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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi. I am a thirty year old female. am a thirty year old female. I was diagnosed with primary hypertension at age 25. My average reading at diagnosis was 145/110, with peak reading at 185/120. In the past few years, my blood pressure readings have averaged out to slightly above normal with medications, averaging 125/95. However, yesterday I had a higher reading of 150/105 and earlier tonight my blood pressure spiked to 140/115 but has now dropped back down to 135/90. I was diagnosed with Type 2 diabetes at age 25 with a fasting blood sugar of 385. Now my blood sugar is in close to normal levels and is treated with Metformin and diet. My A1C is also in normal ranges. I was diagnosed with high cholesterol at age 26. At diagnosis, my total cholesterol was 310. Now it is down to 210 with medication and diet. At diagnois, my LDL cholesterol was 220 and has now dropped to 135 with medications. At diagnosis my HDL cholesterol was 75 and has now risen to 90 with my total cholesterol level being 210 at my last appointment with my cardiologist which was two weeks ago. I have been obese for most of my life and have been unable to lose much weight even with diet and exercise. At my heaviest, I weighed 285 pounds and am now down to 245 pounds which is about 110 pounds overweight. I take Metformin, Benicar, and Vytorin. Last night, I felt naseous and had waves of slight pain and pressure in my chest. I also felt pain in my jawline and left elbow area, whicChatDoctore and went in waves. I was sweating more than usual and was dizzy, but felt better with rest. Today I went about my normal routine, but felt dizzy when I went on my evening walk and now my left arm is numb. With my history, should I go to the ER just be sure this isn t cardiac related? ### output:

Hello, With the history what appears to me that your blood pressure is high of course what appears from the readings. But for now I feel it's not any heart attack for now. If it was then things would haven been complained as different way. As dizziness and sweating can also occur due to low blood glucose levels. Now coming back to the fluctuations in the readings. If you are taking the measurement from any of the digital machines, it can show errors too. Having it done on a traditional Blood Pressure apparatus called sphygmomanometer is advised. Next your blood pressure was high, but which arms that you did not mention? Left or the right? Considering the higher on the left or the right the medication will be advised. Coming to your diabetic profile. Usually, due to sedentary lifestyle, people tend to develop the early high blood glucose levels. Taking part in a regular physical activity like exercise should help it under control without having taking medications on a longer run. For high cholesterol levels this has to be taken care with diet more and exercises equally. As cholesterol levels are increased in most cases because the type of food one eats and doesn't burn out leading to high levels. Avoiding oil completely should definitely give the results in reducing the cholesterol levels. Now your next problem is obesity. Now this is something which definitely needs exercise and diet plan. In my clinical practice of 12 years I have seen cases with obesity, high blood pressure, high cholesterol levels and high blood glucose levels at early ages, but all responded well to diet and exercise well and now all are healthy. Medicine is of course good but on long run not good for body and especially kidneys. So most doctors advice control of the symptoms mentioned above with diet and exercise. I hope that you start the diet and exercise regime sooner so that you get some excellent results. 30 is not the age to visit medical professionals more often. This is the age to enjoy. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: im already 45 years old and i want to get pregnant . i undergo transvaginal ultrasound-HSSG... and these were the result.. 1) uteros; 7.07x4.16x5.38 the uteros is retroverted with regular contour and inhomogenous myometrium . The subendometrial halo is intact. 2.) CERVIX: 2.7X3.17X3.43CM HOMOGENOUS ..3) eNDOMETRIUM: 0.64 cm, thin, hypoechoic... compatible with proliferative phase... 4)Adnexae: right ovary: 2.94x2.12x2.22 cm lateral to the uterus.. With folices within.. Abnormalities:-none.. F1=0.96cm..F2=0.56cm... Withinthe right ovary is a unilocular anechoic cystic structure measuring..... Left ovary:2.37x1.34x1.64 posterolateral to the uterus . . No folice seen. 5) Others: No free fluid in the cul-de-sac HSSG-Remarks: Both tubes are not visualized pre-instillation. On fluid instillation with normal saline there is spillage of fluid delay from both tubes with pooling of fluid around both adnexal areas and cul-de-sac post instillation. Total fluids instilled- 25cc Saline infusion (15cc) in the endometrial cavity showed no pathology . CONCLUSION: Normal -sized retroverted uterus with thin, intact endometrium Normal-sized ovaries with folicies in the right as measured Patent fallopian tubes,bilateral .. I wish and hope that there is still a chance that i can be pregnant.. what should i do and is there really a chance that i still get pregnant?... Please Doc help me understand this all... ### output:

Hello, I appreciate your query. For understanding your TVS - HSG report, you need to understand in brief the process of fertilization. A female requires active functioning ovaries, from which mature follicles (eggs) are released every month. A healthy cervix and vagina is essential for sperm transport into the uterus and then, the fallopian tubes are responsible for transport of sperm and egg, and the fertilization occurs in the fallopian tube. The uterus is where the fertilized embryo will implant and develop. Now, coming to your report, the uterus appears normality ovaries are normal-sized, but follicles (eggs) are seen only in the right one. The fallopian tubes appear to be open (not blocked) as dye has passed from them into the peritoneal cavity. However, to explain to you your chances of pregnancy, theoretically, yes you can get pregnant. However, the major deterrent is your age. How long have you been trying for conception ?? Have you had any surgery or disease in the past? At 45, the capacity of the ovaries to produce eggs is Chat Doctor. That is the major factor that will impede pregnancy. For proper assessment of your ovarian reserve (ability of ovaries to produce good quality eggs), you should have a proper regular monthly menstrual cycle. Also, get your AMH (Anti - Mullein Hormone), which reflects your ovarian reserve. Your AFC (astral follicular count) on ultrasound, is not mentioned, which also indicates your current ovarian reserve. If your ovarian reserve is depleted, chances of pregnancy fall quite a lot. Also, a major factor is your partner/husband s semen analysis report. Please get that done too, after 3 days of abstinence from sexual activity. With these investigations (also ruling out thyroid, sugar and other conditions), please consult an infertility practitioner in your area, as your case will be tremendously benefitted with the use of ART (Assisted Reproductive Technology)I urge you to actively pursue this at the earliest, as time is of the essence in your case. Hope this helped you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello. I am a female, age 40, 5 2 , 140 lbs, & in good health other than fibromyalgia & allergies. I am currently on no Rx medicines other than Chryselle, though I take ibuprofin as needed, chlorpheniramine usually once or twice a day but up to 4 depending on allergy symptoms, a daily multivitamin , a B complex, and Vitamin D daily, & melatonin on occasion for sleep. I do tend to run a low fever at times (99 - 100) although there is not always any kind of infection present & it seems to be something related to fibromyalgia symptoms. I am not & have not been pregnant any time recently, & check-ups have all been fine. My concern is about some lingering symptoms as well as a new one; for some time (at least 6 months now after I realized it was occurring regularly) I have noticed occasional nausea & an odd taste that seems to come from my nose (somewhat metallic, not like blood or mucous, but unpleasant & almost with a bit of bile taste to it). At first I had just checked these off as something due to stress, something I ate, and maybe something odd due to my allergies. After some time I began to notice these recurring more frequently to the point where on their own they had become bothersome, seemed more pronounced when I m at rest but occur at other times as well, and occurred without any obvious link I could attribute to anything else. I have not had any history of stomach problems or ulcers , and don t feel that this is the case now. I have also had headaches, but had been blaming them on needing new glasses or allergy symptoms, but have noticed they have also been occurring even when I have no sinus problems, & have been more intense than just my usual slight ache. I also have what sounds like fluid in my left ear at times, especially during exercise when it makes a very distracting clicking & sucking noise, and I had just written that off as allergy related, although it has become more of a nuisance in the last year. I had been planning on having this all checked out at my next visit. Last weekend however, I bent over to wrap my head in a towel, and when I stood up an orange colored fluid ran out of my nose. I have since then been keeping a tissue handy as my nose does seem to leak unexpectedly now & then, although not as much. It does feel at times as though it has come from above in my sinus somewhere, & other times it has just caught me offguard. With my allergies I have never had this issue. I had a cold recently, & I did visit the doctor last week. No signs of infection were found, but my symptoms were basically brushed off & ignored & not even discussed. I was a bit annoyed at not feeling like my symptoms were taken seriously at all, so I tried to address the issue & I was given an appointment to see a neurologist next week. After looking my symptoms up online, the only thing I find that matches is Cerebrospinal Fluid Leak. I would be more than happy to find out that s not the case, but at the same time I don t want to brush off the symptoms as nothing & treat it like an impossibility. Am I right to be concerned & what should I do or say at a next doctor s visit? ### output:

Hi welcome to Chat Doctor forum. Thanks for choosing Chat Doctor. Forum. You have got fibromyalgia, and getting treatment for it. You are having allergy and getting treated with only antihistamines. When you take only antihistamines you will get the side effects of it as sinusitis, otitismedia, hypertension etc. The discharge, orange discharge, dad taste all suggest sinusitis, and accumulation of the thickened discharge with occasional oozing of blood. Secondarily lead to Otis media. The discharge from the maxillary sinus, and frontal sinus will be directly coming to the oral cavity, and show its color and smell. The leakage of cerebrospinal fluid will be color less, without any smell, and watery in consistency. So you can get it tested by your tissue and let it Chat Doctor. If the tissue is not sticking when it is

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi. im new to this eeg test and im gonna need to know some stuff. i been having axinty attacks for year and 6 mouths it started when i saw someone having a sezure and it bother me and i been having attacks wheree i feel funny, everything feels like is moving sleep problems and so much more. it has now got bad where i cant take a bath, go out, and i cant even wipe my own butt when i use the bathroom yes it is that bad becuase i feel funny and i get feelings of everything moving or a spin. The reason im asking about this eeg is becuase i am getting one and im gonna need to know somethings before i go to the doctors for it becuase my attacks has got realy bad where i may not be able to do some of the steps. things i may not be able to do like closing eyes w hen im not asleep with the white light , open eyes and watch light, the 3 min breathing and overall setting in that room. I forgot to say that im getting this test becuase i try meds and they do not work i been on 5 meds for aanxity. Now i told the doctor that i want a eeg done to help me get over the fear that i got about sezure s from someone having it and to makesure that this was just anxity. Now i try to look up stuff that will help me to forget about my fear but it made thing worse. So all that i try never work. The only way to beat this fear is to have this eeg thing becuase my mind will know that thers nothing wrong. when i spook to him he agree with me nowi got some problems since my anxitys have got super bad if some one told me 1 to 10 i say 10 very bad. In order for me to get this egg and get it done right where the test results are clear and right, I really want to have it in a way that nothing will not effect the results. but heres my problem im gonna have to be on meds for my atttacks or else i cannot stand any parts of the test. heres another problem if i get this test and if i was on meds for my anxitys that work it may effect my chances of helping me getting over this fear and getting results. as i understand this eeg test right it will only be good if you have a attack becuase thiis way the test can tell if its a sezure or not. so even do my axnity attacks are bd and got real bad time to time for this to go right the tesy has to be done while im not on nothing and while imhaving the attacks. So im gonna ask you alot of qestions pls reply to every one of them please. i try to find out about this eeg more but it was not claer to me so i need your help and guide im between a rock and a hard place and i gotta get over this fear and this is the only way. here are my qestions. 1. will i be able to take axnity meds when i get the test done, now i understnd that some meds you cannot take so if theres a way to take something with out it effecting the test that will be graet. i did read something about meds to be asleep. 2. i wan t to know how long does each step that i have to do on the test take, let me be claer i want to know every single step. im talking about the flashing lights the closing eyes and all that. please help me on a hard matter thanks. ### output:

Hi.thanks for the query. I am very sorry to hear about all of your problems! Let me assure you that EEG is a very simple & harmless test procedure where a set of points or electrodes are attached on scalp to record electrical activity in brain. This test is usually done in cases of suspected seizure disorders. Going by your description, you do not appear to be suffering from seizure disorder but rather from symptoms of incontrollable anxiety characterized by feeling funny, repetitive flashbacks of seizure event along with host of other symptoms. If you can consult a Psychiatrist, you can receive effective treatment in form of medications like SSRI/Mirtazapine/Trazodone combined with anxiolytic Chat Doctor. I know you have been through a lot & you are managing things bravely...try to stay calm & consult a Psychiatrist. Good luck

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi. I am female, 22 years old. I am very hygenic (I shower every single day, and sometimes even have a clear-water, no bubble bath, bath in the evenings too). I suffer from extremely sore, painful lumps on my vagina, and general genital area. They are raised and usually quite hard, as if they go deep down underneath the skin. Occasionally I can release fluid/puss from inside of them, but mostly I cannot and it does not look like they have a head on them. I have been on about 8 different courses of strong anitbiotics over the past 18 months and they do clear the lumps up, until 2 weeks later when they come back again. Ive also been prescribed aqueous cream and betnovate cream but neither seem to be doing anything. I have also had huge abscesses and had to have them cut out & drained in hospital under local anaesthetic. Quite recently I have noticed that I have lots of purple/blue bruises appearing in between my legs, high up on my thighs, on my bottom cheeks and further inside, but near to my vagina and near the outer lips of the vagina. They appear in clusters like a rash. Sometimes they appear on their own, too. I also have noticed bruises appearing on my legs (my left shin is extremely swollen like there is fluid inside) and my limbs regularly hurt, like a pulsing pain, until I have to sit down it hurts so much. My shoulders hurt, particularly my left one. I am constantly tired and feel so weak and such pains in limbs and all over my body that sometimes I feel like I could just collapse. Other symptoms include feeling dizzy, constantly thirsty, blurred vision, problems remembering simple things or instructions, intense electric-shock like pains in my temples and lower back of head, severe vitamin b12 and folate deficiences for no reason. I take folic acid although it isnt being absorbed in my stomach for some reason. I have to be given vitamin b12 injections every 8 weeks to prevent anemia. I also have a rare blood disorder so my ferritin is extremely high (1000). Tests have ruled out diabetes. Could you please tell me if you think on any level that I have something to worry about. Or any conditions that you think I should be tested for. Thank you ### output:

Hi, Dear I went through your elucidative query.1-By the facts placed by your query and In my opinion, Cause of the painful vaginal lumps is -your infected groin and thighs, which is the cause for continued boils around your vagina outer lips.2-Taking shower 2 times is not going to help you .3-In my opinion you need treatment of the groin-fungal infection with bacterial super-added infection -on priority.4-Simultaneously you had to take care of the hygiene of the private parts by dilute-dettol sponging 3 times a day.5-Get your HAC done with FBS and PPS and if any problem take treatment under control of the specialist physician.6. Your chronic vaginal painful lump is the complication of the incorrect therapy till now. 7-So as suggested here, please take treatments, your problem could be controlled in 8 was time.3-I would advise-a-Good non-spicy veg bland diet, for 3 was.b-Be on high protein bland diet with buttermilk with banana shakes for 3-4 was time to tone up your disturbed-digestive system.-c-No antibiotics without doctors advise.avoid them as far as possible-d-and control the infections in private parts, as suggested, would resolve this issue.e-if need be I would advise a course of Oflox-OZ for 7 days time to clear the skin infection of the groin with local Betadine application and details sponging SOS.4-Hope this would solve your query,5-Thanks for your query to the Chat Doctor. 6-You are welcome for any further treatments if required.7-I would love to help you out of Your worry about your messed up groin infection and painful vaginal lumps. Thnks. Wellcome.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I appreciate any and all help. My daughter was born in June and all was well. She was a few weeks early and we had a few complications. Fast forward to one month and we noticed her doing a few things that we don t remember my other two girls doing. We recorded it and wrote it down. Fast forward to Thanksgiving. My daughter was almost 5 months and the whole family came down with the flu . She had a 104 fever which lasted two days and was very lethargic. During this time, I thought she had a seizure as I was holding her. The next week I took her to the dr and they said she had bronchiolitis . I was told if she developed a fever to bring her back. A week later she did and we landed right back in the dr office. Once again, we were sent home. I gave her breathing treatments and this time her fever remained 104 for 3 days. On day 3 I took her to the emergency room and we were dxed with double ear infections and given 10 days amoxicillin . On day 11 I once again returned to pediatrician and was told daughter had one ear infection remaining and was still suffering from bronchiolitis. To continue treating at home. We pursued the possibility of seizures and went to a neurologist . They wanted a full work up. So we scheduled MRI and bloodwork. At this point we had been on 15 days of antibiotic. We went for MRI and the MRI was refused due to a low pulse ox when sleeping. My daughter was running 89-92 and sent home. The MRI dr came in and listened to her, he said it sounded like she had bronchiolitis and if not better in a few days to return to the children s hospital. he also mentioned something about a heart condition that can cause fluid in the lungs. We went home and waited. Then the beginning lab results came in from her bloodwork. her WBC was 25.8 RBC 4.23 Hemoglobin 10.8 Hematocrit 32.5 MCV 77 MCH 25.5 MCHC 33.2 RDW 13.9 Platelets 467 Neutrophils 40 Lymphs 50 (atypical lymphocytes) Monocytes 10 EOS 0 Basos 0 Neutrophils (Absolute) 10.4 Lymps (absolute) 12.5 Monocytes (absolute) 2.6 EOS (absolute) 0.1 Baso (absolute) 0.1 Immature granulocytes 0 Immature grans (ABS) 0 Let me add we have seen her turning blue around her mouth as well as her extremities going blue/purple. She cannot eat a whole bottle without falling asleep and eating takes her a couple of hours. We returned to the children s hospital a few days later as she was not better and her WBC was still 24. We were dxed wtih bronchiolitis and leukocytosis and told to retest her blood in a few days. Any advice or suggestions would be greatly appreciated. My daughter ahs been sick for over 6 weeks. Is there anything concerning in these numbers our pediatrician does not seem to concerned. I was also informed her carbon dioxide level was 19%. What does this mean? ### output:

Hi, Thank you for posting your query. You have provided an excellent and detailed description of your daughters' illness. Based on the information, she is suffering from a respiratory infection, most likely a bronchiolitis, causing fever, breathing difficulty and feeding problems. She would need to continue the course of antibiotics for full recovery. Low oxygen saturation and feeding problems can be explained by this illness. Blue extremities (peripheral cyanosis) could occur if she has breathing problems and can not inhale or exhale properly. In addition, we need to exclude a cardiac problem, such as right to left shunts, as they could cause cyanosis and make a child prone to get infections. An echocardiography would help. Seizures can occur with high fever (febrile seizures) and if her MRI and EEG are normal, no anti-epileptic Chat Doctor. Best wishes,

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, Im a 26 year old male with a lot of issue down in my left testicul, lower left abdomen and occasionally, inside of my left foot aches sometimes; when my left testical and abdomen aches. History; 18 (years of age); I caught syphillis it was my first STD. at 19 I caught it again in College and was treat. at 23 I caught gonnerhea twice within the same year. I did not wait the full sevens days both time before ejection, and back to sex. Lastly, at 24 i caught Tric.. and thats when things started to change, i didnt wait the 7 days again, and started back having sex with my girlfriend not knowing if we were giving it to each other back and forth. from 23-26 i have properly either masturbating or had sex, twice a day every single day, at one point i went 8 months straight ejectulating. Then one drunken night at 25, i took one of those sex pills u can get at a store, and smoked weed and drunk Hennessy (Cognac), that day. I didnt know what i was doing, and panic, because of performances reason. After that, the aches in the left side of my testicles, and left side of my Permia ( i think thats what its called), the muscle part of your penis that you can feel tighten, when u move ur penis, push urine out faster, and ejaculate. Extreme pain in that area and left testicules started a couple months later, I also started smoking cigarettes shortly during this period, and marijuana ( all which are bad, and may have caused worsen issues). in November 2012, i went to the hospital after walking down the street and had so much pain in my left testicul that i could not walk, and cab to the hospital..(They did an ultrasound, did see anything) They said it could be hydoceles and epdytimitis,.. took some anti-botics, muscle relaxer and told to see urologist,.. went to a urologist, he did an test for hydroceles, and said it wasnt that or epdytimitis, and told me to come back if pain consisted... I seen another doctor for test work. Everything came up negative... I seldom smoked cigarettes when im stressed, and thats when i can predict the pain in my left test,abdomen, and sometimes the inside of my left foot.... My testiculs,penis, and reproductive system just hasnt been the same. My testiculs rarely tighten up to my body like they use to, even during erection, they just hang and hang. My pain continue everything other day, i almost have to live with it, but dont want to.... My health insurance in over, Im waiting now on my universal health-care to start up, to see anybody... The tip of my penis is everything sensitive, and during sex can cause very quick ejaculation.... I dont know what else to do, i dont know if its nerve damage, cancer, or something new that havent been researched. All the research i do leads to options that doctors has already ruled out... so now im confused. I apologize if its to much information; i was trying to be as thorough as possible as Im trying to get over these issues and function properly. Its difficult to work when the pain araises, it can go from 5 to 10 in mere seconds, and my testis just sagging all the time, is scary and im afraid that I am becoming impoted at 26. I need some help? ### output:

Degree understand your concerns went through your details. In most of the circumstances premature ejaculation is due to performance anxiety. With all those prior problems and stress you had, with a lot of sexual information, for you, it is very easy to have performance anxiety. You need to understand sex. Sex is not essential for living. Sex is not just your pleasure. Daily sex is stress. You should add Chat Doctor. You should get a psychological sex counseling and should alter thinking about sex. Furthermore, you will be alright. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi! My daughter is turning 19 on November. She has had unexplained bruises for the past months which usually go away after a few days or so. Her weight is low, she gets tired easily and sometimes experiences chest pains and nausea. Two weeks ago she had episodes of diarrhea and oftentimes experiences fullness in her stomach after eating even small portions only. Her CBC reveals a high lymphocytes count of .61 (Normal Values .20-.40) and a low neutrophil count of .35 (NV is .50 - .70). Her WBC differential is 5.7 (NV 4.5 - 10); RBC 4.23 (NV 4.0-6.0); Platelet- 230 (NV 150-450); HCT-124 (NV 120-170); MPV-10 (NV 7.4-10.4); MCV 89.13; Monocytes-.01 (NV .00-.07);Eosinophyls-0.03 (NV 0.00-0.05). I pray to God you can enlighten me. Please help me. Thank you very much and may the good Lord guide you always! ### output:

Hi Welcome to ChatDoctorI have gone through your query and can understand your concern for your daughters' health. Her all tests as you described are more or less normal, except lymphocytes count-61 -is high and neutrophil count - 35 - is low An increase in lymphocyte concentration is usually a sign of a viral infection (in some rare case, leukemia are found through an abnormally raised lymphocyte count in an otherwise normal person). A high lymphocyte count with a low neutrophil count is called neutropenia, might be caused by lymphoma. I, Chat Doctor. Not much time should be wasted. There are ways and means for every problem. So take action. Worry meanwhile, Take care of diet -it should be nourishing containing all essential nutrients -fiber, protein, vitamins, minerals in natural form -fruit, green leafy veges.ginger, garlic, bitter gourd and juice all anti oxidants help ill viruses and bacteria son mass basis. To keep metabolism on right path to increase the strength of immune system, take all supplements full of antioxidant serve as antibiotics. Eucalyptus naturally kills specific types of fungus, bacteria and viruses. Grapefruit seed, extract, cumin, cinnamon, oregano, rosemary, basil, nutmeg, pepper, anise, also can be used as a natural antibiotic, antiviral will naturally increase immunity. To keep metabolism on right path to increase the strength of immune system, take all supplements full of antioxidant serve as antibiotics. Coconut water, Aloe vera juice 20 ml + 2 spoons of AMLA juice twice -great antioxidants help increase immunity & kill bacteria on mass basis. Lemon juice with water twice before meals, Turmeric powder, level spoon with a cup of hot milk at bedtime. All these antioxidants maximizes natural minerals so that your body has the raw materials it needs, to do what it was designed to do. To kill bacteria on mass basis. And help increase immunity count. Physical activity in order to renew healthy cell and rebuild itself, so you should make exercise a lifelong commitment. Do 30 mins walk/ exercise - from head to toe, yoga, Panama - deep breathing, Kapalbhatti / Laughing aloud. Proper rest, meditation & positive thinking, to detoxify your system to accelerate the process of recovery. . Contipation is the mother of all illnesses so is mental stress /worry /anger The condition is REGULARITY further suggest you not to worry and take action fast. Proper medication , & Above regimen will surely gradually, help you to lead happy worry free healthy life ahead Magnets &

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Thank You for being available.. I have been suffering for about 8 weeks with what my remote healer says is a severe case of streptococcus which has struck my entire system.. My legs, feet especially very swollen and pinching, agonizing pain, cannot wear shoes as per swollen feet. I have done everything holistic, nothing really working. Cayenne pepper was recommended by my remote healer, I am also drinking organic liquid fresh rosemary which is anti-bacterial, anti fungal, and much; usually these remedies work well on many cases. Taking also kyolic garlic, echinacea, pau d arco.. Soaking in lavendar epson salts, sea salt.. Using healing beach rocks to massage.. Eveything helps a little, but this is intense, nasty and too prolonged. I am miserable with this and have never had anything like it my entire life.. The throbbing, pinching pain is unbearable.. Ankles feel like tight ruff rope around them.. The pain shows up in other areas also, like back, neck..it is all over. I do GH3 shots, pills..lipotropics.. Everything that would address excess water. Tried homeopathic apis mell 3 five times per day.. Morinda and parotid PMG Are you familiar with energetic, psychic attacks as this is what I believe it is because the physical level remedies are not curing this and I usually respond quick to healing with correct support. So I have done everything including sea water soaks at beach. Soothing and cools heat but not swelling and acute soreness. This is no joke. When it first showed up, had it few days and I cured it seemingly; then a few days later, it came back with vengence and has not left since.. Way too much suffering, incapacitates me and do not know what else to do; have tried everything.. My remote healer usually gets rid of stuff like quick but in this case he has not accomplished..may need to see him in person, but he is in Colorado, me in Calif. so not able to do that. Hardly can walk around; worsens at night, full moon and with stress.. I massage often with the rocks in the evening and morning.. If I lay them all over my lower legs, it relieves pain, heat and I see water coming out on to the rocks at times. If I keep rubbing, I can feel water slightly bottom of feet.. I rub with isopropyl alcohol and wintergreen isopropyl rubbing alcohol; helps cool, soothe but cotton pad turns black every time on clean skin. If this is not energetic attack/psychic I know it would have been gone by now with what I have done.. Apple Cider Vinegar as well. I am extremely tired from discomfort; painful to even sit here and type on this computer. Driving me nutz, have to take bath soak just to calm down but this is rediculous.. I know the person sending this negagtive energy that causes such intense physical dis-ease.. My healer removes it, I start feeling a bit better, but it comes back and intensifies as the day goes on.. SICK AND TIRED of this.. I am normally very healthy.. Ankles are really crawl pinch and sharp pointed pain shooting all over. MUST SOAK NOW.. It hits me in upper back area under the neck and into shoulder area. It is an intense burn-feeling pain as well.. and horribly in the toes and foot pad near toes. Please assist.. I must resolve this soon, as I work a lot, busy in my career and this basically put pretty much a stop to eveything..Clothing too tight due swelling, excess body weight all WATER.. ### output:

Hi, Thanks for your question. I do understand your pain and discomfort. I have seen many cases with similar complaints. As per your history is concerned your problem has many reasons, so to make a diagnosis Please find my advice below-:1)Do full blood count with differential2)Do Liver & kidney function test3)Do Fasting blood sugar & Thyroid function test & uric acid test4)Do RA/AS/ESRI hope I was able to ad Chat Doctor. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks,

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have had both knees replaced, right hip replaced, left foot reconstructed, left reverse shoulder replaced, back surgery where a cage was put in, among other surgeries. I had a MRI done last week and found my back has four disk blown and my neck has two disks blown. The surgeon said they could fuse my back but there is only a 10% chance it will help. The disk in my neck is causing headaches. They are going to do injections in it soon. My right foot is deformed and have been told I need reconstruction surgery on it also. I know the feet can affect the back and the back affects the legs. At this point I am not sure which way to turn. Although I have a high pain tolerance I know I am facing some serious pain. I do not want to live the rest of my life in a drug induced stupor from pain meds. In fact I will NOT exsist like that. Please give me some input. ### output:

Hello, Sorry to hear about the list of injuries you faced. Coming to the point, you mentioned that MRI is suggestive of Lumbar and cervical disc degenerative changes. Let's discuss this first and then the rest. What my experience taught me over a period of 12 years with cases related to injuries like you and others I will give my suggestion. First foremost, buy a soft neck collar and start using it. This will stabilize the bones of the cervical region and also will act as s support to the muscular system to allow less compression over the nerve. The disc injuries are most times self-healing, once the inflammation subsides you should not feel much pain. When using neck collar I will advise you to use on/off hot water fermentation so that the muscled which have undergone spasm will relax, and the pain will come down slowly. Along with this. You have lumbar disc degenerative changes, so why don't you first take hot water fermentation so that the muscles of the lumbar region gets relaxed and make you at least stable. Post this use 3-4 pillows and try McKenzie maneuver in passive way. The details of McKenzie you can find over the net. This will help centralize the pain and once the pain is centralized you can use hot water bag to again soothe the nerve roots. Once nerve root is relaxed the pain travelling in its course will reduce automatically. Post which after 5-7 days of doing this you can focus on exercises, but please continue the above advice as well. Exercise should focus on core stability, lower limb strengthening, upper limb strengthening and neck muscle strengthening. Slowly you will develop strength also and the inflammation on the nerve root will be reduced leading to the end result of improved lifestyle. If your pain symptoms are too high then a nerve block may be administered to the nerve root which may block the pain sensation for a couple of months. But if the muscles remain week still, it will again come back so doing the above-mentioned exercise will be of help to avoid recurrence of pain symptoms. Coming to the surgical management, there is possibility of removal of the torn disc element and also fusing the spine, but this may not make you get rid of the pain over all for long. The pain will be present throughout the life and need exercise for the same. This option I do not recommend unless and until the motor functions are compromised. Also, very important is the diet, what you eat is to be focused. Having food which can digest faster without leading to any gastritis should be kept in mind. As with gastritis there may be leading to two symptoms, one compression over the nerve in the lower spine and headache. Having a good diet plan will be good. Please do not ignore the hip and knee muscles as you have the replacement done in the past and the muscles are weak this may aggravate the spine curvature to deviate and lead to other symptoms. Coming to your ankle, I cannot comment much as the history is too brief to guide over anything. I am sorry for it. Please contact a local physical therapist who can show interest in you and give the maximum output. I have tried my best to put forth the best possible treatment plan which should help you. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had my gallbladder out four months ago. I am only 31 yrs old. I have had diarrhea since. I am now being treated for it with Colestid. I have now been in pain for two months which started as a squeezing type feeling in my chest. Right shoulder blade pain (deep inside around trigger point), spinal pain (deep), neck pain (sharp like nerves and strained muscles/pings). Pain occasionally wraps around my right ribs and around incisions. Pain in upper back is terrible. Doctors are not listening since I had an MRI which which reveled a reverse Lordis curve and a bulge at c5 c6, also some minor bone spurs in Thoracic. I have been to many doctors, Neuro who said to take Gabapitin, which I do an night, physical therapy , Ortho doctor who said that the MRI in writing was not accurate to what he saw when I brought him the images. Acupuncturist (who is also a former gallbladder and liver surgeon) thinks that the doctors need to listen to me because he thinks something is wrong that no one is looking at. I am in chronic pain and I get light headed and feel like I m being crushed and strangled (literally, I don t know any other way to describe it, it feels like I m not getting enough blood in my head), it is very prominent and makes me feel like I m going to pass out. Had heart checked at ER (said it was fine), Thyroid (normal), barium swallow (normal), stool sample was normal after treating C-diff infection following surgery w/ Flagyl. It is so bad now to start and getting worse. I feel like my back is breaking, my neck and ribs are in the wrong place, and now my lower back is hurting and shooting pain goes into my right leg and right arm. I have to say that I was (besides the gallbladder issue) normal before, five months ago. I am not being taken seriously because they cannot find anything wrong in my blood (with the exception of a Vitamin D- low- which may be because of the diarrhea or the Colestid, or both) and the MRI. I have been labeled depressed as of yesterday which is a big-cop out I feel. I am not depressed for any other reason that I am in pain each day, 24/7. I have my head together, I am a hard working student, and an overall happy person, but am concerned greatly that I have something very wrong and I have not been treated well. I am very sick (in pain) now and I need someone to help me that will listen, that is all I ask. I have only had an x-ray done of the top of my right shoulder even though I said the pain was near my shoulder blade. My lungs were fine last time they checked with chest x ray. I had two CT scans since surgery (both gave me hives on face), no stones were found. Appetite fine just lots of sever pain. Almost like my back is broken right at the spine. Have an ovarian cyst that is 3.4 cm. On birth control for the last three years. Really, I m in enough agony right now to go to the ER, but that has yielded no answers and either. Thank you so much for reading. ### output:

Hello, most of the symptoms you mentioned can be caused because of a hernia tic disc at C5-C6 level. A hernia tic disc is not a disc to its right position, but it comes out to press the nerve that comes from C5-C6 level. C5 - C6 (C6 nerve root) - Can cause weakness in the biceps (muscles in the front of the upper arms) and wrist extensor muscles. Numbness and tingling along with pain can radiate to the thumb side of the hand. This is one of the most common levels for a cervical disc herniation to occur. What doctors do in such cases is giving medicines against the pain, starting from paracetamol to codeine. This is not a final solution for such a problem cause the hernia is always there. A final solution if your pain can not be controlled is the final remove of the hernia tic his, a little surgery. You should check out this with a euro surgeries

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I WILL TELL YOU THE PROBLEM HAPPENED WITH MY FATHER, HE ALREADY HAVE A STUNT IN HEART AND IN THE MONTH OF JAN 14 HE FACED THE PROBLEM AS HE CANT BREATH PROPERLY AND WE RUSH TO THE HOSPITAL WHERE THEY TOLD THAT DUE TO HIGH BP AND HEART WENT INTO FAILURE AND THE WATER WENT INTO KIDNEY SO THAT WE FIND OUT THE WAY HOW THEY PASS THE URINE AND IF HE PASSED THE URINE THEN HE WILL BE OKAY AND THEN HE IS OK WITH IN TWO DAYS AND THE SAME PROBLEM WAS HAPPEN IN THE MONTH OF MAY AND THIS TIME WE ARE REACHING LATE IN HOSPITAL AND DOCTOR TOLD THAT THEY HAVE 80 PERCENT CARBONDIOXIDE SO THEY PUT HIM ON VENTILATOR AND THE SAME THING WHEN HE PASSED THE URINE HE IS OK AND WE DISCHARGED FROM HOSPITAL WITH IN THREE DAYS AND OUR DOCTOR SAID NOW HIS HEART IS 22 PERCENT WORKING AND WHEN THEY DONE ECHO IT SHOWS 35 TO 40 PERCENT AND WHEN HE FACE THE PROBLEM AT THAT TIME HIS HEART IS 22 PERCENT. AND NOW THE DOCTOR HAS GIVEN THE LASIK MEDICINE FOR URINE AND TOLD IF HE FEEL THE URINE WILL NOT COME PROPERLY AND HE SHOULD BE INJECTED WITH LASIK INJECTION AND RUSH TO THE HOSPITAL AND ALL OUR FAMILY MEMBERS ARE CONFUSED IT IS VERY DIFFICULT FOR HIM TO MOVE ANYWHERE OUT OF THE CITY ALONE, SO PLEASE SUGGEST US ANY OTHER WAY OR NEW TECHNIQUE WITH WHICH HIS HEART IS WORKING MORE THAN 22 PECENT.HIS AGE IS 71 YEARS. ### output:

Hi, Whenever there is increased workload on heart with low pumping capacity, pumping further decreases and heart cannot pump adequate blood out of its left lower (left ventricle) chamber and there is back pressure on left upper chamber (left atrium), lungs, and right side chambers of heart. Which causes breathing difficulty (due to pulmonary edema- fluid collection in lungs) and there is impaired gas (oxygen and carbon dioxide) exchange in lung and there is retention of carbon dioxide in blood. So main treatment of in such person is 1) To prevent further decrease in heart pumping - prevent further heart attack. 2) To prevent workload on heart. Avoid undue exertion, short term illnesses. So it is advisable 1) Restrict daily water intake to 1 liter. 2) Use of diuretics like Las ix which help in removing extra water from blood and keeps lungs free of water. 3) Continue blood thinning medicines that helps in prevention of future heart attack. 4) use of Medicine like Beta blocker, ACE inhibitors or Arms that help in maintaining the pumping capacity of heart. 5) Regular check of blood pressure and keep it under control. 6) Regular check for lipid level and keep it under control using statins. 7) Diabetes control if present with medicines that can be used with low pumping capacity of heart, insulin is preferred. 8) Avoid smoking, alcohol. 9) Vaccination with pneumonia and flue vaccination that prevent frequent respiratory infections. 10) Avoid undue exertion. 11) Revascularization of heart blood vessels which are at risk (this can be known from coronary angiography report) this help in preventing heart attacks. I think this is enough information. If you find it helpful then please do vote.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Date 07/07/2011 Patient Id 0000 Emp. No. Report Date 07/07/2011 17:16 Name Mst. MALAY NEGI Age 8 Yrs Sex Ref. By Dr. C G H S Company CGHS CASH Test Name Value Unit Biological Ref Interval HAEMATOLOGY HAEMOGLOBIN (Hb) 11.8 g/dL 11.0 15.5 TOTAL LEUCOCYTE COUNT 6800 /cumm 5000 13000 DIFFERENTIAL LEUCOCYTE COUNT NEUTROPHIL 62 * % 40 60 LYMPHOCYTE 37 % 25 45 EOSINOPHIL 01 % 01 06 PERIPHERAL BLOOD PICTURE RED blood cells exhibit mild anisopoikilocytosis with occasional leptocytes & microcytes in picture. Hypochromasia observed with occasional pencil shaped cells. No codocytes or basophilic stippling seen. WHITE blood cells show no significant abnormality PLATELETS are adequate NO immature cells or hemoparasite seen. COMMENTS : MICROCYTIC HYPOCHROMIC ANEMIA . BIOCHEMISTRY SERUM UREA 105 * mg/dl 0 50 Tech:Urease/Cobas311 SERUM CREATININE 3.4 * mg/dl Tech: Jaffe/Cobas311 SERUM SODIUM 130 * mmol/L Tech:DISE/Vitros SERUM POTASSIUM 3.8 mmol/L Tech:DISE/Vitros SERUM CALCIUM 9.6 mg/dl Tech:OCPC/Cobas311 SERUM INORGANIC PHOSPHORUS 5.5 * mg/dl Tech:Molydate/Cobas311 SERUM ALBUMIN 3.5 * gm/dl Tech:BCG/Cobas 311 Sample Booking Time 13:10:29 TEST REPORT 07/07/2011 17:16 Name Mst. MALAY NEGI Age 8 Yrs Sex CLINICAL PATHOLOGY URINALYSIS URE PHYSICAL EXAMINATION COLOUR WATERY CLEAR VOLUME 35 mL URE CHEMICAL EXAMINATION SPECIFIC GRAVITY 1010 PH 6.0 NITRITE NEGATIVE PROTEIN ++ GLUCOSE NEGATIVE KETONE NEGATIVE UROBILINOGEN NEGATIVE BILIRUBIN NEGATIVE URE MICROSCOPY EXAMINATION PUS CELLS NIL /HPF EPITHELIAL CELLS NIL /HPF RBCs NIL /HPF CASTS NIL CRYSTALS NIL OTHERS NIL My child is suffering from Hydronephrosis since last year and his left kidney functioning 72% and right kidney 22 % by DMSA scan on August 2010 report. ### output:

Hello, I have seen your child reports. The CBC is almost normal. Kidney function test suggestive of deranged kidney function and urine report suggestive of protein loss. As you already told about DMS scan function that was low. These all report suggest kidney disease. In this age, you have to investigate for etiology. Do ANA, Bag, CV, HIV. After then C3 level. Then go for kidney biopsy. Once cause is found then treat according to that. Meanwhile you have to watch for Urine output, Oral intake, swelling of body, serum potassium level and increasing pattern of urea and creatinine. If anything go wrong and patient became breathless or swelled then go for dialysis. Thank you

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Sir, I m a 19 yr old male. I have a question. I wish you could help me out please. From the last 1.5 months I had itching and redness on the glans and in the below end of glans. I m uncircumcised . And I masturbate almost twice everyday. My doctor gave me prulifoxacin 600mg for 5 days after which my redness and itching went away. I reckon it was Urinary Tract Infection. Later when the meds finished i masturbated, although the itch and redness were gone, the itch is sligthtly present like 5% of the whole. And Please note it only happens after masturbation rest of the time , its fine and it all disappears while the itch after masturbation is only for like 15 mins with a very very slight sensation of prick inside the penis and on the left side of the glans and some engorged red veins just for sometimes after masturbation and then its gone. I ve never had sexual relations yet but yes i admit i have alot alot alot of sexual thoughts across the day and that i stay erect numerous times in a day. The doc was unwilling to provide me any meds cuz i ve met two docs in the past and they said that i ve got mental stress and need psychiatrist. It s true a bit that i ve never been to school since 7th grade which i left challenging the principal and since then i ve completed and excelled in everything from school students and infact have defeated many teachers as well in knowledge despite of learning on my own at home. I ve immense and very hyper (above normal) enthusiasm in biology and especially in Microbiology. It may have been my half knowledge thats causing stress as i ve been stayin very afraid towards diseases but its certainly not OCD and due to recent outbreak of ebola even though there hasnt been a single case of it In India but im staying too precautious . I excercise everyday with dumbells and pushups . I listen music and don t like eating sweet much especially in the morning or as meal. Hence i cut tea from my daily schedule and only drink milk without sugar . I only like spicy hot, bitter and sour but sweet at its least. Recently i ve had abdominal pain below the left side of the ribcage (not the rear side) for six months which had gone for months but came back since yesterday and indigestion for 1.5 months which both the doctor say that s because of my overthinking. And yes last month i did a CBC in which everything was normal except. haemoglobin which was 0.5% less than normal but the docs said its not even a 1% matter of concern and infact i can donate blood with those levels and also my ultrasound i.e sonography (abdomen) reports were completely normal. I m just scared although i know its nothing serious since i never have had sex. I just wish to know whats the problem with my glans (balans) and why the itch . Does UTI take time to heal after 10 days of finishing medicines? Or is it due to excessive masturbation (although i paused for 2 days but of no avail) and its weird but i ve been masturbating since the age of 5 (although no ejaculations till puberty) but it hasnt every happened before or is it due to overthinking as the docs said? I thank u very very much sir ### output:

HelloThanks for query Based on the facts that you have posted you seem to be intelligent guy but unfortunately wasting your knowledge and time which are of the least importance in day to day life. The itching and redness over glans that you get after masturbation is mostly due to infection of glans penis due to contamination (Atlantis). You need to take broad spectrum antibiotic like Definite along with anti-inflammatory Chat Doctor. Along with topical antibiotic ointment like Newsprint twice daily. Most of your problems are due to anxiety. It is better you consult qualified Psychiatrist for counselling. Reduce frequency of masturbation by keeping yourself busy in activities like sports, reading, social work etc. so that you will not get free time to masturbate.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am having excruciating pain in my lower back. I dont believe it is a result of lifting or moving incorrectly. I cant recall anything Ive done to cause it. The pain is very similar to muscle spasams I had 10+ years ago except that back then the pain came and went on its own. Now it seems to occurr when i move in a certain way, like it was caused from an inujury. It started several weeks ago in my left scapula and corresponding back area of my rib cage. However, now those pains are mostly gone. It has move to my lower back. I went to my GP doctor a week ago thinking it might be a kidney stone but he xrayed me and said he didnt think it was a kidney stone. He gave me a muscle relaxer, but i only tried it once knowong it makes me very drowsy and really didnt do much to relieve the pain. I believe its a muscle spasam and am trying to find something to relieve the pain. ### output:

Hi welcome to Chat Doctor I have one through your query regarding pain in lower back. Though, It is a matter of concern, still Low back pain is a universal human experience -- almost everyone has it at some point. The lower back, which starts below the rib cage, is called the lumbar region. Pain here can be intense and is one of the top causes of missed work. Fortunately, low back pain often gets better on its own. When it doesn't, there are effective treatments. Factors causing back pain are sedentary lifestyle. A majority of back, neck, and other muscle pains are related to imbalanced distribution of force throughout your body, which is created by working or staying in unnatural positions for extended periods. Prolonged sitting and poor posture are major risk factors of not only back pain, but also of weight gain, obesity, joint problems, nerve problems like carpal tunnel syn Chat Doctor. . In fact, Your body is always fighting something -- an infection, a toxin, an allergen, a food or the stress response -- and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin, your kidneys or sometimes your whole body. Your immune system is your defense against invaders. But when the immune system becomes weak, the disease cells can grow out of control, the disease overpowers. Here you have to work to strengthen your immune system by following a certain regimen by regular exercise and Balanced diet containing essential nutrients, Your total health depends on what we eat, when we eat and how we eat. So Take FIBER RICH, LOW SALT - LOW FAT DIET, fruit, green veges ginger, garlic to balance Air factor-- Vāyu Dosh -- in our body, vitamins and minerals in natural form -, coconut water,, nuts, almonds, and supplements full of antioxidants as Aloe vera juice + AMLA juice 2 spoons, Lemon juice with water and a pinch of salt and black pepper .fish oil and flax seeds for Omega-3 and Turmeric powder + Almond oil is very important for our sound mental and physical health and strengthen immune response naturally Avoid fried fast foods, sugar, tea, coffee, alcohol, smoking, stress, worry, anger, Constipation Proper regular walk, - back bending postures, Don't ever bend in front, Adopt For proper blood circulation. Exercise, yoga, Kapalbhatti Panama -deep breathing, Anglo Film, Calamari are help full for soothing nerves & relieving your stress inducing sleep and eliminating toxins from our body and help the natural hormones work, Meditation also helps sooth the mind helps in detoxifying and strengthening the immune system to enhance resistance from diseases and pave way for healthy disease free life. Apply hot pack on effected part to alleviate pains. Massage with sesame oil also helps in relieving pain. Take Homeopathic Ruth 30 / Thrice a day / Take 4 hourly / for 3 days. Can repeat if required. Hope this helps solves your query. Take care. All the Westmont hesitate to come with further query if you have any.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello,I am interested mainly about my Testosterone level. I consider it wrong for my problems. I am 28 years old ( 180 cm - 74 kg ).Symptoms: I am changing my mood very often without special reason,anxiety,also i dont have muscles ( and almost impossible to gain),my strength is also pretty low,i have too many fat around my stomach,also sexual wish is low. In general i look as teenager..not as men about 28 y.old.. .sensitive...Down in Medical Background i will write you results of blood testing.I want to say that tests are made in 8 am... My endocrinologist said that results are fine, but i dont agree with her...especially about my testosterone which i consider as pretty low for my age,also SHBG ..... I would like to ask you for your advice...TSH (mIU/L) - 2.536(0.470-4.640)SE - 2 (2-13)LKC (G/L) - 6.1 ( 3.4-9.7)Hgb (g/L) - 164 (138-175)TRC (G/L) - 268 (158-424)Glucose (mmol/L) - 3.9 (4.2 - 6.0)Kreatinin (umol/L) - 89 ( 79 - 125)Urat (umol/L) - 577 (182 - 403)Kolesterol (mmol/L) - 3.6 ( recommendation Trigleiceridi (mmol/L) - 0.6 ( recommendation ACTH (pg/ml) - 41.3 (7.2 - 63.3)FSH (miU/mL) - 2.27 (1.5 - 12.4)LH (miU/ml) - 4.27 (1.7 - 8.6)Prolaktin (ng/mL) - 7.67 (4.04 - 15.2) Kortizol u serumu u 8 am (nmol/L) - 490.4 (115.9 - 1059.8)Kortizol u serumu u 16h (nmol/L) - 296.3 ( 46.9 - 458.2)Kortizol u 24h urinu (nmol/dU) - 506 (59 - 413)E2-Estradiol (pg/ml) - 26.6 ( Testosteron total (nmol/L) - 12.5 ( 10 - 28)Testosteron free (pmol/L) - 466 (174 - 729)Part of free testosterona - 3.7 % (1.0 - 2.7)SHBG (nmol/L) - 16 (15 - 100)Best Regards ### output:

Hello, There are a varied list of causes of the symptoms u mentioned. But what is more annoying to you?You’re non muscle gain as u said can be due to nutritional or organic causes. But your weight for height is OK, so cant be nutritional but can be absorption defects due to varied causes or any organic causes which requires thorough examination. Regd. Anxiety it can be hyperthyroidism, but we require other symptoms which is not given here. But TSH being normal can be unlikely.others causes leading to it must be ruled out. Regd. Low sexual desire, are u on any other Chat Doctor. But looking from far away, I opine that the case is non-organic. Instead of brooding over getting diagnosed, kindly do yoga for 3-4 hour daily or running 4-6 km daily, endorphins and corticosteroid s will be released which causes reversal of all your symptoms and increases your sexual appetite, I am sure that u will reply positively after 1 month by following the precious advice.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, I am from Canada and suffer chronic pain and fibromyalgia for 25 years. I am on methadone as one treatment and it has been recently altered here. Methadose solution for pain 10mg/ml Methadone HCI 10 mg/ml. Dose, drink 1.5ml four times daily. I can not take this as I said it has been changed. Now the government has made it sugar based cherry flavored, gag reflux crap. I have tried to wean my self off but have experienced anger, smashing plates, cried out for doctor assisted suicide as the pain and withdrawal of this drug is making me crazy. I am on subcutaneous lidocaine infusions weekly, nerve blocks in neck and shoulders, cortisone injections in both hips for bursitis and nerve blocks in lower back, L4,L5. I suffer with herniated, degenerative discs, c5,c6 too. I have osteoporosis, parathesia, IBS, awaiting surgery for bladder prolapse, endometriosis which required hysterectomy and oophorectomy and numerous laporoscopies leaving me with adhesions which are a constant cause of further pain. I am a chronic pain disease sufferer and to the world I look great...haha! I initially started to write to you only for advise on taking myself off methadone but here I went on and on. The list is long and I see many doctors and pain specialists however my quality of life is nil and I am only 55 years young. I can not seem to find answers, help or hope other than being prescribed opiates, methadone which has been changed to suit the government not the patients needs and numerous medications that make me worse. I am on a roller coaster of hell and pain and now I am withdrawing off this horrible new recipe of methadone as I throw up trying to take it. Why change something that was easy to take to this horrible sugar based cherry cough medicine taste that burns to the pit of my stomach whereby I need gravol settle? I am frustrated, in pain and have talked to nurse on line tonight...she told me to go to the hospital...LOL! Right! I can not live in this pain...my doctor retired, great guy...now I have a woman who has nine kids and never can catch up or give a you know what about her patients. I give up! This is only the tip of the ice berg...you have now idea many health issues I have! I have to leave my city to go for help to Vancouver, thank God for HOPE AIR! They took me to the last appointment with my Neurosurgeon and he has ordered another MRI, will be seeing me after or before if I can not take the pain! I am a mess...What happened to good doctors??? How did we get FIBROMYALGIA??? I have a clue...DDT spraying all over the playground I grew up in...playground was a gas line and electric power field...what do you think of that? Five out of six women who played there as children were not able to conceive!!! Gee, I wonder! I am on a quest to find answers and thought perhaps I would start here...I doubt I will get an answer though...Great! Off to cyber space this goes...I am from Canada and You are in the States! Nice! I was on a Canadian site...how all of a sudden does it go here and now I need to pay! Well, thanks for nothing....I will proceed elsewhere because I will find an answer and from you...obviously not! ### output:

Hello, While you do not necessarily need to pay here as there is a public forum section (only premium section requires payment) as you seem to have realized yourself it is difficult to provide help in your case. That is not only because the site is registered in the US (there are doctors from all over the world here, maybe Canada as well, you may go through the doctors list), but mainly because we can't prescribe medication online, goes against the sites' policy. It is a sensible rule in particular with medications acting on the nervous system which are a delicate issue. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been taking Lisinopril/HCTZ for about six years. I was initially prescribed 40 mg/day, but about three years ago the dosage was changed to 20 mg/day. It seemed to be working well, until Tuesday, January 21st, about 2:00 PM, I noticed tiggling in both my hands after taking a shower. The tingling turned into viscous red itching hives on my hands that traveled up my forarms to my elbows. The next morning I went to the ER, where they told me that it was probably a reaction to penicillian that I was given for a throat infection. I have taken penicillin before in the past, (I m a 48 year old African American female), and was suprised to hear that after having taken the medication for about nine days, I would develop an allergic reaction. I threw the last two remaining doses of penicillin away, took the prednisone medication and benydril capsules given to me and went to bed. The next morning, I noticed that my hands had swollen up painfully. The hives I had previously on my forarms had gone away, but new more numerous smaller hives were there. I also had numerous hives on my lower torso, and thighs, some small about a quarter of an inch in diameter, some huge, almost five inches in diameter! My lower legs, feet, upper torso and face were completely unaffected. I took more benedyl and my second dose of prednisone and went to bed. Today I woke up with a swollen lip, dizziness, difficulty breathing, and even more vicious, numerous hives on my forearms, lower torso, and thighs. The benedryl capsules were useless and the predisone was not working. I went back to the ER where the doctor gave me benedryl intraveneously, and a stronger 6 day regime of predisone, and blamed this time the Lisinopril that I have been taking. My question is this. Why on earth would I have such severe hives and swelling now after being symptom free with Lisinopril for six years. Also, I wanted to add that I had been using a new body soap for about two weeks without any adverse reactions, and I had bought a new laundry detergent that I used for about a month without any previous adverse reactions. I have been going over my movements for the past week and can come up with absolutely no changes in eating, bathing, hygiene practices, etc. that would begin to address such a strong acute reaction. Your comments please... Sincerely, Ann Coney Denver Colorado ### output:

Hi. Thanks for posting your concern at ChatDoctorI would keep a possibility of Acquired Angioedema due to ACE Inhibitor (Lisinopril) and Urticaria. Angioedema due to ACE Inhibitors is usually not associated with urticariaAngioedema or Quinces edema is the rapid swelling of the dermis, subcutaneous tissue, mucosa and submucosal tissues. ACE inhibitors are one of the common cause of Angioedema. You have been on lisinopril which is an ACE inhibitor!! Though ACE Inhibitor induced Angioedema is noticed at the beginning of therapy, but sometimes it can happen later on. Urticaria OR hives can occur due to various causes like(to name a few):-Infections(bacterial, viral, fungal)- Chat Doctor. -Cholinergic Urticaria: in response to strong emotions, exercise, spicy food etc-Autoimmune disorders like SHE, RA etc.-A few cases have no underlying cause and are known as idiopathic urticaria. I would advise you to get few basic lab tests like Hologram, stool for ova/cyst, Urine routine, Chest X-ray. An oral antihistamine like Fexofenadine OR Loratadine once or twice daily for a week would be suitable. They are non-sedating and won't affect your alertness level. A topical soothing lotion like calamine would help you symptomatically. Take care regards

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: What mental disorder do I have? I m really depressed so it s hard for me to type. I ve just had to re write this so I m very angry, but i ll just put symptoms. Symptoms Used to hear voices (first of my guardian angel and then from god- lasted from January- till Christmas day 2012- only very rarely talk to him agin) - Have many beliefs (voices explained to me about the universe and how he created it from experiments on planets in the solar systems he had made then he let it all die out so that he could use all that power to create a world big enough to plant and create a cycle of many creations and many other stories) - laugh at innopropiate things- laugh at sad things or serious things (that inside i know is not funny, but I can t help it) such as people crying, people shouting or being shouted at, people saying there loved one had died or something sad had happened to them. Don t laugh at funny things, like people laughing so badly at a joke, that I don t think is funny, and I m the only one who doesn t get the joke and I look miserable. - sleeping patterns- cant get to sleep until at least 3am and don t get up until at least 11am. - scared of people- walking past people or seeing people that aren t my sister, my mother, sometimes my father or me makes me disturbed, petrified, paranoid and a panic attack feeling. - staying in bed all the time- always in my bed away from everyone either sleeping, hiding under bed sheets or planning a new life (obsessed with it even though it s not something I like). - obsession with certain numbers- obsession with numbers 2 and 5, always using them for things like, I will have 2 sips and 5 gulps, I will get out the cold shower in 2 minutes and 5 seconds then 5 minutes and 2 seconds. -Talking- I hadly answer people when they speak to me and I never seem like I m listening. - referred to as rude- although I see my self as being polite - don t have any ambitions in life, and just think about death -too scared to go out in public - dont care about anything (I mean anything except for my dad, sister and mother and pets) - crying- always cry when pet usually does but when my last pet died on my birthday I seemed ok about it. -uncomfortable with speaking to people - swearing- I ve never swore, but recently Ive been swearing with words that I would never dare say. - sex- got obsessed with sexual activity, such as wanting to have sex, imagine having sex, and planning my dream life as being raped (even though I would never dare to be raped) -hallucinations or dream- woke up at night seeing blue dots on the ceiling and hearing a Disney film being played although cannot see, then I m being strangled and cannot scream that I can feel- did not wake up from this- same side I was on- same darkness from outside and all just disapeared over time with a pain still in my neck- I believe it was a hallucination. Hugs- uncomfortable with being hugged Delusions- believe that talking or seeing someone that they will call me a lier, criticise me and spy on me all the time- feel as if someone is watching me and more. Thoughts- suicidal and depressive, unhappy, sick feeling thoughts. I just want to know if I have a disorder or not, because something is not right, I already treated for being depressed and there are a lot more symptoms but that s enough I think. ### output:

Hello Lalalalala2222255Welcome to Chat Doctor You have mentioned all of your symptomatology in detail and in elaborative manner. The symptoms you are having like-- Hallucinations (hearing voices of angels, talking to you about supernatural ideas)- Social With Chat Doctor. Also, you are having obsessions for number 5,2, sexual obsessions these may be secondary to the schizophrenia as in about 35% of patients of schizophrenia, Obsessions and compulsions are also seen. Kindly visit a good psychiatrist and take opinion ASAPThanks Take Care

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: please let me know whether it s confirmed pregnancy or missed my careles had beend ib auto hello doctor ,am priya 34yrold, & got married in Nov19th 2010, got ma 1st period on 23rd nov 10 2nd period on jan 26th 11 ,3rd 5thmar 11, 4th april 11,& 5th on may 5th 11 and 6th on may 23rd 11 and doctor suggested me to take carnisure500mg for 20dys .... will it harm in getting pregnant doctor had prescribd 1st with fertly super100mg ,clomid progestrone , levtol 2.5mg& now carnisure ....and my husband is taking tablets for depression as follows Parkin ,Azur , Stalopam, Telma-H, Amlip-5, Matilda,Glizard... and my hubby done semen analysis was Nrmal ... and 2day had gone for pregtest it appear 2lines should i await until 23rd /24thjune to confirm whether m pregnant..... had consulted a doctor and she had prescribed me again with Miprogen , Fol123 , ulgelsyrup ,&nosic tablets... m worried whether m really got conceivd or not .... one of my friend told Miprogen shouldnot be taken .... is it true please let me know as soon as possible had already taken 3tablets... m quite worried about my pregnancy... had been continued with tabletsregularly but on july 2nd 11 got little bleeding in evening and doctor suggested me to take scan immidately done pelvis scanwas performed as follows--UTERUS; Anteverted, measures9.2 x4.3x6..0cms. endometrium is uniform.Endometrial thicknesss measures 8mm. OVARIES:normal in size ,shape & eechotexture. right ovary measure2.5 x1.8cms. leftvovary 3.5x 1.4cms ... IMPRESSION:No Identifiable gestational sac . sugested 2 follow up after 2weeks.. TRANSVAGINAL SCAN WAS PERFORMED: Uterus is anteverted, normal in size & morphology. Endometerialcavity is closed. No gestational sac or foetal pole noted.Fluid is noted lowervendocervical canal & cervical canal . this may represent ongoing bexplusion of products of conception. 2 be correlated with ChatDoctor levels. both ovaries are well visualised & more normal.... ChatDoctor (Beta subunit):serum ChatDoctor (Eclia) specimen-serum -896.3 mIU/ml male & nonpregnantfemale: 100000 pregnant female post LMP Range 4wk 5-100 5wk 200-3000 6wk 10000-80000 7-14wk 90000-500000 15-26wk 5000-80000 27-40wk 3000-15000 yet didnoted consulted particular doctor but other doctor told me 2 await for another week 2 go & confirm ..... and worried about ma prgnany can please want to know what s my stage .... some pple are telling its excess of heat .... please reply 2 ma question ### output:

Hi welcome to Chat Doctor The above USG of pelvis clearly states that the pelvic organs are normal and there is no abnormality seen... The bleeding which you had on 2nd June, need to be known whether it's a single episode and little quantity or large amount... if its large amount, then chances of pregnancy is less. If it's small in quality, then you need to get urine pregnancy test done to rule out the pregnancy... Do not worry, since there is no problem with your reports, you will get conceived soon...hope I have answered your question Take Care

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Diagnosed with Fibromyalgia 20 yrs ago. Long history of migraines, back and neck pain. Physio, traction, neck crunching in past. 63 yrs female. Take half 25 mg Endep, Imigran and Panadol Osteo. Slow loss of fine motor skills in right hand affecting writing. Hand seizes after 3 letters. FM pain worsened by physical activity (when aching), stress, especially weather changes. Presently have neck pain worsened by tilting head back. Pain worsened by laying on neck in bed at night. At times find that Imigran (Sumatriptan) eases neck pain - does this indicate blood vessel entrapment as action of Imigran seems to ease pain in neck at times, when other medication doesn t do anything. Work in school, which requires twisting, turning etc. Cold winter at present in Adelaide, South Aust which exacerbates pain, although I find repeatedly that my best health and least pain occurs in Autumn every year. Get light-headed and dizzy at times. Fell off a low platform onto knees and fainted 2 years ago + excruciating calf pain at night - got up screaming and fainted. Ultrasound revealed clot, suggested Warfarin immediately. I didn t take, sought further advice, saw Vascular Surg, more bloods taken, then just aspirin at night. Took for a while, but not now - bad press recently. Do not have regular gp. See when need scripts. Medical clinic situation rather than family gp. FM mainly self-management. Was secretary of Arthritis Foundation support group initially and learnt a lot about FM but haven t kept up with latest for a while now. Just push on, but neck pain is very restrictive and has been constant for a month now, with just occasional relief - probably due to pills rather than abating of problem. Don t know whether to ignore and hope it gets better, or get some massage, or go down gp line and seek specialist assessment. Am not one who rushes to doctor as over time fm patients usually learn to not expect any answers for pain. Think I ve got to a point of head in the sand self treatment now. Seem to be conflicting attitudes to value of MRI as a friend had for neck probs. I keep looking at barometer hoping it s the reason for pain - perhaps foolish, but when people have conditions for which there is no magic answer or treatment or reasons one becomes complacent I guess. Just wondering whether I should be seeking some answers to this neck problem as it s starting to concern me re: pain and constrictions. Have irregular heart rhythms also which were considered by Cardio to have contributed to faints and dizziness. Still trying to work in a primary school setting but becoming difficult, although it does force activity and movement. Cope with back pain but this neck pain is a bit more concerning when any slight backwards tilt causes compression and more pain flare-up. Daughter aged 38 yrs also has had pain in arms and legs, with hand tingling and heavy aching for many years. No-one has ever really investigated this or given any reasons to her. She had dysgerminoma ovarian cancer with ovary removed at just 13 yrs. 12 mths later another laparotomy to remove other ovary. Turned out to be a haemorrhage of ovary, so it was left. Due to abdominal surgery, she got lypodaemia. Probably more related reason is surgery re: arm pain, but thought I d mention also. Basically, how much should one be concerned re: neck pain?? Thankyou so much. HW. ### output:

Hi.u should be concerned as it was making u daily routine difficult .account to your given history i migraine fibromyalgia I'm Ina out that u may be suffering from cervical spondylosis why don't u try an app and lateral radiograph of c spine which role outs any abnormality or canal stenosis.u should continue your migraine prophylaxis under the supervision of your physical as it ha many aggravating factors in your case.the same applies tour daughter also to have a radiograph done and take to your radiologist and ask h8m whether to have any further radiological investigation.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Have little like bumps which I assume are varicose veins on my scrotum amd today on eof them broke oen like a pimple and bleed profusely. I called my family dr. and he told me to apply pressure to it for 10 mins it did stop bleediig which was brigth red blood. I asked about following up on it and he just said watch it-lol. I have a few of ths on my scrotum but none have ever bleed. Is this the normal process. I am overweidgt but not extreme nad have a rather lg scrotum . Can I excpet more of these to burts? ### output:

Hi, Dear,Thanks for your query to Chat Doctor. Dear I read facts of your query and reviewed it in context to your health issues submitted in your query. I understood your health concerns and feel Concerned about them. Based on the facts of your query the reply of your query is-Your current health issues seem to be due to -Long Standing and Advanced Varicose Veins of the Scrotum-which was not noticed / or was not cared unknowingly. This needs to be verified with other causes of large Scrotum-which could be due to accompanied- Inguino-scrotal hernia/ or accompanied Filial Scrotal enlargement. The Cause of this in your case needs to be investigated. Other causes need to be verified, as discussed above. For this you need to consult Surgeon and Urologist from Surgical Department. Remedy-Dos in your case-Check With Doctor-Rest-for few days-4-5 days-with head low would help you to strengthen the Varicose rupture site and would avoid recurrence in time to come.you need to Urgently plan Micro-Vascular Surgery for correcting the varicose veins in Varicocele which many need ELVT-endoscopic laser ablation of the engorged communicating vessels and Foam chemotherapy to reduce the engorged mass, as your case is advanced Varicocele. Bleeding from the Scrotal Varicose Veins - is not a normal process, and indicates long-standing Varicose veins with thinned out skin over it, with minimal trauma causing bleeding -as happened in your caseReduce on obesity by strict dieting plans from nutritionist and family GP. Check Testosterone / LH/ FSH and thyroid and blood sugar levels, which could be low due to long-standing Varicose Veins of the Scrotum-Varicocele and fix if diabetes/hypothyroidism is the cause of obesity in your case. Get physical check with Urologist who do USG and Color Doppler studies to assess the severity of Varicocele / with accompanied testes atrophy -if it's there. There are many causes which need to be verified amongst the causes discussed above before planning specific surgical remedy in your case. High protein low Calories/low fat / high fiber diet to built up body muscle mass and loose obesity. Proper Gaming and walking exercises would help you a lot but under guidance of Physician-as to avoid more ruptures due to uncontrolled exercises, due to increased abdominal and venous pressure. Vit B12 and Folic Acid- to stabilize aid BMR rise and reduction of obesity.Thus, You should consult Urologist and Physician. This would resolve the complaints of yours. Constant follow-up with local family or specialist Urologist and Physician for long term would give you long remissions of such pains in time to come, which would depend on meticulous follow-up treatment of your health concerns. Just don't worry and be patient and co-operate with your doctors, till you verify with your attending doctors. For early recovery-please follow above dos which would resolve your complex health issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard to following link-http://doctor.Chat Doctor .com/Funnel?page=askDoctorDirectly&docId=70229Wishing Good Healthy Life!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Doctor, Here is what is going on supposedly with my Liver / Gall bladder. Question: What do you think of the medications prescribed and should I be worried about having a fatty Liver ? Is it Genetic? If not what causes it? Thank you The ultrasonography report says that the liver is normal in shape, size and has increased echo pattern. No evidence of focal lesion or intrahepatic binary ducal dilatation. Hepatic and portal vein radicals are normal. Gall bladder, pancreas, spleen, kidneys and urinary bladder are normal in size,shape echo pattern and thickness . prostate is normal shape size and echo pattern normal. Impression : Increased hepatic echo pattern suggestive of fatty infiltration. The latest blood reports say that.... Serum GET (GCNA-IFCC) is 49.00 IU/ml. (Normal range is 15.00 - 85.00) Serum Lipid profile. Total cholesterol (CHOD/POD) is 161 mg/dl. (Normal is less than 200.00) Triglycerides (GPO/POD) is 154.00 mg/dl. (Normal is less than 150) HDL cholesterol (Direct) is 36mg/dl. Normal range is 30.00 to 60.00) VLDL Cholesterol (calculated) is 30.80 mg/dl. Normal range is 10.00 to 40.00) LDL Cholesterol is 94.20 mg/dl. Normal range is below 100. T. chol/HDL cholesterol ratio is 4.47 (normal range is 0.00-6.00) LDL Chol/HDL Chol ratio is 2.6 (Normal range is 0.0-4.0) Serum liver function test report. Bilirubin total (mod. J Groff) is 2.30 mg/dl (normal 0.10-1.20) Bilirubin direct (mod. J Groff) is 0.30 mg/dl .Normal is 0.00 -0.40) SGOT/AST (P5P, IFCC) is 15 IU/ml. (Normal is 15.00 to 37) SGPT/ALT (P5P, IFCC) IS 46 IU/ml. Normal is 10.00--50.00) ALP (p-NPP, Kinetic) is 82 IU/ml. Normal is 53.00--128.00 Total protein (mod Biuret) is 7.40g/dl. Normal is 6.00--8.20) Serum albumin ( BCG-dye) is 4.70g/dl. Normal 3.50--5.20 Serum globulin is 2.70g/dl. Normal is 1.80--3.40 ALB/GLOB (A/G) ratio is 1.74g/dl Normal is 1.10---1.80 Right now the gastroenterologist has recommended the following medicines. Heptathlon 400 mg one tablet in the morning and one night. Udiliv 300mg thrice a day. .Morning, afternoon and night. Sylimarin 140 mg twice a day ...One morning and one night. ### output:

Hi thanks for contacting Chat Doctor. Noted you have fatty liver... It is not genetic condition. In fatty liver fat is getting accumulated in hepatocytes... So also called stenosis. Causes are as below....... Hyper cholesterolDiabetisAlcohol Chemical and Chat Doctor. . Your triglyceride slight high... Main mode of treatment is to cut off oil in diet. Use less oil in cooking.... Use good oil like sunflower oil.... Avoid alcoholFruits more. Avoid trans fat foods like meat and junk foo

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Many years of unexplained health problems and way to many symptoms to put together when it went on that long undiagnosed. I am a waitress by trade and gave it up a few years back because I was so weak and the headaches were that severe. I never fully understood how my health seemed to have improved the past few years some because now I tend bar and work in second hand smoke . I have had some down time but not like in the past. The past several months I have learned on my own not by a doctor that I severly reacted to anchovie paste that was used in a recipe made by a friend. I have eaten ceasar salad for as long as I can remember. I then had an experience with scollops more body pain and some thoat pain. But before the Christmas Holiday I had a few calamari and then I knew i was on track to all of my unexplained health. My throat closed so bad but I felt like someone had kick bocked my chest and could not expand it at all and get air. I have had this before but not this bad and never fully understanding why it happens. Five weeks back it was a haddock dinner at a local restaurant that had just opened. My throat felt like I had thyroiditis for weeks. I did loose my voice some etc.. I am afraid and will seek medical help eventually. At the moment I am just so mad that it took this long for me or anyone to put together. There is not a specialist I have not seen. I am 54 and it all started at age 39 which is the age I went back to work. Never did I see this connection until recently. When we started to sell Lobster and Steamers I went out of work and thought my symptoms getting much worse had to do with this. I went to an allergist who told me that I was developing a sensitivity but focused on celiac disease and that road ended when my GI doctor ruled it out. I now have seveve ischemic colitis and have been kept overnight in hospital for blood pressure dropping low and another time for intestnal bleeding. My questions are these. Will this heal. I cannot sit for any period of time because of my intestines and cannot lift much because of all that feels damaged inside most days. I have recently talked with a woman who watched what I went through recently and she explained she was in the Islands when she almost went into shock. She had seen prior the same allergist that I had gone to before. Can allergies to seafood and shellfish be trickey to catch??????? I was working long shifts just to keep moving because nothing in my body seems to function good if I stay idle. How much did my working in a restaurant have to do with this getting this bad. It all started many years back with a red face, neck and ears. Always around 3 in the afternoon. Then came the unexplained rash and they focused on detergent. Then I was rushed in and told my appendix but the hospital record shows them circuling they were normal. When I kept going back with the same repeated symptoms stating it is the same pain as before the appendix he yelled I only had one. I said I knew. He moved to Florida shortly after and I have lived years very sick. I had also moved at this time and four restaurants across the street that sold seafood. This is when I was originally sent to be tested for MS the first time. Major swelling, headaches, and no feflex response on left side. It was August and windows open and we thought heat being a trigger. Long road but faith. Will I heal?????? How much plays in to my health failing working and living near seafood restaurants?????????? Thanks and so sorry about the length. ### output:

Hi, Thanks for writing in. I would like to reassure you that ischemic colitis is something which can be taken care of to a very large extent. However, the exact course can be determined by actually assessing the severity of the disease. As far as your allergies are concerned, seafood and shellfish allergies are some of the most common ones. It is surprising you weren't diagnosed with this before. This can not only occur when you ingest seafood but can also occur when you inhale the protein when it is being cooked. I would suggest you stay away from the seafood restaurant, and you should be good. Hope this helps.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I wanted to know if I am depressed or what. I have slight OCD , that I repeat a few things. Only there are 2-3 things in total that I repeat but sometimes it increases. Other than this I have some other symptoms as well. I have unstable digestion system, sometimes constipation and sometimes I have to go to washroom little after my meals. Also now I am feeling like I am unable to concentrate. I am a student and I m 22. When I try to focus, it looks like stress on my mind is increasing. Look like everything is being stuffed into my head. Also, I am getting slower and slower day by day. Now when I look back, I remember this slowness started around 6-7 years ago. And I really did not noticed it then. I remember that was the time when it started taking me more time than usual for daily tasks and I remember that was the time when I started reaching a little late at school. From them I can see it increased now. Now I take lots of time while eating and bathing. Late in university class on almost everyday. And all this increasing my stress and I tried my best now to do thing quickly but nothing helped so far. My face also doesn t look fresh. I look sluggish and people say you look in some deep thinking all the time. And yes, I can notice it myself that my mind doesn t stop anytime. It keeps on thinking about different things. Whenever I lay down and free, it started working in one direction or another. With this I have lots of hair dropping everyday, and many of them getting white. I also have continuous big pimples on and around my nose. I use to masturbate even before adolescence . Last night I had a wet dream and lots of liquid flown out. After that I had a very painful tingling sensation(like my penis is going to blown out) and my penis remain fully erected, probably stronger erection than normal. This happened to me earlier 3-4 times in life. The painful tingling sensation goes away when I sleep again after wet dream and when I wake up in the morning everything is normal again. But I have noticed that whenever that happens, I get some really big reddish pimples on or around my nose. When I wake up today, I can see a few on them on right side of nose. I looked swells from right side and really hurts upon touching and do not have any liquid yet. But I said this happened to me earlier so I can say that it will be having liquid(blood etc) after a few days. I m not a native english speaker so please forgive for any English related mistakes. I would really appreciate your help. Could you please tell me what is the problem with me. Edited: As I said earlier, I have problem concentrating. I also forget about things especially names etc... When I started to think about certain things, I keep on repeating my thoughts.... and start thinking or doing sometimes from the start again...... Also I got very angry and flare up on slight things when I am hungry, and when I take meal then everything is again normal......and I also notice that I get tired fairly quickly as compared to my age, especially when I am using my mind. Like I am reading a course book and trying to memorize things, stress will keep on increasing and my whole body muscles feel it.......it looks like I am on my toes and then after some time I take a deep breath and it relaxes my mind as well as whole body muscles. ### output:

Your have really explained your problem very well, and I appreciate it. The current symptom profile is suggestive of mild Generalized anxiety disorder in you. You are always on a tight side, and seem to worry a lot and remain preoccupied with your somatic symptoms. You seem to have an irritable bowl which is common with generalized anxiety, hence your bowl habits tend to be moody. The wet Chat Doctor. Do not worry as there seem to be no symptoms of depression or OCD currently. You may benefit from a course of Low does anxiolytic agent (say a Low does SSRI with pregabalin) along with daily practice of Meditation / Muscle relaxation exercises. You may need some initial training in learning formal procedure and may consult expert for it or there is enough genuine material on net to learn meditation techniques / relaxation exercises.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I am pregnant 17wks and almost 35years old. I have not taken my thyroid meds in a year. I have graves disease, treated by radioiodine therapy when I was 21. Three years ago, I started to get full body cataplexy drops, expecially after climbing stairs or elevations. Hospitalizations many times ruled out many cardiac and sleep study concerns. It was found that any slight decrease in my postassium level caused the hospitalizations after comparing notes for every visit. The doctor experimented and left me on IV potassium for a week and my levels would not go past 4.0 to make me hyperkalemic at any point, but did not make me feel better. Once the symptoms stopped, I would get released. Finally, they diagnosed me with hypokalemic periodic paralysis and potassium supplement nor potassium sparing diaretic would suffice. It actually made it worse. Ultimately, after discovering that sipping Pedialyte slowly all through the day kept me out of the emergency room, they put me on time released low dose potassium capsules 4x a day (10meq) as well as noting my thyroid levels had finally thrown me into hypothyroid after all these years since therapy. A year ago my TSH w T4 reflex was 1.80 and today it is 13.6. My potassium levels have been fine and I do take B12 monthly injections since I was 20 for pernicious anemia diagnosed by spinal tap a year before the Graves disease. I will see my endocrinologist this week but I am worried that the OB referred me to a maternal/fetal medicine specialist. They are getting familiar with electrolyte imbalances and taking the proper chromosome testing for my age and I await results. I am concerned about possibly getting paralysis attacks and falling while pregnant. It has not happened since I got pregnant, even though I feel awfull and stay in bed or on the couch. I am assuming the thyroid levels contribute to this worse feeling of my life because of my own neglect. I thought thyroid medicines made my heart race and made me have paralysis attacks more often, so I stopped to prove I dont have them as often when not taking Synthroid or Levothryroxine. The only other abnormality any specialist came up with during hospitalizations was a nuerologist noted strange brain waves during the test they make you hyperventilate to go to sleep (I did not sleep, only paralyzed myself) and he noted a small sclerosis on my hippocampus that was missed from a different hospital. I have not followed up with the nuerologist in fear because he had no answer for what causes it. Is it possible that tweaking my thyroid levels with treatment can cause the electrolyte issues to suddenly reappear and make it unsafe to be unattended or exert myself as before, noted by my frequent hospital visits of the past? My second fear is how much worse can it get until I deliver if I do not treat my thyroid? So in short I ponder: Obey doctor and suffer possible hypokalemic paralysis attacks/cataplexy body drops and treat as they come, or can the consequence of not treating my thyroid be more harmful to myself and the baby? I am not sure how bad a thyroid can get over another 20 weeks to guess which suffering of myself is worse, by for the baby, I am not sure how either symptoms can affect him. ### output:

Hi. I can understand the concern you have regarding your baby. The most concerning for me at this point would be the report of a high TSH, since you were off thyroxine supplements, because hypothyroidism during pregnancy is known to affect the fetus and its development including neurological development. So I think a visit to your Endocrinologist should be done as soon as possible, and this needs to be corrected. Otherwise, you will need to check and monitor your potassium levels and take supplements as required. You must already must have been informed about avoiding high carboy Chat Doctor. Hypokalemic periodic paralysis is a condition known to be associated with hyperthyroidism. So take care and get your thyroid status corrected. Thank you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, My wife underwent IVF on 10th December 2009. ER( Egg Retrieval) was successful on that day .18 oocytes were recovered .but after two days pain started in her lower abdomin area and started increasing .The ART Specilist stopped the procedure of ET(Egg transplant) as ultrasound confirmed OHSS(Ovarian Hyper Stimulation Syndrom) .Ovaries size had increased (B/L Ovaries enlarged and cystic ( rt ovary - 8 cm, lt ovary - 7 cm, free fluid ++ve)) . She was hospitalised for 3 days.Specilist suggested Periodic Ultrasound . FET(Frozen Embryo Transplant) was planned after 2 months.After two montys no ET was done, as the thawed embryos were not of good quality as per the specialist (Embryos frozen : 4 (Grade 1A/2B)) . Medicine Suggested presentlly is Metformin- 1500mg, folic acid, colsprin - 75 mg. (These continued through out). Second cycle of IVF suggested from next day 21(started on 16 apr 2010 with Lupride 1/2 cc injections) . Some details: 1. Female Age : 31 2. Height : 173cm 3. Weight : 70 4. Reason of Infertility : PCOD (Polycystic Ovarian Disease), 5. Have you had any pelvic surgery? yes 6. Surgery Name : Adhesiolysis( Ovarian Drilling Done on both sides) (Year : 2006) 7. Findings : Both ovaries polycystic, fallopian tubes open 8. Medical problems and current medications of female partner: Suspected uterine Tuberculosis, had ATT (AKT - 2 / 4)medicines for 6 months. 9. In vitro fertilization (IVF) : yes Date : 10 Dec 2009 Stimulation Protocol : D21 onwards : Lupride 1/2 cc (14/11/09 to 8/12/09 (23 inj)), GonalF 225 ml (1/12/09 to 4/12/09 (4inj)), ChatDoctor ( 8/12/09 at 1 o clock at night) Dose of Hmg :300 Days of Hmg :D5,6,7 (5/12/09 to 7/12/09) Follicles grown :18-20 Eggs collected :15 (10/12/2009) Embryos formed :4 Embryos transferred :0 Embryos frozen :4 (Grade 1A/2B) My Question : 1. Is it possible that OHSS may reoccur 2. I want to reduce chances of OHSS. Please suggest how to go about it. ### output:

Hello there, thanks for writing in. I would like to discuss a few things with you. HSS of severe degree is considered unacceptable these days with the introduction of antagonist protocol (agonist protocol as used in your case is more susceptible to develop HSS), especially in PCs women who are very prone to develop HSS. So next time when you undergo stimulation the choice should be an antagonist protocol which significantly reduces the chances of HSS. Using metformin through ovarian stimulation will also bring down HSS risks. Using GRH agonist as a trigger for final maturation of eggs in place of Chat Doctor will aid. At the same time the eggs can be frozen and transferred at a later date in FET. Using lower dose and gradually increasing the dose to obtain a response (response is growth of multiple follicles) should be considered. Some physicians administer albumin infusion at the time of egg retrieval to prevent HSS. Hope the above provided information will assist you to discuss the strategies with your doctor regarding your concern. Take care.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear sir/madmeI am Mr Tong, my father has just passed away three wks ago,after the hernia surgery.The doctor said my father system got infected.Let me tell you something about my father s health. He had got a renal failure, he was on the peritoneal dialysis for about 2 yrs or so. My father did very well with the dialysis procedures.he was very careful and hygenic. On 17 of August 2013 he s got a tummy pain he took Paracetamol to relieve the pain, the pain had gone on and offand on Sunday 18 he still got pain and got a couple of vomit, so my mum recommend him to go to the hospital to check.The surgeon doctor found that he had got a hernia pain aroun his groin. He had to have surgery. I was told that the the surgery will take about 45 minuttes , but it ended up 6 hrs, because the surgeon had open another cut around his tummy, he suspected that the hernia pain may not be only one problem that causse the tummy pain.Before the surgery my father was due to do the peritoneal dialysis,but it delayed 2 hrs and he ended up doing the surgery without diong the dialysis.After the surgery my father was fine he even told me that all the pain disappeared. The doctor came to check and said everything was good and told my father tha t he can drink clear soup or drink if. He felt like to.On Tuesday 20 August my father needs to do Hemo -dialysis , in the dialysis room he felt very cold and i was told by one of the nurses that it was quite normal.The Doctor had organised a CT scan to check if something was not right from the surgery. The result was fine.so the doctor called for a family meeting we was told that there was a bowel obstruction , the bowel was not working and there was bugs in my fathers system and even told that the surivival reate was as low as 10%.and duto to my father was very old (73) and he was on the PD and also had two surgery it was very hard for to cope . He is very weak to fight the infection.The doctor suspected that the infection may come from the tube( for the hemo - dialysis), but the tube was not removed , until wednesday it was tested it was positive. So my father suffered the pain the whole Tuesday night and did not wake up on wednesday , the doctor just gave him antibiotic and painkiller. He was in coma for a couple of day s and passed away on Saturday. During that period he still can breathed , he cant talk he can move his fingers when we asked him. But the doctor said he was already die they can do anything even he stiill breathed.My questions to you is that is there any handling error during the treatment or before the surgery?Was my father given the enough antibiotic(high dose)?If the tube was remove early and tested would it possible to save his life?If the surgeon did not open another cut around his tummy, will it reduce the pain?Thank you so much for ypur answers. I am looking forward to hearing from you.Best Regards, ### output:

Dear sir, my sincere condolences to you and your family. It is always hard to lose a near and dear. You have managed to give quite a bit of information about the circumstances around your dads terminal illness and treatment, however in order to give a professional advice it is not sufficient.1. Firstly, when my peritoneal dialysis patients have pain in their abdomen, they see me (nephrologist) first rather than a surgeon. I usually thoroughly examine the patient and do multiple tests before I can identify the problem. Only when I identify a surgical problem do I call the surgeon. I hope all this happened in your dads case.2. After the initial operation, whatever complications ensued, it will be wrong on anyone's part to comment on them without thoroughly studying your dads' case notes. Apologies for not answering your questions, but doing so will be inappropriate in my view. Best wishes. RB

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Seven weeks ago an old filling fell out from my top left first bicuspid. The filling was replaced but it fell out again and the dentist decided to readjust/enlarge the cavity so a new filling would stay. This procedure was done under local anaesthetic. Once the effect of the anaesthetic wore off, my tooth was very sensitive. I suffered very unpleasant sharp pain especially when drinking and eating either hot or cold. Back to the dentist to readjust the tooth (with carbon). But this didn t help. I gave it 10 days or so to see if time would heal and went back to the dentist. By that time I was using only my right side to chew . The dentist suspected that the filling was putting pressure on the tooth. They took the material away, investigated inside to check the root canal was alright and replaced the filing using less pressure (I think they also changed the type of material) and in two parts so it would impart less pressure. It did relieve the pain I was having to some extent but I was still experiencing pain regularly. Still chewing using the right side only, I began to develop pain in my jaw and cheek bones and basically, for a while, across all my teeth and my whole mouth. This lasted a week or more. I was taking pain killers (although with no efect) and had to blend my dinner as I couldn t chew properly because of the pain. Back to the dentist. I described all the symptoms mentioned above. The treated tooth was the source of the most pain: it was like biting a very small stone giving a sharp pain. Also I mentioned that food was concentrating between the tooth and its neighbouring second bicuspid and the resulting pressure was also giving sharp pain. (The filling was on the side of the first bicuspid). They investigated again, used carbon again to readjust a little more, a fracture/crack on the tooth was also investigated and the idea eliminated, took new X-rays (can be provided), and the conclusion was: We don t know why you are still in pain . Since then (a week ago) I have been suffering very acute sharp pain when I eat and drink, hot and/or cold from the treated first bicuspid to the Second molar (sometimes to the third molar inside my gum!). The pain is much the same each time and varies from tooth to tooth (all top left), but I am also having similar pain periodically now on my cupid to my second molar on bottom left. Pain, pain, pain, each time a different tooth. I am helping myself with massaging the teeth and gum. I am also taking pain killers but they have been of no help. Really don t know what to do next or who to ask for help. (fem-46yrs) ### output:

Hello there. I'm sorry to hear you are experiencing such problems. I will try to help. First and foremost I cannot make any definitive decisions or a definitive diagnosis without considering your full history and undertaking a full examination, but I will use to above information to try and advice you accordingly. Pain around a tooth can either originate from the tooth itself or from the tissues surrounding the tooth. 1 -If the pain originates from the tooth itself it is usually either due to decay which is encroaching onto the pulp (the nerve chamber) or the filling is so deep that it is close to the nerve and some constituents of the filling material are stimulating pain as they find their way through the identical tubules into the nerve chamber. Another possibility is that a composite resin material was used (white filling) and as it contracts when cured (hardened) it pulls against the walls of the cavity which causes pain. One final possibility is that you may have a fracture through the tooth. I know you say this was ruled out, but in fact it is very difficult to rule out fractures in teeth. They certainly don't show up very well on radiographs (X-rays) and they are hard to identified clinically (in the mouth) unless they are extensive. I would like to see the radiographs if possible. Solutions to the above problems involve removing the existing filling, check the base of the cavity, placing a sedative Chat Doctor. This sedative

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello. I have systemic lupus (calm). I usually get lab work done 1-2 times a yr. to check my kidney, etc. due to the lupus. Three yrs. ago, June 2010 Ive been having occult blood (1) in my urine. I asked my Rheumatalogist and she said I probably took the urine test close to my period or near the end of my period and thats why it showed the occult blood, so I didnt worry anymore. This July I had my lab work done and again the occult blood (1) showed up (as it has been in the last 3 yrs.). This time however my Rheumatologist was concerned and told me to see a urologist. Because I couldnt see a urologist sooner, I went to see my family doctor. He ordered a urine test and an ultra sound of the kidney. He diagnosed me as microhematuria. When I finally saw the urologist, she ordered a urine cytology and recd that I get a cystoscopy esp. because my lab showed occult blood (1) along with rbc 4-10 . She wanted to make sure that I dont have a bladder cancer or kidney disease so a cystoscopy needed to be done. When I did the urine test that day, I believe the cup was contaminated thats why it showed the rbc 4-10. When repeated, it didnt show rbc 4-10, but normal rbc 0-2 (below)Results: 1. Urine--- no infection, occult blood (1), rbc 0-2 2. Ultra Sound of Kidney--- 3 x 5 mm nonobstructing stone in the inferior pole of right kidney3. Urine cytology--- benignI recently talked to a 2nd urologist at a social gathering and he told me that I should get an x-ray, kub to see accurately the size of the kidney stones, etc. He actually recd a ct scan but changed his mind when I told him that I was trying to get pregnant. So with that info., he recd me to get an x-ray instead. He also recs that I get rid the stones asap even though I have no pain because if I get pregnant it would be bad. QUESTIONS:1. Should I get the x-ray done when the ultra sound already shows the amt. and size of the stones? I would think the ultra sound and x-ray both show the same size and amt. of stones even though they are two different tests.2. Should I still get the cystoscopy even though I have benign in urine cytology and that I have occult blood due to kidney stone (from ultra sound) ?3. Should I get rid of the stones since Im trying to get pregnant even though I have no pain?4. The 2nd urologist recd I get lithotripsy done soon before I get pregnant even though Im not in pain. Is this the correct or recd procedure?Thanks. ### output:

Hi there, she can affect kidney the best way to detect is RBC in urine examination> 4, urine spot protein creatinine ratio > 0.2 and high DSNA and low c3 levels. Then we call it lupus nephritis. In your case stone is also present. So RBC can be because of stone also. It is important to rule out SHE nephritis as it is more dangerous. X-ray may not be helpful. If you wantvimaging study to document stone size and number than ct pub plain should be done. It has no effect on future pregnancy. If the stone is a single stone of 3 to 5 mm as in the ultrasound. There is no need of anyvtreatment before pregnancy. If a problem arises it can be tackled as such chances are very less as it is a very small stone. Chancellor cancer are only there if your age is greater than 50 yrs in that case also ct should be done before cystoscopy. And most likely cystoscopy will not be needed. Best wishes.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I dont know where to begin. But I think that to describe my problems You need to know the facts that I have been molested by my father in my childhood, I reflected it in my plays, these plays really took the stress off me. I usually took the doll, undressed her and I pretended that someone other than my father, but still somebody adult wanted to see her naked and to touch her, I always did it on myself, I mean I took off my underpants and cried that I didn t want somebody to touch me, but still they told me they have to. In the role of somebody were my teachers, actors, adult people I had known. I felt psychological relief. I still continue it (I am adult so I imagine situation where I am dependent on somebody)but only in my thoughts. Simultaneously when I was about four I started masturbating by crossing my legs, my mom saw it and hated it, she admitted that throughout the childhood she didn t like me at all. It was very compulsive, I even counted it and it could be even 40 per once ( I don t know if they were orgasm, but it was definietely the climax of sth, usually after one time when I imagined myself very dependant on somebody touching me I started feeling angry and sad but my body still had the pleasure and some climaxes throughout the other 39 times). When I was 14 I started to feel pressure on my bladder, an urge to urine, nothing else, no pain or pinching just an urge and I urined in droplets, I still do. It s very annoying but I got used to. But know I see it gets worse after orgasm ( I never get orgasm through touching my clittoris but only through squeezing my legs, but now it s usually 2 to 3 times). My questions are : 1.Are the problems with urining connected to my psychology or it may be something wrong with me inside me, physically? 2. Is it wrong that I don t get climax when I touch my clittoris even when I am aroused, it sometimes gets even not pleasant, and may be painful although I am not violent in it? 3. May these problems mentioned above be connected with the fact that when I was 11 my father violently put me on ground in the way I was lying and then kicked me, mostly in the lower parts of body, and the next day I had the bleeding from the vagina. I thought I got my period then, but lately I started thinking that it could have been because of this kicking, especially that next bleeding was after a year when I was 12, then I had maybe 2 periods and a gap year. I read somewhere that it s normal to have a year gap after two periods so now I think I didn t have 2 gaps, but the 1 st bleeding was because of kicking. I have a problem with going to a gynaecologist because in some way I want to, to feel the pleasure I have from imagining, and in the dependency the situation makes I feel aroused, it s very embarrasing. Unfortunately so far I met gynaecologist who were rather brittle, and for instance told me Come when You start your sexual life , moreover I am so embarrased that some man/woman it doesn t make difference may see I am aroused. It s very uncomfortable, and most importantly I would use her/him by going to gynaecologist. Would You feel used knowing that your patient feels sexual arousement because of the situation? ### output:

DearWelcome to Chat Doctor understand your concerns went through your details. I suggest you not to worry much. I sincerely opine that your fantasies and obsessions are revolving around that incident happened when you were 11. This happens because you are keeping your thinking around what happened then. You must shake your self off. What ever happened is past and has nothing to do with future. But if you become obsessive about it, then it shall ruin your future creating anxiety. The mannerism you are showcasing are normal and do not worry about that. Please describe the whole problem detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome obsessive thoughts. Hope this answers your query. Available for further clarifications. Good luck.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear Sir / MadamI am 71 year old and giving below the latest report of ULTRASONOGRAME ( ULTRA SOUND )REPORT OF ULTRASONOGRAME ::Right Kidney : measures about 8.2 cm ( bipolar ) Left Kidney : measures about 8.6 ( bipolar ) BOTH KIDNEYS SHOW increased cortical echo with maintained corticomedullary differentiation .There is no evidences of calculi or calyceal dilatation A few cortical cysts are noted at lower polar region of the right KIDNEY .Larger one measuring about 10.4 x 8.2 mm .Exophytic cortical cyst of 17 x 14 mm is noted at mid polar region of left KIDNEY PROSTATE : is mildly enlarged measuring about 4.8 x 3.1 x 3.6 cm ( Volume 29 cc ) and shows normal parenchymal echopattern Seminal Vesicles appear normal . Urinary Bladder is well filed and regular in out line . No obvious intraluminal pathology is noted Pre Voidal volume of Urine is about 580 cvc Post voidal rersidue is about 352 ccIt will be highly appreciated if you kindly check the above and provide me with your valuable comments with advice of treatment for curing . ( N. B : I have problems of Hypertension and taking NITROGLYCERINE TABLET OF 2.6 gm ( one tablet in the morning and half tablet at afternoon ) And also I have ASTHMA and taking everyday following inhaler :1- SULBUTAMOL 4 time daily , , 2- Salmetrol with Fluticason Twice daily and 3- Tritropium at night )Looking forward for your co-operation and early reply with valuable comments and advices for curing the above diseases With kindest regards .With regardsTazul Islam ,Dhaka , BangladeshEmail : YYYY@YYYY ### output:

Hi, Thanks for writing in. Coming to your specific queries,1. Right Kidney : measures about 8.2 cm (bipolar) Left Kidney : measures about 8.6 (bipolar) BOTH KIDNEYS SHOW increased cortical echo with maintained corticomedullary differentiation. There are no evidences of calculi or cancel dilatation A few cortical cysts are noted at lower polar region of the right KIDNEY. Larger one measuring about 10.4 x 8.2 mm. Exophytic cortical cyst of 17 x 14 mm is noted at mid polar region of left KIDNEYBoth kidneys are normal. There is mild increased cortical echo, this means the kidneys are appearing lighter gray shade than normal. You may get a serum creatinine test done and check with results if your kidney function is normal. Cysts in kidneys of size mentioned in report can be accepted as normal at 71 years of age.2. PROSTATE : is mildly enlarged measuring about 4.8 x 3.1 x 3.6 cm (Volume 29 cc) and shows normal parenchymal echo pattern Seminal Vesicles appear normal. Urinary Bladder is well filed and regular in out line. No obvious intraluminal pathology is noted Pre Vidal volume of Urine is about 580 CVC Post Vidal residue is about 352 cc. The prostate gland is enlarged and happens in most people at your age. Still if you are having problems in passing urine with urine retention, please consult a urologist for medications. Please inform your doctors of other medicines that you are on. Hope this helps.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I am suffering from allergy since end of August. The diagnosis is different from different doctor. One said is chronic urticaria, another said is due to food allergy, another said is hormone changes and cause my immune system to attack when ever I had ate something which will cause allergy. After observation, I notice that prawn, crab stick, shrimp paste will cause my allergy. At the beginning, it only appear only on my back thigh. The rashes will start with like mosquito bite and very itchy, and getting more and more after I scratch. It will appear on the next or next two days after I ate the food which will cause my allergy.As advised by doctor, I had took a 10 day course of Aerius and Asthator. The rashes came back 5 days after my course had ended. Then, I took Loratadine for another 10 days. Like previous, the rashes came back after 5 or 6 days after my course had ended. I noticed that the allergy reaction and area affected become more serious each time I stopped. Now, it even appear on my arms, waist, swollen on my lips, cheek, eye lids, neck. My lips or eye lids will swollen 15-30 min later if I ate the food which will cause the allergy.Currently, I follow the advice from a doctor, not to completely stop eating food that will trigger the allergy to let my body to accept the food. I will only take Loratadine if the rashes appear a lots.Pls advise what should I do to stop or cure this forever? ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. Of course, I would first think of "Chronic Urticaria" as a diagnosis, but it is important to find the cause.2. As you have symptoms after taking prawn, crab, shrimp, etc. I would suggest you to go for allergy testing (both serum specific IGE and skin rock tests for seafoods). This will help to know whether you are actually allergic to seafoods. (seafoods are very common to cause food allergies and avoidance is the best measure)3. However, as you have chronic urticaria and also, as you develop symptoms after 1-2 days of consumption, I would suggest you other investigations for chronic urticaria also. For my chronic urticaria patients, I advise Complete blood counts with ESR, C-reactive protein, serum ANA, thyroid profile, complete urine and stool analysis as primary investigations. However, I would mention here that nearly 25% of patients with chronic urticaria have all normal reports.4. For treatment purpose, I would suggest you to avoid foods that cause your reactions (the most important aspect of any allergy, I would disagree with TH concept of "acceptance by body"). 5. I would also like to review your other medications like painkillers, contraceptives, and some others which might be contributing to urticaria.6. I usually suggest my such patients to take an antihistamine like HY Chat Doctor. 7. Furthermore, I also suggest them to avoid too hot/spicy foods and sudden temperature differences. Woolen, tight clothing can also irritate skin and hence not preferable for urticaria patients.8. I usually prescribe my such patients a good multivitamin-multimineral supplement and high dose vitamin D after checking vitamin D levels, which might help in some chronic urticaria.9. If psychological stress is a concern for you, please adopt some relaxation strategies as stress can worsen urticaria.10. Please do not scratch the itchy areas as it aggravates itching. I would suggest you to apply a lotion like calamine over itchy areas instead of scratching them. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Sir, My father expired just after angioplasty on 7.1.12 , since than I am feeling pressure on my left side -near under arm portion. Lupid profile conducted. Tests report normal except uric acid 7.00 . My doctor prescribed TMT . should I go for it or not. (reports Tyroid TT3 135.36 ng/dl, TT 4 10.00 g/dl, TSH 0.47, Boood Gulucose fasting 74, urine glu. nil. Cholesterol total 145 , HDL 44, LDL 77, VLDL 24, Triglycerides 120, Total cholesterol/HDL ratio 3.2, LDL/HDL ratio 1.7, Billirubin .. total B. 1.0, Direct B. 0.4 Indirect Bil. 0.6, Alkaline Phosphatase ALP 102 , Aspartate Aminotransferase SGOT 35 , ALT/SGPT 45, GGT 30 , Total protein 7.00,Alb. 4.5 , Globulin 2.5 , A/G Ratio 1.9, , Blood urea Nitrogen BUN 14.0, creatinine 0.7, Uric Acid 7.0, Sodium (Na) 142 , Potassium 4.8 , Chloride 102 , ESR 11 . CBC HB. 15.7, Total WBC Count 5000, Neutrophil 50, Lymphocytes 40 , Monocytes 06 , eosinpolhil 0.4, RBC 4.50 , HCT Haematocrit 41.6 , MCH 34.8 , MCHC 37.7., MCV 92.5 , RDW CV 13.9 , Platelet count 250 , Urine test .. colour Pale yellow , appearance clear , specific gravity 1.015, Peaction 6.0 proteins NIL , Glucose NIl , Bile salts Negative , Bile pigments Neg, Nitrites Neg, Boood Neg, Ketones Absent , urobillinogen Normal , PUS WBC cells 1.2, Urin RBC NIl U. Epithelial cells NILL, Crystals NILL casts NIL , others Nil...... Sir, please advise me . I am hypertensive , taking .. Domtac, OD , covance D , OD , regularly for the last about 10 yrs., started recentely Ecosprine 75 mg. , tonect EZ OD ... Due advise in the light of above is awaited. Thanks .. Dalip Kr. Chhabra 0000t ### output:

Hello Mr Chandra, Firstly I am sorry for your dads' loss. However, that put a positive family history of coronary disease. Other risk factor is hypertension. All the other reports which you have mentioned are perfectly within normal limits and you shouldn't worry about the same, even uric acid at 7, no treatment is indicated at present. Now about TMT, the symptoms you describe are not characteristic for angina, however because of the risk factors which I have mentioned and if you are obese, smoke or have angina stressful life you fall into intermediate risk for coronary event in the future, so for you TMT is a good test to rule out underlying cardiac issues. In TMT they make you run on a treadmill and monitor your blood pressure vitals and see ECG changes. Also, any symptoms during exercise is unmasked. So in short they make your heart exercise and check whether everything is ok than. Hence, if your TMT is fine you may rule out any critical blocks indirectly. So yes TMT would be a good test to rule out heart as the cause of the chest discomfort you feel. Hoping I could help. Regards Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am waking up with a mouth coated in blood -including clots or gobs stuck to my teeth, my tongue , you name it. I can literally scrap layers of gooey blood from my cheeks, teeth or inside my mouth anywhere. This has been a recent development. Started about 3 weeks ago with a sudden on set of fever. My teeth and mouth ached so badly I think I would have rather pulled them out. I assumed it was an infection and used antibacterial mouth wash to no avail(prescribed post wisdom tooth removal Jan 2012) . I am also noticing hard bumps at the base of my gum line mostly above my upper front, top teeth. I had the four quadrant gum cleaning a year ago (with wisdom teeth removal) and dentist says gum health is improving. My concern is the sudden onset. Prior to the quadrant gum cleaning I never experience this. I am not sue where to start as this is not just a little bit of blood. Its is dark gooey copious amounts every night and bleeding throughout the most of the day is occurring as well. I have a history of fibromyalgia (based on lack of factual evidence indicating a more finite diagnosis - not convinced as I feel it is a catch all). PC thinks sjogrens or RA will eventually be the diagnosis, but no SSa or SSb antibodies were detected during the parotid and minor salivary gland biopsy. Nor have any antibodies confirmed a diagnosis. I am in no hurry to have an ailment! However the bloody bloody mouth is concerning. My blood work is never normal and the bloody mouth is really concerning me. However my experience with doctors deters any seeking of advice. I addressed this with my PC on Friday and he seemed like it was normal. while addressing the white nodules forming on my gums. What can cause this? Sudden onset and with high fever (norm 97F. was 103f lasting abut 48hrs but gum pain continues and bloody mouth upon waking is what I am left with. Yet another symptom. I was similar to flu symptoms but obviously not such. Aching in my hips and legs along with wanting to rip my teeth out did not quite equate flu. I do have mild stenosis central spinal canal (C-5) along with osteophyte complexes-which also has never been addressed nor did anyone take the time to discuss the results. All is written of to chronic inflammation (in Dr lingo-i made it up)! Severe gastroparesis has also been diagnosed. Not slowed digestion but lack of. Severe dry eye and skin as well. Last but not least is the diagnosis for amenorrhea (cerebral originating at the pituitary gland) So freddy cougar bloody mouth upon waking, persistent now for a few weeks with hard noduals forming?I have suffered from gingivitis and nothing like this has ever occurred, and again the random onset is what is worrying me. Any ideas minus seeing a doctor? Please off other suggestions minus gingivitis as much as I would like that to be the case the dark gooey blood. combined with horrible stomach problems (have had pulmonary edema as well) I am in the medical field so I am knowledgeable relatively speaking. Idiopathic and science often appear to me as an oxymoron - apparently I am an idiopath! Thank you. Please if your only offer is to see a doctor than Id rather not pay the 15. Thanks in advance ### output:

Hi, Thanks for asking the query, Bleeding gums indicates infection in the gums known as gingivitis, it occurs due to poor oral hygiene, plague and calculus deposition, systemic conditions and hormonal imbalance. I would suggest you to visit the Dentist and get the checkup done, take an x-ray of the tooth which is having pain, go for symptomatic treatment of complete mouth scaling NAD polishing. Tooth which is having pain can be treated with root canal treatment. Brush the teeth twice daily, use antiseptic mouthwash rinses. Take multivitamin supplements. Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello dr, i am 59 yrs old i am disabled now for 17 years. i always worked two jobs before i was disabled i had lots of energy and loved my jobs and was able to pay all my bills and keep roof over my head i did not have anyone to help me if ever i needed it. at 22 i got married and had to still make sure bills were paid i worked at the state house as a secretary. the marriage did not last he did not take care of our home and bills i did it all. i was mentally abused and toward the end pysically abused. all his attention was on drugs and party and loosing job after job. i was terribly traumatized because he was not who i beleived he was as a man when i first married him. so i went into factory work because it was more money than secretarial and went to pyschiatrists to help myself not fall to pieces every day to me from then on was very hard for me to not have the fright and feelin that a bomb was gonna fall on me. my dr. suggested self help books to me and i read and read every one i saw at the libary and practiced to be reborn again as a strong person. l995 i remarried to i thought was a wonderful man and the same happened again cheating mental abuse pysical abuse and i could not have a conversation with him because all he did was yell and terrize me i married a monster. i am separated now and on my own and it feels like i have gone to another planet. it feels so good not to be terrized and abused. i moved out of the state i lived in and back to the state my family lives at least here i have family around. but dr. it is hard finding a good pyschiatrist here so i have no pych. dr. now to give me my medicine. i am bipolar inside of me i feel i can t go anyway i take vey bad panic attacks it comes over me and i freeze and can t run out and at other times i am able to. my head feels so filled up with fright that i can not think and when i am able to try to concentate with all my heart bad thougts come in i try so hard to through it out of my mind. whether i can or not(it stays in my subconsious and come out another time even tho i go to my self help books and also tapes to calm me it does not work i pray to god i read inspirational books and quotes i look into you make life yourself you are the captain of your soul what you do is only my own doing being so depressed. when i was taking my medication i was able to concentrate on what i had to do but nights i feel like the booky man is coming to get me. i am very jumpy and i have a feelin in side like someone is hitting my heart with a hammer. sooner or later i will find a psys. dr, and my day will be much better with my medicine so i do have a primary dr she is nice but doe not want to prescribe me any of the medicine that i take she said the pysc. does it. night time come and i am so panicky can t do nothing i feel like a lump on a log. i have tried herbal medicines from a herbal dr my cousin told me about because i wanted to be physically ok. watch what i eat and i would appreciate any advice from you because maybe you know some thing i can think abou read or whatever to become a smiling person without constant migraine. dr. i thank you in advance for any advice or opinion. thank you again god bless ### output:

I can understand your feelings and appreciate your query on Chat Doctor. After going through your history I can see that anyone could have landed in the same situation that you are in, and you are facing it bravely. Self-help books and techniques are helpful, but a time comes when professional help is needed. Now you need professional help. Combination of professional and self-help will provide better results for you. I would suggest you to start antidepressant medicine and the one that has antianxiety effects as well. You also need some anxiolytic for few weeks and some relaxation techniques. Please ask if you have any queries, I would be pleased to answer. I hope you find it helpful.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am an IT professional I am now 25 years old the girl I am mentioning here have 23 years old. we started love at our degree time. she is now doing MCA final year and after my degree i search for job to make a career faster and getting settled with her, 2 years before we married legally and that was a secret marriage because we don t wan t to miss each other if any problems comes in future. That is the reason why we did that. But now she is avoiding me... she don t like my presence, she told me that I am always scolding her, I didn t gave her peace after marriage, I know I am over caring, but she told me that I am doubting on her etc etc. I loved her so deeply.., I can t bear while she is talking with any other boy or if a marriage proposal comes in her home. I feel afraid always by thinking all these things. I am from a middle class family and she is from a rich family, also she is post graduated now I am feared about that she is avoiding me because of all these reasons. sometimes I feel inferior about myself... that I am not suit for her. I have so many family problems and office tensions. Now I got promoted as Project Leader but I can t work properly... I am always gloomy, I just act as a machine in my office. I feel loneliness , she never try to understand me, I know some where in her mind there is a soft corner for me. But she have such a mind that she don t like to express love, love is a thing that we need to kept in mind. But in my point of view love is a beautiful feeling but without expressing love is nothing. I am crying most of my nights by thinking about her. I don t know how to make her happy. I told her that I am going to leave her because I can t bear avoiding. Sometimes I think about suicide but later I think about my family, my mom, dad...I am the elder son in my family and I have my responsibility towards them. I don t know how to manage all these situations. She never tried to understand me. Two days before she told me that she is in her village and will come back after three days. I can t call her while she is in home. But later I realized from our mutual friend that she is in college, and she told me lie that she is in home. I asked her why you lied... her reply makes me hurted more. She don t like my presence and she don t like to hear my voice. so I told her I am leaving her forever. I know that is not possible for me... but some how I managed one day by switching off my phone. But when I switch on my phone I got 6 blank messages from her that makes me writing this. Also I know I can t live without her. I don t know she loves me or not but her words... I can t forget. How can I disturb the person who don t like my presence. I don t know if I did write or wrong. Please suggest me... help me to overcome this situation. ### output:

Hello You have described your problem in detail. The problem is only due to misunderstanding. A lot of cognitive distortions are there which should be corrected. Assumptions should always be avoided in a relationship. You have mentioned that you are caring and over loving. You have also mentioned that you don't like her talking to any of male friends. Just ask your self is it really care and love or something else. She is a different individual, and she also needs her space. You are intruding in her space and this has resulted in a vicious cycle of doubt and fights. This is the reason she is avoiding you. She is saying that she didn't get peace of mind after marriage. But due to continuous mist rust she has started avoiding you. She just wants peace of mind. I will advise you to go to a Counselor for proper counseling. Then request her to come along with you for Couple Therapy for strained relationships. Talk to her about restarting the life. Decide to change yourself. Don't feel inferior work had so that you can win her again. And also don't threaten her with suicidal threats. This will affect only you and no one else will be affected. If you both are ready to continue again then reach to an amicable state by talking to each other. Thanks

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I started taking Cymbalta---60 mgs.once a day--- late last summer as a result of depression--just meltdowns and crying jags. It has been a really rough last few years including a divorce and a move to another state after 40+ years in a place I love to a place I dislike, but for family reasons.. Before that I had been taking Citalopram (sp/0 for quite a number of years for the same thing with no side effects and mild to moderate relief. A couple of weeks before Thanksgiving I developed diarrhea like I have never had before---watery and uncontrollable to the point I was afraid to go to sleep at night without an old, heavy towel under me to keep from messing the mattress. i am also very drowsy much of the time and have a terrible time getting up in the morning, often sleep quite late (thank heaven I am retired, age 66, and don t have a daily schedule I must meet. Then I have a terrible time not dosing off in the afternoon. My mood has improved significantly, but no cause has been determined for the diarrhea. I have had blood, urine and stool tests--no infection, though I was put on Cipro for 10 days before the test results came back just in case .. Next is an early colonoscopy. My previous colonoscopies have been normal. I see that diarrhea can be a side effect of Cymbalta, but mine did not appear until a couple of months after I started taking it.. I had no problems at all initially. Now I am just plain depressed by the limitations the diarrhea has put on my life. I am hinking I should go back to the Citalapram, and seeing a counselor I found who will take Medicare, and deep six the Cymbalta. Till now I have not known enough to ask my doctor if there might be a connection, but I plan to ASAP when I can get an appointment, which is usually pretty quickly. What do you think? Are there withdarwal symptoms associated witChatDoctorbalta? I am getting really desperate. I cancelled Thanksgiving with my family and two long planned road trips becaus of this. That, in itself is really depressing and I think my family thinks I am turning into a hypochondriac and I am practically living on Imodium, beside losing 5 pounds,which, in my case, is not at all a good thing. My wight has been very normal since I left high school. Also my blood pressure, normally on the low side---90/68--has gone up to as high as 123/70, very unusual for me and very sudden. This was all very sudden! Thank you in advance, Cynthia Timko. ### output:

HI THANKS FOR YOUR QUERY.READ IT WITH GOOD ATTENTION. I WANT TO CLARIFY ONCE FOR ALL THAT ANTIDEPRESSANTS ARE ASSOCIATED WITH DIARRHEA, CRAMPY ABDOMEN, NAUSEA,VOMITING ETC.ESCITALOPRAM IS A SIMILAR CLASS OF Chat Doctor. . I ADVICE THE LATE RTO MY PATIENTS. I ALSO SUGGEST YOU TO ATTEND PSYCHODYNAMIC AND INSIGHT PSYCHOTHERAPEUTIC SESSIONS AND ELECTROCONVULSIVE THERAPY (AS LAST RESORT) FOR BETTER RESULTS AND RESISTANT MAJOR DEPRESSION. I ALSO SUGGEST YOU TO TAKE YOUR LIFE AND RELATIONSHIP IN AN EXTREMELY SPORTIVE AND HEALTHY WAY.THE FLUCTUATIONS IN BLOOD PRESSURE SHOULD BE MONITORED ON REGULAR BASIS CONSIDERING YOUR AGE. I ADVICE YOU TO SCREEN FOR HYPERTENSION AND CONSULT A CARDIOLOGIST.YOUR BP FLUCTUATIONS ARE NOT

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: 30 year old female with headaches coming from the neck area always starting out in the cavity on the left side from the neck vertebrae s, neck and shoulders are in a lot of pain during the headache which without medication lasts several days, person is always very cold (mainly hands and feet), doesn t tolerate heat very well and passes out when too hot, blood pressure always 120/80 or less. If less than 120/80 she has dizziness and vertigo, has short term memory loss, issues with constipation, fatigue, is a carrier of CF but doesn t have the illness. Person was overdosed on Dimenhydrinat when she was 11 years old, which after that noticed a drastic decline in her short term memory. Also was diagnosed with a whiplash at the age of 16 as well as 19 (both car accidents) Below is the report from the MRI findings: TECHNIQUE Multiplanar, multisequence MR imaging of the brain with and without gadolinium. 15 cc Omniscan administered intravenously. FINDINGS There is no intracranial mass, cerebral edema, hemorrhage, or abnormal extra-axial fluid collection identified. There is no acute ischemia. There is no focal cortical encephalomalacia. After gadolinium administration, there is no abnormal enhancement of the brain parenchyma or meninges. There are at least two punctate foci of signal abnormality in the periventricular white matter, located in the deep right parietal lobe, with no associated enhancement or restricted diffusion. These findings are nonspecific, with broad differential diagnosis which includes but is not limited to vasculitis, a demyelinating process such as multiple sclerosis, migraine headaches, toxic exposure, infectious/inflammatory etiologies, hypertension, and chronic microvascular ischemic disease. Findings must be interpreted in the context of clinical and historic information, with followup imaging when and if clinically indicated. If and when a followup MRI is obtained, it should include a sagittal inversion recovery sequence for most sensitive evaluation of the white matter. There is no focal cortical encephalomalacia. No brainstem lesions are seen. The ventricles are normal in size and configuration. There is no Chiari malformation. There is no sellar or parasellar mass identified. There is no cerebellopontine angle mass. There is no sinus disease or mastoid effusion. The orbital contents are unremarkable. Flow is demonstrated in the vertebrobasilar and carotid arterial systems. IMPRESSION 1. Nonspecific small focal signal abnormalities in the right parietal periventricular white matter, with differential diagnosis including but not limited to vasculitis, a demyelinating process such as multiple sclerosis, migraine headaches, toxic exposure, infectious/inflammatory etiologies, hypertension, and chronic microvascular ischemic disease. In a patient of this age, migraine headaches, vasculitis, and a demyelinating process such as multiple sclerosis would be the primary considerations. Findings must be interpreted in the context of clinical and historic information, with followup imaging when and if clinically indicated. Future followup studies should include a sagittal inversion recovery sequence. 2. No intracranial mass, acute ischemia, enhancing neoplasm, sinus disease, or mastoid effusion. ### output:

hellos the report suggests full history and clinical findings have to co-relate radiological and scan findings by a euro specialist, there cannot be evaluation based on reports alone as many suggestive findings are there, and often particular disease findings overlap with other diseases too when not present, hence symptomatology, clinical evaluation, neurological detail examination and history will define the nature of disease, treatment may be done accordingly, please do not worry to get evaluation by correspondence only which may not give correct assessment based advise. Thanks

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had my gallbladder removed 2 years ago due to stones and a minor infection. (They wouldn t remove for months because tests said it wasn t infected and I kept pushing for it) ever since then there has been a whole new set of problems that the doctors won t give me the time of day to explain thouroghly. I ve had several tests done the past 2 years. Colonoscopy and endoscopy. Col. Came back perfect, endo said I have a hiatal hernia, bile gastritis and grade a erosive esophogitis. (Even tho the doc said they forgot to get a sample from my throat) I have had occasional blood in the stool and several black tarry stools and a itchy rectum but they insist there is no hemmeroid. I have severe stomach pain almost constantly and there is also orange balls in my stool fairly often that Iinvestigated once and has white powder in it!?? I also wake up every morning with a very swollen throat (lymph nodes probably) and swollen hands and feet. Also, incase it matters I have an iud because I ve had very messed up peroids my whole life. (2 iitimes a year, full month of bleeding on average) Ihad a cluster of cysts removed on my cervix several years back and a lot of my paps come back abnormal and nothing is ever done about it. The meds I take are pristiq, risperdol, a prescribed antacid and a bile salt pill? And proffesionals out there willing to give me advice would be much appreciated! I can t go on feeling like this much longer! Please and thank u! ### output:

Hello there! Thank you for asking. let's talk one by one1- Sore throat. You just need simple Amoxicillin and some anti-inflammatory aspirin gargles to remedy that. 2-pap smears. If they are abnormal. What are you waiting for? Do you plan to get stage 4 terminal cervical cancer? If you do than continue not doing anything otherwise see a gynecologist and sort things out for you.3-Gastro intestinal discomforts and swelling hands and arthralgias and menstrual irregularities I am suspecting some Systemic Disease like SHE and Behçet. You need ANA, Anti DS DNA & Anti Smith Antibodies test to be on the safer road and getting treated accordingly.4- Your HERD is due to hiatal hernia, and it will be like this until you cure the hernia. otherwise it will lead to Barrel esophagus and then malignancy. The three goals of your treatment prevention of reflux of gastric contentsImproved esophageal clearanceReduction in acid production which are achieved by three waysModifying lifestyle factorsNeutralizing acid or inhibiting acid-producing mechanismsEnhancing esophageal and gastric motility really need Dietary modifications. Avoid stimulants mentioned belfries or fatty foodsChocolatePeppermintAlcoholCoffeeCarbonated beveragesCitrus fruits or juicesTomato sauceKetchupMustardVinegarAspirin and other non-steroidal anti-inflammatory Chat Doctor. Lose weight (if overweight) divide your weight to the height in meters twice and if the result is more than 25 reduce the weight. 2. Avoid alcohol, chocolate, citrus based fruits, tomato based products3.avoid pepper mint coffee and possibly the onion family4.eat small frequent meals rather than large meals.5.wait at least 3 hours after the meal to lie down or sleep.6.refrain from ingesting food (except liquids) with in 3 hours of bedtime.7.elevate the head of your bed at least 8 inches8.avoid bending or stooping positions9.don't use nsaids10.don't smoke11. Have a proper sleep routine12. Use cold milk as

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: im wondering if i have exercise induced asthma...i was playing bball with a friend a while ago and after maybe 5/10 minutes (i was playing hard) he made me stop because the way i was breathing scared him. He saidi was breathing really deep/fast andhe thought i was going to pass out. I didnt notice because im usually like that when i exercise (bball,skateboarding,biking). depending on how long/hard i exercise ill get a tight chest so its kinda harder to breathe (sometimes if i just push myself harder my chest will burn) and end up feeling congested and ill be coughing a lot. I always thought it was normal, but my friend asked if i had asthma...and so i looked stuff up and found out about EIA. Im wondering if i should go to a doctor, cus i have some people telling me im just out of shape...but i dunno cus i rememeber coughing a lot during exercise for the last two years or so. Its a deep harsh cough from the chest. One person told me i might have just normal asthma. I never had allergies before but in the last year or so i have noticed that especially in the summer ill have what feels like sinus problems...just a feeling of pressure around my nose/eyes and a headache. I never used to get headaches much before either. I dunno if im imagining things now cus im wondering wat my symptoms are, but it feels like im either getting sick (cus my sister had a cold recently) or something else..cus my chest feels a little tight, ive got that sort of sinus pressure feeling and a little bit of a headache...Does coughing/getting congested from laughing have anything to do with asthma? cus i dont even have to laugh hard to get that. In a conversation i can laugh several times off and on and then start coughing (with phlegm) ### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to know more about you like your age, nose symptoms, weight, height, family history, etc. etc. However, from your provided details, at present I would like to make suggestions for you as follows:1. Yes, bouts of coughing and breathing difficulty/fast breathing/wheezing (whistle like sound from chest) while exercise and laughing suggest asthma. Asthma is a very broad diagnosis, it can be due to allergies or other non-allergic reasons to. Sinusitis (a sinus disorder) and obesity also worsen asthma symptoms.2. As you have above symptoms and also sinus problems, I would suggest you to consult a doctor who may suggest you investigations for diagnosis of asthma and allergies also.3. I usually suggest my such patients' spirometry with post-bronchodilator reversibility testing and post-exercise testing to diagnose/rule out asthma. 4. Sometimes exercise related breathing issues can also be non-asthmatic, so it is important that you see a doctor and get diagnosed by him/her.5. If you are obese, weight reduction will also improve your symptoms to some extent.6. Control of sinus symptoms with antihistamines (cetirizine or levocetirizine or fexofenadine etc.) and regular steam inhalation will also gradually improve you symptoms.7. Regular physical exercise including breathing exercise and healthy diet rich in vitamins & minerals will gradually improve your lung capacity and immunity respectively in a long run.8. Please avoid exposure to dusts, smokes and air pollution as much as possible.9. For breathing difficulty/wheezing/asthma symptoms, your doctor suggest you to use albuterol inhaler on as-and-when-needed basis or inhaled corticosteroids on regular basis depending upon your spirometry report and detailed examination. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi. I am a doctor and doing PG degree at an institute. I am married since 7 years.I live away from my wife and kids. I have been late in joining my PG course like by 10 years due to some issues. Finally I am doing it. But now due to seperation from my kids, I am feeling very sad, my sadness reflected in my work, making me lag behind other my peers who are far younger than me like 7 to 10 years.I have a very low confidence level. for that, I consulted a psychiatrist, who put me on paroxetine and propranolol. But it wasn t helping me any good except the propranolol. So, I started taking fluoxetine and later escitalopram on my own, which did help me to a certain extent, but that too was inconsistent. I was feeling confident at one point while anxious and helpless with poor confidence at other point. And, the major issue( which has compelled me to write a post here) is that I have become extremely extremely shy of women around! Well, I am an introvert, and have never been so comfortable around females, but that wasn t as serious an issue as this is! It has grown up TREMENDOUSLY! I am extremely timid in front of females, I can t talk looking them in the eyes. If I look, I stare. So I better avoid eye contact. This behavior gives them the impression that I am flirting with them! No matter how good or bad looking the person may be. No matter how old is she from teen to granny. I am terrified by the fact that few of my female teachers above 50 years are in the delusion that I am in love with them! Shit! What s this! It is totally out of my hands. These antidepressants are just making my life miserable in this regard. Otherwise I am fine. Can manage almost anything but not this female thing. I am helpless here. I even tried modafinil for some time. But this also couldn t do any wonders. Mostly my gynophobia peaks in early morning, evening hours. I use to take escitalopram in the night or morning time. Modafinil in the morning or evening. But when I am being helped by escitalopram or modafinil, that time I can confidently face females. But those are very few times. Mostly I am having a disadvantage at female interaction. What should I do? I being a doctor, am expected to be free with female colleagues like my all other male friends are, except me. And everybody knows that I am a married man. So they will be having bad image of me in their minds like he is a pervert..or so. I am not just being able to break this jail which is eating me out of female trouble! Help me plz.. ### output:

Dear serve understand your concerns went through your exhaustive details. You are a doctor, and you know how your mind work. If you become worried, naturally your whole of the cognition pattern changes. Try to be happy against all those odds can naturally help you. I see there are many negatives, but everyone has negatives. You were initially worried because you were compelled to stay away from your family and kids and therefore were not able to concentrate on your PG studies. Then it went on to anxiety, introversion, lack of eye contact with girls etc. at last you are trying to come down heavily on yourself like calling yourself pervert etc. Can you see the pattern of worries hung around? Worries devastate you. You are not the only person in your PG institute staying away from family. There will be many. How they are able to cop ? Ask yourself or talk to them. Initial stages, it is natural that you will have disappointment, distress and nostalgia. Everyone come across. Then you should train yourself to overcome those feelings. Everybody does. I suggest, online counseling and Cognitive Behavior Therapy. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Yes please answer my question. I had a Scooter accident on May 10th 2014.. My Doctor had changed the medication 3 times . Doctor first gave me Clindamyon 300Mg. with Sulfmaeth 800/160 for 10days. The infection did not get better .then I went back to my sane Doctor he changes the antibiotic to Amox-Clav 875 mg for 10 days . Infection no better just becoming more painful and more swollen. Went back to my same DR, he changed the antibiotic to Doxycline for 10 days.. not better.... I took my roommate to his Doctor s referral to see a broken bone specialist. He saw my leg so swollen it appears as if it s two legs from 2 people. This Dr. Stated that I need a wound care Specialist I feel as if My Doctor has been playing games with my life. It has been 30 days and my leg is so infected that it making me sick. I finally received a call A from a Wound Care Management Doctor whom is traveling from Jacksonville. I was so sick and did mot sleep for 48 hours from the pain and suffering that I have endured. I missed the call.. She will be in Daytona today. I am scared this has turned into a staff infection. My Doctor did not drain nor did he seem to be trained in this area. I had to use anger to get him to listen to me. I gave his office a choice to take care of this now or I would change Doctors That is the reason he gave me a referral. The infection is located about 5 inches above my left knee cap. And all around the infection it is swollen with knots all around my upper leg. None of the medication has helped. I trusted this Doctor . I am not a name dropper so I won t mention any names. If I stand on my legs for more than 10 minutes my legs becomes so swollen all of the way to my ankle ,that I can hardly walk. Could this have turned into something that is so serious that I may need to be hospitalized and given interveinious antibiotics . I have Humana Insurance which pays 100% . I am hurt by the Doctor keep telling me that it leg was looking GOOD when in fact it is worse !!! I have someone in my home that is pregnant or I would of driven myself to Bert Fish Hospital which is 20 miles away ,but the best Hospital and the Doctors there will not allow a patient to leave until they check one thoroughly. My Doctor did not take blood sample or X-ray.. Underneath my right arm there is a knot and the pain from this knot travels up my arm around to my right shoulder and to my back. My Doctor finally gave me a referral for a CT . This apt, is not until next Monday. I feel as this is serious . Please give me your advise. It has taken me 45 minutes to compose this letter due to the fact that the pain on the right underarm and shoulder is so bad . I could scream .As well as my left foot and leg continues to swell any pressure on my left leg even just to sit causes it to become more swollen it is red and a hole about a 1/2 inch deep with yellow ,green and brown drainage After I see the Infection Management Doctor arrives in Daytona today and get her advise I believe I should consider change my Doctor. Thank you for the future advise and consideration you can give me.. Have A Blessed Morning. Jeannie Mitchem. ### output:

In my opinion you have osteomyelitis which is bone infection antibiotics success rate against osteomyelitis is very low so surgical removal of the segment if bone infected is the best option, (it is not amputation it is just like scratching infected layers of bone)your arm pain is a bad sign as it could mean infection is spreading one more advice (do not take vitamins as the bacteria will benefit from it more than you) if I was your doctor I would have preformed an MRI or a CT scan first thing Good Luck

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: The crack of my butt -- high almost to where it ends near my lower back is scaly and red and itchy and when I sit on the toilet it leaves a pink blood stain -- not a lot but it s raw enough to slightly bleed but not hurt. In and around my actual anus it is very itchy and has been for years. I try cortisone creams live Walgreens etc but the cream itself makes the condition worse. Prescription strength corticosteroid make it go away and I have even gone so far as to spray the area with flonase nasal spray my mother used for her allergies but I noticed that after I did that I got stretch marks on my lower belly which are now going away. The folds between my buttocks cheeks are now left to right brown/red stained or strangely pigmented mirror images of each other. The texture of the skin is otherwise normal with no skin tags or warts . The area directly around my anus is flaky and itchy and I can peel it off like onion skin. I am a male 46. I have gained a lot of weight slowly over the past 8 years ( about 50 pounds) and I am under psychiatric care for panic and anxiety but in reality I can t climb stairs or walk fast because I get light headed -- this is not panic -- I just assume it is because I am too afraid to let an MD touch me unless its to see a psychiatrist -- I am now taking 4mg alprazoloam per day and mg Inderal. Sometimes the symptoms are better but overall I am severely agoraphobic and my life is awful -- I do not feel like a normal person and it s not mental. I work as a writer and I write very well but my mind is very screwed up. I scare easily and things that would normally just annoy someone, make me get very weak where I have to lie down and sleep -- when I can sleep -- if I am out in the sun or I get hot I feel awful and if my shower is too warm I take hours and hours to cool off. I also have wheezing when I get nervous -- like taking a shower. The wheezing is not that bad but I can feel it. I cannot lift or carry anything -- I get so weak so fast that I have to lie down and rest -- sometimes it takes days to get over this. This atrted in 2006 with a full blown panic attack and some kind of subsequent nervous breakdown but prior to that I was fearful of cold sores which wi Oulw get once every two years -- most of this started after the death of my younger brother which was very bad but I find it hard to believe that everyone else in my family is okay, but I am this big fat, sweaty, out of breath, itchy assed, guy who can no longer work or do anything sociable without having a glass of wine -- if I try to take less xanax I get horrible withdrawal symptoms -- all it does not is keep me from getting withdrawal -- there is really no ther purpose for taking it.. Also, this all started at the same time I developed a lot of discreet keratosis on the backs of my hands and the tops of my feet. ### output:

Hi. I realize the feeling you have with all those conditions. Itching and flaking around the anus and in the buttock area, which tend to be moist is likely due to fungal infection. Fungal infections are notorious to get better with steroids, but recur in the same areas causing a vicious cycle with their use. Blood stains occur due to repeated excoriation and itching and the area becomes macerated when moist. So please get a fungal smear of the area, to see for fungal elements which can be then taken care of by keeping the area Chat Doctor. Also check your blood glucose profile checked because this may be the harbinger of diabetes, which you are prone to being obese. Steroids would cause skin atrophy and stretch marks on repeated use and needs to be stopped, as also can it cause systemic side effects with repeated use. Hope I have answered your query. Thank you.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had brain surgery for Epilepsy in 2005. They removed a section of the right temporal lobe, the hippocampus, and amygdala. Ive been on anti-depressants and anti-anxiety meds since. After many anti-depressants did not help, I was put on Amitriptyline. I take Diazepam for anxiety. With my depression, I had severe insomnia. My Psychiatrist slowly increased Amitriptyline dose and tried adding several meds with it to help sleep and depression. I cannot take Ambien or Lunesta. She tried Trazidone, Ritalin, & when they didnt help, she raised my Amitriptyline all the way up to 200 mg. So I was at 200 mg Amitriptyline and 20 mg of Diazepam at night. I started having uncontrollable muscle spasms when I sat or tried to lay down. She added 3 mg Requip, & then had to up it to 6 mg at bedtime. After concerns over the high dose of Amitriptyline, she lowered it to 150 mg at night and added 10 mg of Celexa. About a week after being put on medicine, I started having problems. Raised BP, cold & shivering, etc. My Psych wouldnt return a call for 3 days in a row, so my pharmacist sent me to the ER where I was diagnosed with drug toxicity. The ER dr had me stop Celexa for 3 days, and then take it every other night until my neurologist could see me. I had to cancel first appt. with my neurologist because I was too sick to drive. I have lowered my Amitriptyline to 100 mg and take the 10 mg of Celexa everyday now, & 20 mg of Diazepam at night. I stopped the Requip. For several weeks Ive had problems with dizziness & falling, especially if I bend over and stand up, or kneel down & stand up. It doesnt matter how slow I move. If I take the meds, I sleep anywhere from 3 to 5 hrs a night. skipped meds one night so I could try taking them in the day. I slept for 15 hours. Tried this a few times, same results. I had an incident over the summer, before Amitriptyline was raised so high and before Celexa and Requip, where I went to bed early one night, woke up 13 hours later, couldnt remember any of the 250 pages I read in a book I had already started, and felt off balance and sick. I went to ER, x-ray & CT scan were clean. I saw my neurologist, he did an MRI and EEG. Both were normal. After being put on Requip, I went back to him. The tremors that I only had on my right side were now on the left. My balance was off, which is wasnt after MRI and EEG. I do see my neurologist Wed., Feb. 5, 2014. What do I need to ask him to do? Sleep study? My pharmacist doesnt think its the meds. My sleep is completely off. I am depressed, with suicidal thoughts (I had suicide attempt in 2006), and I tremor and have balance issues that make me fall or grab on to something all through the day. Help? ### output:

Hi, Thank you for posting your query. You have features of severe depression, and the antidepressants need to be streamlined at an appropriate dose. Your current symptoms are not related to the epilepsy surgery. You should ask your neurologist the cause of your tremors. One-sided tremors are not sued to side effects of medicines. If tremors are due to Chat Doctor. You need toast him whether you have Parkinsonism. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health,

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Greetings! I am happy to find that there is a free medical forum.Thanks to those who started this forum and all the doctors who joined. I am a LUPUS patient, age 31female My lupus was diagnosed in 2009 Lupus nephritis I am on remission and my medicine is 5mg prednisone taken twice a week(Tuesday and Friday) Vitamins(500mg calcium and 500mg vit C) ***My CBC one month before DengueFever is: HGB 125 RBC 4.38 WBC 4.2 PLT 233 Now I have Dengue Fever. I was diagnosed to have This fever on the 3rd day after having a high fever of 38.8 temp. DENGUE TEST used is IgG/IgM combo:result is anti IgG(+) Reactive/Positive 1st Day if fever: bed rest and no medicines taken for fever I just drank pure water 2nd Day: see a doctor and she prescribed *to Start drinking 500mg paracetamol every 4 hours *To drink fluids:oral rehydration salts( dissolved in 2 of pure water) and 1 liter pure water--I drink fluids and I urinate every 1 hour most of the time except at night when I am asleep,I wake up just to drink my fluids. I drink 1 liter of fluid oresol and 1 liter during the day but my 1 liter pure water I drink it for 24 hrs * To take Vitamin c twice a day * green colored stool but no diarrhea * I have profuse sweating Mild abdominal pain Mild joint pains(mild because I am used to the pains of arthritis in lupus) Feeling weak No appetite Feeling of wanting to vomit but I never vomit 3rd Day of fever: CBC result WBC 6.4 HGB 150 PLT 187 Mild abdominal pain Mild joint pains Feeling weak No appetite Feeling of wanting to vomit but I never vomit * I noticed that I have bloated stomach- I don t know if I have it already on the 1st or 2nd day * still have green colored stool 4rth Day of Dengue :CBC Result HGB 130 PLT 192 * my temp subsides to 37 degrees * At Night a muculopapular rash appears still weak but not much mild abdominal pain * with green colored stool and already wet like diarrhea - 3 times to defficate Now I am on my 5th day of dengue: *Temp is 35 degrees my doctor adviced me to continue drinking my paracetamol every 4 hours for 24 hours only * still have rashes * still bloated stomach and mild abdominal pain * with green colored wet stool 5 times to defficate - like diarrhea Why do I have bloated stomach and diarrhea ?is this dangerous specially that I have lupus? What is the effect of dengue on my lupus and will it affect my organs? Is the 5mg of prednisone still okay to take even if I have dengue?i already drank pred 5mg twice while having a dengue fever. Please advise me and kindly give me additional info on good dengue and lupus management and other advice if its okay. Thank you very much!!! ### output:

Welcome to ChatDoctorGreetings of the dengue usually affects the platelet count. As dengue is caused by virus it does have some amount of upper Gastrointestinal symptoms like bloating of the stomach. There is no cause of concern. You can safely continue taking steroid for lupus state. Getting dengue does not usually worsen lupus state. Rest be assured everything is alright. Do get a platelet count repeated. Take disregards Chat Doctor.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 50 year old female and have always been in good health. About four weeks ago I was diagnosed with viral meningitis after a CT Scan, MRI (with and without contrast) and a lumbar puncture. I never had a fever or stiff neck - only a headache that would not go away and vomiting on several occasions. I also developed double vision about 10 days after the headache started. The day before the double vision started I had received a clean MRI; however, once my vision was affected (on a Friday afternoon) my primary doctor suggested I may need to go to the ER. The next morning on Saturday I felt worse and experienced more vomiting so I headed to the ER. They admitted me and after 5 days in the neuro ICU and a round of every test they could run, the final diagnosis was (or it seemed like their best guess) was viral meningitis. I ve now been home from the hospital for three weeks and still do not feel well. Additionally, I have seen a neuro-opthalmologist specialist that agrees with the diagnosis. She reviewed the results of the lumbar puncture as well as conducted a round of tests, and she did not find any permanent damage and believes the double vision is post-viral. I still have headaches and feel like I am slightly dizzy and like I am in a bit of a fog. My neurologist says to rest, drink plenty of fluids and be patient; however, I am very depressed and worried that I am never going to feel well again. Also, the double vision is terrible...although the opthalmologist says it is normal for this to take up to several months to go away. Additionally, the neurologist says you are fortunate that you did not suffer a stroke, seizures, memory loss...and that you are walking and talking . While I am greatful that I did not suffer those things, I have not worked in 5 weeks and have no quality of life. The feeling of being in a fog is worse than the headaches. As soon as I get up and start moving around, I feel strange and feel like I should sit down. I am eating and drinking the fluids as the doctor suggested and resting all the time. Because I m not getting any real clear answers from the doctor, I have spent a lot of time reading articles on the Internet and I am very scared now. Most documentation out there says I should have been better in 7-10 days with Viral Meningitis; however, there are numerous stories of people that say their lives have never been the same and they were sick for months (some years)! At this point I don t know what to do. If I go to another Neurologist for a second opinion, I am pretty sure that my insurance will not cover an additional round of the same tests. The current Neurologist is at a loss other than doing a 3rd MRI - and the insurance company has not yet authorized. ### output:

Hi, I am Chat Doctor. I have read your question and understand your concerns. Let me try to help you Question : What causes dizziness and double vision after suffering from viral meningitis? Answer : Meningitis Causes Scarring (damage) of Sub arachnoid spaces. It is through these spaces blood vessels that carry blood to your brain stem travel Assume the Blood vessels as flexible pipes (or hoses) that carry water. What will happen if some stones are thrown over them. They will compress the flexible pipes. Isn't tit Same way Due to Meningitis, the areas around the blood vessels (Sub Arachnoid Spaces) are damaged. Hence, they interfere with Blood Circulation to your brain stems causes dizziness and Double Vision Some Times, The Nerves can also be directly involved by the scarring (That is electric lines running along the pipes) Most of these cases will heal completely Anyhow, I would advise you to do another MRI after 4 weeks and compare both Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I suffer from diagnosed Adhesive Arachnoiditis and have done for 15 years. For the last 5 years I have been treated with; Oxycontin/160mg three x day, Lyrica / 150mg twice a day, Panadol, Vit c, Vit b, Neocytamen / 1ml a month, Colon Cleanse- nightly ( magnesium oxide, magnesium carbonate). But I have never been well enough to manage and have been bed ridden with; extreme pain, vertgo and vomiting when sitting or standing long, spinal headaches, temporary partial paralysis in limbs and head etc, various pain sensations - some of which are severe etc etc etc. But the most horrific pain is an unbearable pain deep in my sacrum at the site of the myelogram, that caused my arachnoiditis. After a problematic colonoscopy 8 years ago the pain in my sacrum has been more intense and my bowel periodicaly produces such severe pain I cannot manage it. I also have a hiatis hernia , constant nausea, vomitting with severe pain, along with bouts of diorrea. So I lose my meds easily, putting me in a cycle of pain we cannot control. Since immigrating I have not found any knowledgable GP s so I get no advice or refferals and my full time Caregiver has no help, leaving us to manage alone. My old GP told us my meds would need revising yearly as pain levels will only increase as the nerves are damaged and that gradual paralysis will happen. But we have tried for 2 years to get a reveiw to see what stage I am at and increase pain medication etc. However all the Doctors here seem to think arachnoiditis is just long term pain rather than the insidious disease it really is. The pain I go through is so severe I never even knew it existed and we do not understand why Doctors are happy to repeat my scripts, but dont understand that the pain levels increase with the progression of the disease and my meds need reveiwing. Most Doctors do not want to take me and very few even prescribe these kind of meds. Due to selfish drug abusers who never think of the suffering Patients in real pain go through, just so these addicts can get their highs. Specialists authorise my meds and the GP just issues them. But why prescribe a dose which will not even allow me to function in the community and have some quality of life? When I first went on these meds they worked and I got some of my life back. But just like my GP advised; the pain levels and my functions got worse with time, so why dont they increase my dose? I have been told by a few Doctors that my dose is small so what is the difference? If the pain is worse than death why dont they stop it and prevent it? Some GP s go on about addiction to my meds but I have no history and no symptoms of drug addiction or abuse and considering I have absolutely no life with this incurable disease addiction is the least of my worries. Doctors here refuse to discuss arachnoiditis and will not help. We are at a loss as to what to do and I cannot go on much longer like this. ### output:

Hi, Welcome to Chat Doctor Forum. Arachnoiditis is a pain disorder caused by the inflammation of the arachnoid which is one of the membranes that surround and protect the nerves of the spinal cord. This can happen because of an irritation from chemicals, infection from bacteria or virus, as the result of direct injury to the spine, compression of spinal nerves for a long term, or complications from spinal surgery or other invasive spinal procedures. It is indeed a Difficult condition to treat and Most treatments focus on pain relief and the improving the daily function. This includes pain management, Physiotherapy, psychotherapy and exercise. Just continue the medications which has been prescribed to you and go for regular follow up. Don't lose hope. You can divert your Attention by doing yoga and meditation daily. Do Take Care.

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i had came out of school and i was single. i have started working for a company and had devoted myself to them. Through out the first few months working for this company. I had began to noticed that i have a skin disorder called Vitiligo. This has impacted me as i had went into a depression for awhile. I was my own coach and although my father has it i knew it was genetic. Through the years i had seek help for vitiligo, but came to terms that there is nothing else that can be done but wear makeup. However the field i m in is stressful, and there are many demands on workers like myself. Nonetheless i had met someone outside of my work who has a child and since then we now have 2 other boys of which the older and youngest ones have disabilities. The other thing is my preevious employer, i m sure had feeliings for me and was jealous of my spouse. I felt harrassed many times as my employer was personally picking on me. This employer even made up a lie about my spouse which tried to get me into trouble about breaking confientiality. I had felt stressed to go to work. I had expressed my stress/anxiety by gagging before i arrived at work. About a year ago i had went to one of my sons, touraments, where there was lots of people and when he was presented a certificate, i was happy but i had expressed that by gagging 2 or 3 times. I had embarrassed him and my family and myself. That year, had expierence gagging fits @ my sons soccer games, i did not gag at all of them, i had tried to calm myself or even walk away. That did work sometimes. However the interesting thing is, when i had finished my gagging, (it could be 2 or 5 times) i felt relief or a sense normallity. Since then i work indirectly to my previous employer. I know there are some possible stressors. I am forty years old and I have thought about a possible career change. That alone is stressful in itself. But, now after being out of shape and overweight for about a year. I know my health is also taking a toll. I had went to see a naturalpath who prescribed me (ignatia amara 30 ch), i have yet taken them despite knowing the side effects may be horrible. I know this when i went online and it said that when the person feels horrible feeling the medication is working. However , my girlfriend is on medication and she at the beginning felt horrible and the withdrawwals were bad too. However she continues to be on them. Anyway, I still have anxiety, and i still gag. It seems like i get anxiety when there are lots of people around me, i feel a lump in my throat, it feels then that my shirt is too tight or coat. My gagging seems to be impulsive, i sometimes never know when it may happen. My girlfriend is embarrassed when i gag and gets upset with me and will walk away. Sometimes i don t mind because i might vomit. She did say that i need to get help as it is affectiing my home and possible work life. I have even thought about not being here. But, that is not an option, i have too much too loose, my family needs me and i am a role modle. I know that ending my life is no escapegoat and i have the ability to change my life. I have always been a very optimistic person and centered and believed in people. However, sometimes i don t care, and feel angry and alone. I am thinking about seeing my naturalpath again or even my doctor. Any info you can give me will be greatly appreciated. Sam ### output:

Hello, Thanks for choosing Chat Doctor for posting your query. I have gone through your question in detail and I can understand what you are going through. This illness is called agoraphobia and this is treated with relaxation therapy. Further paroxetine is also a good Chat Doctor. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/

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

### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am 56 years old and have had fibromyalgia since the early 1980 s. Over the years I have had lots of joint, tendon and ligament stresses and strains and muscle pain just from everyday things like holding and picking up my children when they were little. It appears that degenerative disc and joint problems run in my family. My mother has now had both hips and knees replaced and several other family members too. I have been told I need a knee replacement in one knee and will be having scope surgery on the other knee tomorrow to repair the meniscus and clear out whatever is floating around in there. What is bothering me the most right now though is I had cortisone injections this past year for tarsal tunnel and other nerve pain caused to the top of my foot from a foot insert that made my shoes too tight. The first injection was in August, and then a second one in November because it seemed they missed the spot on the top of the foot. After the August injection I didn t seem to notice any major side effect, but after the November injection I felt like a hit a wall and had no energy, my muscles felt exhausted and weak, I started having muscle cramps, especially in my calves in the night and pre-waking hours of the morning, for a couple weeks I felt shaky and light-headed, and I also started losing a lot of hair. My primary doctor told me it threw my blood sugars off (I don t have diabetes) and she did blood work and said everything else was fine other than low vitamin D levels. I was referred to an endocrinologist and told the same thing. I was told it would probably take 2-3 months for me to feel back to normal again. I ve been taking vitamin D supplements and a multivitamin with minerals consistently for 6 months now and I don t feel much better, the night time muscle cramping and hair loss has stopped, but I feel totally exhausted and my muscles feel weak and the leg muscles seem to contract and not release, especially in back of the upper leg and behind the knees and the overall joint and muscle pains throughout my body have increased. I can t stand or walk but a few minutes before the muscle cramping and pain kicks in. In the past I experienced hair loss a couple other times, but my doctor and I didn t know why. Now looking back I m sure it was due to the past cortisone injections I had for my knees and I assumed all the other symptoms were due to a fibromyalgia flare-up. I feel like I have aged and turned into my grandmother overnight this past winter. Even my own mother who had both hips and knees replaced moves better and is healthier than me. Is this all due to the cortisone injections? Is the fibromyalgia in hyper speed due to the injections? Could there be some other problem? Will I ever have enough energy and pain relief to get up and go again? I am beginning to think I will need a walker or wheel chair any day now. ### output:

Hello cortisone injected intra-articular does not produce systemic side effects elsewhere in the body as it is formulated to remain within joint and doesn't absorb in blood stream to reach elsewhere in body organs or system. Though your mother may look stronger but since you have fibromyalgia, your case is different. Hopefully you consulted endocrinologist and followed his advice thoroughly. See a fibromyalgia specialist who may like to prescribe pregabalin and amytrytaline tabs if necessary to give more symptomatic relief if necessary.Also, methycobalamin tabs may help. Do not worry, take fresh juices and nutritious diet and take physical therapy exercises.It's a difficult disease but there can be ways to improve quality of life, that is by practicing meditation and spiritual practices also and taking life easy. Mental happiness has proved to have benefited several fibromyalgia patients in some unknown ways. Probably, endorphins chemicals in brain which interpret pains and aches are regulated with meditation practices, and scientifically reduce pain perception or increase pain tolerance and thereby quality of lifebelt wishes