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<s>[INST] Hi, I have earache in my left ear and pain going down the left side of my neck and back of shoulder blade. This started last night but has continued this morning. Painkillers help and I do not have a fever. I have also been taking tamoxifen for the past 3 years. Could ths be muscular? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I would explain that your symptoms could be related to a musculo-skeletal pain or a wrong position during sleep. Anyway, considering the fact that you have been taking this drug, I recommend consulting with your attending physician for a physical exam and a cervical spine X ray study. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. [/INST] Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> </s>

<s>[INST] Background: I m male, 56, 5 10 , 255 lbs, type 2 diabetic. I m on 50mg Atenolol at night and 10mg Lisinopril in AM, 1000mg Metformin & 50mg Januvia in AM & again in PM, and normally around 50 units of Lantus around midnight. Yesterday (01-31-2012 Tuesday) I only consumed 140 carbs throughout the day, tested my BSL at 0130 hrs today (Wed.) and found it was 128. Afraid to take my 50 units of Lantus and not knowing if I should adjust my dosage, I injected only 20 units at 0230 hrs. My problem: I could feel my heartbeat pulsing as I tried to get to sleep, so I checked it, twice. It is 162 over 94, pulse 59. I don t feel dizzy or anything like that. My questions are, should I be concerned over my readings? And, is it safe to adjust my Lantus dosage like that? Should I have just skipped my Lantus? And, should I take an extra dose of Atenolol to lower my BP? Mike in NH [/INST] Hello , 1) the blood pressure reading are not a panic issue as acutely it would not have caused symptoms . Rather the anxiety that you have not taken the prescribed lantus and would it hard would have just triggered the symptoms and in itself this may have given a higher blood pressure reading . so an effect rather than a cause2) However with diabetes your blood pressure should be controlled under 140 / 90 . So titrate your antihypertensive accordingly 3) Never miss an dose of lantus insulin , if you have made changes in your diet and discussion about decreasing dose should be done in detail with your doctor. He would plan up a regime based on your car's and calorie intake . </s>

<s>[INST] Hi doctors this is srikanth(23)... student... i am suffering with back pain from last 5 years.. i undergone treatment but there is no result..MRI scanning was also done but nothing is identified...if i perform any small work it is troubling me... now i want to go for naturo therapy..will there be any result with this..pls suggest me.. [/INST] Yes, there are many types of alternative medical treatments that may help with your back pain. Naturopaths, acupuncturists and chiropractors are all very good at treating back pain. It is also important for you to maintain a good posture, use proper lifting techniques and do regular stretching exercises or yoga. I hope your back pain is resolved soon. </s>

<s>[INST] persistent tenderness in lower right abdomen. 2 particular spots that are tender and it feels like a little cluster of veins . What could it be? What kind of a Dr. do I need to see? This has been about a month now. Not bothersome but I know it is there. Feels like a ketch sometimes. Wondered if I strained something? How long should I wait to be seen. I am a young 75. I don t exercise..but am active. [/INST] Hi.This indeed can be a hemangioma or a chronic abscess.You have to get an ultrasonography of the abdomen and the abdominal wall done. The findings may need to be confirmed by a physical examination by a General Surgeon and CT scan. You may need a surgery for excision of the disease, irrespective of your age. Till then get started with an antibiotic and supportive treatment </s>

<s>[INST] I have been on depo for about a year now and was suppose to get one two weeks ago but didn t for personal reasons and insurance(missed one n got it about two months later). ...... but before that I had an iud after the birth of my now 5 yr old..... so I haven t had a period for about 5 yrs now..... since I didn t get my shot I had brown discharge and now like a mucus discharge and I m wondering if it is normal for this to happen [/INST] Thank you for the question.What you are describing is normal and probably related to a small amount of bleeding from the lining of the uterus. When there is bleeding in small amounts it frequently makes its way out as a brownish discharge. Other causes include:1. Early pregnancy - check a pregnancy test2. Vaginal or cervical infections - an exam and testing recommended3. Bleeding related to intercourse - could be described the same wayI hope that this helps.Dr. Raichle </s>

<s>[INST] Just want to find out if submandibular lymph nodes dangerous to operate.they didn t see any cancer but they said it was caused by dental infection.how soon are you suppose to have it removed.asking because am still raising the money for the op.thank you [/INST] Hi and welcome to HCM, thanks for the query.If there isn't malignancy then it should be removed at all. But if there is persistant enlargement it may indicate some more serious infection. However there is no need to hurry with surgery and nothing can happen if you wait for several months. Wish you good health.Regards </s>

<s>[INST] I have been having SEVERE pain in my abdominal area. The doctor said I have two liver lesions and I had hiatal surgery two years ago. My stomach was in my chest, upside down and an emergency. For two years I was pain free, now I am severe pain again. My gallbladder was checked today. I am really worried...what would you do??Thank you [/INST] Hi....thanks for writing to HCM....The pain may be due to the liver lesions or gasritis...but as the nature of those lesions are not known to me...i cant comment on them...you need to discuss with your doctor in detail about them...that hiatis hernia had nothing to do with this in my opinion.Dr. Ashish Verma </s>

<s>[INST] My husband has stage 4 esophageal cancer that has spread to a lot of his liver, spread also to the lymph nodes, bloodstream and 3 spots on the lungs. He is taking palliative chemotherapy only. How long has he got left, We want to know so that we can get our affairs in order. [/INST] Chemo may be given (possibly along with the targeted drug trastuzumab if the cancer is HER2 positive) to try to help patients feel better and live longer, but the benefit of giving chemo is not clear. Radiation therapy or other treatments may be used to help with pain or trouble swallowing.For cancers that started at the gastroesophageal (GE) junction, treatment with the targeted drug ramucirumab (Cyramza) may be an option at some point. It can be given by itself or combined with chemo. so in 4 th stage only give in palliative treatment .if you r interested in Homoeopathy so in homeopathy medicine r working in good result for this type of cases. </s>

<s>[INST] Dear Sir, My brother getting pain in abdomen at hypochondriac region ann it is decresed by bending forward and pain radiating to back. by this symptoms i concluded it as pancreatitis and now he is taking Creon tablets tid, and esmeprozole bd, now appetitie is increased, pain also releaved but for how many days i need to continue these medication and what is the prognostic examintions. Plese let me know. Thanking you sir Yours truly, Dr. R. Naresh Kumar [/INST] Hi, dearI have gone through your question. I can understand your concern. You are taking symptomatic treatment. You should go for ultrasound abdomen. Search the cause of abdominal pain. Then you should take specific treatment. You will definitely get benefits. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] Not even two weeks ago, I was just getting over a terrible cough. Well, now I am sick again. I cough consistantly, about 70% of the time it's been me coughing so hard and so frequently it makes breathing hard. On top of that, when I end up coughing like that, my chest and stomach hurt, and occasionally I hyperventalate. I am also extremeley congested. With my congestion, comes dizzyness,light-headed, and I am very tired, but I can't seem to get more then five hours of sleep. I don't have a thermometer, so I don't know my temperature, but I feel very hot and have been in the occasional cold sweat. I am only 17 years old, and generally healthy, I am not over weight, and I consume on average 6 bottles of water a day. I excersize and eat healthy. [/INST] Thanks for your question on Healthcare Magic.I can understand your concern. By your history and description, we should definitely rule out bronchitis in your case. So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).If PFT is normal then no need to worry much.In teenage, undiagnosed stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] I am 53 . No smoking no drinking. Regular exercise. No salt. No sugar. No Red meat. I eat a lot of cashew nuts everyday. Creatinine is high. 130 Uric acid os high 386 . BP high 180/100 Could these cashew nuts be causing thse high readings ? Please help [/INST] Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you no cashew but has nothing to do with this high level of readings. It must be some kidney disease that has caused you such a problem. I advice to do USG abdomen special reference to kidney, bladder and ureter. This will detect some of the underlying cause.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you. </s>

<s>[INST] 3 days ago I was making out with my boyfriend, I gave him some hand job and he pre-cum a little, I remember I felt it and then I fingered me, I think i clean myself like with the sheets of the bed and that but it s there a possibility? I know its maybe minimal... and It just misses a week to get my period, I think I just gotta wait a week more, what do you think? [/INST] Hi dear, I have gone through your question and understand your concerns. Pregnancy can occur only when there is entry of semen in the vagina.If there is entry of semen in the vagina by any means (fingering in your case), very slight chances of pregnancy are there.I suggest you to get a urine pregnancy test if the periods are delayed, to rule out pregnancy.Hope you found the answer helpful. RegardsDr Deepti Verma </s>

<s>[INST] Hi doctor,I am 37 years old, married and having two kids. My daughter is 8 years old and son is 4.6 years. I got married 9 years before. For the last 2 to 3 years that is after my second baby I am facing issue in our sexual relationship. I have lost desire, lack of interest, low libido, erectile dysfunction and unable to have sex with my wife. Due to this problem, I am doing masturbation as a source of stress relief and got addicted to masturbation. I feel very guilty of all these things. I need your guidance. Please guide. [/INST] Hi. For further information consult a sexologist online --> </s>

<s>[INST] Hello doctor, I am having bipolar disorder, on lithosun 1200mg, fluoxetine 20mg for the last 1 year. Working night shift since last month. Unable to maintain proper sleep. Please guide me. [/INST] Hi, Thanks for posting your query at icliniq. Fluoxetine is not the kind of medication that needs to be taken for straight one year in bipolar disorder except in some rare cases. Problem with sleep may indicate towards relapse of mania or mixed episode. At this moment you need to talk to a psychiatrist either online or in person. </s>

<s>[INST] hi i have noticed a white raised bump -- feels hardish on the floor of my mouth on the side. I can feel it when i move my tongue towards the side of my mouth. I have looed at in the mirror and it looks like a ulcer or open sore -- the top that was white had fallen open and the spot feels a bit raw [/INST] Hello,Thanks for consulting HCMRead your query , aa you feel white raised bump in floor of the mouth this can be ulcer or inflammation of submandibular gland situated at the floor of the mouth so there is nothing to be worried but I will suggest you to consult dentist for oral examination of floor of the mouth . Inmean time do warm saline rinses , you can apply ointment like Mucopain or Mugel on ulcer , take vitamin B supplements. Hope this will help you. </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here... I m 24 weeks pregnant and i have acute Bronchitis... I recently saw the other day that i have red blotchy area on my face localized in just this one area. What can I do for it to go away. It doesn t itch although its dry. [/INST] Hello,As you explain, the history you should contact your doctor for further follow-ups.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Jnikolla </s>

<s>[INST] Hi doctor, I did a root canal on the upper first molar tooth before three weeks. I had sensitivity towards cold and sweets for years. The tooth was slightly loose. So I did a root canal on it. The second sitting was done before a week. I started to have pressure on the tooth after two days. I consulted the dentist, and he told me that the seal has got broken. The doctor said to me that the tooth should be pain-free for a weekend to have a fixing over it. But, I had more pain than before doing a root canal. The pain was terrible. Now, I have pain, pressure and it hurts even for a light pressure on the tooth. I do not have sensitivity. Now, it has been two days, and still, I have pain over the tooth. Please help. [/INST] Hi. You have an infection still lingering in your tooth undergoing root canal treatment. It causes pain. Your dentist should place a calcium hydroxide dressing in the tooth, and it disinfects the canals. A course of antibiotics should be given. Also, the tooth should be trimmed to avoid contact with opposite jaw tooth. If the pain does not get better, get an X-ray done and upload it to me. So that, I can advise you appropriately. </s>

<s>[INST] Hi, My son is 9 yrs old. He has been put on seroflo 50 since last 2 yrs. For the first year, he was on 2 puffs a day and the second year, the dose was reduced to 1 puff a day (before bedtime). I have had no chance to use Asthalin as SOS as doctor had prescribed but today the weather being very cold, I can hear him wheezing although he is wheezing comfortably with intermittent coughs. I have already given him 2+2 doses of Asthalin in a gap of 4 hours. My question to you is, how often can I give asthalin as SOS? I second question is, is my son going to be dependant on seroflow all his life? [/INST] Hi...1. You can give asthalin SOS 2 puffs every 2-6th hourly depending on need.2. No worry about dependency. These drugs do not act on brain to cause dependency. As you can see they are being gradually tapered and ultimately depending on level of control of symptoms they will be stopped.Regards - Dr. Sumanth </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here... my sister has stage 4 cervical cancer it is in all her lymp nodes and has a tumor on her uterus and masses in her lungs they are not offering treatment how much time do you think she has left? [/INST] Hi, dearI have gone through your question. I can understand your concern.She has cervical cancer with lung metastasis. It is stage 4 cancer. Surgery is not useful in this stage. So treatment options are chemotherapy and radiotherapy. But it will not cure the disease. It just works as palliative therapy. Despite of all treatment prognosis remains poor. So no treatment is good option.Life expectancy is not good. Sorry to say but it is fact.Consult your oncologist and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST] I am 35 and female, not quite 5ft and 8st in weight. I was diagnosed with high bp 4 years ago and placed on Ramipril 5m a day this kept my bp normal. In the past 3 week I have come off them as my husband and I would like another child. In the first week of coming off them my bp only rose slighlty, in the past two weeks I have had readings around 180/110 and 170/100. The nurse has advised me not to exercise and to see them next week. I have in the past various tests on my heart ECGs are relatively normal just showing tachacardia and my heart valves leak which sre quite trivial. I do wonder what causes my high bp, it's not in my family, I was born 6 weeks early in 1975 could this be a cause? I have had die tersts on my kidneys and ultra sounds and they appear normal. My questions are really how dangerous are these bp readings? Is there any medication I can take when I am pregnant and what could be the cause of my high bp? Thank you [/INST] Hi,If you had bgh blood pressure before pregnancy, you should take some medications during pregnancy as well, as high blood pressure will harm both you and the child. There are some medications that are allowed during pregnancy, so I would advise you to talk to your doctor to start a medication.Take careCome back if you have any further questions </s>

<s>[INST] I am sufferring from External & Internal Piles with Anal Stenosis . Also, Frequent Sores in Upper Part of Mouth, Lips , Toungue, Throat and Esophegus with Fever and Stomach Fullness for 7-8 days each month. That disappear automatically and reccurs after 15-20 days. Please advice what to do. Presently i am taking Liquid Parafin (Agarold) as Laxative for Piles from Last 2 months and Stelbid Tablet. Please advice. I am in deep stress. Whether this will develope Cancer in me? [/INST] Hello! Thank you for the query. First of all you need to calm down as this does not sound like a cancer. However you need to look closer to your symptoms and have some diagnostics. If you do suffer from constipations for years, have had blood or mucus in stool and lost some weight recently, you should have colonoscopy performed. Your hemorrhoids might need some surgery which can also set you free from stenosis. Your throat and tongue pains connected with abdominal pain can be due to acid reflux disease and throat inflammation due to acid irritation. If you do have chest burning, upper middle pain after a meal, nausea, you should have upper GI endoscopy. Moreover, you should have abdominal ultrasound, full blood work and urine anaylsis performed. Hope this will help. Regards. </s>

<s>[INST] I have recently been treated for a idney infection that showed e. coli . I finished the antibiotics and I feel it is not completely gone as ow I have intense itching and a rash and I am still tired and a little weak. I am trying to get a hold of my doctor and repeat a urine sample as they said I may need intervenous antibiotics. Can you get intense itching from a kidney infection? [/INST] Hi welcome to HCM. It can be a side effect of the medicines. Stopping the medicines and anti-histamine medicines should help. Intravenous antibiotics are usually given when oral medicines are not effective or if there is fever. Weakness is due to the infection as such and you should recover soon after the infection is completely eradicated. Best regards DR GS </s>

<s>[INST] For the first time in my life, last night (april 25) my trachea and also feeling my bronchi too, had a severe feeling of itching. As if something was there that produced an inward pruritus . It was at times subsiding the feeling, and I was trying to fall asleep, but again, the same feeling was waking me up... I leave in the suburbs, full of spring pollen at this time the place... can this be allergy even though i have NO allergies in anything up to now? What home remedy can I offer my self, to feel better? Thank you [/INST] ALLERGY CAN OCCUR AT ANY TIE AT ANY PLACE WITH ANY SUBSTANCE ITCHING IS ALWAYS SIGN OF ALLERGY ARE YOU TAKING MEDICINES FOR ANY OTHER DISEASE PARACTOMOL BRUFEN DISPRIN VITAMINS DIETRY SUPPLIMENT CAN CAUSE SOAPS SHAMPOO CREAMS OIL CHANGE CAN ALSO BE POSSIBLE YOUCAN THINK OF ANY CHANGE BUT AT PRESENT TKE ANTIALLERGIC SINGULAR 10 MG BD TAB ALLEGRA 120 MG OD SYP ASCORIL 1/2TSF BD ADD ANTACID THREE WEEK REQUIRED TO COMPLETE COURSE TAKE WARM WATER IN EXCESS TO CLEAR OFF ALLEDRGIC AFFECTS </s>

<s>[INST] Hi, I have been feeling forgetful recently. I don t know whether it s something I should be worried about or not. I m a teacher so I have a hectic work life but today for instance, I left my laminator on and forgot to turn it off. I forgot that I was on first aid duty too! I forgot twice about a meeting I was supposed to have with other staff members yesterday. I also feel like I ve forgotten conversations I ve had from years back when others can remember them well. Is this something I should be concerned about and what do you think could be the cause? [/INST] DearWe understand your concernsI went through your details. Hectic schedule is stress and due to stress and over burden, the brain signal could become cluttered and body also gives negative signals to the brain. The main requirement of your body and mind is REST for the time being. Memory problems due to busy life and stress and anxiety are normal and there is nothing to worry about. Take a week break to regain your lost wits.If you require more of my help in this aspect, please use this URL. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] I have a small hard bump at the bottom of my mastoid (?) behind my ear. It seems to be at the base of the bone...does not hurt. Just noticed it. Maybe pea size. What could this be? I've had like pressure in my ear for some time...like my eustacian tube is blocked. [/INST] Hi,Dear,Good evening.Thanks for your query to Health Care Magic.I studied your query indepth. In my opinion the lump on base of acute mastoiditis with chronic otitis media with Eustachian tube block due to the cholesteatoma-Treatment is a-Consult a ER ENT Surgeon who would treat it-by Mastoidectomy-i.e.incision and drainage of the abscess causing pressure on the eardrum with blocked eustachian tube, with scraping of the .Antibiotics and NSAID under cover of ER ENT-Surgeon is the right treatment for such a bump behind the ear. Hope this answers your query and explains the cause of the lump.Hope this would clarify the worry you had.Would love to Wellcome your queries to HCM. </s>

<s>[INST] My sister just informed me that she has been suffering from constant pain. It starts in her lower back, radiates up to the middle of her shoulder blade and then down her left side. She has paid on her left side and it will go numb at times. She often gets what she says is a knot that forms in her left upper arm (bicep) and she has to massage it out. She recently went the doctor and they have run MRI s and CT Scans...but they are unable to diagnose anything. They initially thought she had a stroke...but not now. She told me she is in constant pain...sometimes dull and sometimes intense. She does have Morphan Syndrome (sp?). Could this be a symptom? I asked if she had mentioned that to her doctor and she had not. [/INST] Hello, It is not a sign of Marfan syndrome. Most probably it’s due to spine related problems like a prolapsed disc or nerve compression. Consult an orthopedician and get evaluated. An MRI scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] I had a bit more than a week ago, I thought it was mosquitos bit. It was fine after a few days. But it got worse this week : itching, red area getting larger every day( larger than a size of lemon), a little swollen. The skin around the bit peeled off. It s bearable but I am worried since i nerve had a bit last so long and also I am going to travel soon. [/INST] HiIt would be better to be examined from your doctor for this for probably follow upTake careDr.Jolanda </s>

<s>[INST] Hello, I m a 18 year old female. Today I ve noticed a pain on the roof of my mouth, towards the back. It isn t burnt, I ve felt that before, it truly feels bruised. Is that even possible? And when i rub my tongue against the roof of my mouth it has a slight bump to it. As if swollen. I put a mirror in to try and see the roof of my mouth and it does has a blueish purpleish tint, but I presume that, that ids caused from veins. I have not done, or eaten anything out of the ordinary to cause this. I ve been sucking on some ice to try and sooth it, but I feel as though it only makes it hurt more. Please help or give some advice please. Thanks! [/INST] Helo,Thanks for consulting HCM ,Read your query as you have painful bruises on roof of mouth this can be due to carious tooth , decayed tooth , impacted tooth , or sinus problem , dont worry I will suggest you to consult dentist and go for visual oral examination of roof of mouth if needed go for investigations occlusal radiograph for examination of roof and rule out the cause . In meantime do warm saline rinses 2 -3 times a day , for pain you can take analgesic like Diclomol sp or Ketrol dt .Hope this will help you. </s>

<s>[INST] I hit my head really hard this morning on my car door, have a marble sized lump just above my right temple from the hit. Immediately after hitting my head, it knocked me silly and I was dizzy and stumbling to regain balance. I haven t felt right since. Felt sick to my stomach all day, at one point my vision was slow to catch up when I would look from one thing to another, felt like my right ear was under water for a little while. I still don t feel right in the stomach and my chest feels funny. Not sure if the chest thing is from anxiety over not feeling well from hitting my head. Should I seek medical attention or wait it out??? [/INST] You have to consult the general surgeon to rule out brain injury.and lump may be due to hematoma formation. And if needed do CT BRAIN plain to rule out intracranial injury. And other symptoms may be secondary to it.take symptomatic treatment for it. </s>

<s>[INST] hello i have a 13 yr old son had gallbladder out end of sept full of stones recovered fine then middle of nov started having pain on right side like gallbladder attack had endoscopy all good does have acid reflux medicated for this than had ercp done and clipped a spyncter ode? billy rubin 3.5 at that time middle dec fine for few weeks missed 27 days of school back to pain on right side billy rubin 3.3 now missing school again gave him medicine ursidiol to see if that would help made him sick dizzy stopped takig on fri now yesterday and today sick to stomach and dizzy side hurts what can i do im waiting to hear from dr they are at a loss??? thank you Nicke [/INST] Hi Nicke.Thanks for your query.Read the history about your son who is 13 years old and understood the problems.Hisotry gall bladder removal for multiple stones, reappearance of the similar pain with increased bilirubin more than 3 and ERCP and some procedure noted. This is must have been Sphicterotomy and removal of the common bile duct stones. Since the bilirubin is remaining high there is a chance of injury to the common bile duct or retained stones or cholangitis and so on. I would advise further investigations and getting to the final diagnosis. Full liver function tests along with kidney function tests, Amylase and Lipase.CT scan and MRCP of the abdomen to see in details the liver, bile ducts and most important to see any problem with the pancreas.Further treatment depends upon the final diagnosis and may be some surgical intervention if needed. </s>

<s>[INST] Hello, My daughter who is ten has a rash all over her arms and legs and hands. It is not itchy. I took her to the doctor on Monday and he said for us to put a cortizone cream on it daily. He thought she might be having a reaction to the sunscreen. We have been using the same sunscreen for a couple of years without incident. I gave her another brand, and the rash has not gone away. Thank you. [/INST] Hi, Reenee, Thanks for query. It seems that thise are allergic rashes. Take antihistamine like Cetrizine for some time along with local application. Identify the likely allergen like change of soap,shampoo, body lotion or cream or change of clothes. Ok and bye. </s>

<s>[INST] helloiam 23rs old.with weight 52kgs and height 5'9" .i am fine by the grace of god but i have a small problem with my intestine which bothers me alot,i have a swelling in my right side of the private part.like appendix..how to tackle that problem.please advice me.thank you [/INST] HI,Dear, Thanks for the query from you.1-In my opinion swelling in rt of your private part, appears to be skin tag-2-And as it is not hearting you with any pain or stooling problem,you should forget it for the time being and should not worry.3-Still I would advise you to check up with the local ER surgeon and to get it removed if it worries you more.4-Hope this would solve your query.5-Wellcome to HCM for any more query. </s>

<s>[INST] My mother whom is 80 yrs old has been diagnosed with dementia, in the ER just yesterday she could not talk they did a cat scan of her brain showed me all the white spots and stated she has small vessel disease and he used another work that I believe started with a M (too technical for me to remember) it meant the same thing so he said. she was admitted he stated she may of had a tia, the attending physican today cancelled the mri and started with the heart as she heard something they did a echo cardiagram and the results arnt back yet. Could the heart have something to do with the dementia, she is very confused very fast almost within the last two weeks she has been really confused.What is the long term prognosis is it possible for her to be so confused so fast? [/INST] Hello!Thank you for your question on HCM!I understand your concern, and would like to explain that acute episodes of confusion are normal in persons affected from dementia. The cardiac tests, have resulted normal, and we can exclude this as a possible cause of this confusional state. Regarding the small white spots in her brain, they indicate for a small vessel disease causing a vascular dementia. They are not related to any cardiac cause, but to high blood pressure or diabetes. Dementia is a progressive disorder, which is treated with different neurotropic drugs (donepezil, rivastigmine, memantine) and to help maintain as much as possible an adequate cognitive function and a lot of emotional support is needed. Unfortunately the situation deteriorates progressively. Antipsychotic drugs may be necessary in case of frequent confusion episodes. Hope to have been helpful!Greetings! Dr. Iliri </s>

<s>[INST] I have been feeling sick intermittently for the past few days along with a dull, tightening pain in te upper abdomen inbetween my ribs or there about. I also experience frequent headaches, mainly on the right hand side near the front and can be worse when initially stand up. It's a throbbing sore head that if often present when I first wake up Thanks [/INST] Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You have been feeling sick since few days, with tingling pain in the upper abdomen, and frequent head ache, especially when you woke up . The pain in the upper stomach may be due to Gastric irritation, or peptic ulcer. It can cause head ache also. Or the head ache may be due to sinusitis, as it is more when you wake up. I advise you to consult a physician for diagnosis and treatment. You may need to have gastroscopy, x ray of para nasal sinuses, besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards. </s>

<s>[INST] Good evening Doctor, My son is 5 years old and weigh 19 kgs. He gets frequent problem of short breath after 1-2 days of cold. some doctors say he is having bronchitis, some say it is asthmatic attack. for last 3 years he is suffering this problem. He is fine for few months and during weather change he again gets this problem. This time he got ill on 30.11.13 then he was admitted for a day. after giving a weeks medication he got fine then again after a week he got ill (fever + short breath) given levolin 0.63 three times a day, budecort for three days (twice daily) we continued with montair kid plus since 30.11.13 and still we are giving. A week back he got OK, but on 05.01.14 again he got cold. Though short breathe is not this time, but having problem of running nose and cough sound. My first question is how long we can give Levolin (Twice daily) without any side effect. In last three years he might have taken levolin very often. Next question - Does levolin helps in running / blocked nose and in congestion. My next question is at what age will he able to fight cold without medication / he will be free of short breathe. Third when he gets short breathe I get tensed, how much risk is there in such cases. Waiting eagerly for your reply, please. Regards [/INST] Levolin helps to relieve the bronchospasm and shortness of breath. It can be given whenever the child has breathing diificulty (bronchospasm), generally for not longer than 2 weeks ata stretch. No it doen not relieve runy or blocked nose. THese problems generally improve as the child grows older but no definite age can be predicted. This is treatable condition and with proper treatment the problem can be well controlled. </s>

<s>[INST] My mother (65) has been taking Nexito-10 for a along time as per advice of Psychiatrist but recently she has been suffering from Parkinson disease as a result we conduct a medicine specialist who prescribed along with other medicine Propranol-40mg instead of Nexito-10. Please clear me is Propranol-40mg relief the mental problems of my mother? [/INST] Hello,Propranolol can not be substituted for nexito. And nexito is not contraindicated in in parkinson disease. Rather depression and parkinson occur togather commonly.So you must talk to your doctor about this.Thanks. </s>

<s>[INST] Hello doctor, I noticed after masturbation that my penis had friction like burns on the gland portion of my penis. I got circumcised at the age of 21. So, I have a little extra foreskin. I had a few small red bumps show and then disappear. One doctor said it was balanitis and the other said penile friction. One prescribed an antifungal cream and one prescribed Bacitracin. The area burns a little. What do you think? [/INST] Hi. I have gone through your history and seen the attached photograph (attachment removed to protect patient identity). I think it is due to penile friction. I do not see any signs suggestive of fungal infection. You should apply a steroid-antibiotic combination like Mometasone Fusidic acid cream on the affected area twice daily for a week's time. Besides this, keep this area as dry as possible. Use plain water for washing this area and avoid vigorous masturbation till it gets healed. For more information consult a dermatologist online --> </s>

<s>[INST] when i was 14 i had a tear in m my penis on and off and i would pee blood finally i got a circumcision at 16 and the problem went away it came back 3 months after 1 time when i went to pee and thats it now im 19 will ill be able to have kids when i get a little bit older and will i be able to have a normal sex life will the tear effect me from having children [/INST] HIWell come to HCMIf you have had some local problem with ureter or urinary meatus and not the actual pathology of semen production or sperm then this may not effect the ability of conception and this is just nothing to worry, hope this information helps, take care, have a nice day. </s>

<s>[INST] my (46 year old)boyfriends BP was 172/90 this evening. It is usually high and he does not take medication. He will generally take his BP reading at the Walmart pharmacy and it is almost always too high. I'm trying to get him to see a Doctor. Only symptom seems to be headaches so he isn't interested in making an appointment yet. [/INST] Hello, I understand your concern towards your boyfriend's health, he would be fine. A blood pressure of 172/90 mmHg is already at stage 2 hypertension. If he does not start taking blood pressure medications he risks developing a "hypertensive crisis" Which can lead to organ damage e.t.c Please advise him to go to the hospital so he can be started on the appropriate medication. For now, you can get him Tab. Bisoprolol 10 mg once daily and Hydrochlorothiazide 25mg once daily. Warm regards </s>

<s>[INST] What would cause severe pain immediately below the breast line and pain in the teeth occurring during sleeping hours and lasting approx. 10 minutes. Occurs intermittently about once or twice a month in a 54 year old female with hx of family heart disease [/INST] rule out heart problem.it could be due to gastritis caused by hot & spicy food or inolrence to specific food.It is unlikely to be connected to family history of heart disease. </s>

<s>[INST] Hi doctor, How to know if a baby is getting the right amount of milk? [/INST] Hi. The ways to know if the baby is getting an adequate amount of feed are as follows. The baby sleeps well for two hours post an adequate feed. Baby passes 6 to 8 times urine. Baby has a weight gain of 25 to 30 gm per day. These are the three main points determining the adequacy of the feed in babies. </s>

<s>[INST] Dear Dr, I am 42 years old, and last week beacuse of liver pain i went for sonography and bood test asnd result of sonography is : Hepatomegaly with fatty infiltration & Blood report : SGOT is 70 & SGPT is 90, I want to know what is this & it will cure in how many days? [/INST] Welcome to H.C.M. I am Dr Krishna Dubey.My pleasure to help you.Hepatomegaly with fatty infiltration & slightly increased SGOT & SGPT is going in favor of fatty liver.It can be reverse and you can be fine as earlier if you stop (Alcohol if you drink) .Avoid fatty food and eat healthy food.Control your weight.Daily exercise for 30 minutes is very help full.Repeat sonography , SGPT and SGOT as advised by your treating doctor. Hope you will satisfy with my answer.Keep in touch.Always welcome for further query.Thanx. </s>

<s>[INST] Hi there, We found a lump on our 9 month old sons left shoulder and in his left arm pit . The peads dr gave him an ultra sound and did bloods. all came bk normal and were told its a re-action from the bcg. But we still have concerns and still worrying could you please explain in detail. Tld it was his lyphnoids were up. As you can imagine the first thing you think is cancer. Please can you set our minds at rest. Your information would really help A scared parent regards Kelly [/INST] Hi. Its not a cancer in first place. Its infection which causes enlargement of lymph nodes specially in babies. It will advisable to give a course of broad spectrum antibiotic like cephalexin or augmenting or cloxacillin in appropriate doses. If the swelling decreases in size, it rules out cancer. Also, if it persist, please get a biopsy done and go for further investigations. </s>

<s>[INST] Hi, my name is David and I have a liver tumor 10cm hanging off the tip of my right liver lobe. I found out it was cancerous 2 weeks ago. Diagnostics show has not spread anywhere. However, I feel like it is taking up more and more space in my abdomen. It is very uncomfortable and my right side and right intestinal is kind of hard and bloated. I am scheduled for a consult at Georgetown U Hosp on the 30th, but all I can think is "Get this the hell out of me!" The oncologist sugggested surgery to remove asap but the hospitals wouldn't schedule before 30th. I have a consult at Hopkins on April 4th. I am having this sense of urgency. How quickly can something like this progress or move? [/INST] Hi David, How are you? I am so sorry to hear about your diagnosis and I understand your apprehension about the tumour. But Liver cancers in general tend to grow very slowly and are generally less aggressive than the other cancers. They usually appear in patients suffering from cirrhosis, esp due to hepatitis c. In your case I take it that your rest of the liver is normal. You also mentioned that the tumour is hanging off the tip of the lobe - this is very good for you for two reasons : 1. There is a very very low chance that the tumor can involve or invade a blood vessel, which would alter your prognosis to the negative to a great extent (very common in tumours growing inside the liver). 2. Surgical removal becomes very easy as the surgeon does not need to go through the main liver tissue to resect the tumor. Although the operating surgeon is the best judge (and also since I do not have access to your scans), in these kind of tumors, he could potentially get away with resecting just 2 cm of the tip of the liver. I often resect these kinds of tumors laparoscopically and you should explore the possibility with your surgeon. I hope this helped and I hope you get better soon.Please do not hesitate to contact me with any further questions - [email protected] </s>

<s>[INST] My husband forgot his blood pressure pills when he went away to work and was Without them for five days. I couriered them and he has them. I told himTo get a monitor which he did. He took his pressure and it was 145over 118. Is this bad and will it go down Now that he is back on his med? [/INST] Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you and give my opinion. You should know that when we treat hypertension our goal is to have mean value below 140 / 90 mmHg.A person might have high value during emotional, physical strees or if he doesn't take a regular medication. You should not worry about the blood pressure value that you have found,it is nothing bad. Stoping the drugs for 5 days is of course responsible for this high blood pressure value. Hypertension is a chronic disease and it should be treated all live long. Stoping the medication will lead to hight values. Of course if your husband will start taking the medications in a regular way than every thing will come back as it was before.If he had stable values under treatment before than starting medication will bring back stable values again so don't worry.Hope I was helpfull. Best regards, Dr.Ervina. </s>

<s>[INST] I had a bout of vomiting and diarrhea in the middle of the night and now my rectum is bleeding. NOT just spotting on the toilet paper. I don't bleed unless Iam sitting on the toilet and when I cough the blood spurts out. I first noticed it this morning before I hopped in the shower I coughed a lot( I have a bad cold right now ) and 3 big spots of blood had dripped out onto my floor. Now everytime I'm on the toilet today blood spurts out..should I go see a doctor or wait it out? [/INST] Thank you for your query Yes, any rectal bleeding should be checked out immediately, especially in the quantity you mentioned and that spurts. Do you have any history of hemorrhoids, liver disease or intestinal/rectal surgery? Did you have any recent diarrhoeal disease? Sometimes increased intra abdominal pressure (such as when you cough) could rupture tiny blood vessels in the anal canal that can bleed If this continues, I recommend you go to the ER. If it is minimal or stops, see your physician ASAP to rule out serious disorders and prevent further blood loss. Expect to be hospitalized, with blood work. Depending on where the bleeding point is and how big it is, how much blood loss has occurred, you may need cautery/pressure dressings, blood products. These are just a few things. It may just be a small vessel bleed and you may be allowed to go home after a few hours Hope this helps. Wish you good health. Please get back to us if you need any clarification </s>

<s>[INST] Good morning. I just got the results from some blood work and a urinalysis . My urine has WBC Esterase 3+, Occult blood Trace and WBC 11-30. i did some research and it looks like i have a bladder or kidney infection . Can you tell by these results if it is a kidney infection or a bladder infection? Are there any alternative ways to treat one, rather than antibiotics? Thanks! [/INST] Hi, Welcome to HCM. With these results, it is only to possible to say that the infection is in the urinary tract. It is not possible to localize to the kidney or the bladder. The difference is made out by clinical examination where kidney infectionn causes fever and painful and tender loins or CT SCAN. Antibiotics are the only ways to treat infection. Take care regards </s>

<s>[INST] hi im 22 female my two sides of the kidneys are big than the normal size (kidney enlargement) i having this problem for past 3 weeks and effects are i feel the vommiting sensation, pain in the breasts , having disturbance when urinating and i dont know how it happens and itching in kidneys sometimes i need the help doctor and i dont have diabettes and my body is restless and gets tired i dont what type of disease is this when i touch my kidney it was different for me [/INST] Hello Nice to see you again get your ultrasound and other test done to find the cause of renal enlargement. Sign & symptoms you are talking about don`t occur simply due enlargement of kidneys.So find out the cause renal enlargement and get your self checked for other ailment also. ‘Hope I have answered your query, “Wish you Good Health and trouble free speedy recovery” </s>

<s>[INST] Hello doctor,I have a red area that is itching on the penis head for a week. It looks like balanitis according to the pictures I searched. I also have pain after urinating. I have tried with Nystatin cream, but I have more itching than before. I cannot go to the ER, but the quickest appointment with the specialist can be scheduled in a week. Please help. [/INST] Hello. I understand your concern. Please send a picture of the affected area to help you better. I need to see to suggest the appropriate diagnosis and treatment. </s>

<s>[INST] I am BDD patient for last 20 yrs. Started SSRI with anti-psychotic for 4 yrs.Recently I became severely sensitive to antipsychotic. My present symtomps are,intermittant fever,weak,Lathergy,Increased Heart pulpitation.Wht should I do now,pls?Shumon Raja (Age.45 yrs) [/INST] all of these symptoms may be due to drug effect ..please consult your psychiatrist heay change drug or change dosage of drug ..usually antipsychotic drugs have such symptoms </s>

<s>[INST] Hi.i m 32yr mbbs,2lscs last one n half yr bac...hav severe pain in bac n abd ...diagnosed as gall stones in feb 2014 wen it was single measuring 9.2mm...hav repeated episodes of pain appox 10 times from feb n last one on 13 aug...pain always occurs around 3.00am...had repeated scan on aug 14wen it showed two stones 8mm n 9mm...started udiliv yesterday. ..ll it b effective. ..want to delay surgery ...or is surgeries the only treatment. ..if yes can it b delayed? pls help [/INST] Good morning I am sorry to hear about your ill health The only treatment for your symptomatic gallstones is surgical removal of gallbladder Usually it is done by laparoscopic method with negligible complications Medications like udiliv are not solely sufficient for the treatment of this condition Hope this would answer your question Wish you a speedy recovery </s>

<s>[INST] Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? [/INST] Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online --> </s>

<s>[INST] good day. I am 37 yrs old, 72kg. I have this pain on the left side of my upper chest that spreads to my back as well as to my upper arm. Sometimes also to my neck. Seen my dr, he says i'm suffering from condylitis. What is condilitis? Is it curable? What medication should be used? [/INST] Hello,Condylitis is an inflammation of the cartilage (rib in case of the chest) giving rise to pain of chest with referred pain to arm and neck. It is totally curable. • Use alternate application of ice and heating pad every 6 hourly over the most painful part of the chest, arm; only ice over the neck region. • Avoid weight lifting or strenuous activities. • Non-steroidal anti-inflammatory agents as Nimesulide, Ibuprofen, Tramadol hydrochloride work excellently, should be taken with prescription from the doctor in suggested doses only. • Deep breathing exercises, other light exercises of the neck, back, and upper limbs work fantastically. • Avoid stress and anxiety.• Avoid smoking/alcohol.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel </s>

<s>[INST] Last week I was kicked right above my shinguard while playing in a soccer game. I immediately had swelling the size of a golf ball and bruising. The swelling has gone down slightly within the week but now the pain has come back with a vengeance over night. Is this normal? [/INST] Hello, You are right. The pain is due to the injury you had playing soccer as there are very much skin and fascia covering over the shin region the injury must have not healed. as you mentioned the swelling came down with a weak but the tissue healing is a little slow. This is common and need not worry as this is normal. You can do quick icing and that should take care of the pain. Slowly start doing the ankle toe movements and static quadriceps and static hamstring exercise so the muscles become stronger and the pain doesn't come back. In my clinical practice, most sport injury cases have these common complaints and this is normal. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST] hi my grandson was in hospital w pneumonia a month ago. He had blood work 2 weeks ago which revealed low white blood cell count and false positive hiv. I am so very worried. I know his immune system is very low. Please tell me what your diagnosis would be and my next step. Thank you. [/INST] HIWell come to HCMIf this is pneumonia then the white blood cell count would have been increased but as you said it is low so the pneumonitis is ruled out here false positive is not considered as diagnostic criteria and this is not taken into consideration, the test need to be repeated with the deferent methods, hope this information helps. </s>

<s>[INST] Hey doctor I'm a 27 years old female and my periods have been irregular and they started when I was 19.I want to concieve I would love to conceive twins and I'm taking folic acid tablets,I have had my periods twice this month,I would live to know what are my chances of conceiving let alone conceiving twins! Please help [/INST] You will first need medication for regularising your periods. Then you may need medication to help with ovulation induction.At present conception may be difficult with irregular cycles. I suggest you see your doctor for investigations.You will need blood hormone tests and imaging studies to determine the cause for the irregular cycles. </s>

<s>[INST] I am trying to learn as much as possible about pain pumps as I am considering having one implanted due to 4 failed back surgeries back in 2010. I have been suffering chronic back pain ever since and have tried every other option available with no success [/INST] Hi, dear. I have gone through your question. I can understand your concern. You should search for the cause of back pain. You may have some disc prolapse or some vertebral problem. You should go for MRI spine. This will give some idea regarding your cause. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] Hi, I have been experiencing dizzy spells lately and have never before. I sometimes feel nauseated and have been experiencing stomach pains. My stomach pains hurt more when I am walking. The pain feels like there is something pushing down on my stomach. [/INST] Hi, thank you for posting.I have gone through your query and I understand your concerns.According to your symptoms I can say that you suffer from gastritis. Gastritis is the inflammation of the mucous of stomach.To determine the causes you need:1. Fibrogastroendoscopy.2. Liver function test.3. Abdominal ultrasound.4. Complete blood count5. Urine test.To improve your health condition you should follow these guidelines:1. Eliminate spicy and acidic foods from your diet.2. Do not drink alcoholic drinks, carbonated drinks, coffee and milk.3. Quit smoking(if you do smoke).4. Take proton pump inhibitor medicines such as Omeprazole for 6-8 weeks.Contact your gastroenterologist.Take Care.Dr. Behar. </s>

<s>[INST] Hello. I am a 42 year old healthy male with no increased risk behaviors for cancer . I have trace hematuria (no stones...confirmed). It could be nothing I suppose, but I have a herniated L4 L5. Could this possibly cause this? Stiffness and pain experienced with the disk, as well as some flank pain and trouble (pain) flexing abs...particularly in the AM [/INST] Hello, Thanks for posting this question in HCM Let me clarify your problems in detail as follows::::::::::: First of all i would like to tell you that a given medical symptom can be due to various causes. For example back pain can be due to problem in spine or even can be due to problem in kidney, pancreas and so on. The other aspect in this regard is that a patient can have back pain due to two or more causes also. I mean one can have spine as well as kidney/pancreas/other problems together. Now let us see your problems. I understand that you have disc related problem. This can explain the back pain. Apart, you also have hematuria. This in turn can be due to infection in urinary tract, prostate, kidney, stones and so on. This requires evaluation, clinical as well as investigations like CT scan which can define stone/other problem better than simple ultrasound Hematuria is not due to disc related problem Your disc related problems requires evaluation by a neurologist Please visit a center having these facilities and get evaluated at the earliest Hope this helps </s>

<s>[INST] Hi I m 24 yrs old female, family history of hypertension, been having episodes of rapid heartbeat,intense pressure on entire upper left hand side of the body, shortness of breath, dizziness and nausea with upper neck pain and pressure on left side of neck with pressure at the bottom of head. been recurring for the last few months but seem to be getting more frequent and intense recently. [/INST] hello,I have gone through your query.Thanks for using HCM.first of all i would like to know your level of Blood pressure at the time of spell of symptoms.Also you must note exact heart rate.You should get an ECG at time of spell of rapid heart rate.If primary heart check up is normal then you should get other investigations related to neck and thoracic out let,My best wishesDr.Rajesh Teli,MD. </s>

<s>[INST] Hi, today I went to an orthopedic doctor because I’ve been having horrible neck pain that leads to migraines, and also I have a bad posture so I got my back x-rayed. They said I scoliosis but it’s very mild so I will have to go to physical therapy for 2-6 weeks to fix my posture. They didn’t say anything about my neck leading to migraines or really anything about my neck. Is the scoliosis causing my neck pain and headaches? Will the physical therapy stop my headaches and neck pain? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. As per your history, as you already consulted with orthopedician, and diagnosed as mild scoliosis,, so you continue with physiotherapy, that will help you. Mild scoliosis may be due to improper posture, so correct it. And it may cause neck pain and headache. so it will go after physiotherapy. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale </s>

<s>[INST] Hello doctor, I have some pain due to injury. Last week, I was at a construction site and marine plywood that is used for construction fell and hit me on the back of my head. My head is fine but my upper back is still in pain and chest also. I did not fall down when I was hit but the impact pushed my upper body down and forward I think beyond normal that is why I am getting back and chest pain. I did not go to the hospital because I do not feel the need. I am sure they will just tell me to give time and take pain killer. Can I get your advice? Is it possible I fractured my spine? What should I do? I am just taking Ibuprofen. Pain is not very bad I am still doing things normally and I can move. I am just wondering why I am still in pain after one week. Can this be a fracture? Please advise. [/INST] Hello. It seems that you have suffered whiplash injuries. This is common following high energy impacts on the upper body. From the mechanism you described, it seems unlikely to sustain a fracture. However, it is very difficult to be certain without clinical examination and x-rays. How is your pain? Is it tender at any particular spot? Is the tenderness is on the midline of your spine or on the sides? Pain directly in the midline with a particular spot of tenderness is something I would recommend that you get an x-ray. The fact that you are otherwise moving and carrying on with life normally is reassuring. However, unfortunately, whiplash injuries can take many weeks to settle. With regard to the chest pain, it is possible that the injury might have caused a crack in your ribs. X-rays are not very good at showing this. The treatment, in any case, is rest and painkillers. I hope this helps. </s>

<s>[INST] my 1 and half year old daughter had suddenly watery eyes and a runny nose,and kept rubbing her eyes endlessly,she doesnt have a cold,and I later learned that while I took herfor a walk,our house was sprayed by an insecticides,and now she had a diarrohea,please tell me is this an allergy? [/INST] HelloThis is likely a reaction to the insecticides and since she's a little too young for me to suggest you give her benadryl, if this continues for more than a day you need to take her to the doctor </s>

<s>[INST] I am a 67 years old male.My BP was 128/70.Since two weaks I have shooting back pain and I took Tramadol HCL 50 mg,4 times a day for about 5 days.My back pain did not come down and my BP shoots to 188/103.Kindly help me why my BP has incresed and what remedial action I do for bringing down my BP and my back pain.My email address is YYYY@YYYY [/INST] HelloWelcome to Healthcare Magic.Your BP raised due to backache problems, anxiety and tension.First be calm and take deep breathes whole the day to relieve worry.For bachache take complete rest in supine position for minimum 3 days.Continue painkillers.For BP conult your physician and get the x ray chest done with trademill test and also 3 times BP measurements after rest.Take low salt diet and routine exercise.Thanks for contacting.Take care... </s>

<s>[INST] Hi doctor, I am a 43 year old man, who has lived with epilepsy since I was 13. I have had very few seizures, maybe one every 4 or 5 years. The last one was four months ago. After I had that one, I recovered and was fine, but about a month ago, I started having what seem like auras. They are different than the auras that I have had in the past. There are two types, from which one was not so severe. I will be working on something or thinking of something, and it seems like my brain just turns off for a second. These are distracting, but not very disturbing. I have several of these during the day, up to 15. The second type is more severe and disturbing. It usually causes me to jump with fright. For a few seconds, I can hear what is being said to me, but I cannot understand the words. Sometimes I can, but I must really focus. Sometimes, I can still speak, but I also have to focus hard. I might have two or three of these each day. Afterward, I have a headache that might last an hour or two, and NSAIDs do not help much. I take Tegretol, 200 mg three times a day. I was also taking Klonopin after the seizure four months ago. This has been going on for a month now with little change. It just started one day, and it has been the same ever since. I did not have any head trauma or seizure activity since the one four months ago. The access to healthcare here is good, but doctors get patients in and out as quickly as possible, so I do not feel like the doctor is going to do anything if I am not in danger. I have already had an MRI and EEG, and everything seems normal. It is just very upsetting because I cannot enjoy my normal life. Every time it happens, my head hurts, and I am scared and nervous that something is wrong. I am continuing to see the doctor, but I do not have much hope that it is going to help. [/INST] Hi. I have analyzed the symptoms you described in the query. The appearance and pattern of aura are actually suggestive of the fact that the electrical activity of your brain is out of control. Though it is not a full blown seizure, it is surely an early phase of seizures. I suggest you increase the dose of Tegretol (Carbamazepine) to 200-200-400. It would be best if you can repeat the MRI brain whenever the pattern of seizures changes. There is a possibility that something might have changed in brain structure also. When you go for MRI, please get an MRI brain epilepsy protocol. This protocol studies the medial temporal lobe region of the brain in detail. The way your seizures are; most likely they are coming from the medial temporal lobes. I hope my answer helps you. For more information consult a neurologist online --> </s>

<s>[INST] Just had a MRI saying L4/5 disc level has a moderate size central disc protrusion which is associated with indentation of the thecal sac and compression of the subarticular bilaterally and contact with both the L5 nerves. The L4 nerves are clear. Is this serious and will it get worse as i get older as i an 15 [/INST] Dear you should have consult with neurosurgeon imediataly for your problem what you have is not minor that can cause serious problem avoid weight lifting and sternous exercise while you see your doctor's thanks </s>

<s>[INST] Hi. This is Lejeesh. 24 years, Male, 180cm, 83 kg. Did not have any big desease. Have little issue with Piles. Porbably because of my eating habits and sleepless nights. My query is regarding small lumps inside my body. I can feel it with my hands. At my legs, both hands, stomach. I know almost 10 lumbs inside my body but I am not quite sure about the cause. Should I be concerned about it? [/INST] Hi,Dear,Dont get hopeless and desperate.Thanks for the query to HCM.-I went through your query in-depth and Understood your health concerns.-You should not be concerned about these painless and HARMLESS lumps unless they grow out of proportion or cause some pain.In my opinion the cause-- of your Multiple body lumps- is the -Multiple LIPOMATOSIS.Cause -is due to the genetic inheritance from your family.-These lumps are not related with your eating habits and sleepless nights.Hope this would help you to work a plan with your doctor.Wishing you early and fast recovery.Wellcome to my HCM Clinic for further queries in this matter.Wishing you Good Health ASAP.Have a Good Day .Regards,Dr.Savaskar ,M.S.Genl-Thorasic CVTSSuper specialist in Asthma/Cancer and non-curable diseases. </s>

<s>[INST] I had a laminectomy/Discectomy 1 yearago now I have sharp back pain with leg weakness. Xray showed anterior osteophytes at multiple levels and narrowing at L4/L5 of lumbar. Mri and ct done as well. Dont have those results yet. My surgeon wants to discuss a possible fusion surgery. Good idea or not? [/INST] You are having neurideficit in form of leg weakness. Go for mri LS spine and look for canal diameter. Decision regarding neurosurgical intervention will depend on these parameters. Hope my answer will help you. Take care. Don't forget to rate me. </s>

<s>[INST] Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. [/INST] Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help. </s>

<s>[INST] THE PATIENT HAS LIVER ABCESS SINCE 17 DAYS , PRESENTLY THERE EXISTS 270ML OF PUSS AND HE HAS BEEN DISCHARGED . ALSO SUFFERING FROM DIABETES AND IS CONTROLLED BY INSULIN INJECTION, THE PATIENT S AGE IS 55 , WEIGHT IS ABOUT 60KG . I WANTED TO KNOW IF YOU COULD HELP ME OUT FOR A DIET CHART FOR HIM AS HE STILL HAS LIVER ABCESS EVEN AFTER BEING DISCHARGED , I TRIED FINDING IT ON NET BUT NO SITE IS DISPLAYING A DIET CHART FOR A PERSON WHO HAS LIVER ABCESS AND IS ALSO A DIABITIC PATIENT. PLEASE HELP AND REPLY AS SOON AS POSSIBLE. YOURS FAITHFULLY, HARSHESH CHOPRA [/INST] I think then you should continue with the same diet of diabetes that he used to use before. It will be o.k even with that adjoined abscess of liver. The better the control of his diabetes, the prompter his recovery will be. </s>

<s>[INST] we inter-coursed on 11th to 15th days after the period to become pregnant . Is it advisable to travel by bus or by car (on 28th day). [/INST] helloo, Having inter-course between 11 to 15 day doesnt confirm that u r going to conceive for sure. Travelling by bus or car is not going to create any issue until it is a rash one.its necessary to keep precautions. Better consult your gynaecologist once. </s>

<s>[INST] Hello doctor, I have a stomach ulcer that is not caused by H. pylori, and it is not a NSAID ulcer as well. What can I do to completely get rid of this ulcer? I am taking Ranitidine for it. The ulcer has come and gone over the past two years roughly. The stomach ulcer was diagnosed by asking a series of questions and by touching my stomach area. [/INST] Hello. First of all, from your history, it is not proven that you have an ulcer. It may just be underlying gastritis. I suggest you: For more information consult a medical gastroenterologist online --> </s>

<s>[INST] hello my father is aged 60 ,his creatnine level 2day was found 2 b 1.8 ,he has hypertention but he takes medicine for d same and normaly remains under control,what precautions should we take to reduce the creatnine level and wht diet should we follow. [/INST] Hi, dearI have gone through your question. I can understand your concern.Your creatinine level is slightly high. There is high chance of kidney damage in hypertensive patients. You should consult your doctor and start treatment to reduce your creatinine level. You can start with lasix tablets. It is a prescription based medicine so consult your doctor and take treatment accordingly and regularly check your creatinine level.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST] I M 28 Years Old,wt is 73 kg,ht is 5 feet 10 inch,a student of masters.I m going to marry in the next year.bt i m very much worried of my penis size.it is 4 inch during erection & the diameter is 3.75 inch.on top of that i m extremely habituated with masturbation.and yet now it is 2-3 times in a week.semen amount is 2-3 ml per ejaculation.now i m worried Whether my penis will b able to satisfy my life partner During sexual intercorse & whether it is possible on my part to become father????is there any medication or advice to increase the length and diameter of my penis??would u pls give me ur valuable suggestion to get relief of my extreme anxiety and tension??? [/INST] Hello, Please understand there are no successful measures to increase the penis size except reconstructive surgery even that may not be a success. Therefore please be satisfied with your current penis size. The 4-inch erect penis is more than sufficient for any sexual intercourse. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist </s>

<s>[INST] My little grand daughter who is 10 weeks old has had about 6 nappies with lots of yellow jelly in the poo, she has had slight traces of blood in the poo as well. She has also had projectile vomit and is not taking her bottles. Took her to the G.P who said it was a viral infection, we are all worried. [/INST] Hi...I went through the history points you have provided - THIS IS NOT A VIRAL INFECTION.I feel that your baby is having cow's milk protein allergy (CMPA). Unusually babies grow out of this sort of allergy by 1 year of age. My suggestions for you - 1. Mother should go off cow's milk protein completely. This means that you should avoid consumption of anything and everything related to cow's milk - like - milk/ curds/ ghee/ butter milk/ chocolates/ biscuits/ ice creams etc. Even while buying commercial food products, you need to see the ingredients and if they contain milk - do not consume them.2. Feed you baby only exclusive breast feeds till 6 months of age and then start rice based feeds. 3. If this is followed scrupulously - the baby will stop having diarrhoea in another 3-4 days and then start gaining weight too.4. If you feel your feeds alone are inadequate for the baby, then Zerolac is the only option. I request you to keep me posted about the recovery of the baby and follow of the case.I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards – Dr. Sumanth </s>

<s>[INST] Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? [/INST] Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] i have a knot in my neck and don t know what I should do I have been to the drs and they say its nohn bu I know better had act scan they say its goodit ts bigger when drink a lot of liquid thk they left somethinn they toke my thyroid could that be [/INST] Hi,Dear,Thanks for the query to HCM.I studied your problem in depth and I understood your concerns. Cause for the lump in your neck-In my opinion your description needs more clarification-as to -whether the lump is on the front side of the neck or sides of the neck.This is because your lump is not there as per your doctors.In my opinion-your lump-appears to be -a Engorged veins -as it comes after drinking lot of water?Check with your BP with your family doctor.For Final Diagnosis and treatment needs clinical data from a Doctor.Its not thyroid as you think -otherwise Your doctors would have asked you to do USG and other tests to rule it out.and Hence for further treatment I would advise you to Consult ER Surgeon , who would treat it accordingly.This advise is based on the facts from the history you give and needs further clinical check.Hence I would advise you to check with ER Surgeon.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you.Hope this would relieve your problem.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N. </s>

<s>[INST] hello, yesterday I woke up with aching teeth , I assumed from the symptoms the cause to be either dental problems or sinusitis . During the day I have felt slow swelling, payed no attention to it, brushed my teeth trice during the day and gone to sleep. Today I woke up with badly swollen upper lip and aching teeth. Teeth seem to be aching from movement of some sort. Upper lip is swollen and I think there is a lump, main swelling is inside the moustache area of the lip within it. I have little to no cash right now and cannot afford going to a doctor if it is not a major cause. I was at the bar two nights ago, but teeth ached a little before. My first upper right tooth was dislocated during a fight 8 years ago. I hope I gave enough information for you to help me at least to know what is the cause of this. Thank you in advance [/INST] hello and welcome, as you mentioned,your upper right tooth has dislocated 8 years ago,there is chance of traumatic injury occured with the tooth resulting in periapical abscess as well as apical periodontitis. Usually in such cases,root canal treatment is indicated depending on the condition of tooth. The pus has to be drained and curetted, Please do visit an endodontist and get the treatment. analgesics will give only temporary relief. for permanent cure,you must get the treatment done. ANTibiotics has to be administered for the infection underlying. take care. </s>

<s>[INST] My 6 year old has been diagnosed with pinworm today and has taken the dose of vermox this morning. How long does this take to work please? When will all the worms be dead and out of his system? Been told to repeat the dose (5ml) in 2 weeks time aswellMany thanks [/INST] Hi...usually the drug works in 24-48 hours. Your doctor was right, you need to repeat the dose in 10-14 days time.Hope my answer was helpful for you. Happy to help anytime. Further clarifications and consultations on Health Care Magic are welcome.Dr. Sumanth MBBS., DCH., DNB (Paed). </s>

<s>[INST] Hello, am having frequent (recurring every half hour) pain in abdomen which subsides when I try to pass stools but recurrs again. Has been happening for the last 4 hours. Unable to walk around due to pain. Will enzoflam help for temporary reduction of pain till I see a doctor. Had this from earlier prescription from 1 year back. Pls help [/INST] Hello and welcome to Healthcare Magic. Thanks for your query. Enzoflam is an NSAID pain killer medication, and NSAIDs can cause gastric irritation. Your symptoms appear to be indicative of a gastro-enteritis (probably due to giardiasis or amoebiasis), and hence I feel that taking Enzoflam could probably worsen the gastritis. There are other pain-relieving medication which are more gastric-friendly and would be more appropriate in this situation. Even if you would like to take Enzoflam, it's better to take it along with an anti-ulcer medication like Ranitidine (Zantac) - available over-the-counter. Also, avoid spicy and oily foods and take a bland diet. Drinking plenty of fluids, especially cold milk, can also help alleviate your symptoms. Best wishes, Dr. Sheeba Stephen </s>

<s>[INST] hello there, ive noticed a clear see through like discharge( a bit like jelly) today what does this mean? ive been trying to conceive but no look yet but have noticed my breast has a little pale yellow like milk leaking( like when you first become pregnant) i had my period at bgining of last month and have done pregnancy test a week and a half later but was negative please help [/INST] hi, mucous discharge can be seen physiologically and pathologically. in physiological conditions like, during ovulation, sexual arousal, before menstruation and during pregnancy. in pathological conditions like infections also discharge can be seen. as you are having mucous discharge, secretion from the milk and delayed periods there is chance of pregnancy. as some urine pregnancy tests are less sensitive, you can repeat the test or better go for blood test for pregnancy after consulting doctor. take care. </s>

<s>[INST] My wisdom teeth recently grew all four of them, but the one on the bottom left hasn t completely grown and i started feeling pain with an ear ache, and then my throat now hurts, and when i wake up in the morning i spit a tiny bit of blood , thats barely noticeable! should i be worried? the tooth ache is much less today, but my throat itches and ear hurts! [/INST] Hi,Thanks for asking,As your one wisdom tooth is partially grown so debris gets accumulated under the flap covering the tooth.It causes inflammation, swelling and ultimately pain.Consult a dentist for irrigation under the flap(operculum), follow antibiotic coverage.Maintain oral hygiene and use antiseptic mouthwash.Do warm saline rinses daily for healing.Take care </s>

<s>[INST] my brother is suffering from CKD stage 3, his creatinine level i think its 56-64% .someone told us to drink wheatgrass juice? Does wheatgrass juice helps to patients of age 34years with CKD stage 3, who is undergoing chemotherapy too? are the side effects of chemotherpy really scarry...! please advice. [/INST] Wheat grass should not cause per se any problem with either chemo or to CKD. . However wheat grass juice is high in potassium and CKD patients are unable to remove this potassium and develop hyperkalemia ( high potassium) which is dangerous. Some chemotherapy medications can be stressful for kidneys should be monitored during and after chemo. The concept of everything natural is safe is so obviously fallacious - as if there are no poisonous plants or fruits in nature. All plants are also chemicals - simplest example is sugar (actually a chemical C6H12O6) extracted from sugarcane (natural) </s>

<s>[INST] in my younger age up to 5 years i was very fair but when i grow up my skin tone get darker and darker now its fully dark because i was suffered from asthma problem so i on took many heavy dose drugs,is it affect our skin tone,how should i get rid of this ,i am a male and i am 28 years old,please offer me a solution,i feel very guilty,when I seeing my earlier stage photos no one accepting me,please help. [/INST] hello and welcome to healthcare magic,as you go older the layer of the skin is added so this in natural but as you are asthamatic and have steroids so this can also affect your skin colour as this is a sideffect of it.take vitamin e and vitamin b complex to counteract this,take care </s>

<s>[INST] Q1: what will happen if I dont take my prescribed dose of seroquel xr, and I ve been told by my doctor to take my dose (50mg+50mg+400mg) about 6 or seven o clock each day, if I miss the dose and don t take it till tomorrow evening, how will it affect me?? and what will it do to my brain\body. note: I have not taken my dose since half eleven last night. [/INST] Hi, I understand your concern. IT is good to take the prescribed dose of Seroquil regularly. A regular follow up is advised to readjust the dose. A sudden break in taking routine dose for several days is likely to cause withdrawal symptoms with sometimes relapse. But missing a single dose does not cause much difference to body/brain. When a dose is missed, it should be taken as soon as remembered. But if it is nearer to next scheduled dose, it should be dropped. Thanks. </s>

<s>[INST] Hi, ive been really stressed out over this, for the past 3 days the left side of my stomach will shock(it wont hurt just an entense zap) then it gets very numb and tingly for a few seconds then it gets very hot them boom its gone can you tell me what that might be? Should I be worried? [/INST] poosibility are inflamations or infections gall bladder,appendix,kidney.pancreas.gastritis,duodenitis or hiatus herniacan be investigated by ultrasound abdomen and endoscopic examinationneed to consult doctorpresent medication would becourse of stomach specific antibiotic metronidazoleantispsmodic sosantacid gel </s>

<s>[INST] Hi this is Ali from Bangladesh.My son Radit, 7 years old, suffering from hyperactive,restless and impulsive since he started walking. Few days back he had a blood test and result ammonia level is 55. all other reports are ok. pls advise your commemts. thanks. [/INST] Hi55 micromol/ L is towards upper limit of normal range for serum ammonia. Get your child investigated by a pediatrician/ child psychiatrist. </s>

<s>[INST] Hi, I ve been told I have a rare condition where my bones are crumbling in my hips and I have to have two new ones.My doctor didn t tell me what it was called and I was too shocked to ask. Could you tell me what it is as I would be most greatful. Thanks, Denise. [/INST] it sounds like you have avascular necrosis of the hips. this leads to abnormal motion at the hip joint, causing accelerated degeneration of the joint. this leads to eventual cartilage loss and soon, bone to bone contact and subsequently severe pain on movement of the hip.this condition can be caused bu several factors including steroid use, alcohol, autoimmune diseases, injuries around the hip etc. in some cases no identifiable cause is found.should it be due to the above factors, you should stop usage of steroids, unless there is no other choice and alcohol intake.i tend to agree that you need hip replacements, provided that you are significantly affected by the pain ie unable to perform your normal daily activities. however if you are coping well with the pain, there is a role of watchful waiting, only performing the surgery if necessary. </s>

<s>[INST] My 60 yr old diabetic male friend has been having intermittent episodes of RLQ pain. Negative CT/X-rays. (At the VA) . But, for the first time he had the abd pain and it radiated up into his heart region.. he described it as excruciating. It resolved eventually. I realize that this is far too limited of information to come up with anything definite..gall bladder, gallstones or liver issues come to my mind. Any further speculative ideas? [/INST] thank you for using HCM i understand your queries... if a patient like him come to my place. initially i would give him some analgesic for pain relief temporarily which would be easier for further evaluation...1. there are a few reason for RLQ pain like gall stones. liver infection.stomach ulcer2.i would do a few test like LFT ,to evaluate liver function.3. An usg to rule out any abnormalities in liver and gall bladder stones.4.some time it could be due to acid pain...5.you already said that his x ray was fine so then there in no problem in lungs..i hope you got sufficient information </s>

<s>[INST] this week i have to travel by the plane for 10 hours how many mg of klonopin should i take before i get on the plane ? to avoid any panic attacks can i take 10 mg of klonopin an hour before the i get on the plane and then take 15 mg take when i got on the plane thanks [/INST] HIThanks for using healthcare magicI think, you should try 1 mg of klonopin (clonazepam). That would help to control panic attacks. In case, you get this, you can take 1mg on sos basis. That would help to control the anxiety attack. You can also try some relaxation exercise in plane. That would keep you relax and calm. In case, you need further help, you can ask.Thanks </s>

<s>[INST] I AM A 60 YEAR OLD FEMALE, I HAVE A BLOOD PRESSURE PEICE OF EQUIPENT AND EVERY OTHER NIGHT IT IS IIN THE REGION OF 100 OVER 60 WITH A PULSE RATE OF 65. I FEEL SO TIRED AND UNABLE TO DO MUCH AS I AVE VERY BAD ARTHIRTIS IN SPINE AND D.D.D.. RHEUMATOID IN THE HANDS AND HAD A CORIZONE 3 MONTHS AGO HAS WORN OFF. MY HUSBAND HAS BOWEL CANCER SO AS WELL AS HI CHEMO AND ALL THAT COMES WITH THAT ... I AM FEELING SO T I R E D , I AM EXHAUSTED, AND HAD A EDEMA 2 IN SPAIN WHERE ALL MY LEGS SDWELLED UP LIKE TREE TRUNKS. I EAT WELL AND CANNOT UNDERSTAND WHAT IS WRONG WITH ME. I AM JUST DIGNOSED WITH CHRONIC FIBROMYALGIA ALSO. WHAT SHOULD I BE DOING. DOC SEEMS UNWORRIED BUT 5 OF MY FATHERS BROTHER AND SISTERS DROPPED DOWN DEAD WITH STROKES BEFORE 50 YEARS. I HAVE HIGH CHOLESTEROL BUT DOC WON.T PUT ME ON STATINS ANS SAID THEY WOULD MAKE MY JOINTS HURT EVEN MORE. HELP! YOURS FAITHFULLY, MRS GAL [/INST] Hey therei would suggest you to go for stress thallium test to evaluate your catdiac functiona liver function and kidney function should also be done.Thanks </s>

<s>[INST] i have had really bad cramps with dyiarea and blood in my stools i have also thrown up twice. my lower abdomen is very sensitive to touch and it is also warm to the touch. i was wondering if this is something i shoulod have looked at? [/INST] Hi, You are suffering from desentry which needs urgent treatment otherwise you may develop dehydration and electrolyte disturbances, take plenty of water, fruit juice and consult your doctor. Take care </s>

<s>[INST] yes I have a question my father is 65 years old and broke out a few days ago with a small rash that looked like bugs bites that s now all over his stomach upper legs and all over his arms can you pleas help us figure out what it can be it itches so bad [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Application of Hydrocortisone cream or Calamine lotion will work well. He can take non-sedating antihistamines (Levocetirizine) once or twice daily for 5-7 days. He should take care of his hygiene & regular shower. Let him stay away from direct contact of sunlight as it may trigger his discomfort, use of chemical cosmetic lotions or harsh soap should be avoided. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K. </s>

<s>[INST] I am a 39 year old female. About four days ago I was stung on the arm by a wasp. It hurt for about an hour and itched like a mosquito bite for a few days. About two days ago I was stung on the hand, right below my index finger. This time it was much more painful. I have swelling and redness on about a 1 inch radius of the sting. I found no stinger. I've been experiencing periods of intense itchiness. I also have dull pain in my entire hand and wrist. I have also been experiencing periods of numbness and tingling of my hand up to my wrist. Is this a typical reaction for a sting on the hand. [/INST] Hello,Welcome to HCM,When bees sting a person they will inject venom through their stinger into the skin of the victim.People stung by bees will have an allergic reaction to the sting and in severe cases it will causes anaphylaxis.For any Bee sting, following measures should be followed1.If the stinger is present remove it immediately. 2.Apply ice or cold packs to the area to reduce the body's inflammatory reaction.3.Wash the area with soap and water4.Take antihistamine such as Benadryl.5.Pain relievers such as ibuprofen or acetaminophen can also provide relief of symptom.Aforementioned measures should followed whenever there is a bee sting.Thank you </s>

<s>[INST] Hi Doctor, Frequenlty i will have abdominal pain after taking food and sometimes stool. Doctor suggested me to take CT Abdomen scan... But if i take Brakke tablet my pain will get reliefed. After stopping milk i feel my pain and stools are little controlled... Please suggest what i have to do for this problem? [/INST] Hello Your findings suggests that probably you are suffering from peptic ulcer.CT scan is not ideal for this condition.I suggest to go for basic investigations first.Initially I suggest routine hemogram,ultrasound of abdomen and upper GI endoscopy for the patient.Upper GI endoscopy is vital for you.Biopsy can be taken if needed. Brakke tablet is an antibiotic and it is prescribed for infective etiology.You need proper evaluation.CT scan can be done if needed.Get well soon.Take CareDr.Indu Bhushan </s>

<s>[INST] Hi doctor, I will first summarize my case, and then I will put my query. I had been diagnosed to have GAD and social phobia before 10 years, and I was taking Paxil 20 mg daily in the evening along with CBT. The result was excellent. The anxiety and depression went away, but with a very high level of weight gain, significant fatigue and some sexual dysfunction (low libido). Due to the side effects of the drug, I tried to withdraw it all together around two years back, and there was a relapse. Therefore, I have come back to the medication with some changes. Initially, my doctor replaced Paxil with Prozac and Wellbutrin XL, and then replaced Prozac with Zoloft. Wellbutrin had many side effects on me. Hence, I avoided it altogether. He also avoided Effexor. I am currently on Zoloft 50 mg in the evening along with Buspar 10 mg four times daily. The query now is, which of the following strategies will have few side effects like fatigue, weight gain, impotence, decreased libido, and to delay the ejaculation? A combination of 20 mg Prozac during the evening time along with Buspar 10 mg every six hours daily. A combination of 10 mg Lexapro in the evening along with Buspar 10 mg every six hours a day. A combination of 50 mg Zoloft every evening along with Buspar 10 mg every six hours daily. How would you arrange the side effects? I would like you to mention the side effects regarding impotence, libido, weight gain, fatigue, drowsiness, negative impact on the system and liver in long-term usage, control GAD, SAD and social shyness, delayed ejaculation as a positive side effect, interfere with food, other medicines and supplements etc., in a descending order. Please discuss every question in detail according to your practical experience. Best regards. [/INST] Hi. I read your query. Out of the three options, the third option would be the best possible concerning the balance between the effectiveness and side effects. Zoloft (Sertraline) and Lexapro (Escitalopram), both are almost equal regarding the side effects and efficacy. Based on my experience, Prozac (Fluoxetine) is a weaker drug regarding the effectiveness. With my practical experience, impotence and loss of libido are known side effects of all the three drugs. The probability may vary but, it is about 10 to 20 %. Lexapro is the most drug to cause weight gain when compared to Zoloft and Prozac. Again, fatigue and drowsiness are known to occur with all the three medicines. But, it is more familiar with Lexapro. Delayed ejaculation is not a predictable side effect. Hence, cannot say among the three. Zoloft and Lexapro do not interfere with almost all the medicines, whereas, Prozac may do so. The long-term impact on the body and liver is almost negligible for all the three. They are all safe on a long run. The effectiveness of control on SAD (seasonal affective disorder), GAD (generalized anxiety disorder), and social shyness is better with Zoloft and Lexapro compared to Prozac. Between the two (Zoloft and Lexapro) it is hard to judge. Some patients benefit more on Lexapro and some on Zoloft. To conclude, I reiterate that, based on the information you have provided, the third option is the best among the three. (Zoloft 50 mg with Buspirone 10 mg, every six hours). With best wishes. For further queries consult a psychiatrist online --> </s>

<s>[INST] My pancrrease may not be working up to what it should also have gout. What would be best to do ? I was at Dr last thur. and he prescribed Creon for pancrease and Uloric for gout. what is best. I am 78 my Brother passed almost 2 years ago with cancer of pancreatic also a first cousin passed about 1 year ago. What can I look for or expect in the future. [/INST] Welcome to HCM.You have to be careful for it because you have strong family history.Go for regular screening for condition of pancreas by measuring rbs, s.amylase,s.insulin,usg and even ct-scan abdomem.Avoid any hard drinks if you have habit.Take more liquids and keep proper hydration.Avoid heavy,oily,spicy diet.Take proper sleep and avoid stress.You have to take intravenous hydration during severe episodes.Keep watching for sugar level and ketoacidosis.Go for regular follow up and keep in touch with your doctor. </s>

<s>[INST] I recent and xray on my back and pelvic area because of a sciatic nerve flare up. I underside the information about moderate loss of disc height but not the significants of the statement there is a moderate amount of stool in the ascending colon. Could you explain the significants of that statement? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Loss of disc height indicates some kind of age related wear and of your intervertebral discs. You can go for an MRI scan for better evaluation. Stool in colon is of no clinical significance and is a normal finding and no treatment is required. Wishing you good health. </s>

<s>[INST] I am a sexually active teenage girl, I am currently using the nuva ring as a contraceptive and I just ended my period yesterday. This morning when I tried to put the new ring in I noticed I couldn t get it in much farther than the opening and then about half an hour ago (just after sex) I tried to push it in farther where it is supposed to sit but I realized that there is swelling in what I m assuming is my cervix. It s feels like a large lump. What are some possible causes of this and should I be going to a doctor? [/INST] Hii , Welcome To HCM & Thanks For Asking Your Query Here however a vaginal lump is rarely caused by Nuvarings ,but Common side effects of Nuvaring are vaginal infections and irritation,which may lead to a a vaginal abscess more specifically it may be a Bartholin's Abscessit can occur when Bartholin’s glands, located on either side of the opening of the vagina, becomes infectedhowever a vaginal lump can be caused by many other medical conditions and as u did not mention any other symptoms like if there is any pain or discharge in lump , if you have fever or not , seriously it needs thorough medical check up and investigations to spot a confirm diagnosis i will strongly advise you to contact your Gynecologist, he will perform a physical examination to check for any lumps within the vagina your doctor may want to perform a biopsy on any masses found in the vagina to rule out other sources of the problemI hope it help Thanks & Get well Soon </s>