supportive treatment over long period of time with abstinence from alcohol

If you are a doctor, please answer the medical questions 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 found to have spondylolisthesis at around 12. Fast forward to 2012, and it was found at L4-L5 level, there is a minor disc bulge with minimal flattening of the ventral aspect of the thecal sac with no compromise of the exiting nerve roots. At the L5-S1 level, there is a minor anterolisthesis of L5 relative to S1. The disc bulge extends to the foramen on the left, without any significant impingement of the exiting root. There is an unusual appearance the facet joints bilaterally at the L5-S1 level. No pars defect on either side at L5. There is a small well-corticated bone fragment seen, related to the facet joints bilaterally at this level, larger on the left than the right. Possibly developmental. There was also some superimposed degenerative change at the facet joints. Anterior Spondylilolisthesis of L5-S1(as reported on MRI, CT scan, and from Surgeon Dr. Ganesh Swamy in Calgary, Alberta). Fast forward to now, I moved back to Ontario, I ve had 5 children(yes, you read that right FIVE children), and my pain is significantly worse. I go to my nurse practitioner I m on lyrica(6-9 75mg caps.per day), 8 extra strength Advil, 12 Tylenol 1 s daily to try and manage pain. I got sent to North Bay, Ontario for an MRI, to be told that the only thing wrong with my back now is an ever so slightly slipped disc at L5. None of the other problems exist.I also had an X Ray in 2013 that stated the same. Can someone explain to me how my back got miraculously better, my pain got significantly worse, and maybe an explanation as to what s wrong. I just don t want to be in pain anymore. I want to be able to play with my kids again. I also have had 2 ultrasounds on my liver saying it s large n comparison to my body, and yet when it was felt by my specialist, he sad it felt just fine it doesn t seem large at all. Please, i m begging you, help me. I have nowhere else to turn and Im in pain nearly every day ### output:

Dear patient spondylolisthesis at 2 levels L4l5 and l5s1 back in 2012 and constant increase in pain since then may be due to increase in Lachesis and degeneration in facet joints. You are taking high dose of analgesics which itself suggests significant liability. first I would like to advise digital of X-ray of lumbosacral spine anteroposterior and lateral views. Lateral views should be taken in full flexion and full extension position also known as dynamic views. This gives idea about instability due to Lachesis. I would also advise recent MRI of lumbosacral spine with screening of whole spine to know about condition of disc and facet joints. Please do it now. Please consult expert spine surgeon around you. If X-ray is showing dynamic instability surgery may be indicated. Thanks.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had a raise in my PP glucose level ( 155) in 2004. Since then I have no problems in my glucose level both FBS and PP. They are always within limits FBS < 100 and PP < 120. However as of November 2011, I had fluctuations in my PP that rose upto 180 after 2 hrs of food. However, all other readings like H1bc, C-Peptide levels are well within normal limits. The latest taken last October was H1bc 4.7 and C-Peptide 3.01 taken at Appolo HYD. My lipids are quite normal except triglyceride which is fluctuating between 140-180. My BP is 70/110 - 120/80 always. My weight is 70-71 Kgs. I am a male and aged 62. The current problem is that I had cramp like symptoms in both my legs on Jan 04 2014 after an air travel lasted 6 hours. Then it disappeared after a day. Again I got it yesterday and it continues today as well. I feel discomfort at the calf muscle and a slight burning sensation on ankle area while I walk. There is no shooting pain nor tickling pain but a feeling of discomfort in both legs especially below the knee at the calf muscle. I have no pain during sleep. The discomfort starts only after I woke up form bed and start moving. Thank you ### output:

You are having a vascular claudicationhere are the factors specifically in your case)1) diabetic vascular problem - decreased blood circulation especially at the lower extremities2) calf pain at walking - this is an effect of number 1, when you walk, the blood and oxygen demand of your muscles increases, considering the fact that you already have a limited blood supply to start with BEC of number 1, you start to feel an ischemic pain (pain in any part of the body due to lack of oxygen carrying blood, the supply of your blood, cannot cope up with the increased demand of blood during walking only)3) relieved by not walking on it (decreased oxygen and blood demands of muscles, hence no pain)4) burning sensation (is a sign that a nerve is also not getting enough blood supply)here is on practical tip you can do by yourself to confirm your problem try using a stationary bike and use it for 15mins. Are the symptoms similar? If yes then that's your answer right there. You indeed have it. Next what to do. Well it's an expected part of having diabetes. Exercises strengthen muscles and train muscles to function with less oxygen and helps muscles to work better despite impaired blood flow in your legs. As a result you will be able to do more with less pain and be more active with an overall increase in health and well-being. Exercise will help in controlling your blood sugar and blood pressure, which will aid in decreasing your likelihood of developing more severe Peripheral Vascular disease

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Ive been having strange symptoms for the past year, and if you want to count my battle with GERD and Esophageal Spasms, 4-5 years. Ive been on numerous PPI meds sine then, but the bigger problem with what I face now is an onset of neurological symptoms that first developed about a year ago. The most prominent of these symptoms include Tinnitus, Lightheadedness, Blurred Vision, Loss of Balance, Neck and Back pain, and heavy Heart Palpitations. The heart palpitations are more obvious about 10-20 minutes after eating and I know my blood pressure can run pretty high (around 150) but no doctor really seems to think this is a big deal. I was diagnosed by a Family Doctor about 5 years ago with a condition called PSVT. However, a Cardiologist debunked this and said I had nothing to worry about. Well, that was a long time ago and I think my condition may have worsened. Either way, I still cant help but think my spine is the culprit.Now before anyone jumps the gun on the possibility of me having MS or a Brain Tumor, I had an MRI of my brain back in September of last year and a CT scan about a week ago and they botChatDoctore back fine. I have been, however, seeing a chiropractor for my spine where I believe the cause is.Chiropractic hasnt really made me good enough for a long period of time and the adjustments they make dont seem to hold, so Im pretty much done with that option. Ive been seeing a wonderful GI and Neurologist as of last December but my insurane cut out and I can only see people locally with my doctors referral. I was on the brink of getting some imaging done of my cervical spine, but my insurance failed the authorize it on time before my 26th birthday.Anyway, thats where I think the problem is. Im currently awaiting a follow-up to a trip to the ER I had last week with my PCP but until then I could definitely use some advice or enlightenment as to some possibilities. I understand these symtpoms are difficult to pinpoint, so if it helps, when I went to the ER they said I had an outer ear infection and sent me home with some nasal spray. Whatever it is, its affecting my sinuses/ears. ### output:

Hi, Based on the details you suffer from multiple problems the one being is peripheral vertigo secondary to ear infection which can produce tinnitus and vertigo. You need to have betahistine 16 mg twice daily for short duration along with paracetamol 800 mg twice daily which will help to regenerate ear nerve (eighth nerve) along with vestibular rehabilitation exercise in addition to antibiotics. Meet your family physician/ENT surgeon for the prescription the PSVT and post meal worsening consult cardiologist once again or take second opinion cervical and lumbosacral spondylosis, orthopedic /neurologist can help you which depends on clinical examination Hope this will help 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: My son is 24.. has myotonic dystrophy type 1 (DM1) and autism...though considered high functioning. Lots of issues... Right now, he had an upper endoscopy in April and found he has the disease where the esophagus reacts to food like it is allergic, so he is on spray steriod of a type twice a day. He has swallowing issues and parallel to that, twice in the last four years he has suddenly dropped weight... 40 pounds in three months, changing nothing about how how he eats, which is a lot. Now he is in his third bout and I see his appetite increasing. Plan to weigh him tomorrow and see if loss part has mysteriously stopped as it mysteriously started...and now, third time, he has been losing but has a big appetite. . He is 5 10 and was 225, now 194 with NOTHING changing about his eating. So yeah, thinking dumping as I know the whole swallowing to rectum can be effected by DM1. With the added autism, the habits are hard to change. I don t know whether to keep watching what he eats and he sneaks to fillin what I don t know... or call the family Dr. We moved two years ago from all the Drs he had been seeing and only has a family doctor here and one for sleep studies and now a GI we saw once. He has extreme hypopnea and central apnea. He has tourrettes and yes, hands and feet effected by myotonia...and calves, abdomen, face, tongue, eyelids. Not sure if the fp takes this serious and wish we had a neurologist who specializes in DM1. Onset of symptoms are debatable. I adopted him at 2 and a half. His feet needed arches and he had ear infections often. So congenital form? not sure. Learning issues, language issues, tics, hands began to hurt. By 11, more physical symptoms showed up. Took until 16 to get diagnosis. He has cognitively slowly changed and physically the same. I dont know what to do about the eating and who to see? What if he is still losing? His comprehension is changing and he is hard to understand many times, most times when he talks. I feel I can t just let him eat and eat and eat...but if he is losing.... I don t know. ### output:

Hi there. One common cause of unexplained loss of weight in the setting of problems that your son is having could be parasitic intestinal worms. Even though the diet remains the same or even increases in affected patients, they continue to lose weight. I suggest you get a stool examination done to look for enteric parasites or any signs of occult blood. The GI disorder that you are talking about can also cause malabsorption of nutrients but the patients who are suffering from them show other symptoms of vitamin deficiency as well. Look for any signs of listlessness, lethargy, irritability or any skin or nail changes in that case. So keep an eye out for this and get his stools checked in the lab to start 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: Sir, I Mrs Rakhi Sanjay Sharma,am 40 Year old Lady & my Husband is also of the same age.For the last 4 years, we are married and I have not succeeded in getting pregnant. My husband has very poor sperm count & sperm motility rate is said to be very poor. I too had problem of fibrous growth in my vagina . The fibrous growth was however removed by operation in last year by Dr. Naina Patel of Anand Gujarat. My Gyna Specialist Mrs. Naina Patel of Anand in Gujarat ,had administered lot of drugs to my husband for 3 months but there was no change in results.My Husband was administered with certain drugs to improve upon his sperm count & motility rate . On finding no change, I was asked to go for IUI .or IVF . During last month meeting,I was told that I can t have issue from my husband sperm and was advised to go for Donor sperm.Some of the Doctor has advised my husband to take medicine of Heyforte Plus to improve upon sperm count and motility of sperm. We both are running out of time very fast for in reproducing age. We seek your advise please . My Name is Rakhi Sanjay Sharma. our em address are YYYY@YYYY , YYYY@YYYY YYYY@YYYY ### output:

Hello state, Welcome to the forum. Due to changed lifestyle stress, tensions and pollution there are many couples suffering from the same problem. Do not lose heart. Every individual is made for a different purpose. We treat it is only God who heals and gives. If you want your husband can take the medicine to increase sperm count. Since he already had been under treatment just give him a month gap. Let him get stress-free and relax. There are many other reasons for low sperm count like excessive smoking or alcohol intake in the past, some nutritional deficiencies, stress, accidents, obesity, genetic cause, etc. You will be amazed to know that some couples who are clinically fine are also at times not able to conceive. It is all in the hands of God. Some men feel very week, some complain of dizziness, some get hypertensive yet others irritant as they start taking the medicines to increase the sperm count. A husband should be given high protein diet, energy giving food like legumes, beans, eggs, red meat, dairy products, nuts, fruits, veggies, berries so that the medicine works well and brings the desired results. The medicine may take 4-6 months to show results. It is better to maintain abstinence while the husband is under treatment. To be able to conceive the spermatozoa should be at least 20 million/ml, 75% should be alive, talent 50% active, 30% normal. There is no harm in trying donor systems as confidentiality is maintained and results are positive. Acceptance and mental preparation depends upon both the husband and wife else it may ruin life. You can try visiting Holy places, Nagapatnam and many other places if you are a believer. Have a nice day, take care.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am 70 years old. About 10 to 15 years ago,I suffered hemolysis . I went 2 days later to the hospital( emergency section) because I got dizzy when I came off my bed and couldn t make it to the toilet. The doctors found out the next day that I have a G6pd deficiency and told me that if I had delayed 1 day my arrival to the hospital, it would have been too late. The day I had the hemolysis, I had eaten in the morning just a few fave beans. I told the doctor that I never had hemolysis before. I have been eating fave beans in big quantities all my life and never had a problem, so why now I have? He answered that things like that can happen any time or not happen at all. So don t ever eat fave beans again.....and a series of medicines .... From that day on I never had any problem. I ve been eating every thing what so ever exept fave beans. Now that I google through the Internet, I became afraid to eat anything and confused from the contradictions I notice about what to eat or what to avoid eating. P I will appreciate your advice. I am lost and don t know what to eat anymore. My wife tells me that for the last 10 - 15 years I ve been eating every thing except fave beans and nothing happened, so continue the same thing. Thank you in advance Tony. ### output:

Hi, Lets first began with understanding of HEMOLYSIS due to the "G6PD-Enzyme deficiency"- in a simple term. The red blood cell in blood carry oxygen, now oxygen has certain free radical as well as super oxides which are present in the air as well as are formed in body due to various chemical reaction, not the RED BLOOD CELL is equipped with special chemical formation capabilities which uses "G6PD" convert the toxic free radical / super oxides into non-toxic oxygen hence, protection the damage to the cell. The free radical are those which makes our skin wrinkle as we age and the exposure to such atmospheric and food free radical makes us look old, in case of the RED BLOOD cells they rupture them if there is G6PD deficiency cause the detoxification chemical is not formed due to absence of" G6PD Enzyme" and the rupture on these cell in known as hemolysis (hero=blood, lysis=destruction) NOW I think it will make more sense to talk about the OXIDATIVE STRESS/ OXIDATIVE FOOD LAVA BEANS has the largest amount of oxidation content hence eating it will release huge amount of oxidization molecules making it harder for RBC with our G6PD to form the required neutralization/detoxification chemical and forces RBC TO rupture. *** following is the list of things having high oxidative power and needs to be avoided.1) Too much animal protein in your diet.2) Oils that have been heated to very high temperatures.3) Preservatives in your food.4) Chat Doctor. g. painkiller)5) Alcohol.6) Chlorinated water that you

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am female. Late 50s. I still love my husband of 25 years. Over the last 10 (or so) years sexual intimacy has diminished and now disappeared. I thought that this was a natural adjustment, especially for my husband, at this time of life. 3 years ago he resumed a relationship by phone and letter with his girlfriend from school days, arriving at the point where he was convinced they were in love (again) Although painful (for both of us) I saw it through on the understanding that there was a definite element of mid-life crisis going on. As we talked I was able to regain hope of the possibility for finding renewed love, openness and intimacy. However, during this time he turned to self gratification via pornography on the internet. I have endeavored to be patient and understanding whilst also making sure that my own desires and needs are recognised. I have tried everything I can think of from humour to love to opening my heart to tears to seduction. Nothing works and my husband will not open up or let me in on what is going on for him. Perhaps he is at sea himself and yet I do feel let down that he cannot make some effort for my sake. I know the behavior is not in the normal spectrum of behavior. Looking back I can see that although my husband has shown love and affection to me in many ways, I do not think he has ever found it easy to be truly intimate. I could say the same for me to some degree and have tried to acknowledge my own insecurities but I do genuinely think that the lack has been rather more on his side. Even in early courting he would rarely hold hands and he has never really wanted to engage in kissing or caressing or to engage in pleasant shared activities such as sharing a bath (for example) This has in turn restricted my own responses or ability to take initiative as I have felt like I was trying to push something that wasnt required. This goes to the deepest core of my being and who I am. Now I feel Im getting on a bit and find it increasingly hard to know what to do or to expect from our relationship. I try and stay positive but sometimes I just cry myself to sleep. Sometimes my husband hears it and does nothing. Then I feel bereft. I recently heard the term sexual anorexia used. Im not particularly keen on labeling but thinking about it,from what is said, many factors seem to make sense. Is this a good way to seek to understand the problem? How can I find support and the best way forward? Can you help me? Thankyou for listening. ### output:

Hi, First, let me tell you that sexual anorexia is a term where sexual appetite has lost due to fear of sexual activity. In your case, as your husband met his girlfriend and then established relationships. I think its emotional anorexia as he is not taking care of you and not emotional attachment with you. So it can be solved with a calm and cool approach. You should not behave and act but listen and have time to spend with him. Have a conversation of past happy and romantic time spent together. Also, talk to him about your great trips to gather etc. This will encourage him to again bound with you. 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 WAS A DRINKER SINCE 10 YEARS. I USED TO TAKE 180 TO 240 ML PER DAY. MY CONSUMPTION INCREASED TO 300 ML PER DAY IN JAN 2010. I STARTED SHOWING SYMPTOMS LIKE SHIVERING IN HANDS, LOSS OF APPETITE, VOMMITTING SENSATIONS ETC IN AUG 2010. IN SEP 2010 I CONSULTED A DOCTOR .MY USG REPORT SHOWED FATTY LIVER CHANGES &LIVER ENLARGEMENT. I WAS GIVEN 2 DAYS TREATMENT IN HOPITAL. MY LFT REPORT WAS ;- BILLURBIN 1.49 , SGOT 80, SGPT 84. AFTER 10 DAYS MY LFT WAS NORMAL. AFTER THAT EVERY MONTH I USED TO FOR USG AND LFT . TILL DATE MY ALL REPORTS ARE NORMAL. BUT WHEN I CONSUME ALCOHOL FOR 2-3 DAYS MY APPETITE LOSSES AND SLIGHT PAIN IN LOWER ABDOMEN IN RIGHT SIDE HAPPENS .THEN I QUIT FOR 10-15 DAYS THE PAIN DISAPPEARS AND APPETITE BECOMES NORMAL. I HAVE STOPPED TAKING ANY LIVER MEDICINE SINCE NOV 2010. NOW A DAYS WHEN I PRESS MY LOWER (RIGHT) ABDOMEN IT SLIGHTLY PAINS.FOR HOW MANY WEEKS SHOULD I NOT TAKE ALCOHOL. SHALL I AGAIN GO FOR LFT& USG. ### output:

Hi ! Good morning. I am Chat Doctor answering your query. My reply to your query on alcohol would be that one should quit alcohol consumption completely to stay healthy. Liver is not damaged on a single insult caused by the alcohol, but it happens due to chronic repeated insults as is happening in your case. Gradually it might lead to cirrhosis leading to portal hypertension and hepatic failure. Therefore, I would advise you to quit alcohol completely and modify your lifestyle towards the following:1) Routine regular exercises depending on your medical fitness2) More of roughage and enough liquids in your diet3) You could add as many fresh fruits in your diet, and more of carboy Chat Doctor. If you observe the above, there might not be any need to go for artificial liver tonics along with so frequent investigations, and you would do well overall. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi, im a young basketball athlete who s life goal is to make it pro (19 soon to be 20) and i suffered for a looong time from jumper s knee in both legs... as you most likely know this is a chronic injury that leads to the degradation of the tendon (in my case it was in the lower pole of the kneecap, due to overuse, and i played 2 years with it) my doctor was amazed i could stand all that pain for so long, but well i did, untill my leg started giving way and i stopped... conservative treatment didn t work, especially for the left one, which had the most damage and some torn fibers, so i had arthroscopic surgery for debridement and im 2 months post op, i can walk run etc, but hte pain is still there at a lesser degree while it would be ok for a sedentary person, my goal is to make it back and be able to get to my old standarts without pain and build up from there... physio has helped, but it didn t get me where i wanted, and i don t think it will now (judging from the right knee s results) my options, thus, are these... 3 injections prp in each knee (controversial info all over the web about it, but two of my three doc s are SURE it helps with tendinosis) and then eccentric training to strenghten up the new collagen and make my knees as brand as new... or at least it should work like that second is peptide therapy (cjc1295 and ghrp2) plus some intravenous concoctions that are supposed to help A LOT (all the results and evidence in here are anecdotal, from both the web, and guys i know that pointed me to this biologist who does this, who works with proffesionnal athletes and has quite the name here in greece) and finally, the bodybuilder s way which is taking deca durabolin in maintenence doses plus proviron-cialis to be sure my endogenous testosterone produccion will stay safe and anavar as a main anabolic, and train low intensity, high volume, especially eccentrically, just as i would without them but adding the weight to my training periodically in that monthly-cycle now, i don t want to be chastised about ANY of these ways, as i am ready to take the risks... i want to take it to the end, either play basketball or nothing... and i will do ANYTHING... i need some words of advice, any doctor s word that has any evidence of any of these working or not, would be greatly appreciated, but i would like the REASONS behind your responses! thanks in advance and sorry for the long post ### output:

Hi I have read all the details you have given. In my opinion since Jumpers knee is an overuse injury causing damage and degeneration, newer therapies like PRP (Platelet Rich Plasma) are to be preferred mainly because they have the regeneration potential and virtually no side effects. Decadurabolin- I would not recommend at all due to long term side effects. I do not know much about peptide injections.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Female 34 year old, 176-180 lbs, fibroid tumors, chronic sinusitis. 2 prior surgeries to remove nasal pollups. Third most recent surgery x 2 weeks ago to remove nasal pollups. Surgery went well, seeming normal recovery. However, developed two blood clots in r leg ( below the kne in calf area.) Blood clots were discovered a week following surgery. Immediatly started on Lovenox. 24 hours after beginning lovenox tx, exhibited siezure like symptoms, inclusing headache, aura, muscle spasm and slurred speech. Admitted to hospital, all ct scans and blood work were negative. Seizure symptoms decreased significantly following the 18 hours after the initial seizure/hospital admission. Seizures returned after about 5 hours later. Hospital did not discharge as the seizure persisted continously. Is there possibility that the seizures are side effect of surgery to remove sinus pollups? Speculated that it could be side effect of Levenox because she does not have bleeding in brain. ### output:

Hello, There is an increased risk of seizures following anesthesia, but typically the individuals already has a risk of having seizures if they occur. It is highly unlikely that Lovenox would cause seizures, unless as you said there was bleeding into the brain, but that could be seen with a CT scan or MRI. The symptoms you describe, although they can be seen in seizures, don't particularly strike me as such. A typical seizure involves convulsions with loss of consciousness. The period after seizures however can present as you described. There are more focal seizures that again can show up as you describe. Continuous seizures would cause significant harm, most likely loss of consciousness as they often spread to involve the whole brain. In any case, an EEG should have been done on you to evaluate for true seizure activity, and if you haven't had one done, you definitely should. The description of the symptoms could easily be due to a migraine as some types of migraines can actually result in neurological symptoms with confusion, slurred speech, weakness, vision loss, and numbness/tingling. I feel that this would be more likely, unless an EEG was done, and it showed true seizure activity. Surgeries can cause stress on the body which can result in both headaches and seizures. I don't think it is Lovenox would cause either unless as you note there was bleeding in the brain. If an EEG was done and there is seizure activity, then she should be started on a seizure medication such as Kendra 750 mg by mouth twice a day. If this is the case, then she has likely had a propensity for seizures, which was simply unmasked by the surgery. None them less an MRI with and without contrast with an epilepsy protocol (thin T2 cuts through the temporal lobes) should be obtained to evaluate for any lesions in the brain. 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: My mom is having a very hard time with allergy but is afraid to take anything because she takes so many other medicines. She takes Metoprol Tartrate (50 mg.) Hydroxyurea (500 mg.) Folic Acid (1 mg.) and an aspirin. Can she take a Zertec or Zertec D? My email is YYYY@YYYY ### output:

Hello, Thank you for asking at Chat Doctor. I went through your mothers history and would like to make suggestions for her as follows:1. There are so many types of allergies, so I would like to know more about your mothers symptoms as well as details of the other medications as well as medical disorders. This will help me to make more specific suggestions.2. As you have asked about Zyrtec D (use for allergic rhinitis - nose allergies), I assume your mother has nose allergies - nose obstruction, running nose, sneezing etc. 3. Zyrtec (Cetirizine) usually does not interact with the mentioned medications. However, Zyrtec D contains a decongestant medicine which may not be desirable for heart patients. As your mother taking Metoprolol and aspirin, I assume she might be having some heart-related problem. So, Zyrtec would be safer for her rather than Zyrtec D.4. If your mother has kidney or liver problem, then Zyrtec can cause more side effects. So in that case, necessity as well as dose of Zyrtec should be discussed with your doctor before taking it.5. Another option is to use local nose sprays. Intranasal antihistamine (Elastane) as well as intranasal corticosteroid (Fluticasone propionate or mometasone) are available in market. They act more locally, on nose membrane. As very small portion of these spray enter blood, they usually do not interact with other medications. They have less generalized side effects also.6. If your mother has severe nose congestion, please get her nose examined by an ENT surgeon as long term aspirin use can cause nose polyps. Also, metoprolol can cause nose congestion in some patients. Please discuss these possibilities with your mothers' physician who will review her history and complaints in detail and then decide accordingly.7. Please do not reduce/stop metoprolol and aspirin by yourself as it could be dangerous.8. I would also suggest your mother allergy testing for common air-borne allergens such as house dust mites, pollen, molds, insect proteins, animal dander, etc. This will help her to identify the substances causing allergies to her as well as to know the measures to avoid them.9. In general, I would suggest her to avoid exposure to dusts, smokes and air pollution as much as possible.10. Regular breathing exercises and steam inhalation would also help her in a long run for nose symptoms. Hope above suggestions will be helpful to your mother. Should you have any further query, please feel free to ask at Chat Doctor. Wish your mother the best of the health ahead. Thank you & Regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I want you to ask about MS condition. Through all my life I had weird things happen to me. I was quite sick child, all the time on antibiotics. At age 6 my limbs went numb suddenly, so I couldnt walk for over month ( with no explanations why), I had my half face numb (infected nerve) in couple years later, they treated it and said it could be infected by tick. I was all the time neurotic child, all the time had a problem to deal with the people and stress, problem with balance since childhood, experienced of fatigue , bluer vision , feeling to tired ( they said lower blood pressure), when it came to stress i have started shake, problem to talk and i thought i am experiencing a heartatack.As teenager it went worse, In my 15 my nodes in the neck were removed because of several infections which wasnt possible to treat any somehow. Later on I started have stomach problem (later on i was treated 4 times on helicobacter , but it seems it still come back, urine problems ( they said it could be because of sugar inbalance), lover back, limb and shoulder problem (pain, numbness, loosing feeling, sometimes difficulty to take something to the hand, or step in to the door without hurting myself ), sensitive to the pain, experiencing itching, pains, problem with multitasking, emotionaly cold, sometimes feeling having problem to really give a love, concentrating, geting quickly bored with things and people, bad memory , i dont remember half of my life, and when it comes to multitasking, i dont remember what i have done or what i should do etc.... In my 21 I experienced of panic attack, difficulty swallow which continues till now, doctor said it was because of overtired. They said i have low thyroid function, so taking 50 levothyroxine for over 8 years. I am now 29, most of the symptons are still pesist, some of them i learned how to deal with ( pains, difficulty swallow, panick attacks, dealing with the stress ), some of them were treated by doctor ( like helicobacter, bowl problem, varicose veins ) . Hope i did explain myself clearly, as I am not native english speaking. I need a help, recently i heard about ms, i read about it and consider myself, that might is my case. i have a 2 years old kid, thats the main reason to find out for me more about this condition, because he is experiencing the same balance problem as I do when he become tired. So I am worried for him, more then for me. What can you advise me? Thank you very much Mirka ### output:

Hi.mitral stenosis, varicose veins and peptic ulcer disease will be taken care of by your physicians.as for your mental health I would advise you to visit a psychiatrist and get some counseling done by a psychologist if you have apathy towards further pills.you may be prescribed some low-dose medication which will be convenient.and get on with some relaxation techniques you have to learn.please don't lose hope.you will be better if you want to.thanks.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 29 year old female, 5 9, 142lbs. I had spinal fusion surgery december 2010 with instrumentation from T4 to L4. I have had increasing back pain since late July which has gotten progressively worse in August. For the past 3-4 weeks I had noticed in an increase in needing to urinate but I just thought I was drinking more. I also was having stomach pain/cramping and a lot of back pain but I attributed the stomach pain to IBS and the back pain to just worse back pain since I ve had surgery. Since this past week my back is swollen in spots. Friday night pain got worse, I had chills and muscle spasms. Then by Monday my entire spine felt like it was on fire with a lot of pain and stiffness particulary in my mid-upper back and neck. I went to see my general pracitioner Monday this week who found bacteria, white blood cells, nitrites and blood in my urine. She prescribed sulfameth trimethoprim to take with aleve. I have been on this since Monday. The burning sensation along my spine has decreased however there is alot of pressure in my back...just feels huge. I am having more pain in the mid-lower left side and there is swelling there and am very fatigued. I may have had a slight fever if any but my regular body temps always 96-97. Yesterday I developed more abdominal pain that wasn t there before and I am still having muscle spasms. My question is whether or not I need to seek additional medical treatment or if this is a normal response to antibiotic treatment and just wait it out . I have called my surgeons office and dr office but still haven t been called back and I don t know what to do. I am fearing a kidney infection and of course I m very concerned about any infection settling in my hardware along my spine. How do they check for a kidney and or spinal infection? Can you please recommend a course of action. I really don t want to go to an ER because I always feel like that s for trauma stuff but I don t know what other options I have at the moment. Please give me some guidance. Thank you. ### output:

As you have mentioned in your history it is clear that you are suffering from disc prolapse. For this you have to take some painkiller like tab kilos or tab attract twice daily after meals along with tab shall 500 mg or tab toscal-gem once daily after meals with tab rant ac or cap Gomez twice daily empty stomach at-least one hour before any meal. I suggest you to take painkiller not on regular basis but only when your back pain is unbearable or disturbing your routine activities. You can also use holdup gel or powergesic-plus gel for local application. It is also very beneficial in relieving the back pain and provide you some comfort. Apart from these you can also go for some physiotherapy exercises after an expert opinion of physiotherapist. Also, you have to sleep on a plain surface because it is a good practice in case of back pain which is due to disc prolapse.

If you are a doctor, please answer the medical questions 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 WIFE S ELDER SISTER IS PSHYCATRIST PATIENT MORE OR LESS SIX YEARS. STILL THE TREATMENT IS GOING ON BUT SHE IS NOT NORMAL. PROBLEM IS AFTER HER FATHER S DEATH. SHE IS TELLING & SHOUTING SOMEBODY IS CALL ME. SOMEBODY IS CRAB ME. BEFORE THREE YEARS SHE WAS SHOUTED LIKE THIS. BUT NOWADAYS SHE DIDN T TAKE HER FOOD PROPERLY AND NOT WALKING, NOT TALKING. WITHOUT OTHERS HELP SHE CANNOT ABLE TO DO SOMETHING. EVEN GOING TO TOILET, BRUSHING TEETH , EATING FOOD. SHE LIKE A STATUE. BUT SOUL IS THERE. HER NAME IS AAAAAAA 23 YEARS OLD. STAYING IN METTUKUPPAM, CHENNAI. WOULD U CLEAR HER PROBLEM? BECAUSE SO MUCH OF DOCTORS SAID THE SAME WORD THIS ONLY. THAT IS THERE IS NO MEDICINE IN MEDICAL WORLD. MY EMAIL ID: YYYY@YYYY . I AM WAITING FOR UR EXCELLENT ANSWER. THANKYOU SIR. ### output:

As you said she is suffering from a mental disorder of chronic nature (6 Years or more) with initial symptoms of Irrelevant talks (Shouting), Auditory hallucination (Hearing voices) and Paranoid ideation (Somebody will crab me). Her condition deteriorated despite psychotropic treatment for last 6 years. Now she is having Poor self-care with Resistivity & Emotional blunting. Well, the case description fits into the mental illness called schizophrenia (?). Schizophrenia with prominent negative sign & symptoms is very difficult to manage but once her symptoms comes under control she will remain well-adjusted to her social condition for long duration of time, off course with continuing Chat Doctor. Available options for her include ....[1] Second generation anti-psychotic (like quetiapine, risperidone, clozapine, piperidine etc.) either alone or in combination with other first/ second generation anti-psychotics targeting specifically her negativity & resistivity[2] Electron convulsive therapy (ECT)[3] Hospitalization for short duration of time (If needed)[4] Behavioral Therapy[5] RehabilitationSchizophrenia does not have so much gloomier picture as you have developed perception about this illness. As I said, once the symptoms are under control by the use of appropriate psycho-pharmacological intervention, she will remain well for long duration of time. What is needed is a dedicated & comprehensive effort from treating psychiatrist & care taker. Thank You (Viewer rating for my Answer is Awaited)

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Impression Abnormalvestibular-evoked myogenic potentials consistent with a bilaterial worse on the roght sacculo-collic reflex abnormality suggesting an abnormality of the bilaterial sacculus or inferior vestibular nerve what does this mean in english ? ### output:

Hello, A HEMP was performed (Vestibular Evoked Myogenic Potential) test in order to assess parts of the patients BALANCE SYSTEM that lie within the inner ear. This is one type of BALANCE TEST that can be done usually when someone complains of dizziness, wooziness, or disequilibrium. Other tests that also assess the integrity of the inner ear mechanisms include CALORIC TESTING, POSTUROGRAPHY, NYSTAGMOGRAPHY, and others. Specifically, a HEMP assesses 2 items of the inner ear. One is called the TRIPLE and the other are the ACCUSE. Information is also gathered in this test about the VESTIBULAR NERVE (superior connection to the TRIPLE and inferior connected to the ACCUSE). The test found an abnormality present in BOTH inner ears (Right worse than Left). However, the test COULD NOT determine exactly whicChatDoctorponent of the system was not working properly. The abnormality picked up by the test was that of the SACCULO-COLLIC REFLEX (SCR). This is one of MANY postural reflexes the body utilizes which keeps head and the body aligned against acceleration forces. In this case the SCR is stated to be abnormal. This reflex keeps the head and body aligned against forces of movement or acceleration in a VERTICAL PLANE to the body. As an example, if a person were to be in a free fall situation because they jumped off the rooftop or from a ladder, the fact that the head and body don't go FLAILING while in the air is because of this Reflex ability to make instantaneous adjustments to the muscles of the neck and torso so that everything stays aligned. Once the person hits the ground then, anything can happen but while there is an acceleration force in a vertical direction the SCR will automatically keep head and body from going crazy in the air. Pretty nifty, yes? In the case of this individual the SCR was measured as abnormal on both sides (right side being worse than left). As a result of making that call the doctor went on to state that in their opinion either the CALCULUS or the INFERIOR VESTIBULAR NERVE connected to the calculus were not working properly. The CALCULUS is the element of the balance system found in the inner ear that sends information to the brain on vertical LINEAR acceleration of the head (and body since the 2 are connected). The INFERIOR VESTIBULAR NERVE is the cable that ties the CALCULUS to the brain and transmits the data. Apparently, the articles and superior vestibular nerves are A-OK. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: In late July I was hospitalized after reporting to the ER with dizziness/faintness, tingling, etc. I was tested for Lyme and thoroughly screened for stroke (I am in my early 40 s, BMI of 22, healthy eater, relatively active...but not disciplined with daily exercise, non-smoker, weekly drinker of wine/beer while cooking or with dinner). I was admitted for observation to the cardiac unit and underwent EKG, Echocardiogram, MRI, chest x-ray, and connected to a heart monitor. ( I was injected with heparin and remained in bed during the two night stay.) All test were within normal range and I was schedule for discharge. When the nurse removed the IV from the back of my hand ( in the bed, laying upright) I experienced vasovegal syncope and asystole for 10.67 seconds (heart monitor was still in place to capture the event). Recovery took place without intervention beyond verbal & touch stimulation. I am prone to elevated feelings of anxiety with needles, heights, hospitals, medical stuff, ). After five more days in hospital waiting for surgeon to return from vacation, a dual lead pacemaker was implanted. Multiple post op complications occurred including pericarditis, a lead perforation and 7 weeks out infection of the surgical site due to a lack of wound check & surgical glue still in place allowing for bacteria to grow. A referral to an electro physiologist cardiologist took place at week 8 post op and at week 9 post op it was determined the pacemaker would be removed. The explant surgery happened in a day surgery and I have been home for 2 plus weeks without device. My current doctor s approach is one of assessment, with my increasing my fluid intake, adding salt to my diet (blood pressure now averaging 105/69) and wearing an event monitor to capture events. My anxiety is huge and I am just beginning CBT counseling to help. I have not returned to work or any normal routine as I fear experiencing an episode. Logically I know I fainted due to the IV being withdrawn, however experiencing the heart stop has me feeling a real lack of confidence. How common is vasovagal syncope with asystole heart response and was a pacemaker absolutely necessary? I only wish the second approach had come first, as the fear level would not be conditioned into my thought process. ### output:

Hello,first let me congratulate you for giving such excellent description of your history. I personally feel you had simple vasovagal syncope .regarding pacemaker implantation and its removal I can't give opinion on either side without seeing your ECG's and record of monitoring. Interestingly you are fine without pacemaker. And now more or less you have anxiety. It is uncommon to have asystole in vast legal syncope, but it is known. This event is not indication of pacemaker. I would suggest overcoming fear, and you should join your work. You may get 48 hrs holder monitor and if that is normal, go to your work with full confidence. My 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 im 26 and i have had asthma since i was 6 month old asthma has become better over lazt 10 years. but for the last yr or so i keep getting chest infections every month or so. today om coughing up phlem my voice is going and my chest hurts when i breath and my throat hurts a little. i also work in a bakery for the last 12 years and flour and stuff has never bothered me. i go to the doctors every time and they just give me the same antibiotics / amoxycillin,prednisolone etc but they cant pin piont why it keeps happening. im going back today to see them can you help?? thank you ### output:

Hello. Thank you for asking at Chat Doctor. I went through your history and from your history I would like to suggest you as follows:1. Were I treating you, I would suggest tablet montelukast and levocetirizine daily at least for 2-3 months.2. I would also start inhaler formoterol and budesonide in low dose daily for at least 2-3 months.3. Simultaneously, I would suggest you regular steam inhalation and warm saline gargles to hasten the healing process.4. Once you have no longer episodes of cough & chest complaints, I would plan to reduce your medications gradually.5. As you are working in a bakery, I would specially suggest you to cover your nose and mouth with a mask while working. If possible, you could take steps (like keeping window open) to improve ventilation in the area where you work.6. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution. Regular breathing exercises and a healthy diet rich in vitamins and minerals (e.g., adequate amounts of green leafy vegetables, fruits, sprouts, etc.) will definitely help you in a long run.7. I would suggest you allergy testing, which will help you to identify substances causing troubles to you and also measures to avoid them.8. If above measures do not help, personally I would suggest you spirometry to know your lung capacity and identify type of lung problem you have. Hope above suggestions will help you. Regarding your main question, I would say, Asthma, if you cannot be cured, can be very well controlled by regular medications without affecting your daily life. If allergy testing identifies some allergen, you may be prescribed specific allergen immunotherapy, which can change your immune system to improve your asthma. Also, if daily exposure to bakery dust (including yeast, wheat flour, egg, other dusts) is the cause of your symptoms, avoiding bakery dust will help you a lot. I must also mention that it takes long time to develop allergies and asthma. So no matter you have tolerated bakery dusts so far, maybe it is now increasing your symptoms (its known as Bakers asthma, you can read on internet). Should you have any further query, please fell free to ask at Chat Doctor. Wish you the best of the health. Thank you & Regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, A few months ago, I keep smelling a moldy smell in the air (in my room) and its really bothering me, Ive began to sneeze a lot, my nose is always runny in one and stuffy in the other. After some time, Ive finally located on the back of a piece of furniture, there were tiny, hairy black spots growing all over the surface area. Ive cleaned everything with bleach and sanitize everything and I stopped smelling the moldy smell. However, for past two-weeks, I keep smelling a strong pungent urine smell everywhere, especially at night as I lay in bed before falling asleep. During the day the smell is more faint and doesnt last as long. But at night it seems like my bed was once soaked in a pool of urine but is now dry; when I smell every surface area of the bed, it smells like clean linen but the urine smell just floats in the air. Dreadful as it sounds, I actually get down on the carpet and sniff for the smell and I find nothing. I own a small dog for almost three years now, he is house-trained and only goes outside or in a designated area in the house (we trained him to use a litter box.) I checked the carpet area around his litter box and there are no urine smell either. When it smells so bad and someone is home with me, I ask if they smell it too but no one never smell anything. I have had migraine headaches for years and when the pungent smell lingers for too long it triggers my migraine. Every day for two-weeks now, I would wake up with a runny nose and sneezing for the first 30-45 mins. When I get out to go to school or at work, I sometime smell a faint urine smell as well, it reoccurs outside of home. This have led me to searching online: some people smell cat urine during their pregnancy or it is a bodily smell. I am not pregnant and I do not have any vaginal disorder or bodily smell, so could it be that I am just imagining it?I did not hit my head or am suffering from any concussion. The smell is too strong to disregard. Is this a psychological disorder? Is there a way to treat this problem? Could it be an allergy? I apologize for such a long post and thank you for your valuable time. ### output:

Hello, You need to consult a Neurologist to ensure that the migraine attacks are not as frequent as you think. There are several types of migraine, or worse case scenario he would ask you to get a sleep-deprived EEG done to ensure there are no abnormalities with an MRI backup. Allergy tests are certainly required, specific IGE blood test against aeroallergens including molds to ensure that the rhinitis bit is figured out. Long acting antihistamines with nasal sprays will help. Cinnarizine is an antihistamine that combined with paracetamol and risperidone has anti-migraine effects, so may be worth trying. Best Wishes.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, please help! I had a large filling on my back lower molar that was leaking my dentist said and it was to big to fill again and he said it needed A crown...After the permanent crown was placed I was having increasing , longer lasting , throbbing dull achy pain around the whole jawline and tooth area. This went on for a bout a month. I called the dentist and explained my symptoms and he said I needed a root canal the tooth was dieing. He called me in a round of antibiodics and I made a apt for the root canal a week out, however the pain got so bad I didn t last until the scheduled apt, bad enough where it was waking me up out of my sleep, had me in tears. so he called me in a stronger antibiodic and he moved up my apt for the root canal, performed it this last Thursday. Said the tooth was infected and I had a lot of imflammation and it bled a lot during the root canal. He did the root canal right thru my permanent crown. Later that night when the numbness wore off I was in bad pain. It felt like I had gotten punched in my face and 3 teeth yanked out all at once. The pain radiates all thru my jawline and into my ear. even felt like it was in my neck/lymph node. I made it thru the night with a ice packs and a lot of tears and called my dentist the next morning. They said they would call me in a rx for a steroid and pain med to help during the healing process. I started both right away and still no relief. No pain meds seem to help not even a little. Ive tried motrin 800, aleve, Tylenol 500, and vicodin 750 (from dentist). It has now been 3 days since my root canal still in very uncomfortable pain especially when I try to talk. Cant chew on that side, jawline and ear still hurting bad. I finshed my rx s of 2 antibiodics given to me as well as my 12 pills of steroids given to me...Is this all normal?? I know you can experience some pain after root canal therapy but how much is to much. Its bad enough where I have missed days of work , please please help! ### output:

Hello and thanks for consulting Chat Doctor.I have gone through your query and understand your concerns. According to the history given by you, I think the RCT(root canal treatment) is done successfully. Yes you can have some pain following root canal but not so much, and it should subside with some antibiotics and painkillers. If I were your treating doctor I would first take an x-ray to know the amount of infection down to the root of that tooth. RCT should be done to remove the infection or release the pressure caused by access if any. Some antibiotics like cephalic 200 and Oneida 500 for infection. Review after one week If RCT is successful you will not have any pain or discomfort.I would suggest you to talk to your doctor about this or take a second opinion Hope this answers your query. Take disregards

If you are a doctor, please answer the medical questions 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 15. Several months ago, after several suicide attempts, self harm, homicidal thoughts, bouts of rapid anger that led me to scream at people over nothing and once or twice to randomly start strangling and animal, stop and not even know why I did what I just did, panic attacks,mood swings and several other things, my parents decided to takd me to the doctor.I was diagnosed as bipolar and the doctor gave me a mood stabilizer.what didn t really make the depression or mood swings go away, it did help to stabalize my mood.next time I saw the pschiatrist, my parents told him that they had noticed not only changes in my mood but also changes in my personality. I was more social and outgoing and talked more as well as changes in humor sense conversation style and several other changes in my personality. They thought the changes were good and they didn t notice any major changes. According to them, the aspects of my personality that had changed were all just symptoms of a disorder and the medicine fixed them, so that their going away was a sign that I was getting better and becoming who I really am. Up until then, I had no idea I had changed. I didn t like the idea that I had changed because it means that I m no longer the real me in my eyes. I m who the medicine has made me and I m now a different person than who I really am. Those aspects of my personality were a part of what made me me and I hate that a medicine changed me without me even knowing. Now to the actual question. I used to hear voices a lot. They told me to kill myself and others as well as other things, but they went away. Recently, they ve come back so now, my doctor has given me Risperidone, a medicine he says will make the voices go away and stay away. I m worried that the antipschotic he gave me will change my personality even more and I ll endd up as another person who is completely different than myself. So, could antipschotics change me? Will they? Also, not the main question, but does the fact that I m bipolar, hear voices, have homicidal thoughts, see troubling images, tried to strangle animals in a random moment and other stuff mean I m crazy? ### output:

Degree understand your concerns went through your detailed description. I suggest you not to worry too much. You are just 15. How can you think about something which even a 70-year-old cannot dare? You tell me that your personality changed. Personality is genetic. It cannot change. Every person is unique in his personality. Attitude, aptitude, behavior, impulse etc. change, never personality. Every change is for good. Nothing is bad because these are developmental tasks the body takes up. Body and mind cannot go forward if they don't change according to situation. Psychotic medications cannot change anything in your body. They make some nerves inactive, thereby delaying or killing some signals which are negative. So, as a person who do not have any idea about mind and its features, please stop thinking unnecessarily. You respect and abide people who are trained and heed to their advices. Hope you understand. 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: Hi doctor Hope this email finds you well. I have an issue which is making me worry as I see no solution todate.I had an accident 2 years ago and injured T8.We went to india to have it repaired and according to the doctor it was successful.The doctor assured us that the spinal code was not damaged only inflammation which they decompressed. They told me that the nerves will take time to grow and might take 18-24 months.Its now 2yrs since the operation and the best result I have is feeling my stomach. I still have no bladder control.My legs tend to move involuntarily as I have no feeling of them and sometimes they really jump when my nails are cut.Due to this I had to see a neurologist last week. In our town its very difficult to get a neurologist. This one comes once in a month.He examined my belly and legs and said the growth is now upto T12. He gave me some muscle relaxers and when I informed him if there is any nerve growth medicines he said its better if it heels by itself instead of interfering with the normal body mechanism. No other test was done to me.As you know this is a worrying situation for me and its getting me worried Would like some advice from your goodself if there is any thing can be done. Thanking you in advance and hope am not a bother. Msellem Hamoud ### output:

Hi, thank you for providing a brief history of your illness. Since you mentioned you have met an accident and injured the T8 level spinal column area and the neurosurgeon have decompressed it. Understanding the scene here is you are a bit annoyed by the bladder control, movement of legs and abnormal sensation. Now since it's been 2 years and a much done onto for your good till date by all specialists. Help is always an inch away and doctors are always here to help. I wish to know if you have tried doing physiotherapy, if not than you should start it again. As the surgery was successful the later part was to take the regular medicines and regular physiotherapy. Bladder control exercises are known to a physiotherapist which he can teach you and brain always tends to keep learning. Now since you are looking here with some remedy for you, I would say that the doctors have done a great job till date, now you have to put a conscious effort to undergo a physiotherapy session and get yourself helped. Physiotherapy is not only about exercise but even about the deeper science behind it. All things done till now by doctors was excellent, now the body has to produce some internal medicine which has to make a help. Symptomatic help was done at the best. Now it's the body turn to produce the requirements. I have seen many patients with such injuries and on the later side of the years are helped by a physiotherapist and things have turn on a positive side for many. Kindly try to undergo physiotherapy and make the body metabolic system to take the next charge. It's never easy to get back on but it's never impossible to become better again. With the grace of almighty I wish you a positive outcome 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: Hi- I am a 40 yr-old femal, an athlete & in very good health/feel great (aside from some chronic pain issues from an accident long ago & high anxiety levels for which I take xanax & neurontin) otherwise (outsanding cholesterol, blood pressure etc), but have a history of excessive alcohol intake for the past 25 yrs. Approximately 3 years ago my ast & alt levels were very slightly raised & an unltrasound (they were checking source of upper right quadrant ache) showed mild fatty liver. I have since dramatically decreased my alcohol intake, and go through alcohol breaks. I still, overall though, drink WELL above the recommeded guides for women on vacation & on most wknds but nothing that seems to raise eyebrows of those around me (other wknds I abstain completely). My liver tests were normal after this up until one in 2/11 until one this past week which was done in conjunction w/ routine physical- at the time I had not had a drink in approx a wk but had a lot the holiday wknd prior. All bloodwork was good except my AST was 54 (alt was 35). I have been using marijuana from a vaporizor for a bit over a yr & also taking hydroxycut recently (I am actually very small but prefer to be about 3-5 lbs less than my current weight) and am wondering if I should have further testing/be excessively worried & also if the marijuana &/or hydroxycut can impact ast levels? Apparently the dr (not my regular) is not recommending further tests, but believes the ast is related to alcohol. I worry that after so many yrs of drinking it s to late for me & that the damage is irreversible (I know most liver tests come back normal when there is a problem & so feel must be something bad wrong if they are abnormal) which causes me to actually want to drink & just give up. Would an ultrasound be sufficient to tell me if I am past the pt of irreversible harm or is a biopsy necessary? ### output:

Degree understand your concerns went through your details. I suggest you not to worry much. I think your opinion is wrong. You are just 40. Your body can repair those damages caused by illicit lifestyle. Give it around 5 years and your body will show you how. Your problems are reversible if you stick to perfect lifestyle. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Lifestyle changes, change in thinking pattern, relaxation etc. are as essential as medicines. Psychotherapy can help you to change your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. 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: Hi there I had a Mri done the other day because of burning back pain and right side rib pain. My report reads as follows sounds like a lot of things are going on. Made an Appt to see my Doc on the 24th of this month. here is my report a mild upper thoracic levoconvex curvature. There is a mild kyphosis at the T11-12 level. The cord demonstrates normal size and signal characteristics. Mild acute, Modic type I endplate degeneration is seen about the anterosuperior endplate of T12. No suspicious marrow infiltration is seen. There is mild lower thoracic endplate degeneration including small Schmorls nodes. Multilevel disc desiccation is seen within the thoracic spine with mild loss of height.At T2-3, left greater than right facet arthropathy is seen without spinal canal narrowing. Mild left- sided foraminal stenosis is seen without nerve root impingement.At T6-7, a tiny right central disc protrusion is seen which flattens the right paramedian thecal sac without cord compression or foraminal stenosis.At T7-8, a tiny right central disc protrusion is seen which indents the thecal sac without cord compression. Facet arthropathy is seen without foraminal stenosis.At T9-10, a central disc protrusion is seen with an annular disc fissure. This indents the thecal sac and gently contacts the ventral thoracic cord without compression. Facet arthropathy is seen without foraminal stenosis.T11-12, a tiny disc bulge is seen with flattening of the thecal sac but no lower thoracic cord compression or foraminal stenosis.Review of the remaining levels reveals less prominent discogenic and facet degeneration without significant spinal stenosis, cord compression or nerve root impingement. In comparison to the 2009 study, degeneration has progressed.Evaluation of the paraspinal soft tissues is unremarkable.IMPRESSION:Progressive thoracic endplate, discogenic and facet degeneration including small disc herniations, notable at T9-10 where a central disc herniation and annular disc fissure contacts the ventral cord without compression or nerve root impingement. ### output:

Hi, Thank you for posting your query. I agree that the MRI spine report is long and reports a lot of abnormalities. However, they are minor in nature and there is no need to worry about them. These abnormalities are due to degeneration of vertebral bodies and discs (located in between the bones over back). As a result, there is mild compression or pinching of nerves in the back. This is giving rise to the pain. Treatment would require medications such as pregabalin capsules for pain relief. In addition, physiotherapy with back extension exercises would also help. 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: Hi Doctor Recently I have been diagnosed with an enlarged fatty liver .echogenisity is also high.Size of my liver is 15.5 cm.all other ultrasound test for abdomen were normal.my shot and sggt levels are high by 30 to 40 % of normal range. Hb is 10.9 ESR 18 KFT normal Bi lure Ben .567 Please advise how to treat this? To add it further I was detected with positive helicopter bacteria for my superficial ulcer in my stomach through endoscopy . I am not having major physical symptoms other than constipation even after taking lubowel 8 ( twice a day) and laxopeg sachets twice a day.I am taking iron supplement .can this leads to constipation? Day before yesterday I have finished my ltc kit course for ulcers.my triglycerides are marginally high , 196 Total chl 162 Hdl 29 Vldl 39 LDL/HDL 5.6 Direct LDL 103 creatinine 9 Potassium 4.9 Sodium 141 Chloride106 Uric acid 7 ESR 18 RDW 18.5 platelet count 355 Rbi 4.99 MCV 74.9 MCHC 31.2 MPV 9.2 vitamin D 24.3 Vitamin B 12 197 Folate8.1 Human tissue transglutamine 6.06 I am stressed and panic disorder patient but I have not taken any anti depressant and trying to beat with yoga. Please advise and also suggest me about my diet plan.Can I take boiled eggs? ### output:

Hello, Thanks for approaching! You have to follow these guidelines in your diet for your "fatty liver".1)No junk, processed food and food with preservatives.2)Avoid white rice, white breads, corn flour. Have multigrain breads and flour, brown rice.3)Avoid potatoes, water chestnut, sweet potatoes, lotus stem, jackfruit., bananas.4)Use olive oil/canola oil for cooking.5)Avoid butter/ghee/excess oil/cheese./spicy food.6)Avoid red meat. Remove the skins from poultry after you cook it7)Avoid full cream milk. Have skimmed or single toned milk.8)No soda. Have herbal teas/fresh lime.9)can have egg white in any form(no yolk)10)No alcohol.11)Try to bake, broil, steam, grill,roast, boil foods instead of frying them.12)Regular walk/exercise/yoga/physical activity. Pls take care of your constipation, Can have any mild Laxative Isabel husk/Trial/Avipattikar churn. Hope this information will help you in regulating your diet. 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 numbness in my right knee for the last four years. Now, i started playing Badminton and the numbness radiated up to hip. So, I consulted a Neurologist and advised to have a MRI. MRI findings reveals Cervical Spondylosis - Nerve Compression. So, he recommended for a Cervical Spine Operation to relieve Nerve Compression. However, he referred to a Neuro Surgeon for correct findings. Neuro Surgeon advised the same.Following is my MRI Findings:MRI Cervical spine:Findings reveal generalized changes of Cervical Spondylis.Impression: Primary narrowing of bony spinal canal in antero-posterior dimension at C2 to C6 vertebral bodies level. Diffuse bulge of dessicated C5-C6 disc with broad based herniation in postero-central and left paracentral aspect and associated with large posterior verterbral body osteophylte. it is compressing the thecal sac and cervical cord with changes of myelopathy. Narrowing left lateral recess and left exit foreman is noted. Diffuse bulge of degenerated C4-C5 disc with broad based postero central protrusion and associated with posterior verterbral body osteophylte. It is intendig the thecal sac with mild narrowing of bilateral recess and bilateral exit foremina. Diffuse bulge of dessicated C3-C4 disc with broad based protrusion in posterior left paracentral and intra foraminal aspect, narrowing left lateral recess and left exit foramen. MRI Spine Thoracic:Impression: MRI Dorsal spine findings reveal straightening curvature of dorsal spine and evidence of focal lesion in D5 verterbral body suggesting ? hemangioma.My Condition:Three weeks back, I had Restless leg syndrome also for two days, after that disappeared. When i sit in the chair for half hour and while getting up, I experience some nerve pulling and limping when walking for a while. I lose control while standing in one leg, lose balance while wearig socks, no balance while walking. Difficult when get up from sitting, planting my right foot is always with painMRI Spine Cervical: My mother has Cervical Spondilysis, is it a hereditary. Please let me know, whether Ayurvedic treatment will work. If it is, how long I have to undergo treatment in the hospital. How my problem will be diagnosed. Approx. expenses. Thank you for taking time to read and please do reply.Regards, KalifaAbu Dhabi ### output:

Although your MRI findings are making you restless but I think Ayurveda has a lot to help you. In all such cases a procedure called Kate vast gives excellent results. Along with this internal medicine as triodashang GGUL and punarnava GGUL and R compound gives excellent results. It may take 2/3 months for complete recovery but I believe you will start feeling better after 10 sittings of Kate vast. 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: female age 46, non smoker, social drinker, no previous health problems, exercise regularly, not overweight I have been having pressure in the chest for over a month with a little tickle in my lungs but no cough. No fever but tired feeling all the time. Went to my doctor and he did an ekg and lung function test (where I blow through a tube). He said everything looked fine but was a pattern of allergic breathing? so told me to take Claritin for a couple of days. Nothing improved so I went back to my doctor and he gave me Dulera to take for a couple of days. Still no improvement. I am guessing I need a chest x-ray next but any idea what it could be? ### output:

Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. You seem to suffer from -HERD with esophagitis with tickle in lungs without cough. The pressure in the chest is mostly from esophagitis with bloated stomach. The accompanied HERD with acid reflux with stomach gases from pyloric and LES(lower esophageal sphincter-Dystonia dystonia) is giving the chest pressure with cough like feeling but no coughing in real terms. The problem is therefore is in the Stomach and Esophagus with legal irritation giving bronchial irritation with accompanied bronchospasm like feel, but no bronchospasm as such. The feeling of short less of breath is from diaphragmatic pressure by bloated stomach. Dos Suggested-In the given scenario as discussed above, You need to Consult Physician and Surgeon to fix the cause of the HERD with acid reflux. Causes of the basic IBS causing HERD with acidity needs to be ruled out. Check up for HERD from IBS due to accompanied- perianal ailments like fissure in ANO, parotitis, Sigmoid spastic colitis with amoebic colitis and other causes like Diverticulosis/Polypoid cold need to be ruled out by-Stool Ova/Cyst test/ photocopy from Surgeon/Colonoscopy / CT Contrast abdomen for Diverticulosis and Crohn's disease. Thus Check-ups from a team of Chest physician /GI Surgeon/Colonoscopies / EGD-Esophago-duodenoscopist would be needed to fix the causes and treat them accordingly. Hope this reply would help you to resolve the health issues with help of doctors attending on you. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello after abdominal pain in my lower back and left leg I started to feel the numbness: it goes in my left foot, left thigh, left buttock and a bit in left side of my vagina/rectum. MRI showed S1 compression- but a neurologist says it has nothing to do with my genital area. I found on your website a very similar cause- and the doctor said it s NERVE COMPRESSION. my question is: how long you can have it before it s too late for surgery? can S1 affects genital area? what specialist I should see about it? (Neurologist said : find a good PM&R doctor) When the numbness goes away? how can I know the nerve is not damaged? here are my MRI results Please HELP !!! Findings: Mild disc desiccation consistent with degenerative disc disease is noted within the lumbar spine. At L1-L2 and L2-L3 no neurocompressive changes are identified. At L3-L4 there is annular disc bulging with flattening along the ventral margin of the thecal sac. No resultant central or foraminal stenosis is seen. At L4-L5 there is annular disk bulge with impression on the thecal sac. Disk material causes encroachment within the inferior left neural foramen. At L5-S1 there is central and left paracentral disc herniation with impingement and displacement on the left S1 nerve root in its lateral recess. More diffuse disc bulging also cause encroachment within the bilateral neural foramina. Degenerative endplate changes are seen at the L5-S1 level. The vertebral bodies demonstrate normal height and narrow signal characteristics. The conus medullaris is at the L1 level and displays normal morphology. IMPRESSION Central and left paracentral disc herniation L5-S1 with impingement upon the left S1 nerve root. This is superimposed on more diffuse disc bulging. Degenerative endplate changes at this level is also noted. Annular disc bulging at L4-L5 with impression on the thecal sac. Annular disc bulging is also noted L3-L4. ### output:

Hello and welcome to Chat Doctor, The intervertebral discs are cartilaginous structures present between vertebrae. The disc acts as lubricant for smooth motion of the vertebral bodies during movement of the spine. At times the disc starts bulging out from its normal position. The bulging disc starts impinging nerve roots which emanate from the spinal cord. The nerve emanate through small foramina in the vertebral bodies. These foramina are intact in your case. In your case, discs are bulging at the level of L4-L5 and L5-S1. Due to the compression, the area supplied by these nerves are affected. This is responsible for the pain and numbness in the foot region. The S1 nerve does not supply the genital region. The treatment for this condition is complete bed rest. If the condition does not improve on bed rest, surgical measures may be required. Thanks and take care Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: when I was about 2 years old I had bacterial spinal meningitis. I was unconscious and did not know my mother from my grandmother. I was fed antibiotics through my ankle and was fortunate to live through this devastating illness. I do remember a couple of snippets from my illness when I was 2. I have no outward repercussions, however I was wondering if, at the age of 2 it could have affected my nervous system. I seem to be very emotionally sensitive and have been on anti depressants for over 10 years. These help very much and i am glad i live in an age when these are available. I don t seem to be able to make mental connections as quickly as most seem to do. My IQ is very average and in school I was almost always the last one to finish a test. i read rather poorly and slow even at this age 62 and do not enjoy reading that much (neither here nor there i guess) I don t mind but I had always tried real hard to study and work on my school work .I always took more time than most in school. I do not seem to catch on as quickly as most. I do not mind as I am 62 years old and am retired. Life is pretty great really although hard, it is for most i beleive. I am good at artwork and conceptual thinking. I know you can not tell me anything definitive but I was wondering what sort of internal brain damage there could have been - I was very very athletic and that was another thing (with my artwork) that i was quite strong in. Can you tell me anything about nerve connections that could have been slightly damaged at the age of 2 - I have heard that at 2 your nervous system is finishing it s development. Can you tell me anything in your experience or reading? I am just trying to know myself better. Thanks, Lauren Thomas. ### output:

Hi, I am Chat Doctor. I have read your question with care and understand your apprehension. Let me try to help you Question 1 : I was wondering what sort of internal brain damage there could have been - I was very, very athletic and that was another thing (with my artwork) that I was quite strong in. Answer 1 : Spinal Meningitis affecting Brain is not common. But, in your case, I have very well say that it has not affected at all because 1. You were very athletic 2. You are good at artwork and conceptual thinking Question 2 : Can you tell me anything in your experience or reading? I am just trying to know myself better. Answer 2 : One point I would like to disagree is your assessment of your IQ. I do not think that your IQ is very average. Being the last one to finish a test in school does not mean that your IQ is average. It means that you have a lot to write, and you wanted your answer sheet to be more perfect. So Please don't worry Be happy and cheerful 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: my husband had a allergic reaction after eating at different resturants one time he ending up in the er,with hives and his tongue swelled up he s has a epic pen now but we are not getting any answer from our dr. we ve done different test but nothing is showing up so what can we do now? ### output:

Hi sir/madam, swollen tongue can be easily treated by the help of Ayurveda. Let me advise you about tongue swelling. Swollen tongue is actually an abnormal condition in the tongue occurring due to tongue inflammation, where either a part or the entire tongue gets enlarged, and fatter than the normal tongue size. It is true that tongue in its swelling conditions is taken as a kind of defense mechanism which helps in fighting against the infection and aids in healing. However, when there is an excessive swelling for longer time; the swollen tongue can be actually very much harmful. It must be mentioned that tongue inflammation or the swollen tongue condition can result from the excessive fluid accumulation in the tongue tissues and termed as Angioedema. This swollen tongue can also occur due to excess deposit of abnormal substances like the amyloid protein and also can be result from any kind of allergic reactions to certain medicines. Symptoms Of Swollen Tongue:-1. Enlarged, puffy tongue due to excessive swelling2. Difficulty breathing when tongue swelling outgrows to the throat or the air passage.3. Discoloration or redness seen sometimes due to inflammationProblem while swallowing foods. Causes of swollen tongue:-1. Tongue sores usually caused due to virus.2. Strep infections can cause swollen tongue.3. Sometimes burning of tongue while eating food in hot conditions can lead to the trauma and swollen tongue.4. Vitamin D deficiency can also lead to swollen tongue and other tongue inflammation.5. Certain allergic reactions can cause swelling in tongue.6. Patients suffering from genetic disorders like downs syn Chat Doctor. 7. Tongue cancer, leukemia etc. causes swollen tongue.8. Breakdown of skeletal muscle tissue or Rhabdomyolysis can cause swollen tongue.9. Hypothyroidism, amyloidosis etc. can also lead to tongue swelling.10. Excessive alcoholism and smoking also causes swollen tongue. Next I am going to tell about the home remedies you should follow:-1. Take enough of butter, soups, yogurt, gravy and broths in regular diet. In fact try to switch on the semi-solid foods which help in providing relaxation in swollen tongue condition.2. Cold temperature helps in reducing the tongue swelling. So keep some ice cubes in your mouth and relax yourself.3. Include celery sticks in diet and provide enough relief to your swollen tongue.4. Make a dilute solution of turmeric in a warm glass of water and gargle with the solution to get relief from tongue inflammation and swollen tongue.5.

If you are a doctor, please answer the medical questions 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 PCOS AND I AM TRYING TO HAVE A CHILD, INITIALLY I TOOK TABLETS TO FORM THE FOLLICLES, DID FOLLICULAR STUDIES EVERYDAY. 1 FOLLICLE RUPTURED AFTER A COUPLE OF DAYS, FOR WHICH I WAS ASKED TO KEEP RELATIONS, I KEPT, THE 2ND FOLLICLE DID NOT RUPTURE TILL IT REACHED A SIZE OF 34 x .... THE GYNAC TOLD ME, ITS FORMING A CYSTS, SO NOW SHE ASKED ME TO TAKE SUSTEN 300 FOR 15 DAYS. THEN TO DO A HPT AND CHECK. SHE ALSO MADE A STATEMENT THAT IF I GET MY PERIODS, TO BE PATIENT WITH MY SELF. NOW MY QUESTION IS WHAT EXACTLY DOES HELP DOES SUSTEN 300 TABLET GIVE. SINCE I VE KEPT RELATIONS AND MY CHANCES ARE TO GET PREGNANT, WILL THIS TABLET DESTROY THE CHANCES. AWAITING YOUR REPLY REGARDS SP ### output:

Hi SP, Let me explain the cycle for you to understand use of the medicine. For a lady with cycle of 28 days, around 6-7 follicles (eggs within them) are put forward. Out of these only 1 will rupture in normal cycle, multiple if stimulated with hormone injections. Around 13-14th day of periods(around 18-24 mm size), the follicle will be right size to rupture & push the egg out, it stays alive for 24 hrs. This is the time you should have intercourse & sperm meets egg. It forms the baby/ embryo. Once follicle ruptures, remains of the follicle will produce progesterone hormone which will act on inner lining of uterus & make it right thickness for baby to sit, further it will maintain the embryo in uterus & prevent early pregnancy bleeding/ abortion. This support is required till 12 weeks of pregnancy, when the placenta appears. AUSTEN is this hormone progesterone. Especially in POD these hormones are not well-formed naturally, so supplementation is required. I don't see any use of that follicle of 34 mm. Once more than normal range, they are not healthy. Only when right sperm, meets the right egg, at right time, at right place, in right hormonal status of body & reaches right thickness of uterine lining will healthy baby occur. Every attempt will not lead to pregnancy. You have to patiently try for the right opportunity. You will surely get it, as luckily you are ovulating in spite of PRO. Furthermore, you have a good chance of pregnancy Hope I have clarified your overall the best Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: After having mild pain in lower part of stomach for say 15 months, full colonoscopy was done and other tests namely- complete haemogram, LFT, KFT, B 12, 25OH VITAMIN D3 , URINE R/E, STOOL R/E were carried out. the results of haemogram were normal except ESR value - 20 mm/Ist hr. VITAMIN B12- SERUM = 147 (197-866) VITAMIN D (25 OH) TOTAL = 4.10 ng/ml. LFT : AST( SGOT )-SERUM/ PLASMA = 45 (5-40) ALT(SGOT)-SERUM/PLASMA = 77 (5-40) Colonoscopic Diagnosis: DISTAL ILEAL ULCERS .Examination done upto distal 10cm ileum.Multiple superficial to deep ulcers were present in distal ileum. Multiple Biopsies were taken For HPE.Rest of the colon shows normal mucosa. No polyps, strictures, growth, vascular malformationor any other lesion seen. (Rest tests shows normal study.) After one week treatment following tests were also carried out: CECT SCAN-Upper abdomen -Normal study. Hbsag = Non Reactive Anti HCV-IgG = 0.07 Index ( 1.00) After taking medicine for 15 days, i noticed abdominal pain and back pain upto neck in the evening. the day i took the medicine, i feel pain in the evening and when i stopped taking medicine, the pain is gone. doctor advised me following tests : small bowel anema = ( to be done) amylase = 74.00 U/L ( 13.00-53.00 ) lipase = 85 U/L ( 67..) tb quantiferon = (REPORT YET TO COME) mantoux test = (REPORT YET TO COME) Now i m not taking medicine and feels no pain. i,ve quitted drinking since last 15 days. now i request you to look into matter and advice is that abdominal pain occurs due to the medicine i took? Should i continue those medicines ? May be these medicines have not suited my body? med: meberverine, mesacol, rabcita dsr, folvite ### output:

Hello there, Distal Ideal ulcers with raised ESR are suspicious for Intestinal Tuberculosis (TB). Looking at the tests prescribed for you, I think your doctor is already trying to rule out the presence or absence of TB. I think you can safely continue the current medications as I don't think they are the cause of your pain. If you don't mind I would like to know if you are you having any low grade fever, cough, weight loss? Have you noticed any swellings in your neck or armpits? Hope I have answered your query. Looking forward for further information from you. I will be available in case of any further queries. Get well soon.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: A few months ago, I noticed the middle finger on my left hand started getting stuck in the closed position when I would wake up in the morning. I also noticed there is a small bump at the inner base of that finger. After doing some research online, I found that this might be pointing toward arthritis (specifically trigger finger ). I am 33 years old, so this seemed odd to me, but I made a mental note and went about my business. Plus, it started getting a little better as time went on. Recently, I ve found that anytime I sleep on my left arm it starts to go numb and tingle (it falls asleep ). This has been going on for about a week, or so. And, for a couple of days within that timeframe, my left pinkie finger would tingle throughout the day. That sensation has gone away, but my arm still falls asleep when I lay on it. I am young (33), athletic (slender/muscular 230lbs, 6 5 ) and have always thought of myself as a generally healthy person, but this is starting to worry me a bit. I have thought this might be stress related, as I ve been working long hours at work, or that maybe I just need to get more sleep, as I am lacking in that area, as well. Any thoughts or recommendations would be appreciated. Thank you! ### output:

HI, Dear,Welcome to Chat Doctor. Based on the facts and data of your query, You seem to have a complex problem from the disturbed forearm compartments, mostly due to the-overwieght issues with service spondylitis/ and due to the hypothyroid entrapment of the forearm nerves / or could be due to the? Rheumatic nodule with synovitis, on the base of the left-hand middle finger / or could be due to the accompanied dupeutrans contracture, which may start like this/ or due to the psoriasis teno-synovitis of the left hand. All these possibilities would need to be ruled out by check up with and Second Opinion from your Physician or with your Orthopedic doctor/ or Sports doctor, as you are an athlete. Remedy-1-Check out with Ortho-Surgeon and Physician team if need be, would be needed to find out the cause of the stuck middle finger with nodule at the base of the left middle finger. Only after proper X-ray and CT study of the indicated parts as advised from OrthoSurgeon, you could get the correct treatment either with the medicines and or with the surgical correction if need be.2-At 33 with 6ft 5 inches, you are still overweight, though muscular, and need to reduce on at least 20 kg to reduce the load on the hormonal system, which appears to be stressed with the stressed immune system, which seems to be causing this teno-synovitis or rheumatic problem in your upper arm and hand. Hope this reply would help you to resolve your sever anxiety. Welcome for any further query in this regard Will appreciate writing your feedback review comments, to help the needy patients like you at Chat Doctor. Good Day!! Chat Doctor. S. Genl-CVTS

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My Son, Soham Basu has effected with seizure on 09.06.14m The convulsion lasts more than one and half hours, in between the convulsion I called my friend, Dr Kaushik Seal and he attended him half an hour and instructed me to admit my son to Medica Superspeciality Hospital where my friend practiced as Neuro Surgen. After admission, the hospital has done EEG, MRI, CITI scan and ECG, but no cause and abnormility has found and the Doctors advised to take LEVIPIL - one tab - 250 mg. at morning and 500 mg at night and they realed my son on Wednesday, ie, 11.06.14, But again he was effected on 13.06 for half an hour. Doctor said the medicine will continue. After taking medicine he is sleepy and sometimes mild headache. My querry is why this convlsion is being happened again and again when no disorder is found ? and whether LEVIPIL is good for taking , since he is student now and studying at 7th class, Whether it is Epilepsy really and how long days this medicine will be taking ? and whether this hampers his brain for future . I am his father and we are too much worried about him since he is our only son .Please advice us accordingly. Moreover, He has fallen down from our balcony of the first floor to the ground at the age of one and half years of his age and we admitted in AMRI Hospital, Dhakuria , but nothing has come out as irregularities. He is 12 years 6 months now and his weight is 62.90 KG. Whether the Convulsion is happening for the transition period from minor to Teenager and because of hormone secretion .... Please have look into the case of my son and reply us. Dr. Arnab Chakraborty , Neurologist, will be best person in this case , since he is handling so many cases of Epilepsy as I heard. ### output:

Hi, I am Chat Doctor. I have read your question and understand your concerns. Let me try to help you Question 1 : My quarry is why this convulsion is being happened again and again when no disorder is found ? Answer 1 : Sometimes, the cause of seizures are found immediately. Sometimes, it takes more test to find the exact cause of seizures Question 2 : Whether LEVEL is good for taking ? Answer 2 : Yes. Fits have to be prevented. So Levetiracetam has to be taken. Question 3 : Whether it is Epilepsy really, and how long days this medicine will be taking ? Answer 3 : We need more tests to know the answer for this I understand your apprehensions as a father. I would request you to please wait a bit more and ensure that your son takes the tablets regularly and really swallows them. 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: Hi. for the first time in my life I was told by an ultra sound that I have 2 kidney stones, one in each kidney, each about 1/2 cm. I am scared to death, not knowing what to do. The Dr says just drink a LOT of water and it should PASS or break down. I am now starting to feel an on and off sort of throbbing mild crampish kind of pain in my right front side. I am a woman. Question: am I supposed to wait for pain to arrive at any time soon? Could it pass without more pain? It seems too LARGE to do this without pain. HOW could I help pass it quickly before it maybe grows and becomes harder to pass? Tired of drinking water. Anything I can take naturally without medicine or do I need medicine? I prefer alternative or holistic or homeopathic remedies. I also recently discovered -incidentally through an MRi from a minor car accident, 1 .9 cm benign fluid-only cyst on each kidney. Are cysts and kidney stones related? I have never had a healthv issue in my life. My glucose was high at 98 and the AC1 hemoglobin at 6.1 high risk for pre-diabeyic type 2 THIS IS AN AWFUL DISEASE NOT IN MY FAMILY I am thin and maybe not enough of a love life, still single at 49 no kids hoping to have ONE with my commitment-phobic finally wanting marriage AND a kid boyfriend. EVERYthing at once, and so many needs. Please help me to feel at peace with all of these things. I don t know how the different conditions affect EACH OTHER. I just started taking a sugar controller herbal tea yesterday. I generally eat healthy my whole life and am shocked by all of this? Age maybe? No excuse. Not everyone has these things. I love life , a loooong life and want to get rid of the sugar problem, the stones and the systs and high choleterol NOW before anything happens. Thank you I am sorry if you need a credit card but I don t have one to pay anything Can I have one free question? ### output:

HelloThanks for query. You have been detected to have stones of a size of 5 mm in both the kidneys. Assuming that you do not have severe pain I would say that these are non obstructing stones of a small size and will pass out through urine and nothing to be worried. They will pass down naturally without any medications. You have to ensure that you would Chat Doctor. Avoid spicy food and milk products, chocolates, cabbages in excess. As regards two cysts detected in kidneys, they are of no significance at all They are from birth and benign in nature and does not require any treatment at all. As regards Diabetes the blood sugar levels of 98 and HbA1c of 6.1 does not signify Diabetes. Hhowever regular moderate exercise like walking for 45 minutes with diet control will keep you away from being Diabetic. Please be assure yourself that you are enjoying good health, What ever symptoms you have are due to anxiety.

If you are a doctor, please answer the medical questions 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 was undergoing follicular scan from D9 and on D18 my Endometrium thickness - 0.94 of Type - P and in left ovary had follicles PL (T 1.9 AP 1.4 L 1.8) and AL (T 2.5 AP 1.6 L 2.3 ) And PM (T 1.3 AP 0.9 L 1.4 ) This day i took the Fertigen injection and went for a repeat scan to check for ruptured follicle on D20 however this day there were no ruptured follicles and the readings were as follows ENDOMETRIUM THICKNESS - 0.95 TYPE - ES? no FRU fluid FOLLICLE SIZE - L (T 3.1. AP 2.4 L 2.6) M (T 3.0 AP 2.3. L 2.7 ) MM (T 1.5 AP 1.3 L 1.4) and it showed haemorrhage in L and M, however MM was progressing LUF . I was asked for a followup scan on D23 where they found a ruptured follicle with following readings ENDOMETRIUM THICKNESS - 0.98 TYPE - S and FOLLICLE SIZE L [Ruptured] CL ( T 2.4 AP 1.6 L 2.4 ) LUF- M ( T 3.0 AP 2.4 L 3.0 ) MM ( T 2.0 AP 2.0 L 2.0 ) i made contact the same night and also started my course of Duphastone 10 mg. i am 34 yrs old and weigh 75 kg and my height is 5.5 ft . I have been working out doing aerobics and had enrolled in a weight loss therapy clinic where they give gel massages and steam belts and all to reduce weight. QUESTION::My question to you is can i continue with my aerobics and weight loss therapy after the follicle has ruptured. I have not dared to continue going to aerobics and weight loss sessions as yet and today is D25 also want to know with my weight i worry it can bring in complications....both to conceive and after conception. Please suggest what i can do. Thank you. ### output:

Hi, thanks for writing in. I appreciate your dedication towards losing weight. But I must emphasize that while there isn't any proven harm in continuing aerobics till you get pregnant, medically steam belts are not an approved form of treatment for weight loss. Although there are few studies reporting the safety of sauna bathing, there isn't much scientific research on sauna belts even though the working principle is same in both. With such conflicting evidence, I would suggest you to continue aerobics and consult a good dietician for tailor made diet chart till you conceive. Once you get pregnant, you will have to go for pregnancy friendly exercises or yoga and eat a healthy balanced diet. Hope this little piece of information helped. 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: dr. im 42 years old, my first baby expired before four years who was 10months.my and my hsbnd reports are fine.why i cnt concieve again .he dnt want I.V.F.how i can concieve natarully.wht is my healyh problem.i want to concieve naturully as soon as possible not by i.v.f.can m2 tone help for it. ### output:

Hi, I guess your concern is about getting pregnant, naturally without IVF, at the age of 42 years. You have mentioned that you are taking medicine - M2 tone for regularization of menses. The dose and since when you have started taking the medicine is not shared by you. After taking the medicines whether the menses have become regular or not, it is also not shared by you. It is natures rule, as we get older the functions of our body will be decreased quantitatively and qualitatively. The ovaries also decrease in its function as women become old. The reproductive age group, that is maximum chances of conceiving is more usually at 20 to 40 years. Around the age of 50 to 52 years, women stop her menses. This indicates she can't conceive anymore. The age 45-48 years is a transition zone from highly reproductive age group to the age group where menses stop. And here the chances of getting pregnant are not as high as reproductive age group and not low as 50- 52 yrs of age. But still there are a chances of getting pregnant in this transition age, and you are at 42, so there is a hope of getting pregnant. Be positive and don't lose hope. However, irregular menses at this age decreases the chances of pregnancy. But, as you are on medicine for irregular menses, once the menses becomes regular, the chances of getting pregnancy increases. So there is double positive hope for you. Some people thought they are in reproductive age group, because of problem, either in husband and wife, chances of getting pregnancy decreases. You have told that MY AND MY HUSBAND REPORTS ARE FINE. So there is triple positive hope. As you have lost your first child, and you are at the transition zone, it's better to go for an accelerated method of pregnancy. The accelerated methods are-IVF, GIFT, GIFT, CSI. The advantage of accelerated methods is getting twins of triplets is also there. My suggestions:1. Have patience. Wait till the menses becomes regular. Then pray to God for natural method of getting pregnant.2. At the age of 42, transition zone I would recommend u for accelerated methods - assisted reproductive techniques (ART) - IVF, GIFT, GIFT, CSI and to visit nearby infertility specialist to know pros n cons of each. I pray God to give strength to your family about the loss of first child and bless you with a cute and healthy baby as soon as possible. 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: Symptoms: 1) Pain Left side, L4,5 facet area - chronic @ pain level 5 2) Pain, left side, low buttock wrapping into thigh/hip joint - severe & generally chronic @ level 8 with occasional variation - increases with walking 3) Pain - left calf, central calf outside only, extreme pain and commensurate with buttock pain - History: 56 yr. old male with 30 yr. history of degenerative back issues generally resolved by Chiropractic. Pain described above started in Jan. 2012 - Tests & Procedures since Jan. 2012: MRI lumbar, many issues, but inconclusive. 3 wks. PT with no resolve. Med-branch block (2) in April, L4/5. Results - minimal relief for less than 2 hrs. Trans ESI #1, May 1, L4/5, followed by 5 wks. PT. Results = 70% pain dimminishment - success duration = 5 wks. followed by full return of symptoms. Myelo/CT 7/12 with results inconclusive. - Current Status: Neuro #1 consulted in March referred me to pain mgmt. for diagnostics. I consult with a new spinal neuro later this month - Pain Mgmt. Dr. referred me to his in-house associate today for 2nd opinion. That Dr. suspects the problem is the hip, but agrees back is a mess---just not the source of the severe butt/calf pain. Ordering a hip MRI. Mentioned a condition with 10 syllables that I didn t catch, but started with glute xxxxxx. MRI should confirm. Any thoughts what condition he suspects? ### output:

Hi, Firstly, Sorry to hear about your condition. Coming to the point. As mentioned you have intervertebral disc issues and this is leading to Radiating pain. I consider this condition as Lumbar Radiculopathy. In this condition, over a period of time, there leads to a lot of weakness in the lower limbs and that leads to other secondary symptoms. What I feel is the Physician might be looking for any Osteoarthritis of the hip, but I think it's better to not get into OA Hip. Let's come to a solution which I have been trying in cases with multiple disc injury and radiating pains. I prefer you start the exercises for stabilizing the core along with strengthening the hip muscles more. You may find videos online and can perform slowly and gradually increase the repetitions. Consider, that pain might be present while performing exercise, but if a proper prescription is followed for 3-5 months things can be better and controlled. Over a period of long time the exercise prescription needs to be re-assessed and Re-plan for best of your suitability. Important that nerve blocks, painkillers, chiropractic, etc., are short-lived in such cases with chronic history of the disc degenerate disease. 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: hello doctor.. My mom has tuberculosis.. treatment is started 2 weeks ago... i.e from 9 may 2014. medicines taken are rifampin and isoniazid(R-Cinex) along with thynorm 25mg before breakfast, pyridoxine hydrochloride (benadon 40 mg half tablet) & prednisolone dispersible tablets (i.e wysolone) after breakfast but this wysolone tablet for 1st week 3 times 2nd week 2 times i.e after breakfast and dinner & 3rd week only after breakfast.. Then pyrazinamide (i.e pyzina 750mg) 2 tablets after lunch and at night after dinner ethambutol hydrochloride tablet i.e themibutol 800 mg.. before starting with this treatment i.e on 8 th may 2014 Tapping was done.. and now from 20 may 2014 pseudomonas aeruginosa was found so on 20 & 21 may doripenem 500 mg diluted in 10ml steriled water was given after that from 22 may ertapenem 1gm IH was given for 5 days till 26 may. Now doc told to stop this injection but didn t told us to do any test. And she still has fever around 102 to 103.. Doctor told to take crocin if it crosses 102 and maphtol if it crosses 103.. Her diet is also not proper. She don t feel like eating as she use to eat before.. She has loss her weight too.. She is still coughing & cough is normal white or water colour.. Sometimes she has breathing problem too.. Even stomach upset sometimes.. when there is fever at night she become wet due to sweat. Please doctor advice me.. Is this treatment going on is proper ?? And how many days will this fever & cough remain..?? When she will gain weight?? why is this stomach upset now.. is it because of medicine side effect or other disease like jaundice or something because some jaundice we dont come to know..?? what vegetable fruit should be eaten & which should not be eaten as she has cough too?? is it ok to have non veg ?? please specify name of fruits and vegetable to give & not to give.. please doctor reply soon.. i am worried a lot.. please please please ### output:

Dear Friend. Welcome to Chat Doctor. I am Chat Doctor. I have read your query in detail. Furthermore, I understand your concern. A patient with Tuberculosis on treatment doesn't have any special dietary restrictions. However, patient should avoid Spicy food, alcohol. Should be given lots of green leafy vegetables. Should be given lots of fruits. If on treatment develops any pain abdomen, jaundice, visual disturbances, it should be reported to your doctor. This is my best advise for you based on available details. If you have any further query please ask me. Stay Healthy. ChatDoctor, 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: Hello, my name is Dan and I am so desperate for help. Let me start from the beginning. The evening of 12/12/11 I took a 15 mg adderoll to help me study for a test. That night i experienced intense palpitations and had to call an ambulance. My heart rate eventually slowed down, and after x-rays, taking my blood, and even a urine test, they discharged me and told me I had to further complications. Well it has now been 2 weeks since this episode and I am experiencing extremely odd symptoms. Symptoms include: Shortness of breath chest pain weird tingly feelings all over my body constant fatigue periodic palpitations headaches inability to workout without palpitations also, i am experiencing a very specific pain in my upper stomach, right below the heart. when i press on this area, i get a sharp pain that usually is followed by palpitations. I have no idea what is wrong with me. I have already been to the ER twice, and after doing various heart check-ups, was told that i am completely fine. I know I am not fine, and ive been this way ever since the adderoll and extreme palpitations that came with it that night. Please help :/ Thanks. ### output:

Hias you have taken doses of stimulant amphetamines these side effects are very common and will take time to clear away all your symptoms fall under the category of side effects of amphetamines am I penning them down here More common: Bladder pain bloody or cloudy urine difficult, burning, or painful urination fast, pounding, or irregular heartbeat or pulse frequent urge to urinate lower back or side painless common: Cold or flu-like symptoms cough or hoarseness fever or chillsIncidence not known: Blistering, peeling, or loosening of the skin chest pain or discomfort confusion convulsions dark-colored urine diarrhea difficulty breathing difficulty with speaking difficulty with swallowing dizziness double vision faintness headache inability to move the arms, legs, or facial muscles inability to speak itching joint or muscle pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs loss of bladder control muscle cramps or spasms muscle pain or stiffness muscle spasm or jerking of all extremities' nausea pain or discomfort in the arms, jaw, back, or neck red skin lesions, often with a purple center red, irritated eyes seeing, hearing, or feeling things that are not there skin rash slow speech sore throat sores, ulcers, or white spots in the mouth or on the lips sudden loss of consciousness sweating swelling of the feet or lower legs tightness in the chest troubled breathing uncontrolled repeated movements (tics) uncontrolled vocal outbursts unusual tiredness or weakness vomiting so don't worry just don't take anymore amphetamines as the amphetamine will clear away from your body you will be fine

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, I am a 35 year old male, and aside from high blood pressure and high cholesterol (both treated by medication ), I am in very good health. Last week I went to my doctor for a routine physical, and he was alarmed at my total bilirubin level of 1.8. It had always been 0.6 or 0.4 in the past. He also was surprised at a 60 point jump in my cholesterol level, despite my being on medication for that, and having it be stable for many years. I am having another test done in two weeks, but now paranoia has set in as I find every on-line article about elevated bilirubin levels being potential signs of cancer (or gallstones). I could not find anywhere what the typical high total bilirubin levels are in cancer patients, so I do not know how my 1.8 level compares. I would like to know this if possible, and also, is a spike in the bilirubin level likely to happen for any other reason? It does not seem to fluctuate like sugar levels or blood pressure can, so I am worried that it is an indicator of something bad. Any information regarding that type of bilirubin level would be very greatly appreciated. And also, would there typically be other indicators present at the same time in a blood test that would indicate cancer as a possibility? Thank you very much. Sincerely, Marc YYYY@YYYY 2-23-13 UPDATE: Yesterday I had a liver function/bilirubin test. The results were that my total bilirubin came down to 1.2 (0.2 direct and 1.0 indirect). My cholesterol was not checked, but now my sugar went from 92 two weeks ago to 110 now! I am concerned that with a big jump in my sugar now and cholesterol two weeks ago, and in conjunction with a high bilirubin, this may mean that I have some liver or pancreas problem. I am extremely concerned. My doctor wants me to wait a month and then repeat the tests. Any thoughts would be extremely appreciated. Incidentally, all other tested levels were in the normal range, but I don t know if that means I can rule out a liver or pancreas problem. Thank you all so much. ### output:

Hello, caucus, Let me assure you that you don't have liver or pancreas cancer. Bilirubin is a combination of conjugated and conjugated, that indirect and indirect components. Usually the Direct fraction is more than the indirect. The total can fluctuate anywhere from 1.2 -1.4 mg/DL. In your case you have a slightly higher indirect fraction. This is very commonly seen as a fasting hyperbilirubinemia. There are rare genetic disorders such as Gilbert's syn Chat Doctor. This is a benign condition and the bilirubin levels go up more during infections, stress etc. Condition is diagnosed by liver biopsy. Very rarely this is associated with pigment gallstones. As for cholesterol levels, if you had a rich fatty meal the day before, even if the blood was

If you are a doctor, please answer the medical questions 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,THIS IS ZAFAR IQBAL (MR.) FROM KARACHI PAKISTAN, SINCE 6-7 MONTHS I AM FACING THE PROBLEM OF LIVER, CURRENTLY I DID LFT TEST WHICH IS AS FOLLOWS:-BILIRUBIN TOTAL 1.4MG/DLBILIRUBIN DIRECT 0.5 MG/DLSGPT 78 U/LALKALINE PHOSPHATASE 5.1 MG/D1AND MY CBC TEST IS AS FOLLOWS:-HAEMOGLOBIN 14.8 GM/DLR.B.C. 4.06 X 10E 12/LHAEMATOCRIT 35.7%M.C.V. 87.9 FLM.C.H. 36.4 PGM.C.H.C. 41.7%W.B.C. 6.6 X 10E9/LNEUTROPHILS 45%LYMPHOCYTES 50%EOSINOPHILS 03%MONOCLES 02%PLATELETS 1,78,000SERUM URIC ACID 5.1 MG/D1SIR, I AM IN BIG TROUBLE SINCE 6-7 MONTHS AS ALWAYS FEELING VERY TIRED AND FEELING WEAKNESS, I NEED YOUR FAVOR TO PLEASE KINDLY GUIDE ME AS HOW I CAN BE NORMAL AND HOW CAN I GET MY SGPT, BILIRUBIN DIRECT & ALKALINE PHOSPHATASE AS NORMAL,.KINDLY ALSO RECOMMEND ME THE DIET SO THAT I CAN RECOVER.YOUR KIND ADVICE WILL BE HIGHLY APPRECIATED.,THANKING YOU IN ADVANCE FOR YOUR KIND COOPERATION.,REGARDS.ZAFAR IQBAL (MR.)EMAIL ADDRESS : YYYY@YYYY / YYYY@YYYY SKYPE: zafariqbal183CELL NUMBER 0092-322-0000 ### output:

Hi, thank your for posting. After I saw very carefully your results I can say that you have light damage of your liver. The causes maybe are caused by viral infection, different intoxication, internal disease(this is related with other organs), etc. To complete your lab results you also need an ultrasound to see liver and gallbladder function. You should make functional proof of liver test, this shows if the disease is early or acute. You should eliminate spicy foods, animal fats, coffee, milk, salt, fried foods and alcohol from your diet. You should use a lot of soup, fruits, boiled vegetables and olive oil. You should contact a hepatologist. 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, my father is 80 years old and suspectedly suffering from Idiopathic Parkinson Disease. The thyroid test is awaited. He has been recently discharged from hospital and brought home and is bedridden. He was walking and doing his chores some 30 days back when he suddenly started hallucinating and falling. During hospital admission he was found to have some delirium, acute constipation, lack of orientation but had no tremors. His heart, blood, urine , X-ray, MRI and USG (Abdomen) reports were okay and doctors were very hopeful that with physiotherapy he will walk again. Accordingly, after discharge, I am giving him care, prescribed medication and physiotherapy at home. He has now following problems:- (a) Passing green stools, (b) Unable to walk and has to be assisted by two persons. His left leg seems weeker and accordingly right step wobbles left and front of left leg, (c) Orientation has returned and irrelevant talks have reduced. He had a brief episode of non-physical aggression (unlike before when he was physical and longer lasting). I want to know how can I help him to walk again and if it is correct that he can walk? His medication is Syndopa 110 TDS, Fludrocortisone 1mg OD, Metoprolol XL 50 mg OD, Urimax 0.4mg OD, Shelcal 500mg OD, Pantocid 40mg OD, Amantidine 100mg BD, Donepezil 5mg OD, Pramipexole 0.25 mg HS, Folic Acid OD, Capsule Autrin BD, TAb Escitalopram 10mg HS, Losartan 50mg BD and Quetiaprine 25mg + 50mg BD. ### output:

Hi, thank you for providing the brief history of your father. As you mentioned he is having idiopathic Parkinson disease it is possible that the reason is unknown. But as per my knowledge of understanding, since you mentioned his age as 80 years, it is aging related process which is stopping him from being comfortable. I have seen Parkinson cases and been providing physical therapy to them at doorsteps. Focussing on each and every aspect of the patient is very important, and I was able to cope up well with recovery of them. Usually, medication and physical therapy are The support system to the patients. For my patients I use to provide the oxygen therapy as to help their metabolic function to be at optimum. Oxygen is the primary source of energy required for the cells to recover and function normally. Along with exercise the use of oxygen has added an advantage of the physical therapy I provided since the oxygen helps the neural tissues to be functioning well. Also, exercises are a must to improve the metabolism and the Chat Doctor. As continued reading the history, I could understand that the condition is progressive, to control the progression the absorption of the

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: For past 10 years when I push my lower right side of stomach I get pain only when I press with fingers.I am 53 years male, had mri, ct scan , test for kidney stone , hernia , appenidix and all of them were ruled out . Yet sometimes I get same side lower back pain, and kiddney pain at least that s how it seems. Had also virtual colonoscopy using a siemens sensation 4 multi-slice CT scanner, spiral CT images were obtained of the abdomen her eare findingds The colon is well distended. Evaluation of the colon is limited die to mild diffuse residual colonic fluid and stool. The well distended and evacuated portions of the colon are without stricture, obstruction, constricting lesion, definitive evidence of significant gross focal mass freater than 1 cm, or evidence of diverticulitis. The appendix is normal ther eis ill-defined focul soft tissue present in the cecum adjacent tot he ileocecal volave which liekly represents reidual adherent stool, though a small polyp cannot be entirely excluded. Minimul sigmoid colonic diverticulosis is present Is there a natural way of diet to get rid of these possibilities? ### output:

Hello Thanks for the query.Your Report is suggestive of mild sigmoid diverticulosisDiverticulosis of the colon affects nearly one-half of individuals older than age 60 years. Fortunately, only 20% of patients with diverticulosis develop symptomatic disease. Asymptomatic diverticular disease discovered on imaging studies or at the time of colonoscopy is best managed by diet alterations. Patients should be instructed to eat a fiber-enriched diet that includes 30 g of fiber each day. Fiber softens the stool and helps prevent constipation. It also can help decrease pressure in the colon and help prevent flare-ups of diverticulitis. High-fiber foods include:Beans and legumes, Bran, whole wheat bread and whole grain cereals such as oatmeal Brown and wild rice, Fruits such as apples, bananas and pearsVegetables such as broccoli, carrots, corn and squash. Chat Doctor. Fluid will help soften your stool. Exercise also promotes bowel movement and helps prevent constipation. The incidence of complicated diverticular disease appears to be increased in people who smoke. Therefore, avoid smoking. Symptomatic uncomplicated diverticular disease with confirmation of inflammation and infection within the colon should be treated initially with antibiotics and bowel rest. Patients should remain on a limited diet until their pain resolves. For long-term medical management of uncomplicated diverticular disease, rifaximin (a poorly absorbed broad-spectrum antibiotic), is associated with 30% less frequent recurrent symptoms from uncomplicated diverticular disease. Furthermore, the use of probiotics has been shown to decrease the incidence of recurrent attacks. Hope I have answers all your queries.

If you are a doctor, please answer the medical questions 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 stomach bleeding 3 times in last three weeks. The first time this happened to me was October 2014 and endoscopy was done but could not find where the bleeding started. I have stopped all anti inflammatory meds. I.e. Lodine, aspirin but I am in a lot of hip pain causing difficulty walking. I didn t go to the hospital with the most recent bleeds since the place of. Bleeding can t be found, so I just suffer thru for a few days of discomfort. But the most recent bleed came with a feeling of tightness across my chest and left side neck pain that kept me up all night. Also I had more abdominal bloating with Hugh belches and gas. I am taking iron and eating food that build red blood cells. This is occurring once a week for past three weeks. What should my dr. Be recommending for tx of inflammation and locating bleeding area. Thanks Maria brock ### output:

Hi, Dear,Thanks for your query to Chat Doctor. Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Upper GI -Unknown Bleed site-With NSAID chronic use for Severe Hip joint pain-Under Evaluation. As there doesn't appear to be blood vomiting, indicating the bleeding from Stomach is gradual and is from oozes mostly caused from Gastric Erosion from Chronic Use of Aspirin. As no site is found in Stomach, you need to find out sites of bleeding in intestines and in colon. Remedy For your case problem--Protective PPI to control Gastric erosions-Volez D -1 x 2 times a day.-Shifting to Gabapentin from Aspirin/NSAIDs-for severe Hip Joint.-Statins-Atorvastatin- to control high cholesterolemia- and Teams 40 mg to control high BP -Anti-anginal Chat Doctor. -Hemostatic sealants / like endoscopic hemostats or oral hemostatic agents-Gaviscon Liquid-2 SF x 3 times with food intake.-Tab It B12-2500 MCG x once a day.-Tab Folic Acid- 5o MMX once a day.-BRAT diet-Banana/rice/ smashed apple/ toasts-Bland light volume diets.-Besides NSAIDs accompanied other causes need to be ruled out. Get following tests done-Superior Mesenteric arteriogram / Colonoscopies to detect colonic bleeding sites like cancers / or erosive lower bowel bleeding from NSAIDs. / or from Colonic polyps / or accompanied Diverticulitis if any. Assessment and treatment accordingly from Surgeon or Gastroenterologist would be needed to investigate and treat your case accordingly. In Brief -Your long term use of NSAIDs need to be omitted and need to be changed to Gabapentin or Nor co/ 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! My mother aged 78 years who is being suffering from bronchitis allergy for past one decade... two days back she suddenly had short breath with noise while breathing and her foot and ankle are swollen. She has varicose veins.. Doctor have put her on CHESTON DT, DERIPHULLIE SYRUP and ZIFI 200 all twice a day... Her chest x-ray shows as all normal... is she on write medicines? please help me out.. ### output:

Hi, thank you for providing the brief history of your mother. As by history I can understand that your mom is 78 years old, so the Cardiorespiratory endurance will be less. Also, on addition she has asthma, so the respiratory system is weak. She has varicose vein and not the foot and ankle are swollen. To assist further a thorough neuromuscular assessment is advised. To understand the situation a little knowledge about the conditions is needed. Bronchial Asthma - as you know when people having difficulty in breathing they will consume more energy and feel weaker with fatigue. When there is bronchial Asthma the patient feels weaker to perform any activity due to early fatigue and less oxygen supply. They will have shortness of breath, difficulty in doing deep breathing. Varicose veins - this is like the clots obstructing the normal venous return and led to high blood pressure. As sometimes this leads to swelling as well. Age - as she is 78, she will have slow metabolism and the vascular system will also be slow which may lead to insufficient flow of blood to various organs of the body including the brain. In my clinical practice I deal with geriatrics range between 79-107 years of age. I have a strong recommendation for them to perform exercises. The exercises are divided into various forms. For your mothers initial complain of swelling in ankle and feet I will advise to elevate the feet and perform ankle toe movements. As it will improve the venous return and reduce the swelling & pain. Also, for asthma I will advise doing regular breathing exercises. These include the following -* deep breathing exercises* pursed lip breathing exercises* diaphragmatic breathing exercises* costal breathing exercises* abdominal breathing exercise. For the aging factor - general body exercises to improve the metabolism and immune system. By doing regular general exercises the vascular system Improves and also the blood supply to different organs which helps the other organs nourish. Also, aging demands a physical exercise, but each case has different way to deal and get helped. In aging the pain levels are not bearable and also due to lack of exercise the muscles and joints become painful. Exercise will also improve the blood supply, breathing ability, functional Mobility etc. My geriatrics patients recover in 4-8 weeks of time and prolong the therapy as long as they can perform. As by doing regular physical therapy exercise they live healthy and mobile.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 a problem on the bottom of my right foot there is a bump in my archto the left before the heel and when i have my boyfriend feel the lump inside my foot saying lump is under skin feels like a ball some sort,also in the mornings every morning seems to me its getting worst that i struggle to get to the restroom like shaking maybe weak holding walls just to get to the poddy. let alone i dont feel as the urgency to use the restroom in morning as i should feel ....(correct) but after i use the restroom i feel as if it releases toxins of some sort only because its like im not in pain.. its not diabeties which i never been tested but me and my father checked my blood sugar many times before eating and after but as he was suprised he sorda was in shock stating he couldnt believe how perfect my sugar he said it was unbelievable. also im 34years old a woman and in 230 pounds....also my mom had a hyper throid problem she had surgery and takes pills to live everyday. alsoive been using meth everyday for about 5 6 years i try not to tweak i sleep and eat everyday..also i have teeth problems i have maybe 1 open cud be 2 decayed teeth in the back to the gum i brush and clean teeth after i eat i meen if i suck in lets say inward to try suck out infection i can get it from my gums i dont swallow the fluid knowing it can kill me.. but i cant let my face gums get swollen with abcess. also i feel i cant walk to far i can but really bad pain as i get off my feet.. i dont think my arches fallen ,i dont think i need to change shoes,.. im very bitchie. also the foot that has the problem the right foot well the right knee im afraid to actually use it to the fullest abilty because i feel think know it will pop out place .ok let me think oh yes also seems like my 3rd toes on both feet are starting to let the second toes sorda overlapse the 3rd not alot but started doing that like 3 months ago...any suggestions before i go to er to give them advice or questions or tests u think i need to take..thank u very much and god bless sarahfina oh i also had spinalmeningitis when i was 2 i think and had zoster herpes on my head at 15 becuz chicken pox never went away fully when i was young if any questions for me ask i know my body very well and better than anybody can tell me i rarly get sick but when i do its bad. ### output:

Hello dear Paraffin, warm welcome to Chat Doctor.come have evaluated your query thoroughly.* This description of the foot lesion is most likely to be callus formation.* Needs to confirm with clinical examination by a consultant surgeon. Hope this clears your doubt . Wishing you fine recovery. Welcome for any further assistance. Regards take care. Hello rearward welcome to Chat Doctor.come have evaluated your query in details . Hope this will help you for sure . Wishing you fine recovery. Welcome for any further guidance. 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 a 48 yr old female who had a follow-up CT w/wo contrast the other day. The first one was in april of this year because I felt nausea all the time for about 2 months. Same thing happened last year around the same time of year but they did upper GI and that was fine, and it just went away! So when it happened this year again, we did CT scan . First one in april says 0.5 cm subscapsular low attenuation lesion in left lobe of liver.to small to accurately characterize. also a subcentimeter right renal cyst . Urinary bladder is underdisteded. And there were some cysts on pelvic wall likely ovarian, more numerous on the right than the left and together measuring 6 cm on right and 2 cm for the one on left pelvic wall. So, all that said...the Ct I just had the other day says left hepatic lobe lesions are stable. what does that mean? and minimal focal fatty infiltration along falciform ligament???? also,stable subcentimeter right renal cyst???? interval resalution of cysts noted along left pelvic sidewall on prior examination. 1,7 cm right anterior pelvic cyst is unchanged. two additional right pelvic cysts present on prior exam have resolved. impression was the pelvic cyst is likely ovarian in origin (I had left ovary and tube removed about 4 years ago due to a cyst of 6 cm which was benign and the tube was bad because endometriosis that I didnt know I had! stable subcentimeter hepatic low attenuation lesions and small right renal cyst. mild benign depression of the superior endplate of L1 (I have a herniated disc L4-5, and spinal stenosis and arthritis around a very old fracture from when I was a kid. So....can you tell me what all this means? nausea is gone for now...tired alot and drink 5 hr energy drinks to keep working all day! and about once a year my ferritin gets very low...H&H is always fine, but my hematologist gives me IV faraheam treatment. had gastric bypass 8 years ago and lost about 100 lbs, had my gallbladder removed about 15 years ago, had partial hysterectomy about 12 years ago due to bleeding, I see a hematologist because I have Vonwillabrands. Runs if the family! So can you tell me what all that stuff really means??? thank you! ### output:

Hi, Welcome to Chat Doctor. What all that stuff mentioned in your CT Scan report means is that you are perfectly alright and do not have any major problem. Since the lesion in the liver is stable, it is most likely a hematoma which does not require any treatment. You have had a very eventful past medical history and lets us hope we do not have to continue with that anymore. What you really need is, to relax and look at the positive side of life and enjoy life to the maximum and stop worrying about your ailments.

If you are a doctor, please answer the medical questions 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 38 years old.I have good physical health. But my mental status is not like that. I am always in a confution state. I am doing meditation and yoga but of no use. I am feeling alone. I have no friends. I am really afraid to talk to them about my personal problems just because i feel that i am always criticised about my mistakes. I can t take any decision properly. I can t take any stern decision.I always talk with god only. I feel that he is always with me.What all unhappiness comes i talk with god only. I can t reveal my problems to my mother also. I feel that they will criticise me for my mistakes. What i have to do now? In my job also every one is telling that i am not intelligent and not good for my job. I am a post gratuate in Sociology besides I have taken MA in journalism and Now i am doing MBA in Tourism but no use. I have a child but she is very intelligent and she is scoring marks in everything. My husband is no more.He expired and i am alone for the last nine years. But i am afraid to marry because i don t know why.I sometime feel i want sex but sometimes i feel i don t want and feel that all people are mad because i feel sex is a bad thing .I feel ashamed to do sex. But sometimes i get so much urged in sex that i can t even control my self. But when i got married also i feel ashamed to do sex with him. But after that when become ok he started rejecting me and not even looking at me. Everybody is saying that i am beautiful but i don t feel like that. But my husband also did nt love me. Ireally like to hear from him that he loves me a lot and i really want a lot of kisses and huggings but he didnt give me that tome even if i asked him also. But Now what can i do? He is also not with me now. ### output:

Degree understand your concerns went through your details. I suggest you not to worry much. I can understand the condition you are in. Furthermore, I sincerely suggest that you do not have any mental troubles. You are just disappointed with life. I know what disappointment is. But, if god closes a door in front of you, he also opens ten other doors. But, if you stand in front of that closed door, you may not be able to see the other open doors. You need to get away from that closed door and see wide. You are worried that you are worthless. How can a person, who is qualified so much, can say she is worthless? You should change your attitude towards life. That is all the treatment you want. Think positively. There are a lot of people like you, or far more troubled than you. In fact 80% people far more troubled than you, in one way or other. Understanding life should clear your problem. Believe me. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. 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: Hi, I m a 24 year old female I weigh 130 pounds and I m 5 6 with severe lower back pain and frequent migraines. October 2009 I found out I had a nodule located on my thyroid which a biopsy proved inconclusive to being malignant or benign. So my doctors decided to do a surgery removing only the left side of my thyroid due to the location of the nodule. Results from that surgery proved to be malignant hurthle cell carcinoma. 4 months after that surgery I underwent a total thyroidectomy and also had 7 lymph nodes removed due to calcification. For a few months following that I lost my voice randomly and developed nodules on my vocal cords from what they said was the endotrachael tube and had to see a speech therapist. I also had a calcium drop from 10.1 (pre-surgery) to 8.4(post-surgery) consistently. 6 months after my second surgery I took the radioactive iodine and then did the body scan. Although the doctors said it turned out good I was told there was supposed to be 0 traces of iodine in my system with the exception of my thyroid. I did the scan 4 days after swallowing the iodine and the scan showed it in my bladder and kidneys. is this due to just being excreted? And if so is that normal for 4 days after the scan? Also I did a thyroglobulin test that i was told was supposed to be 0 and it was .6, could this be significant? All that was specifially to ask this, A few months after the treatment I started developing lower back pain, when I saw my endocrinologist I informed him of it but since I was having a hard time adjusting to the proper dosage of snythroid(for a 3 month period I was hypothyroid) he convinced me I was just achy and having body pains due to being hypo. For 4 months now I have been pretty much within normal ranges on my TSH and FT4 but my back pain won t go away. Even just standing for 20 minutes or more causes horrible pain if I have to bend over or sit down or move positions. It almost takes me breathe away. Could this be my calcium change? Or possible cancer in the bone? Or is it possible for your vertebreas to fuse together? HELP ME ### output:

As mentioned in your narrative you have got rid with just a muscle spasm nothing else. For this you have to take some painkiller with muscle relaxant like tab danger or tab osteopath after meals when your back pain is worse enough to disturb your routine work along with tab shall 500 mg once daily preferably in afternoon with tab rant ac or tab carotid empty stomach. You can also use holdup gel or powergesic-plus gel for local application as it is quite helpful in relieving your back pain and muscle spasm. Apart from these you can also go for some physiotherapy exercises after an expert opinion of physiotherapist.

If you are a doctor, please answer the medical questions 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 ,am 34yrold, & got married in Nov19th 2010, got ma 1st period on 23rd nov 10 2nd period on jan 26th 11 ,3rd 5thmar 11, 4th april 11,& 5th on may 5th 11 and 6th on may 23rd 11 and doctor suggested me to take carnisure500mg for 20dys .... will it harm in getting pregnant doctor had prescribd 1st with fertly super100mg ,clomid progestrone , levtol 2.5mg& now carnisure ....and my husband is taking tablets for depression as follows Parkin ,Azur , Stalopam, Telma-H, Amlip-5, Matilda,Glizard... and my hubby done semen analysis was Nrmal ... and 2day had gone for pregtest it appear 2lines should i await until 23rd /24thjune to confirm whether m pregnant..... had consulted a doctor and she had prescribed me again with Miprogen , Fol123 , ulgelsyrup ,&nosic tablets... m worried whether m really got conceivd or not .... one of my friend told Miprogen shouldnot be taken .... is it true please let me know as soon as possible had already taken 3tablets... m quite worried about my pregnancy... got some little flow and done pelvis scan & transvaginal ultrasound on 3july 11 and it got stop & again it flowed on 6thjuly continuosly .....tilll 9th july.. is ma pregnancy had vanished ... had done agn scan but couldnot find gestation ring (sac) under gone ChatDoctor on 7th,9th,&12th of july .... it was Nil... doctor had advice me to take All9 tablets now for 2mnths .... is it possible to get concvice agn.... i dint get ma periods this month of august 5th .... and m not sure when is ma cycle also .... had intercourse 2dy ....is there any chance ofconceiv shall i go for pregtest .... if so when ... and m nt takin ny tablets now.... and hd agn intrcourse on 7thAugust.... & yet idint get ma period...... willl i get conceive.... if so when should i go for pregtst...... please me eager awitn to receive ma baby to this wrld.... ### output:

Welcome to ChatDoctorRead your prob, first you should rule out the cause of infertility by getting blood test for gonadal n thyroid Mormon. You should mention sonography have you POD or not. You should get sonography for follicular study so that you come to know about ovulation, as per its report you try to conceive. As you will come to know about your fruitful period. So discuss all of it with your doc n do as per his advice. Do not worry it is curable n you will get 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: Hi, my name Is Carlie. Im a 25 year old female and ive been having these symptoms for about 5 months now. All my blood tests came back fine and so did my stool sample. I have been sent a referal to a neurologist but I am starting to feel im losing my mind. Ive lost weight going from 65kg to 56kg in 3 months without change to my diet. Although I am not feeling hungry as much as usual im making sure im eating. I did have diarrhea for about 6 weeks where I was going to the toilet 20+ times a day with no found medical reason. Having no recolection of important things people have told me. Trouble concentrating on things. Unable to go with the flow of conversation and forgetting what im saying halfway through. Hot flushes like someone has poured a bucket of warm/hot water on my head and it flows down my whole body. Fainting spells where I feel like im shaking. Zoning out when talking to people. Friends and family have commented on how I constantly repeat myself during one conversation or telling then the same thing multiple times because I didnt remember telling them or stand there staring. Nausea and vomitting (not always together). Some severe headaches (about 8 in this time frame) I feel like its hard to focus my eyes and am seeing white spots and lines sometimes very bright white. Hot feet at night. Sweating even though I feel cold to touch. I have suffered from anxiety before but do not believe this is because of that. Ive never felt more in control of my mental health. I feel like im living in another world and its starting to effect my everyday life. I do not drink any alcohol or do drugs. I am no longer on any medication but did take anti psychotics to help me sleep for about 2 months in this time frame but it started before and continued after use. Thank you in advance for your time :) ### output:

Hello ! I went through your question carefully. I understand your concern. There are many points in your situation that need to pay attention. The lost weight and frequent diarrheas can cause nutritional deficiency, causing your memory problems. There are some main disorders that may be the cause of your problems. A hyperthyroidism can cause this clinical situation, so I would strongly recommend thyroid hormones' analysis to rule this out. This would explain also the hot flashes. A rare disorder, called pheocromocytoma, which is a tumor of the renal gland can cause similar troubles. I would like to know if you have measured your blood pressure during your troubles. If these episodes are associated with high blood pressure and tachycardia I would recommend the analysis of metanephrines in your urine, to exclude this disorder. Another point would be a food intolerance like gluten intolerance, so you should also be checked for anti-gliadine antibody. But this would be exceptional at this age, as it begins since childhood. If all the above tests result normal, a neurological evaluation and a head MRI would be necessary. Hope to have been of help! Thank you for using Chat Doctor! Greetings,

If you are a doctor, please answer the medical questions 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 had taken the abortive pills about a month ago n i m sure it was successful however i have had minimal bleeding like my last day of periods for a month now. i did get my period this month and it was heavier than usual and now after my peroid, the bleeding stil persists....will ethamsylate help? ### output:

Hello, Thank you for your question. Abortion, also known as pregnancy termination, is a medical procedure that is done to end pregnancy. There are 2 main ways to do an abortion: Medication abortion-you take pills to end pregnancy. This only works until 10 weeks into a pregnancy (that means 10 weeks after your last period). It is also sometimes called medical abortion. Women who have a medication abortion need to take 2 separate medicines. Surgical abortion- a doctor uses surgical tools to end the pregnancy. This can be done in the first or second trimester. The procedure take 15 to 30 minutes, but most women spend a few hours at the clinic. Medical abortion, you will take a medicine called mifepristone. 1 to 2 days later, you will take another medicine. This one is called bisoprolol. You can take second medicine at home. The medicines cause your body to end the pregnancy. It might take 4 to 6 hours after taking the second medicine for this to happen. When it does, you will bleed from your vagina. You might also see blood clots or piece of tissue. Common symptoms of medical abortion include pain and cramp in the lower abdomen after you take second medicine. This last for up to 6 hours. Bleeding from the vagina. Bleeding can be very heavy for a few hours after you take bisoprolol. Light bleeding might go on for a few weeks. There also fever, nausea, vomiting and diarrhea. In some cases, abortions do not work completely. In other words, they do not always get rid of all the pregnancy tissue. If that happens to you, you will need to have a procedure to remove any leftover tissue. Sign that an abortion was not complete include bleeding for more than 2 weeks after an abortion, not having a period in the first 6 weeks after an abortion. After medical abortion, your first period may longer than usual, because the treatment uses hormones that may impact your cycle length. This period can also be heavier as the body may have additional tissue to expel after the procedure. I recommend you to use pads during the first period after an abortion that allows the doctor to monitor the amount of blood you are losing. The second period after an abortion is likely to return to how an individuals periods were before. Some women may find that it takes two or three cycles for their periods to return to normal. If this does not happen, you should go to see your doctor. Etamsylate, no need in this case. You can wait and see. If you feel fatigue from heavy bleeding, you may need your doctor to reevaluate your condition. Hope I have answered your query. Let me know if I can assist you further. Best regards,

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I was told my red blood count was 8.9 and would have to have 3 months of Lupron shots before I could have a hysterectomy (my uterus is enlarged and I am full of fibroids). I am seeing a recommended obgyn for the surgery. This is not the first time my blood count has been low. Should I contact my family doctor to let her know my count is low or assume the count is low from the fibroids. I have been on atenol for blood pressure 2 years ago after I was diagnosed with sever anemia. I had a pretty serious nose bleed the other day, and am nauseated everyday, heart palpitations, lack of energy, and my chin and arm have been going numb, frequent urination, extremely heavy periods, pain in my kidney area. Could this be from the anemia? I am not sure if I should be asking for more blood work to be done to check my vitiman D and B12 levels, they were low last time I was diagnosed with anemia. My current family doctor is booked up, so if I seen someone it would be a nurse practitioner. When I went 2 months ago with the above symptoms, the nurse practitioner drew no blood, ordered the trans vaginal ultrasound and kidney ultrasound. The kidney ultrasound was normal. My doctor canceled the trans vaginal ultrasound without telling me. I called and spoke to her assistant and reminded her that I was bleeding heavily. She had her assistant call to reschedule ultrasound. I had to wait another week. My doctor s assistant called to tell me my ultrasound showed and enlarged uterus and full of fibroids, that they would schedule an appointment with an obgyn for a hysterectomy. I called back asking for pain and nausea medicine. Again the assistant called prescribing nausea med and aleve. I don t know how serious my symptoms are, and if doing the Lupron shots, eating high iron and over the counter multivitamin is the right thing to do to get my blood count back up and wait for surgery in Janauary or should I see one of my doctor s nurse practitioner s because by doctor is booking out to November? ### output:

Dear friend. Welcome to Healthcare for your queries . I read your concern and your tiredness and weakness is due to ANEMIA. Anemia is due to fibroid as of your health concern, If fibroid is left untreated it can cause much more bleeding and your health becomes decorated even if managed by iron and multivitamin supplements, I would suggest you to book an appointment with GAEC Specialist and get fibroid removed by hysterectomy procedure and after procedure Vitamins and Iron supplements will surely improve blood level and your symptoms will be reduced. Do not be panic about pain in kidney region, Get checked for urine test and a course of antibiotics will cure the symptoms. Do not be worried, Your energy will be restored back to normal again ... You can ask me if you have any further queries. Regards Chat Doctor. Kingston John David

If you are a doctor, please answer the medical questions 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 need your kind advice and for following issue of mine. Following is my shorty summary of treatment. I belongs to Allahabad, during my study days around 21 year ago I was suffered from seizures and approached to Nuro Specialist in Allahabad. After Head Xray and EEG Doctor start giving me AED Tageratol 300 mg but Seizure not fully controlled later on he changed the medicine to Phenytal 30 mg - 3 tablets a day. When again seizure not fully recovered he advice Contrast CT SCAN Brain and reports diagnose me with neurocysticercosis, then Doctor advice me 2 Tab Albendazole for 3 months every morning along with Eption 100 Mg - 3 Tablets in night after 3 months Doctor advice to stop taking Tab Albendazole and keep continue Eption 100 Mg - 3 Tablets in night. Later on after 3 years [Seizure Free] I shifted to Delhi but Eption 100 mg - 3 Tablets continue taking in night. Then I have contact to another Nurologist in Delhi, he again advice the CT Scan and reports were normal hence he advised to reduced the Eption gradually by 3 Tablets to 2 Tablets and I continue taking 2 Tablets of Eption 100 mg then after 1 year Tablet reduced to 1 Tablet [Seizure Free]. Later on again after 2 years I shifted to Mumbai due to my service transfer but now I continue the Eption 100 Mg - 1 Tablet every night. Since I am living seizure free from past 18 years apx and having much active life (Doing Driving 100 Km a day, Swimming, Horse Riding ,Rock Climbing etc, also taking Hard Drinks twice in week ), but still taking Eption 100 Mg - 1 Tablet every night , hence to stop medicine again I contact to Nuro Specialist in Mumbai he gone through my medical history and and advice Test, after according to latest MRI / SCAN reports , which are normal, Doctor me to stop taking Eption 100 MG One Tablet straightaway. So regarding this I need your suggestion and opinion. Now almost 10 days passed , since I stopped taking one Tablet of Eption 100 Mg, and feeling comfortable but little bit worrying seizure recurrence and and feeling headche. Is any chance of recurrence of fits after stoping medicine, why am having slight headache . ### output:

Hello Mohit SharmaWelcome to Chat Doctor As per guidelines usually after a single episode or in some cases two episodes of seizures, patient is advised to take AED's. As you were also having Neurocysticercosis which was the cause of your seizure, and you had finished the treatment of Neurocysticercosis also. Following which you took phenytoin 300 mg. per day, and presently you are seizure free for about 17-18 years. Usually AED 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 never done this before? I have chronic back pain ever since 1998 when I was T-boned by a drunk driver when my family and I went to the air and sea show in Ft. Lauderdale, FL. I had really great insurance, unfortunately, my company went under when the economy went down in 2008. Needless to say, I was with my company for over 16 years and when they shut their doors my whole life took a turn for the worst! I had to work wherever the unemployment office would send me which were jobs that were paying nothing compared to what I was making and would eventually lay me off when it was time for the probation to be over so that they would not have to pay for my benefits! They actually can get away with that in Florida! I have been bounced around so many jobs that it s not even funny! At one job I fell in the rain on one step! Can you believe that, I slipped on one step and I saw god when the corner of that step hit my right side but I was being a trooper and eventually left at 3:00 p.m. cause I could not take the pain any longer! I ve been out of work since they eventually I got laid off and am in the process of applying for Social Security Benefits. I am 58 years old and I have been to a pain management doctor which only takes cash payments which are now up to $240 every 28 days (he doesn t give refills) I couldn t afford him anymore but I am going crazy with this pain. He would prescribe to me Lorcets 10/625 (which generic is hydrocodone/acetamin) then reduced it to 10/325, gabepentin, flexiral, valium, adderrall. I had to stop seeing him, his office was like something out of a weird movie where you see the zombies come out! Anyway, I couldn t afford him anymore but I still suffer from this pain, I have herniated, bulging discs in my back. I have the MRI that states such. I cannot take this pain anymore, I am truly suffering, sometimes I get really bad thoughts because of this pain! I take extra strength tylenols like candy and they make my stomach so sick and they don t do the job cause after taking the prescribed medication, this is like eating candy. Is there anything that you can do to help me with my pain? Like I mentioned before, I have never done anything like this on line and I so hope that one of you doctors can help me? Thank you. Oh by the way, would you be able to prescribe me with something for this horrible pain? ### output:

Hello, Its really hurting to know of your condition, and I empathize with you. I appreciate the bravery you have shown despite such a situation. The extent of disc bulge in MRI and severeness of neural symptoms like paresthesia if limb decide is an operative spine treatment is needed. There are some Chat Doctor. Other therapy is steroid injection at the nerve root and this may give somewhat long term relief along with spinal physiotherapy and wearing belt.

If you are a doctor, please answer the medical questions 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...from past two months i developed a habit of chewing tobaco....because of which white patches have appeared inside my cheeks...i know this because of the tobacco i am consuming....so i am dropping the use of it now....and now i request u to suggest some medication or remedy for cessation of those white patches from my mouth.. ### output:

Heloo.pt.-A systematic review found that no treatments commonly used for leukoplakia have been shown to be effective in preventing malignant transformation. Some treatments may lead to healing of leukoplakia, but do not prevent relapse of the lesion or malignant change. Regardless of the treatment used, a diagnosis of leukoplakia almost always leads to a recommendation that possible causative factors such as smoking and alcohol consumption be stopped, and also involves long term review of the lesion, to detect any malignant change early and thereby improve the prognosis significantly. Removal of possible predisposing factors and reviewBeyond advising smoking cessation, many clinicians will employ watchful waiting rather than intervene. Recommended recall intervals vary. One suggested program is every 3 months initially, and if there is no change in the lesion, then annual recall thereafter. Some clinicians use clinical photographs of the lesion to help demonstrate any changes between visits. Watchful waiting does not rule out the possibility of repeated biopsies. If the lesion changes in appearance repeat biopsies are especially indicated. Since smoking and alcohol consumption also places individuals at higher risk of tumors occurring in the respiratory tract and pharynx, "red flag" symptoms (e.g. hemoptysis - coughing blood) often trigger medical investigation by other specialties. Surgical removalSurgical removal of the lesion is the first choice of treatment for many clinicians. However, the efficacy of this treatment modality cannot be assessed due to insufficient available evidence. This can be carried out by traditional surgical excision with a scalpel, with lasers, or with electrocautery or cryotherapy. Often if biopsy demonstrates moderate or severe dysplasia then the decision to excise them is taken more readily. Sometimes white patches are too large to remove completely, and instead they are monitored closely. Even if the lesion is completely removed, long term review is still usually indicated since leukoplakia can recur, especially if predisposing factors such as smoking are not stopped. MedicationsMany different topical and systemic medications have been studied, including anti-inflammatories, antibiotics (target Candida species), carotenoids (precursors to vitamin A, e.g. beta-carotene), retinoids (Chat Doctor. Vitamins C and E have also been studied with regards a therapy for leukoplakia. Some of this research is carried out based upon the hypothesis that antioxidant nutrients, vitamins and cell growth suppressor proteins are antagonistic to oncogenes is. High doses of retinoids may cause toxic effects. Other treatments that have been studied include photodynamic therapy.