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### Instruction: Answer this question truthfully ###Input: Hello doctor,I and my partner had sex yesterday. We were using condoms but he had changed the condom three times already. On the last one, he took it out because he felt like he needed to ejaculate but it went away after he had pulled out. He then asked me to masturbate him and he ejaculated a little not even a lot. So I realized that the tip of the condom was ripped. I was scared of what if his precum went inside me. He says no but most guys does not even feel when their fluid comes out. I was ovulating last week I do not know if I should take plan b pill or not? I am also scared of the side affects. ### Response: Hello. You are right to state that if the condom was torn, there may have been some precum gone inside the vagina and even that can make you pregnant unless your partner is absolutely sure about it. You can choose to take the emergency contraceptive pill within 72 hours of intercourse. It would cause bleeding in the next five to seven days and may be even scanty to heavy. That should prevent any implantation and prevent fertilization by increasing the tubal motility. If you are not sure then you may consider this method of contraception. Side effects may differ in different users from headache, dizziness to nausea and delayed periods in the next cycle with heavy flow. You may choose not to use it. Ideally speaking the chances are getting pregnant cannot be ascertained or quantified as you are not sure about the ejaculate. If you want you can wait till your next periods and if you miss them by seven days, then you can do a pregnancy test done to affirm or neglect the pregnancy. And if positive then safe termination by the medical method can be opted under specialist supervision.

Hello doctor,I and my partner had sex yesterday. We were using condoms but he had changed the condom three times already. On the last one, he took it out because he felt like he needed to ejaculate but it went away after he had pulled out. He then asked me to masturbate him and he ejaculated a little not even a lot. So I realized that the tip of the condom was ripped. I was scared of what if his precum went inside me. He says no but most guys does not even feel when their fluid comes out. I was ovulating last week I do not know if I should take plan b pill or not? I am also scared of the side affects.

Hello. You are right to state that if the condom was torn, there may have been some precum gone inside the vagina and even that can make you pregnant unless your partner is absolutely sure about it. You can choose to take the emergency contraceptive pill within 72 hours of intercourse. It would cause bleeding in the next five to seven days and may be even scanty to heavy. That should prevent any implantation and prevent fertilization by increasing the tubal motility. If you are not sure then you may consider this method of contraception. Side effects may differ in different users from headache, dizziness to nausea and delayed periods in the next cycle with heavy flow. You may choose not to use it. Ideally speaking the chances are getting pregnant cannot be ascertained or quantified as you are not sure about the ejaculate. If you want you can wait till your next periods and if you miss them by seven days, then you can do a pregnancy test done to affirm or neglect the pregnancy. And if positive then safe termination by the medical method can be opted under specialist supervision.

### Instruction: Answer this question truthfully ###Input: Hello doctor, My mother had a total knee replacement two months ago. Doctor suggested to put knee splint for nearly a month, and after that, she went to physiotherapy and her knee is very stiff now. She could not able to bend her knee, and having excess pain. Almost her BP is raising during physiotherapy and the pain stays for a day. Is this normal? ### Response: Hello. You have mentioned that your mother had her knee replaced two months ago. I am assuming it is a primary rather than a revision. I will be concerned as much as you are as by six weeks we expect at least a 0 to 90 degree knee bend. By this, we mean that the patient can bend her knee sitting on the edge of the chair and have her foot planted on the ground comfortably. If this is not the case then we need to look at her progress with physiotherapy. If this is slow but steady and the patient is making satisfactory progress weekly and is able to actively participate in the physiotherapy without much post-therapy pain, then I will recommend continuing with physiotherapy but keep a strict eye on the developments and progress. If it is neither i.e. range of motion is less than 0-60 and the patient is struggling with physiotherapy then you seriously need to go and see your surgeon. And I will recommend a MUA (manipulation under anesthesia) which will improve her ROM (range of motion) and make her life with physiotherapy much easier. Also, if you wish you could upload her x-rays post-operatively and a picture showing her ROM and may be I can help ou further and will be able to guide you towards the next steps that you need to take. In the mean time ice the knee after each physiotherapy session.

Hello doctor, My mother had a total knee replacement two months ago. Doctor suggested to put knee splint for nearly a month, and after that, she went to physiotherapy and her knee is very stiff now. She could not able to bend her knee, and having excess pain. Almost her BP is raising during physiotherapy and the pain stays for a day. Is this normal?

Hello. You have mentioned that your mother had her knee replaced two months ago. I am assuming it is a primary rather than a revision. I will be concerned as much as you are as by six weeks we expect at least a 0 to 90 degree knee bend. By this, we mean that the patient can bend her knee sitting on the edge of the chair and have her foot planted on the ground comfortably. If this is not the case then we need to look at her progress with physiotherapy. If this is slow but steady and the patient is making satisfactory progress weekly and is able to actively participate in the physiotherapy without much post-therapy pain, then I will recommend continuing with physiotherapy but keep a strict eye on the developments and progress. If it is neither i.e. range of motion is less than 0-60 and the patient is struggling with physiotherapy then you seriously need to go and see your surgeon. And I will recommend a MUA (manipulation under anesthesia) which will improve her ROM (range of motion) and make her life with physiotherapy much easier. Also, if you wish you could upload her x-rays post-operatively and a picture showing her ROM and may be I can help ou further and will be able to guide you towards the next steps that you need to take. In the mean time ice the knee after each physiotherapy session.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I did not use left side for eating prior to RCT. Little pain was there but not sensitivity. After one corner broke then I went to the doctor and they suggested me for RCT as it happened because of cavity. One of my tooth second last from the end of lower jaw. One day it broke down and I went to doctor then they said you should go for RCT and I took RCT treatment. Prior to this I did not use that side for chewing as sometimes it hurts suddenly. So before RCT one of the corner was broken down already.After RCT, again one corner broke down again and now when I close my jaws it hurts. Also when I rub my finger slightly it hurts sometimes a little pain. No sensitivity is there with cold water but hurts little when I close my jaws or I rub my fingers on it. ### Response: Hello, Welcome to ChatDoctor. I have gone through your query and understood your concern. When a tooth decays and when the nerve layer of the tooth is affected, it starts to give out pain and it loses its vitality becoming more brittle. Hence it could have fractured. Also, to save such tooth, root canal treatment will be performed. Mild pain/discomfort after RCT is quite normal for the next 3 to 5 days for which you would have been put under pain killers. This period is for tooth healing and it is essential that you do not disturb or bite food on that tooth. Once it completely heals, crown procedure is generally performed. Placing a crown over the root canal treated tooth is mandatory to protect the tooth and to prevent further fracture of the tooth. Do visit your dentist for the crown procedure and till that do not eat hard, chewy foods and avoid chewing food on the involved side.

Hello doctor,I did not use left side for eating prior to RCT. Little pain was there but not sensitivity. After one corner broke then I went to the doctor and they suggested me for RCT as it happened because of cavity. One of my tooth second last from the end of lower jaw. One day it broke down and I went to doctor then they said you should go for RCT and I took RCT treatment. Prior to this I did not use that side for chewing as sometimes it hurts suddenly. So before RCT one of the corner was broken down already.After RCT, again one corner broke down again and now when I close my jaws it hurts. Also when I rub my finger slightly it hurts sometimes a little pain. No sensitivity is there with cold water but hurts little when I close my jaws or I rub my fingers on it.

Hello, Welcome to ChatDoctor. I have gone through your query and understood your concern. When a tooth decays and when the nerve layer of the tooth is affected, it starts to give out pain and it loses its vitality becoming more brittle. Hence it could have fractured. Also, to save such tooth, root canal treatment will be performed. Mild pain/discomfort after RCT is quite normal for the next 3 to 5 days for which you would have been put under pain killers. This period is for tooth healing and it is essential that you do not disturb or bite food on that tooth. Once it completely heals, crown procedure is generally performed. Placing a crown over the root canal treated tooth is mandatory to protect the tooth and to prevent further fracture of the tooth. Do visit your dentist for the crown procedure and till that do not eat hard, chewy foods and avoid chewing food on the involved side.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have been experiencing upper left abdominal pain just beneath lower ribcage and on the opposite side in the back. I have intermittent, dull, and deep chronic pain.I am 43 years old, nonsmoker but consumes alcohol (not for the last four months). My blood pressure is 120/80 mm Hg. I am currently on Omeprazole 20 mg daily (one month).I am diagnosed with pneumonia and pulmonary embolism. It is confirmed by chest CT. I was prescribed Pradaxa for three months (stopped taking medication on Mark 26). I have a history of acid reflux, sleeps on a 6-inch wedge pillow to manage the symptoms.Tests I underwent are ### Response: Hello. I must appreciate the detail history you provided which is very helpful in diagnosing your condition. After reviewing your history, in my opinion, this pain is not related to pulmonary embolism. It looks like to be associated with some gastritis and stomach issue. Now coming to your queries, the CT Abdomen has ruled out serious abdominal issues such as malignancy but it could not rule out peptic ulcer disease. You can just wait for it and take the medications which I am prescribing. I do not think that waiting is going to cause any further issues as it does not look like to be something serious. Take the following treatment for two weeks and if no improvement then we can consider EGD. None at the moment. Gastritis. Peptic ulcer disease. Esophagitis. Gastritis. Continue Omeprazole but increase it to twice daily before meals. Syrup Gaviscon (Alginate)10 ml three times daily after meals. Both these for two weeks. If no improvement will consider EGD.

Hello doctor,I have been experiencing upper left abdominal pain just beneath lower ribcage and on the opposite side in the back. I have intermittent, dull, and deep chronic pain.I am 43 years old, nonsmoker but consumes alcohol (not for the last four months). My blood pressure is 120/80 mm Hg. I am currently on Omeprazole 20 mg daily (one month).I am diagnosed with pneumonia and pulmonary embolism. It is confirmed by chest CT. I was prescribed Pradaxa for three months (stopped taking medication on Mark 26). I have a history of acid reflux, sleeps on a 6-inch wedge pillow to manage the symptoms.Tests I underwent are

Hello. I must appreciate the detail history you provided which is very helpful in diagnosing your condition. After reviewing your history, in my opinion, this pain is not related to pulmonary embolism. It looks like to be associated with some gastritis and stomach issue. Now coming to your queries, the CT Abdomen has ruled out serious abdominal issues such as malignancy but it could not rule out peptic ulcer disease. You can just wait for it and take the medications which I am prescribing. I do not think that waiting is going to cause any further issues as it does not look like to be something serious. Take the following treatment for two weeks and if no improvement then we can consider EGD. None at the moment. Gastritis. Peptic ulcer disease. Esophagitis. Gastritis. Continue Omeprazole but increase it to twice daily before meals. Syrup Gaviscon (Alginate)10 ml three times daily after meals. Both these for two weeks. If no improvement will consider EGD.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My father is 56 years old. He is having negative thoughts and talks about deaths, has a vivid dream with severe sleepiness. He is not enjoying anything which he enjoyed before. He has short-term memory loss. He has fatigue with increased appetite. He has little issue in breathing during sleeping. He can identify people. But, he is unable to remember what happened before five minutes. He is completely confused by his dreams and reality.These problems have started in my father after a traumatic event in which my father has lost his brother and two sons of his brother in an accident that happened before three months. He has a previous history of Bell\\s palsy, a little hearing loss, and was also diagnosed with a small lesion in the hypothalamus which is not cancerous. I want to know whether these traumatic events have played a part in these symptoms or its due to the lesion. The MRI of the brain shows the possibility of glioma. Please suggest. ### Response: Hi, Welcome to Chat Doctor forum. Your father may have PTSD (post-traumatic stress disorder). It is less likely to be due to glioma. The symptoms of a vision problem and memory loss are due to gliomas. You can give him a small dose of antidepressants and Benzodiazepine for the sleep disturbances. You can give him Sertraline 50 mg daily and Clonazepam 0.5 mg at night for the sleep. We need to re-evaluate him after 10 days and manage the dose. Your father has symptoms both due to the brain lesion and PTSD (family member loss). If your father starts to have psychotic symptoms due to gliomas, then you can give him a small dose of antipsychotic in the future.

Hi doctor,My father is 56 years old. He is having negative thoughts and talks about deaths, has a vivid dream with severe sleepiness. He is not enjoying anything which he enjoyed before. He has short-term memory loss. He has fatigue with increased appetite. He has little issue in breathing during sleeping. He can identify people. But, he is unable to remember what happened before five minutes. He is completely confused by his dreams and reality.These problems have started in my father after a traumatic event in which my father has lost his brother and two sons of his brother in an accident that happened before three months. He has a previous history of Bell\\s palsy, a little hearing loss, and was also diagnosed with a small lesion in the hypothalamus which is not cancerous. I want to know whether these traumatic events have played a part in these symptoms or its due to the lesion. The MRI of the brain shows the possibility of glioma. Please suggest.

Hi, Welcome to Chat Doctor forum. Your father may have PTSD (post-traumatic stress disorder). It is less likely to be due to glioma. The symptoms of a vision problem and memory loss are due to gliomas. You can give him a small dose of antidepressants and Benzodiazepine for the sleep disturbances. You can give him Sertraline 50 mg daily and Clonazepam 0.5 mg at night for the sleep. We need to re-evaluate him after 10 days and manage the dose. Your father has symptoms both due to the brain lesion and PTSD (family member loss). If your father starts to have psychotic symptoms due to gliomas, then you can give him a small dose of antipsychotic in the future.

### Instruction: Answer this question truthfully ###Input: Hello doctor,Before two weeks, I have undergone I and D for breast abscess, from that day I have stopped feeding my baby. On 21st of March doctor checked and said no need of dressing and there is a small lump still present keep warm compress it will go and told me not to feed the baby. I am keeping warm compress daily once but no result. Yesterday, the wound completely healed and there was no leakage of milk from the wound. So I started feeding my baby.In the night I fed my baby on the wounded breast but in the morning I observed swelling again on the breast. So I kept hot compress and started pumping. Then I observed a very thick pus on my nipple just a drop. After that, I am trying to hand express and pumping but the pus is not coming out. Now I am very afraid that my gynecologist may again suggest I and D. In the present scenario it is very tough for me to go hospital every day for dressing carrying a small baby. Please tell me whether it can be healed by antibiotics? Can I feed my baby? If I feed baby will that pus affect my baby? ### Response: Hi. Please do not worry. A single episode of a small amount of pus exudation may occur. Ideally, you should have pumped away the first set of milk and then started feeding. But please do not get distressed now. Keep breastfeeding your baby keeping following things in mind. After feeding from the affected side, use the breast pump to evacuate any residual milk (Do not worry your body will generate enough milk for the baby). Keep hot compressing twice a day. Maintain proper breast hygiene. Do visit your gynecologist if you develop any fever or rise of local temperature. Take care.

Hello doctor,Before two weeks, I have undergone I and D for breast abscess, from that day I have stopped feeding my baby. On 21st of March doctor checked and said no need of dressing and there is a small lump still present keep warm compress it will go and told me not to feed the baby. I am keeping warm compress daily once but no result. Yesterday, the wound completely healed and there was no leakage of milk from the wound. So I started feeding my baby.In the night I fed my baby on the wounded breast but in the morning I observed swelling again on the breast. So I kept hot compress and started pumping. Then I observed a very thick pus on my nipple just a drop. After that, I am trying to hand express and pumping but the pus is not coming out. Now I am very afraid that my gynecologist may again suggest I and D. In the present scenario it is very tough for me to go hospital every day for dressing carrying a small baby. Please tell me whether it can be healed by antibiotics? Can I feed my baby? If I feed baby will that pus affect my baby?

Hi. Please do not worry. A single episode of a small amount of pus exudation may occur. Ideally, you should have pumped away the first set of milk and then started feeding. But please do not get distressed now. Keep breastfeeding your baby keeping following things in mind. After feeding from the affected side, use the breast pump to evacuate any residual milk (Do not worry your body will generate enough milk for the baby). Keep hot compressing twice a day. Maintain proper breast hygiene. Do visit your gynecologist if you develop any fever or rise of local temperature. Take care.

### Instruction: Answer this question truthfully ###Input: Dear Doctor,I am a 29 year old female suffering from PCOD, taking medicines from past 1 year. But still it has not reduced. I was into Metformin and Folic acid. At the same time I have also taken medicines for conception (i.e, clomiphene).Follicar study has been conducted for four times and only once the egg ruptured, but I did not conceive.From december onwards the follicles are not maturing upto required level.Again during February and March my doctor put me on K-35 as my periods during past 1 year were not regular and still are irregular (I have to take tablet Norgest thrice daily for 5 days and then periods come).Recently I have consulted another doctor, she has prescribed me to stop taking Metformin and instead to start on APCOD sachet (Myo-inositol) and Safegest D (dehydroepiandrosterone) and during periods Adova (Anastrozole).But I have not yet started the medicines. I am a bit confused, whether should I totally stop Metformin and start with these new drugs? ### Response: Hi. Metformin is a very effective medicine in PCOD (Polycystic Ovarian Disease) treatment. It reduces weight, increases sensitivity to insulin and decreases an ChatDoctor. All these effects are helpful in the treatment of PCOD. But as you say it is not effective in your case; you can start these above mentioned medications instead of metformin. But use of myo-inositol in PCOD is not very clear. You should consult an expert gynaecologist for your treatment. If you have further questions, feel free to ask an obstetrician and gynaecologist online.

Dear Doctor,I am a 29 year old female suffering from PCOD, taking medicines from past 1 year. But still it has not reduced. I was into Metformin and Folic acid. At the same time I have also taken medicines for conception (i.e, clomiphene).Follicar study has been conducted for four times and only once the egg ruptured, but I did not conceive.From december onwards the follicles are not maturing upto required level.Again during February and March my doctor put me on K-35 as my periods during past 1 year were not regular and still are irregular (I have to take tablet Norgest thrice daily for 5 days and then periods come).Recently I have consulted another doctor, she has prescribed me to stop taking Metformin and instead to start on APCOD sachet (Myo-inositol) and Safegest D (dehydroepiandrosterone) and during periods Adova (Anastrozole).But I have not yet started the medicines. I am a bit confused, whether should I totally stop Metformin and start with these new drugs?

Hi. Metformin is a very effective medicine in PCOD (Polycystic Ovarian Disease) treatment. It reduces weight, increases sensitivity to insulin and decreases an ChatDoctor. All these effects are helpful in the treatment of PCOD. But as you say it is not effective in your case; you can start these above mentioned medications instead of metformin. But use of myo-inositol in PCOD is not very clear. You should consult an expert gynaecologist for your treatment. If you have further questions, feel free to ask an obstetrician and gynaecologist online.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I flossed by a tooth where a filling almost came out and my tooth and gum have been hurting all night. Also have a tooth that is by this molar that fell or chipped out. I do not know if it is an abscess or an exposed nerve in my molar that is right behind it. Took Tylenol 2 every 6 hours twice. It did not help. Used Benzocaine on the area. Helped 20 %. Do not feel comfortable using it at home. ### Response: Hello. Is the pain sharp or dull? Any gum swelling? If the pain is sharp, lancinating and referring to the same side jaw, temple, ear or throat, then this could be from the tooth with the chipped out filling. Most chipped out fillings expose the underlying nerve which causes severe pain. Ideally an X-ray is required to determine the depth of the cavity and to check for nerve involvement. If the nerve is involved, a root canal treatment and crown procedure will be done to save that tooth. If the pain is from the gums and is dull in nature, this could be an accidental gum injury due to flossing or there is a chance of the attempted food deposit to get deeply pushed into the gums causing this pain. If this is the case, a deep localized scaling should be performed under local anaesthesia to relieve any deeply wedged food deposit. A clinical examination and X-ray is required to diagnose the cause of this pain. I see that taking painkillers and topical anaesthetic in this situation were not much of help to you. Please visit your nearby dentist immediately and get the root cause identified. Meanwhile, try warm saline mouth rinses and avoid hot, spicy foods which may aggravate your pain. Take care.

Hello doctor,I flossed by a tooth where a filling almost came out and my tooth and gum have been hurting all night. Also have a tooth that is by this molar that fell or chipped out. I do not know if it is an abscess or an exposed nerve in my molar that is right behind it. Took Tylenol 2 every 6 hours twice. It did not help. Used Benzocaine on the area. Helped 20 %. Do not feel comfortable using it at home.

Hello. Is the pain sharp or dull? Any gum swelling? If the pain is sharp, lancinating and referring to the same side jaw, temple, ear or throat, then this could be from the tooth with the chipped out filling. Most chipped out fillings expose the underlying nerve which causes severe pain. Ideally an X-ray is required to determine the depth of the cavity and to check for nerve involvement. If the nerve is involved, a root canal treatment and crown procedure will be done to save that tooth. If the pain is from the gums and is dull in nature, this could be an accidental gum injury due to flossing or there is a chance of the attempted food deposit to get deeply pushed into the gums causing this pain. If this is the case, a deep localized scaling should be performed under local anaesthesia to relieve any deeply wedged food deposit. A clinical examination and X-ray is required to diagnose the cause of this pain. I see that taking painkillers and topical anaesthetic in this situation were not much of help to you. Please visit your nearby dentist immediately and get the root cause identified. Meanwhile, try warm saline mouth rinses and avoid hot, spicy foods which may aggravate your pain. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 26 years old. I am diagnosed with hypothyroid about four years ago. I started from 0.25 mcg Levothyroxine, and now taking levothyroxine 0.75 mcg. Recently, I lost 4 pounds which is very bad because I am 5.6 tall and my weight is 116 pounds. I feel weak and dizzy very often. I also have irregular heavy periods and symptoms of having too much male hormone (too much hair on legs, bikini, etc, severe acne especially a week before expected period). Since one year my periods cycle became longer, before it used to be 28 days and now it is 38 days.I am also worried because of low insulin and pretty normal glucose. What does it mean? May it be because I am on gluten-free diet for two years? Please also look at my sex hormones prolactin looks too high, and I am not sure about testosterone. ### Response: Hello, Welcome to Chat Doctor forum. I just read your query and the detailed information you have mentioned in the attached reports. (attachment removed to protect patient identity). The thyroid function is good and you must take your medicine regularly as usual. Do not worry about the insulin levels it is a good thing, it means you are perfectly normal. Your prolactin levels are the ones that you should be worried about as they are the ones causing your irregular periods. They need treatment. I would suggest that you take tablet Cabergoline 0.25 mg orally twice a week for two weeks and then repeat your serum prolactin levels. Your testosterone levels are within normal limits and perfectly normal as well. I hope this helps.

Hello doctor,I am 26 years old. I am diagnosed with hypothyroid about four years ago. I started from 0.25 mcg Levothyroxine, and now taking levothyroxine 0.75 mcg. Recently, I lost 4 pounds which is very bad because I am 5.6 tall and my weight is 116 pounds. I feel weak and dizzy very often. I also have irregular heavy periods and symptoms of having too much male hormone (too much hair on legs, bikini, etc, severe acne especially a week before expected period). Since one year my periods cycle became longer, before it used to be 28 days and now it is 38 days.I am also worried because of low insulin and pretty normal glucose. What does it mean? May it be because I am on gluten-free diet for two years? Please also look at my sex hormones prolactin looks too high, and I am not sure about testosterone.

Hello, Welcome to Chat Doctor forum. I just read your query and the detailed information you have mentioned in the attached reports. (attachment removed to protect patient identity). The thyroid function is good and you must take your medicine regularly as usual. Do not worry about the insulin levels it is a good thing, it means you are perfectly normal. Your prolactin levels are the ones that you should be worried about as they are the ones causing your irregular periods. They need treatment. I would suggest that you take tablet Cabergoline 0.25 mg orally twice a week for two weeks and then repeat your serum prolactin levels. Your testosterone levels are within normal limits and perfectly normal as well. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My son is 13 months old and 8 kg weight. He is having loose motion over a week. I have given him Oflomac-M and Sporlac tablet twice a day. As he did not suffice, stopped giving him Amul milk and started Isomil. Later he was fine for the next 2 days and when I started back Amul milk since yesterday, again the stools are thin. As of now I am giving him Darolac twice a day. Should I give Zinc supplement for him? I am feeding him with tapioca water, curd rice, and rusk. Stopped biscuits also. He is absolutely fine and active. Was the medication sufficient? If not please suggest for his speedy recovery. Is this because of lactose intolerance? Do I need to stop feeding him on packaged milk? Currently we are using Amul. Thanks in advance for your response. ### Response: Hi. I have read your question in detail and I know that you are very concerned about your child but do not worry. By what you quote it seems that your child has probably got lactose intolerance, resistant stomach infection or worm infestation. I think you should do stool routine microscopy test and stool culture test to look for any infection and stool for reducing the sugar for lactose intolerance. It is seen in chil ChatDoctor. Continue Similac formula milk and stop Amul milk. Continue Darolac (Lactic Acid) for three days and Zinc syrup for a total of 14 days to increase gut immunity. No need to stop other foods or giving special items like tapioca water. Also, give deworming syrup like Bandy plus (Albendazole) 10 ml once at night before sleep. Take care.

Hi doctor,My son is 13 months old and 8 kg weight. He is having loose motion over a week. I have given him Oflomac-M and Sporlac tablet twice a day. As he did not suffice, stopped giving him Amul milk and started Isomil. Later he was fine for the next 2 days and when I started back Amul milk since yesterday, again the stools are thin. As of now I am giving him Darolac twice a day. Should I give Zinc supplement for him? I am feeding him with tapioca water, curd rice, and rusk. Stopped biscuits also. He is absolutely fine and active. Was the medication sufficient? If not please suggest for his speedy recovery. Is this because of lactose intolerance? Do I need to stop feeding him on packaged milk? Currently we are using Amul. Thanks in advance for your response.

Hi. I have read your question in detail and I know that you are very concerned about your child but do not worry. By what you quote it seems that your child has probably got lactose intolerance, resistant stomach infection or worm infestation. I think you should do stool routine microscopy test and stool culture test to look for any infection and stool for reducing the sugar for lactose intolerance. It is seen in chil ChatDoctor. Continue Similac formula milk and stop Amul milk. Continue Darolac (Lactic Acid) for three days and Zinc syrup for a total of 14 days to increase gut immunity. No need to stop other foods or giving special items like tapioca water. Also, give deworming syrup like Bandy plus (Albendazole) 10 ml once at night before sleep. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My mother is currently taking treatment from a psychiatrist for depression. Her major symptoms are heaviness in the head, lower back pain, mood swings, feeling sad, and negative thoughts. Recently MRI and CT scan were done. CT scan was fine.MRI indicates multiple small T2/FLAIR hyperintense foci without restricted diffusion are seen in bilateral centrum semiovale, the subcortical and deep white matter of bilateral frontal and left parietal lobe. No demonstrable signal alteration was seen in the corpus callosum at present. No evidence of restricted diffusion or blooming seen.Features suggest the possibility of demyelinating etiology or pronounced microangiopathic changes. Please suggest what should be done? Either psychiatry treatment, or neurology treatment? Her main issue is the heaviness of head. She wakes up with negative thoughts, feeling like crying and suicidal behavior. She is currently on Ventab Xl, Mirnite, Clonotril, Olimelt, Lupirtin SR, and Sertee. ### Response: Hello, Welcome to Chat Doctor forum. I understand your concern and would explain that your mother\\s symptoms seem to be related to depression with psychotic signs. The lesions in MRI are suggestive of small vessel disease. I would recommend taking daily baby Aspirin 80 mg to help the progression of these changes. In my opinion, her current therapy is quite complicated, and many interactions between ChatDoctor. I would recommend stopping Mirnite (Mirtazapine) and Sertee (Sertraline) because they both interact with Ventab XL (Venlafaxine). Increasing the dose of Ventab XL may be necessary. Treatment of depression will help reduce the headache. You should discuss with her psychiatrist on the above treatment option.

Hello doctor,My mother is currently taking treatment from a psychiatrist for depression. Her major symptoms are heaviness in the head, lower back pain, mood swings, feeling sad, and negative thoughts. Recently MRI and CT scan were done. CT scan was fine.MRI indicates multiple small T2/FLAIR hyperintense foci without restricted diffusion are seen in bilateral centrum semiovale, the subcortical and deep white matter of bilateral frontal and left parietal lobe. No demonstrable signal alteration was seen in the corpus callosum at present. No evidence of restricted diffusion or blooming seen.Features suggest the possibility of demyelinating etiology or pronounced microangiopathic changes. Please suggest what should be done? Either psychiatry treatment, or neurology treatment? Her main issue is the heaviness of head. She wakes up with negative thoughts, feeling like crying and suicidal behavior. She is currently on Ventab Xl, Mirnite, Clonotril, Olimelt, Lupirtin SR, and Sertee.

Hello, Welcome to Chat Doctor forum. I understand your concern and would explain that your mother\\s symptoms seem to be related to depression with psychotic signs. The lesions in MRI are suggestive of small vessel disease. I would recommend taking daily baby Aspirin 80 mg to help the progression of these changes. In my opinion, her current therapy is quite complicated, and many interactions between ChatDoctor. I would recommend stopping Mirnite (Mirtazapine) and Sertee (Sertraline) because they both interact with Ventab XL (Venlafaxine). Increasing the dose of Ventab XL may be necessary. Treatment of depression will help reduce the headache. You should discuss with her psychiatrist on the above treatment option.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 36-year-old female. I am inquiring about thyroid issues. I am constantly exhausted (even when I do actually sleep). I cannot seem to lose weight even though I am more active and eat better than ever. I have dry skin, nails are brittle and some ridges, my hair is coming out by the handfuls, foggy brain and memory. My doctor did a thyroid test and these are my results.Thyroid peroxidase autoaby - 12.2TSH - .70Free-T4 - .9Free-T3 - 3.1.She also checked my iron levels, Ferritin - 26.She has advised me that I am in the normal range and my issue is depression and I need to exercise more. She has prescribed Wellbutrin 150 mg. I understand that according to the ranges listed on the results I do fall within normal, but I seem to be on the very low end of the range. Is it possible that my thyroid is causing my issues even though they are in the normal range? Would it be worth getting a second opinion from an endocrinologist? ### Response: Hi, Welcome to Chat Doctor forum. Your symptoms very well fit into thyroid problems but if the thyroid reports are normal (even if it is in the low normal range) it excludes thyroid diseases. One thing that you can do is to repeat TSH (thyroid-stimulating hormone) test after two months. But also get tested for a ChatDoctor. Depression could be the only cause in your case and with continued usage of Wellbutrin (Bupropion) you may notice improvement, but do get these tests and revert back. I hope this helps.

Hello doctor,I am a 36-year-old female. I am inquiring about thyroid issues. I am constantly exhausted (even when I do actually sleep). I cannot seem to lose weight even though I am more active and eat better than ever. I have dry skin, nails are brittle and some ridges, my hair is coming out by the handfuls, foggy brain and memory. My doctor did a thyroid test and these are my results.Thyroid peroxidase autoaby - 12.2TSH - .70Free-T4 - .9Free-T3 - 3.1.She also checked my iron levels, Ferritin - 26.She has advised me that I am in the normal range and my issue is depression and I need to exercise more. She has prescribed Wellbutrin 150 mg. I understand that according to the ranges listed on the results I do fall within normal, but I seem to be on the very low end of the range. Is it possible that my thyroid is causing my issues even though they are in the normal range? Would it be worth getting a second opinion from an endocrinologist?

Hi, Welcome to Chat Doctor forum. Your symptoms very well fit into thyroid problems but if the thyroid reports are normal (even if it is in the low normal range) it excludes thyroid diseases. One thing that you can do is to repeat TSH (thyroid-stimulating hormone) test after two months. But also get tested for a ChatDoctor. Depression could be the only cause in your case and with continued usage of Wellbutrin (Bupropion) you may notice improvement, but do get these tests and revert back. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 50 year old. My height is 179 cm and weight 85 kg. Recently, I have tested for free testosterone and vitamin D. Both are on lower side. I am also taking Thyronorm 75 mg since last 7-8 years. I have attached my medical file of past health issues. After 7 PM, I feel very low and confused. My sex drive has also been affected. I am doing exercise for about 1 to 1.5 hours daily, and still I am gaining weight. I have also persisting heel pain. I am partially bald. 14 years ago TRT was done. The report and medication are attached. My doctor has prescribed Arachitol 6 lakhs units once a month for three months. Please suggest some medicine for my condition. I would also like to know whether the TRT is required again. Thanks. ### Response: Hi, Welcome to Chat Doctor forum. Well, for your low testosterone and low vitamin D you need to take supplements. For vitamin D, I recommend Cholecalciferol sachets or tablets 60000 units weekly once for three months. Also take Calcium supplements every night. For testosterone, you need to get Testosterone injections once in 15 days. But neither low vitamin D nor low testosterone can explain your forgetfulness or confusion. It needs further evaluation to know the cause of forgetfulness or confusion. In that regard, I recommend the following tests to you. Serum vitamin B12, serum sodium, and serum cortisol (8 AM and 4 PM). Regarding your inability to lose weight, you need to increase the intensity of your exercise and go on a low-calorie diet.

Hi doctor,I am 50 year old. My height is 179 cm and weight 85 kg. Recently, I have tested for free testosterone and vitamin D. Both are on lower side. I am also taking Thyronorm 75 mg since last 7-8 years. I have attached my medical file of past health issues. After 7 PM, I feel very low and confused. My sex drive has also been affected. I am doing exercise for about 1 to 1.5 hours daily, and still I am gaining weight. I have also persisting heel pain. I am partially bald. 14 years ago TRT was done. The report and medication are attached. My doctor has prescribed Arachitol 6 lakhs units once a month for three months. Please suggest some medicine for my condition. I would also like to know whether the TRT is required again. Thanks.

Hi, Welcome to Chat Doctor forum. Well, for your low testosterone and low vitamin D you need to take supplements. For vitamin D, I recommend Cholecalciferol sachets or tablets 60000 units weekly once for three months. Also take Calcium supplements every night. For testosterone, you need to get Testosterone injections once in 15 days. But neither low vitamin D nor low testosterone can explain your forgetfulness or confusion. It needs further evaluation to know the cause of forgetfulness or confusion. In that regard, I recommend the following tests to you. Serum vitamin B12, serum sodium, and serum cortisol (8 AM and 4 PM). Regarding your inability to lose weight, you need to increase the intensity of your exercise and go on a low-calorie diet.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My son aged 32 years is suffering from schizophrenia for the last six months and not accepting any treatment and since the last 10 days his symptoms got worsened and became violent and today he tried to get injured and he is suspicious on everybody thinking everyone is talking about him and plotting to harm him and asking us to kill him by giving poison and today he became very violent and after consulting a psychiatrist doctor today we gave him Risdone liquid 2 ml by mixing with fruit juice. Now he is sleeping calmly tonight. Please help us for further treatment. ### Response: Hello. I can understand your concern. A lot of patients of schizophrenia or other psychotic disorder refuse to take medicines and this becomes difficult in treatment. Risperidone liquid is tasteless and odorless and can be given without knowledge to the patient. But keep one thing in mind that he should not become suspicious that he is being given medicine by mixing with food. Most of the patients come to know about this. You will have to remain alert for this. This should be followed strictly. In coming days he will become ready to take medicines by own. Till then you can give him Risperidone liquid. He is on 2 mg per day and if needed, the dose can be increased to 3 mg per day. The second option in his case if he refuses to take even food or juices from you is long-acting injectables. Long-acting injections of Haloperidol or Fluphenazine or Risperidone or Paliperidone are available. These have actions for around 15 days and can be given to him if he refuses to take medicines. This can make treatment easy for him. You can discuss with his doctor for this treatment option.

Hello doctor,My son aged 32 years is suffering from schizophrenia for the last six months and not accepting any treatment and since the last 10 days his symptoms got worsened and became violent and today he tried to get injured and he is suspicious on everybody thinking everyone is talking about him and plotting to harm him and asking us to kill him by giving poison and today he became very violent and after consulting a psychiatrist doctor today we gave him Risdone liquid 2 ml by mixing with fruit juice. Now he is sleeping calmly tonight. Please help us for further treatment.

Hello. I can understand your concern. A lot of patients of schizophrenia or other psychotic disorder refuse to take medicines and this becomes difficult in treatment. Risperidone liquid is tasteless and odorless and can be given without knowledge to the patient. But keep one thing in mind that he should not become suspicious that he is being given medicine by mixing with food. Most of the patients come to know about this. You will have to remain alert for this. This should be followed strictly. In coming days he will become ready to take medicines by own. Till then you can give him Risperidone liquid. He is on 2 mg per day and if needed, the dose can be increased to 3 mg per day. The second option in his case if he refuses to take even food or juices from you is long-acting injectables. Long-acting injections of Haloperidol or Fluphenazine or Risperidone or Paliperidone are available. These have actions for around 15 days and can be given to him if he refuses to take medicines. This can make treatment easy for him. You can discuss with his doctor for this treatment option.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 39-year-old female. I am fatigued, sluggish, difficulty concentrating, migraines, and difficulty regulating temperature. I have periodic tightness in the chest and fluttering sensation. My EKG, CT chest, and chest x-ray are normal and the COVID test is negative.My Vitamin B12, folate, and vitamin D were low. I started supplements last month and levels are in normal range now, but I still have symptoms. Borderline low white count, ABS lymphocyte count, and slightly high platelets. I was diagnosed with lupus as a teenager but then in the early 20\\s I was told that I do not have it. My father died at the age of 59 of a sudden catastrophic event, possibly a heart attack. Also my D-dimer was slightly elevated and so was my sedimentation rate.I have a history of cancer in the family, especially breast cancer. So, I am more concerned about cancer. I am currently on \\x80\\xa8Lamictal, Lexapro, and birth control pill. ### Response: Hi, Welcome to Chat Doctor forum. Your reports are normal nothing seems worrisome (attachment removed to protect patient identity). Since you have a family history of breast cancer, you should get a mammogram done. Also get your BRCA gene (breast cancer gene) tests done. It is a blood test and if it is positive then it means high chances of getting cancer in the future. If it is negative, it is good. Also, you should take supplements and should stop birth control pills, they can also cause cancer sometimes. You should use a mechanical method of contraception like condoms, and should do regular exercises to reduce your weight too.

Hello doctor,I am a 39-year-old female. I am fatigued, sluggish, difficulty concentrating, migraines, and difficulty regulating temperature. I have periodic tightness in the chest and fluttering sensation. My EKG, CT chest, and chest x-ray are normal and the COVID test is negative.My Vitamin B12, folate, and vitamin D were low. I started supplements last month and levels are in normal range now, but I still have symptoms. Borderline low white count, ABS lymphocyte count, and slightly high platelets. I was diagnosed with lupus as a teenager but then in the early 20\\s I was told that I do not have it. My father died at the age of 59 of a sudden catastrophic event, possibly a heart attack. Also my D-dimer was slightly elevated and so was my sedimentation rate.I have a history of cancer in the family, especially breast cancer. So, I am more concerned about cancer. I am currently on \\x80\\xa8Lamictal, Lexapro, and birth control pill.

Hi, Welcome to Chat Doctor forum. Your reports are normal nothing seems worrisome (attachment removed to protect patient identity). Since you have a family history of breast cancer, you should get a mammogram done. Also get your BRCA gene (breast cancer gene) tests done. It is a blood test and if it is positive then it means high chances of getting cancer in the future. If it is negative, it is good. Also, you should take supplements and should stop birth control pills, they can also cause cancer sometimes. You should use a mechanical method of contraception like condoms, and should do regular exercises to reduce your weight too.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My son is 9 months old and weighs about 8.5 kg. He has reached all his milestones in time. But the problem is he does not sleep well at night, maximum at a stretch it is only one hour. He keeps walking up and only a bottle can soothe him. During the day he is active but nights are really tough. He does not wake up completely but will be crying in his sleep itself and can soothe only with a bottle. Please suggest something with regard to this. ### Response: Hi, Welcome to Chat Doctor forum. Do not worry. It is a common problem among chil ChatDoctor. Baby is asking for the bottle because it pacifies him. So to put him to sleep follow these steps. 1. Wake him up at morning 7 AM. 2. Do not allow the baby to take more than two naps per day. Each nap should be less than two hours. 3. Avoid all screens and gadgets. Screen time should be less than half an hour. 4. Give him a warm bath at night before going to bed. 5. Rocking motion that is cradle helps to make baby sleep better. Put him in the cradle. 6. Usually, babies wake up at night due to short sleep. You can make routine by putting him to sleep without picking him up. You can give the bottle once or twice during nights. 7. Engage the baby in physical activities in the morning like making baby crawl or creep. 8. Light should be dim at night and you have to make him see early morning sunlight because it resets clock in the body. 9. First try all this. If it does not help then I will prescribe a hormone. Behavioral.

Hi doctor,My son is 9 months old and weighs about 8.5 kg. He has reached all his milestones in time. But the problem is he does not sleep well at night, maximum at a stretch it is only one hour. He keeps walking up and only a bottle can soothe him. During the day he is active but nights are really tough. He does not wake up completely but will be crying in his sleep itself and can soothe only with a bottle. Please suggest something with regard to this.

Hi, Welcome to Chat Doctor forum. Do not worry. It is a common problem among chil ChatDoctor. Baby is asking for the bottle because it pacifies him. So to put him to sleep follow these steps. 1. Wake him up at morning 7 AM. 2. Do not allow the baby to take more than two naps per day. Each nap should be less than two hours. 3. Avoid all screens and gadgets. Screen time should be less than half an hour. 4. Give him a warm bath at night before going to bed. 5. Rocking motion that is cradle helps to make baby sleep better. Put him in the cradle. 6. Usually, babies wake up at night due to short sleep. You can make routine by putting him to sleep without picking him up. You can give the bottle once or twice during nights. 7. Engage the baby in physical activities in the morning like making baby crawl or creep. 8. Light should be dim at night and you have to make him see early morning sunlight because it resets clock in the body. 9. First try all this. If it does not help then I will prescribe a hormone. Behavioral.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 23 years old male. I have a short and curved penis. My penis full erection state is 12 to 13 cm, 4.7 to 5.1 inches, and the curvature is towards the left side. I went to a local sex clinic, and he suggested me an unbranded ayurvedic tablet. Is it safe to take tablets for penis enlargement and to cure penis curvature? Or Is there any other way to increase my penis length and to cure the bend? I used to masturbate before. But I stopped it now because of my small penis. I am losing my confidence level on everything. Please, suggest me a permanent solution for penis enlargement and curvature. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). First of all, there is no medicine to increase the size of the penis. It is not a muscle. Medications are available to treat erectile dysfunction and other problems. The size of the penis after erection should be between 4 to 6 inches, and the extent you have mentioned falls under the standard category. So there is no need to worry about the size. Your next concern is about curvature. The mild curvature is not a big problem. It can be present in many people. I cannot tell you exactly about it. So for that, you can visit a nearby urologist or a reputed ayurveda physician or any general physician so that he can examine you clinically and guide you appropriately. Do not take any random medicine in the name of ayurvedic medicine. You are almost normal except about one concern, so for that visit your physician. There is no need to lose confidence without any reason. For more information consult an ayurveda specialist online

Hi doctor,I am 23 years old male. I have a short and curved penis. My penis full erection state is 12 to 13 cm, 4.7 to 5.1 inches, and the curvature is towards the left side. I went to a local sex clinic, and he suggested me an unbranded ayurvedic tablet. Is it safe to take tablets for penis enlargement and to cure penis curvature? Or Is there any other way to increase my penis length and to cure the bend? I used to masturbate before. But I stopped it now because of my small penis. I am losing my confidence level on everything. Please, suggest me a permanent solution for penis enlargement and curvature.

Hi. I have gone through the attachment (attachment removed to protect patient identity). First of all, there is no medicine to increase the size of the penis. It is not a muscle. Medications are available to treat erectile dysfunction and other problems. The size of the penis after erection should be between 4 to 6 inches, and the extent you have mentioned falls under the standard category. So there is no need to worry about the size. Your next concern is about curvature. The mild curvature is not a big problem. It can be present in many people. I cannot tell you exactly about it. So for that, you can visit a nearby urologist or a reputed ayurveda physician or any general physician so that he can examine you clinically and guide you appropriately. Do not take any random medicine in the name of ayurvedic medicine. You are almost normal except about one concern, so for that visit your physician. There is no need to lose confidence without any reason. For more information consult an ayurveda specialist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 35 year old male. I cheated on my wife and I am really scared that I may have HIV. When I say scared, I mean night terrors, huge anxiety, and no appetite (lost 15 pounds in three weeks). I cannot work and it is all I think about. The circumstances are as follows. I performed oral sex on a female. I then fingered her and then masturbated myself with the same hand. I have asked a few professionals and they say I am only at risk theoretically but have no real risk of contracting HIV. However, my body tells me differently. I have had a sore throat for 20 days, no appetite, pain where my liver and spleen are, weakness in my legs that come and go and a hint of nausea every now and then. I have night sweats that awaken me but they are accompanied by panic. My heart feels like it is going to burst. My tongue and mouth burn, but I think that is acid-related because my breath is awful, no matter how much I brush. I had an Alere combo HIV test at 25 days and that was negative. I have never had a fever, rash, swollen nodes, or any of the common symptoms. My questions are what is my real risk of contracting HIV? The health department said I do not need to retest and that 25 days was enough time for accurate results with that type of test. Is that true? Could this all be anxiety and guilt? ### Response: Hello, Welcome to Chat Doctor forum. I understand that you are worried but it is not the end of the world. Hope this helps. Take care. For more information consult an HIV AIDS specialist online

Hello doctor,I am a 35 year old male. I cheated on my wife and I am really scared that I may have HIV. When I say scared, I mean night terrors, huge anxiety, and no appetite (lost 15 pounds in three weeks). I cannot work and it is all I think about. The circumstances are as follows. I performed oral sex on a female. I then fingered her and then masturbated myself with the same hand. I have asked a few professionals and they say I am only at risk theoretically but have no real risk of contracting HIV. However, my body tells me differently. I have had a sore throat for 20 days, no appetite, pain where my liver and spleen are, weakness in my legs that come and go and a hint of nausea every now and then. I have night sweats that awaken me but they are accompanied by panic. My heart feels like it is going to burst. My tongue and mouth burn, but I think that is acid-related because my breath is awful, no matter how much I brush. I had an Alere combo HIV test at 25 days and that was negative. I have never had a fever, rash, swollen nodes, or any of the common symptoms. My questions are what is my real risk of contracting HIV? The health department said I do not need to retest and that 25 days was enough time for accurate results with that type of test. Is that true? Could this all be anxiety and guilt?

Hello, Welcome to Chat Doctor forum. I understand that you are worried but it is not the end of the world. Hope this helps. Take care. For more information consult an HIV AIDS specialist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,My daughter is 15 months old, and it has been three weeks that she did not sleep at night. 1 to 2 hours at most and then she will cry waiting for me to bring her to the living room because she wants to play. She would not stop crying if I ignore her (I am trying to let her try to soothe herself), even if I try rocking her or put the pacifier. She will only stop crying once I brought her to the living room. I am working, so I sent her to a babysitter during the daytime. I thought she will sleep more during the daytime, but apparently, her sleep routine is just the same as before. Her babysitter said that she slept for 1 to 2 hours in the morning and the afternoon.She is healthy, so active, happy as usual and looks completely fine to me even though she does not sleep enough. Is this normal? Will this new habits affect my daughter\\s health or growth? What cause her sleep routine to suddenly change? (Previously she will sleep throughout the night, with 2 to 3 times milk feeding in between). What can I do to put her back to her previous sleeping habit? I really need advice. ### Response: Hi. Sleep habits of babies vary from one another. Your child is normal and there is no cause of concern. Most of the babies do this but become difficult to handle cause of working parents. She requires more patience. I really appreciate your concern. This will not affect her growth. Sleeping habits change because they become more active and locomotion takes priority over feeding. They like moving around. There is nothing anybody can do except handle with patience as you have been doing. Take care.

Hi doctor,My daughter is 15 months old, and it has been three weeks that she did not sleep at night. 1 to 2 hours at most and then she will cry waiting for me to bring her to the living room because she wants to play. She would not stop crying if I ignore her (I am trying to let her try to soothe herself), even if I try rocking her or put the pacifier. She will only stop crying once I brought her to the living room. I am working, so I sent her to a babysitter during the daytime. I thought she will sleep more during the daytime, but apparently, her sleep routine is just the same as before. Her babysitter said that she slept for 1 to 2 hours in the morning and the afternoon.She is healthy, so active, happy as usual and looks completely fine to me even though she does not sleep enough. Is this normal? Will this new habits affect my daughter\\s health or growth? What cause her sleep routine to suddenly change? (Previously she will sleep throughout the night, with 2 to 3 times milk feeding in between). What can I do to put her back to her previous sleeping habit? I really need advice.

Hi. Sleep habits of babies vary from one another. Your child is normal and there is no cause of concern. Most of the babies do this but become difficult to handle cause of working parents. She requires more patience. I really appreciate your concern. This will not affect her growth. Sleeping habits change because they become more active and locomotion takes priority over feeding. They like moving around. There is nothing anybody can do except handle with patience as you have been doing. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 17-year-old male. I have an extremely poor back posture. It came from forever not keeping my back straight and watching tv, reading, and other sedentary activities that leave my back hunched over. Now, despite being skinny, my core is lopsided, there is no tone whatsoever, and I imagine it had done a lot of mental effects as well. I would also like to mention that I cannot push out my belly and breathe deeply without hurting my lower back. When I try to stand up with correct posture, I shake uncontrollably as if I have no stability. I want to know if there is any possible program to help with this to get me back on track physically? Are there ways for me to recover from the mental and respiratory effects too? I have pictures of me to give you an idea of what I am dealing with. What exercises can I do to develop muscles here? ### Response: Hi, Welcome to Chat Doctor forum. I have seen the pictures. (attachment removed to protect patient identity). Yes, you can get back to normal if you start now. Your back does not look too bad. You need to start an exercise program called 1. McKenzie back stretching exercises. 2. McKenzie back strengthening exercises. 3. Core strengthening exercises. 4. Shoulder deltoid strengthening and trapezius strengthening exercises. These exercises will help you with all your problems. Also, start yoga and breathing exercises slowly and then build up. Do all this under the supervision of a physiotherapist. This will really help you. I hope this helps. Exercises Follow up after one week of starting exercises to tell me about the improvement, so that I can change the level of exercises.

Hello doctor,I am a 17-year-old male. I have an extremely poor back posture. It came from forever not keeping my back straight and watching tv, reading, and other sedentary activities that leave my back hunched over. Now, despite being skinny, my core is lopsided, there is no tone whatsoever, and I imagine it had done a lot of mental effects as well. I would also like to mention that I cannot push out my belly and breathe deeply without hurting my lower back. When I try to stand up with correct posture, I shake uncontrollably as if I have no stability. I want to know if there is any possible program to help with this to get me back on track physically? Are there ways for me to recover from the mental and respiratory effects too? I have pictures of me to give you an idea of what I am dealing with. What exercises can I do to develop muscles here?

Hi, Welcome to Chat Doctor forum. I have seen the pictures. (attachment removed to protect patient identity). Yes, you can get back to normal if you start now. Your back does not look too bad. You need to start an exercise program called 1. McKenzie back stretching exercises. 2. McKenzie back strengthening exercises. 3. Core strengthening exercises. 4. Shoulder deltoid strengthening and trapezius strengthening exercises. These exercises will help you with all your problems. Also, start yoga and breathing exercises slowly and then build up. Do all this under the supervision of a physiotherapist. This will really help you. I hope this helps. Exercises Follow up after one week of starting exercises to tell me about the improvement, so that I can change the level of exercises.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My Mother underwent a cataract procedure. After the procedure, we were informed that there was some complication while doing the procedure and they have to do another retina surgery. The same happened next day. It has been more than three weeks but there has not been any remarkable improvement. She gets irritation. It feels as if there is some hair or dust particle in that eye. It pains sometimes but the pain has no specific trigger. She also complains of seeing multiple floaters blocking her vision. There is a remarkable improvement in her near sight. She is able to read without using glasses. But the far sight is not clear. As per her, it is worst than her earlier vision before the treatment. Kindly advise what should be our next steps. Also, is the treatment going in the right direction? ### Response: Hello, Welcome to Chat Doctor forum. Sometimes, complications happen in cataract surgery also. It is mentioned in the medical literature that there is zonular dialysis this makes a little tricky surgery. This makes lens weak and there are chances of particles of lens going back towards the retina. But this is completely treatable and I did it in many patients and seen in many patients doing fine. It is like you are ChatDoctor. Now, the irritation and pain are a superficial problem and is related to the surface and also could be because of sutures which were used during retina surgery. This will be fine for a period of time and I will be prescribing medicines. Little vision will be compromised but the good thing is that her near vision is fine. Distance vision will take time like four to six weeks and will not be normal as the other eye. The treatment is going right. So do not worry. I suggest you try Systane Ultra Eye

Hello doctor,My Mother underwent a cataract procedure. After the procedure, we were informed that there was some complication while doing the procedure and they have to do another retina surgery. The same happened next day. It has been more than three weeks but there has not been any remarkable improvement. She gets irritation. It feels as if there is some hair or dust particle in that eye. It pains sometimes but the pain has no specific trigger. She also complains of seeing multiple floaters blocking her vision. There is a remarkable improvement in her near sight. She is able to read without using glasses. But the far sight is not clear. As per her, it is worst than her earlier vision before the treatment. Kindly advise what should be our next steps. Also, is the treatment going in the right direction?

Hello, Welcome to Chat Doctor forum. Sometimes, complications happen in cataract surgery also. It is mentioned in the medical literature that there is zonular dialysis this makes a little tricky surgery. This makes lens weak and there are chances of particles of lens going back towards the retina. But this is completely treatable and I did it in many patients and seen in many patients doing fine. It is like you are ChatDoctor. Now, the irritation and pain are a superficial problem and is related to the surface and also could be because of sutures which were used during retina surgery. This will be fine for a period of time and I will be prescribing medicines. Little vision will be compromised but the good thing is that her near vision is fine. Distance vision will take time like four to six weeks and will not be normal as the other eye. The treatment is going right. So do not worry. I suggest you try Systane Ultra Eye

### Instruction: Answer this question truthfully ###Input: Hello doctor,I met with a girl a few months back. She had been rubbing her vagina and then put her finger in my backside. She said she was clean but hard to know. After about three months, I got tested for STD panel and came up negative with everything including HSV 2 except for HSV 1, which came up positive. However, the test used was herpeSelect Elisa IgG, which I read is known to have false positives. My score was 3.3. I read if the score is less than 3.5 then it could be a false positive.A week later, I retested using herpeSelect immunoblot, which is supposed to be more accurate and tested negative for HSV 1 and 2. However, for the past three months, I am having itching in my backside, which could be due to sweat and anxiety. Do I have anything to worry about or trust the latest results that I have no herpes and put this to rest? ### Response: Hello. 1. The manifestation which you are saying are not of herpes, they normally present as grouped vesicles on an erythematous base. 2. Herpes has an incubation period of five days, it means symptoms would have to develop within five days of infection. 3. Your test are absolutely normal and you do not have to worry about it. 4. If you would have any vesicular eruption which is extremely painful, then you would have chances of herpes, so go for Tzanck smear and DFA (direct fluorescent antibody) test for it. 5. Always indulge yourself in safe sex practice because herpes genitalis caused by HSV 2 (herpes simplex virus) is an incurable condition. Take care.

Hello doctor,I met with a girl a few months back. She had been rubbing her vagina and then put her finger in my backside. She said she was clean but hard to know. After about three months, I got tested for STD panel and came up negative with everything including HSV 2 except for HSV 1, which came up positive. However, the test used was herpeSelect Elisa IgG, which I read is known to have false positives. My score was 3.3. I read if the score is less than 3.5 then it could be a false positive.A week later, I retested using herpeSelect immunoblot, which is supposed to be more accurate and tested negative for HSV 1 and 2. However, for the past three months, I am having itching in my backside, which could be due to sweat and anxiety. Do I have anything to worry about or trust the latest results that I have no herpes and put this to rest?

Hello. 1. The manifestation which you are saying are not of herpes, they normally present as grouped vesicles on an erythematous base. 2. Herpes has an incubation period of five days, it means symptoms would have to develop within five days of infection. 3. Your test are absolutely normal and you do not have to worry about it. 4. If you would have any vesicular eruption which is extremely painful, then you would have chances of herpes, so go for Tzanck smear and DFA (direct fluorescent antibody) test for it. 5. Always indulge yourself in safe sex practice because herpes genitalis caused by HSV 2 (herpes simplex virus) is an incurable condition. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My husband is a 30-year-old. Last week, he went to the gym the first time after a year and did heavy biceps exercise with high repetitions. After two days, his arms were swollen, and he was not able to make his arms straight. Yesterday we consulted with a nephrologist, and he told to do tests for CPK and serum creatinine. The CPK level was 15850 which is very scary to us, and when the doctor saw reports, he said that it is a muscle breakdown but did not tell us to have an IV therapy and asked to drink lot and lot of water.We are quite worried about the kidney failure thing and wanted to know that is there really no need to admit in the hospital? Symptoms,1. After a day of rough biceps exercise, arms were stiff and swelling, which has resolved 40 % by now.2. Urine is clear, and the color is almost like water. The average urinate time is 10 to 15 seconds.3. No other symptoms of pain other than both hands which have a dull ache.His report says,Yesterday CPK was 15850 and creatinine was .96. Today it was 15400 and Creatinine was .86My question is, should we get IV, or it will it decrease over time? How is his kidney doing? ### Response: Hello, Welcome to Chat Doctor forum. My opinion is that he should be admitted to the hospital. Good that he has enough urine output so far. But it can decrease any time, and kidney functions will start to ChatDoctor. The best is to admit him for close intravenous hy

Hello doctor,My husband is a 30-year-old. Last week, he went to the gym the first time after a year and did heavy biceps exercise with high repetitions. After two days, his arms were swollen, and he was not able to make his arms straight. Yesterday we consulted with a nephrologist, and he told to do tests for CPK and serum creatinine. The CPK level was 15850 which is very scary to us, and when the doctor saw reports, he said that it is a muscle breakdown but did not tell us to have an IV therapy and asked to drink lot and lot of water.We are quite worried about the kidney failure thing and wanted to know that is there really no need to admit in the hospital? Symptoms,1. After a day of rough biceps exercise, arms were stiff and swelling, which has resolved 40 % by now.2. Urine is clear, and the color is almost like water. The average urinate time is 10 to 15 seconds.3. No other symptoms of pain other than both hands which have a dull ache.His report says,Yesterday CPK was 15850 and creatinine was .96. Today it was 15400 and Creatinine was .86My question is, should we get IV, or it will it decrease over time? How is his kidney doing?

Hello, Welcome to Chat Doctor forum. My opinion is that he should be admitted to the hospital. Good that he has enough urine output so far. But it can decrease any time, and kidney functions will start to ChatDoctor. The best is to admit him for close intravenous hy

### Instruction: Answer this question truthfully ###Input: Hello doctor,My 84-year old stepfather had, apparently, two radical left-ear wall-up mastoidectomies in the late 50s and 60s. The second was done to fix the poor job done by the first at a county hospital for the indigent. Recently, caregivers said they were planing on using hydrogen peroxide in his left ear to clear much wax buildup. I learned of these surgeries from my step dad and from reviewing some ancient medical records. As his POA, I need to know of any dangers possible if hydrogen peroxide is administered in such an ear canal that, I understand, is permeable, and leads into his mastoid chamber. ### Response: Hello, Welcome to Chat Doctor forum. As I understand, your father had undergone two ear surgeries when he was in his 30s or so. He would have either undergone canal wall up or canal wall down mastoidectomies. Radical and modified radical come under CWD, and cortical comes under CWU mastoidectomies. Anyways, hy ChatDoctor. The ear has been disease-free for many months now, implying, there has been no ear discharge of pus or liquid. 2. No ear perforation, which would have presented with discharge and pain. 3. No raw area in the ear canal. The posterior canal is not permeable. In a wall down surgery after removing the wall, we close the defect with autologous cartilage or some material. Probably in his days, they may have left the cavity open. In either case, it gets lined by the skin, and that will be the case in your father also unless he has any disease or perforation. It is okay to use hy

Hello doctor,My 84-year old stepfather had, apparently, two radical left-ear wall-up mastoidectomies in the late 50s and 60s. The second was done to fix the poor job done by the first at a county hospital for the indigent. Recently, caregivers said they were planing on using hydrogen peroxide in his left ear to clear much wax buildup. I learned of these surgeries from my step dad and from reviewing some ancient medical records. As his POA, I need to know of any dangers possible if hydrogen peroxide is administered in such an ear canal that, I understand, is permeable, and leads into his mastoid chamber.

Hello, Welcome to Chat Doctor forum. As I understand, your father had undergone two ear surgeries when he was in his 30s or so. He would have either undergone canal wall up or canal wall down mastoidectomies. Radical and modified radical come under CWD, and cortical comes under CWU mastoidectomies. Anyways, hy ChatDoctor. The ear has been disease-free for many months now, implying, there has been no ear discharge of pus or liquid. 2. No ear perforation, which would have presented with discharge and pain. 3. No raw area in the ear canal. The posterior canal is not permeable. In a wall down surgery after removing the wall, we close the defect with autologous cartilage or some material. Probably in his days, they may have left the cavity open. In either case, it gets lined by the skin, and that will be the case in your father also unless he has any disease or perforation. It is okay to use hy

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 25 years old,male. I am getting wierd type of muscle spasms since past 15 years. Those spasm gets triggered when I do sudden movements like when suddenly get up from chair and start walking, I get spams. It lasts for 5 to 10 seconds. Spasms look like my legs and hands are rapidly contracting and cramping just like tetanic cramps. I consulted neurologist and he told me that those spasms are due to deficiency of vitamin D which leads to poor absorption of calcium. He has given me Vitamin D treatment for six months and told me that my spasm will completely vanish. One month has passed since I have started the treatment and I am seeing improvements. Still I get spasm but intensity has reduced. Still 5 months to go. So will I get rid of them? I am feeling anxious about them. Please give me your opinion. ### Response: Hi, Welcome to Chat Doctor forum. I must assure you that you are in right hand and right thing communicated to you about the tetanic spasms which you are experiencing for the last 15 years. Majority of patients (read all) show good response to Vitamin D supplementation when there is deficiency and same can be hoped in your case. I would like to add something at this level. Since you are taking Vitamin D but not the Calcium. This leads to inadequate calcium to absorb and low calcium and spasms. Talk to your neurologist to add Calcium or increase at least 500 to 1000 mg per day. This will ensure that there is enough calcium to absorb since absorbing machinery is overworking due to supplementation of Vitamin D. The Calcium supplementation is likely to cut short the duration of symptoms.

Hello doctor,I am 25 years old,male. I am getting wierd type of muscle spasms since past 15 years. Those spasm gets triggered when I do sudden movements like when suddenly get up from chair and start walking, I get spams. It lasts for 5 to 10 seconds. Spasms look like my legs and hands are rapidly contracting and cramping just like tetanic cramps. I consulted neurologist and he told me that those spasms are due to deficiency of vitamin D which leads to poor absorption of calcium. He has given me Vitamin D treatment for six months and told me that my spasm will completely vanish. One month has passed since I have started the treatment and I am seeing improvements. Still I get spasm but intensity has reduced. Still 5 months to go. So will I get rid of them? I am feeling anxious about them. Please give me your opinion.

Hi, Welcome to Chat Doctor forum. I must assure you that you are in right hand and right thing communicated to you about the tetanic spasms which you are experiencing for the last 15 years. Majority of patients (read all) show good response to Vitamin D supplementation when there is deficiency and same can be hoped in your case. I would like to add something at this level. Since you are taking Vitamin D but not the Calcium. This leads to inadequate calcium to absorb and low calcium and spasms. Talk to your neurologist to add Calcium or increase at least 500 to 1000 mg per day. This will ensure that there is enough calcium to absorb since absorbing machinery is overworking due to supplementation of Vitamin D. The Calcium supplementation is likely to cut short the duration of symptoms.

### Instruction: Answer this question truthfully ###Input: Hello doctor,A little over two years ago, I experienced some stress in my life that resulted in a high level of anxiety and depression. I was prescribed Paxil and took it for one year. At the time, I was also taking Diovan and Atenolol for hypertension, Pantoprazole for reflux, and Simvastatin for high cholesterol. One positive side effect of the stress was that I lost 25 lbs and went from 195 lbs to 170 lbs. I also started to eat more healthy foods and started to exercise regularly. One effect of my anxiety and depression is that I would awaken frequently during the night and morning between 3 AM and 5 AM and feel very agitated and get panic with upsetting thoughts. Over the past year or so, I have managed to improve my condition with counseling, meditation, etc. I am also no longer taking any medicine since my health dramatically improved. I am at the point where I am doing well, but still awaken very early about 4 or 5 AM, no matter when I go to bed I feel very anxious and my heart starts to pound. I used to have bad thoughts, but I have managed those and now just feel the physical feelings. The thoughts diminish gradually throughout the day and seem to end at about 5 PM. I am wondering whether I have a cortisol or adrenaline problem. What are your thoughts regarding the same? Please guide. ### Response: Hi, Welcome to Chat Doctor forum. 1. Have a thyroid function test done first for given weight loss and heart pounding.2. You should also consider seeing a primary care physician PCP and have an electrocardiogram EKG done. Revert back with the details asked and to an endocrinologist online.-

Hello doctor,A little over two years ago, I experienced some stress in my life that resulted in a high level of anxiety and depression. I was prescribed Paxil and took it for one year. At the time, I was also taking Diovan and Atenolol for hypertension, Pantoprazole for reflux, and Simvastatin for high cholesterol. One positive side effect of the stress was that I lost 25 lbs and went from 195 lbs to 170 lbs. I also started to eat more healthy foods and started to exercise regularly. One effect of my anxiety and depression is that I would awaken frequently during the night and morning between 3 AM and 5 AM and feel very agitated and get panic with upsetting thoughts. Over the past year or so, I have managed to improve my condition with counseling, meditation, etc. I am also no longer taking any medicine since my health dramatically improved. I am at the point where I am doing well, but still awaken very early about 4 or 5 AM, no matter when I go to bed I feel very anxious and my heart starts to pound. I used to have bad thoughts, but I have managed those and now just feel the physical feelings. The thoughts diminish gradually throughout the day and seem to end at about 5 PM. I am wondering whether I have a cortisol or adrenaline problem. What are your thoughts regarding the same? Please guide.

Hi, Welcome to Chat Doctor forum. 1. Have a thyroid function test done first for given weight loss and heart pounding.2. You should also consider seeing a primary care physician PCP and have an electrocardiogram EKG done. Revert back with the details asked and to an endocrinologist online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,How accurate are skin prick tests for predicting positive reactions? My family is interested in a pet and I have had negative skin prick and blood work tests for dander. Before we bring a pet in and before my kids become bonded, is it reasonable to assume negative tests will translate in no reactions. Occasionally, when I interact with animals, I have a reaction but it is difficult to determine whether it is actually the pollen which I am highly allergic to. ### Response: Hi. Skin prick allergy testing is one of the most accurate ways of diagnosing the allergen, one is sensitive to. It is definitely more accurate than blood immunoCAP testing (blood allergy testing). Skin prick testing checks your sensitivity to the protein in question. Even if sensitive, it need not mean you are allergic. Whereby, a positive result need not always mean you will get allergy with the protein. It means that your immune system is sensitised to that allergen and that an allergy can occur in subsequent exposures to the allergen. A negative in skin prick testing will mean that you are not sensitive to that protein and that you will not end with an allergy upon its exposure. This is true. But it is specific for the particular type of allergen. What all animal danders were included in your profile and what was the response to each? Is there a photograph or record of the wheal or flare that developed after each prick? Was the test read by a clinical allergist or immunologist and were you provided a report as to that you are not allergic to any animal dander? Were you diagnosed with pollen allergy or sensitivity? Have you observed any symptoms of allergy while in gardens or bushy areas? Or in any particular season? Does any one else in your family have allergies?

Hello doctor,How accurate are skin prick tests for predicting positive reactions? My family is interested in a pet and I have had negative skin prick and blood work tests for dander. Before we bring a pet in and before my kids become bonded, is it reasonable to assume negative tests will translate in no reactions. Occasionally, when I interact with animals, I have a reaction but it is difficult to determine whether it is actually the pollen which I am highly allergic to.

Hi. Skin prick allergy testing is one of the most accurate ways of diagnosing the allergen, one is sensitive to. It is definitely more accurate than blood immunoCAP testing (blood allergy testing). Skin prick testing checks your sensitivity to the protein in question. Even if sensitive, it need not mean you are allergic. Whereby, a positive result need not always mean you will get allergy with the protein. It means that your immune system is sensitised to that allergen and that an allergy can occur in subsequent exposures to the allergen. A negative in skin prick testing will mean that you are not sensitive to that protein and that you will not end with an allergy upon its exposure. This is true. But it is specific for the particular type of allergen. What all animal danders were included in your profile and what was the response to each? Is there a photograph or record of the wheal or flare that developed after each prick? Was the test read by a clinical allergist or immunologist and were you provided a report as to that you are not allergic to any animal dander? Were you diagnosed with pollen allergy or sensitivity? Have you observed any symptoms of allergy while in gardens or bushy areas? Or in any particular season? Does any one else in your family have allergies?

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 41-year-old male having a problem related to sex. When I have sex with my partner, I have an erection coming too quickly, or I lose the erection within seconds of leaving my partner pretty disappointed. I know that it is due to severe performance anxiety, that I am unable to control it. When I am relaxed, I can hold it for at least five to ten minutes.After a lot of hesitation, I started taking Viagra 50 mg. I do not think that I have an ED problem. I have taken it thrice till date having beautiful results each time. My partner is very happy. Is it safe to take Viagra for persons not suffering from ED? When the sex was irregular, the need for Viagra is also limited. It is used three to four times a month. Does regular usage mean that I cannot get an erection? Should I have to reduce the dosage or should I need to stop taking it completely? I do not have any side effects. I have moderately high BP, and I am taking medication for it in a low dosage. ### Response: Hi. You should check with your doctor about the medicines taken for blood pressure. It should not be a Nitrate. There is no harm in taking Viagra (Sildenafil) when you are not regular on sex. You can consult an an ChatDoctor. Sometimes, it can be due to other medical conditions. As you have not given your family details, it is difficult to comment more. It is the premature ejaculation causing the loss of erection. It has to be differentiated from the ED. If it is a problem, then a different medicine has to be taken, and a sexologist will help you more.

Hi doctor,I am a 41-year-old male having a problem related to sex. When I have sex with my partner, I have an erection coming too quickly, or I lose the erection within seconds of leaving my partner pretty disappointed. I know that it is due to severe performance anxiety, that I am unable to control it. When I am relaxed, I can hold it for at least five to ten minutes.After a lot of hesitation, I started taking Viagra 50 mg. I do not think that I have an ED problem. I have taken it thrice till date having beautiful results each time. My partner is very happy. Is it safe to take Viagra for persons not suffering from ED? When the sex was irregular, the need for Viagra is also limited. It is used three to four times a month. Does regular usage mean that I cannot get an erection? Should I have to reduce the dosage or should I need to stop taking it completely? I do not have any side effects. I have moderately high BP, and I am taking medication for it in a low dosage.

Hi. You should check with your doctor about the medicines taken for blood pressure. It should not be a Nitrate. There is no harm in taking Viagra (Sildenafil) when you are not regular on sex. You can consult an an ChatDoctor. Sometimes, it can be due to other medical conditions. As you have not given your family details, it is difficult to comment more. It is the premature ejaculation causing the loss of erection. It has to be differentiated from the ED. If it is a problem, then a different medicine has to be taken, and a sexologist will help you more.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 31 years old, before 16 years underwent anterior discectomy of c3c4&c4c5 with fusion. Even had neck pain and pain got radiated to neck and back while working. Suffering with pain for 16 years but I got used to it. But for past few months neck became very very week am not able to bare my head weight and not able to keep neck in straight position. Now for past 20-25 days having severe neck pain, weakness of full both hands and legs sometimes with numbness. Eye pressure and back head pain. I am not able to keep neck at straight position. Getting breaking sound if I rotate the neck. Neck movement is restricted. I have attached my recent MRI report, can you please tell me what is the actual issue with this. ### Response: Hi. I have gone through your query and medical history along with the attached reports (attachment removed to protect patient identity). The problem does not seem to be due to the fused C3-4 or C4-5 levels. Infact a disc prolapse at C5-C6 with nerve compression is causing the present symptoms. I would suggest you to go for physiotherapy sessions including cervical traction along with neck strengthening passive and active exercises,SWD/IRT. It would always be better to avoid going through another surgery considering the post-operative complications. Hence, in my personal opinion, you should avoid a re-surgery and go for conservative line of management. Analgesics,anti-inflammatory tablets, hot fomentation and use of cervical soft collar will help. If the symptoms do not improve, you can consult an Orthopedist/Neurosurgeon for further management.

Hello doctor,I am 31 years old, before 16 years underwent anterior discectomy of c3c4&c4c5 with fusion. Even had neck pain and pain got radiated to neck and back while working. Suffering with pain for 16 years but I got used to it. But for past few months neck became very very week am not able to bare my head weight and not able to keep neck in straight position. Now for past 20-25 days having severe neck pain, weakness of full both hands and legs sometimes with numbness. Eye pressure and back head pain. I am not able to keep neck at straight position. Getting breaking sound if I rotate the neck. Neck movement is restricted. I have attached my recent MRI report, can you please tell me what is the actual issue with this.

Hi. I have gone through your query and medical history along with the attached reports (attachment removed to protect patient identity). The problem does not seem to be due to the fused C3-4 or C4-5 levels. Infact a disc prolapse at C5-C6 with nerve compression is causing the present symptoms. I would suggest you to go for physiotherapy sessions including cervical traction along with neck strengthening passive and active exercises,SWD/IRT. It would always be better to avoid going through another surgery considering the post-operative complications. Hence, in my personal opinion, you should avoid a re-surgery and go for conservative line of management. Analgesics,anti-inflammatory tablets, hot fomentation and use of cervical soft collar will help. If the symptoms do not improve, you can consult an Orthopedist/Neurosurgeon for further management.

### Instruction: Answer this question truthfully ###Input: Hello doctor,For months I have struggled with low mood, debilitating anxiety, intrusive thoughts about the past, avoiding anything to do with the past, suicidal thoughts, self harm, and daily guilt and shame that has stopped me from hanging out with friends, or being successful in school. Everyday I just try to survive. My appetite sucks, I have trouble falling asleep and have frequent nightmares, I am exhausted all the time. I finally decided to get help. I saw a psychiatrist today, who concluded I do not fit any diagnosis, and with therapy I can learn to deal with the situation that causes these things. But there is no situation? How can someone be in so much pain for so long and the answer is basically that I am just too weak to handle life? I have never felt so awful ever and coming to that appointment was a big step for me. I feel like such a loser, I got nothing out of it except humiliation. Should I consider reaching out to a different doctor? Or am I overreacting and she is probably right? ### Response: Hello, Welcome to Chat Doctor forum. I would beg to differ with the psychiatrist who you have consulted and all the symptoms you have mentioned are depressive symptoms which do need treatment with medicines. Therapy can only help increase the effect of medicines, it is not a replacement . I would prefer that a psychiatrist or a doctor should prescribe you a standard dose of an SSRI such as Sertraline 50 mg, and add low dose mood stabilizer such as Divalproex sodium 250 mg. Major depressive disorder secondary to a stress in past along with a probable personality disorder , will need further history to arrive at a diagnosis. Also consider doing some deep breathing, relaxation exercises.

Hello doctor,For months I have struggled with low mood, debilitating anxiety, intrusive thoughts about the past, avoiding anything to do with the past, suicidal thoughts, self harm, and daily guilt and shame that has stopped me from hanging out with friends, or being successful in school. Everyday I just try to survive. My appetite sucks, I have trouble falling asleep and have frequent nightmares, I am exhausted all the time. I finally decided to get help. I saw a psychiatrist today, who concluded I do not fit any diagnosis, and with therapy I can learn to deal with the situation that causes these things. But there is no situation? How can someone be in so much pain for so long and the answer is basically that I am just too weak to handle life? I have never felt so awful ever and coming to that appointment was a big step for me. I feel like such a loser, I got nothing out of it except humiliation. Should I consider reaching out to a different doctor? Or am I overreacting and she is probably right?

Hello, Welcome to Chat Doctor forum. I would beg to differ with the psychiatrist who you have consulted and all the symptoms you have mentioned are depressive symptoms which do need treatment with medicines. Therapy can only help increase the effect of medicines, it is not a replacement . I would prefer that a psychiatrist or a doctor should prescribe you a standard dose of an SSRI such as Sertraline 50 mg, and add low dose mood stabilizer such as Divalproex sodium 250 mg. Major depressive disorder secondary to a stress in past along with a probable personality disorder , will need further history to arrive at a diagnosis. Also consider doing some deep breathing, relaxation exercises.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I prematurely gave birth to twins on the 18th at 25 weeks and two days. The reason behind it was told to me that my regular gynecologist did not put some closure on my uterus to avoid premature birth, which is a common issue in twins. Mine was a normal delivery. My boy was born at 865 g and girl at 585 g. They have now survived for over 45 hours in the NICU. The doctors have just been telling me that the children are alive and breathing. That is all they tell me. I am still very worried. What are the chances of such children to survive in NICU after they have survived for several hours in most odd conditions? I know they are going through the toughest challenges to breathe through their underdeveloped body but I still want to get a generic view. All their body parts have been found to be growing and fine in the last level-2 ultrasound. ### Response: Hello. Both your babies are extremely premature as well as extremely low birth weight. The main complication that arises is due to incomplete development of lung. So, immediate surfactant therapy and oxygen support would be required. The next common complication is sepsis. Complete asepsis is to be maintained. Tertiary level NICU (neonatal intensive care unit) care which should be handled by qualified neonatologist is the primary requirement. A complete aseptic environment is to be created. In my practice, I have very mixed experience in the prognosis. I have seen these babies succumbing mainly to the sepsis. As per me, the baby with more weight has a better prognosis. It also depends on the level of NICU care being provided. For more information consult a paediatrician online

Hi doctor,I prematurely gave birth to twins on the 18th at 25 weeks and two days. The reason behind it was told to me that my regular gynecologist did not put some closure on my uterus to avoid premature birth, which is a common issue in twins. Mine was a normal delivery. My boy was born at 865 g and girl at 585 g. They have now survived for over 45 hours in the NICU. The doctors have just been telling me that the children are alive and breathing. That is all they tell me. I am still very worried. What are the chances of such children to survive in NICU after they have survived for several hours in most odd conditions? I know they are going through the toughest challenges to breathe through their underdeveloped body but I still want to get a generic view. All their body parts have been found to be growing and fine in the last level-2 ultrasound.

Hello. Both your babies are extremely premature as well as extremely low birth weight. The main complication that arises is due to incomplete development of lung. So, immediate surfactant therapy and oxygen support would be required. The next common complication is sepsis. Complete asepsis is to be maintained. Tertiary level NICU (neonatal intensive care unit) care which should be handled by qualified neonatologist is the primary requirement. A complete aseptic environment is to be created. In my practice, I have very mixed experience in the prognosis. I have seen these babies succumbing mainly to the sepsis. As per me, the baby with more weight has a better prognosis. It also depends on the level of NICU care being provided. For more information consult a paediatrician online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 25. Since three days, I have been experiencing sensations like twitches/ jerks/ tremors specifically in my chin area. I noticed that when I talk, eat or when something falls down from my hand suddenly, I get a tremor in my chin. They last for a second only. I went to a doctor (not a neurologist but an internal medicine specialist) and as per him, I have a B-complex deficiency and he gave me 30 tablets of B-complex. He feels that the tremor while talking or eating that I face is coincidental. However, he did tell me that if I was very anxious we could get an MRI done. Apart from this, I also get mild muscle twitches in the eye, face, and legs. And sometimes, I feel a shortness of breath and when I get very scared there is tightness in my throat. I actually read a lot about this on the net and to be very honest, I have become very scared after reading about brain tumor, multiple sclerosis, etc. I wanted a second opinion. My doctor said I am otherwise very healthy so I should just take the vitamins and focus on my work and other activities. But I cannot stop thinking about brain tumor and other neurological disorders. Should I get an MRI? Or is this something that is not serious? Please help. ### Response: Hello. I understand your concerns. From what you mentioned, you most likely have what is called benign fasciculation syn ChatDoctor. You should not worry, it is benign and you do not have to perform MRI or any other investigations. Do you feel anxious most of the time? Do you have a stressful life? Do you eat and sleep well? I suggest

Hello doctor,I am 25. Since three days, I have been experiencing sensations like twitches/ jerks/ tremors specifically in my chin area. I noticed that when I talk, eat or when something falls down from my hand suddenly, I get a tremor in my chin. They last for a second only. I went to a doctor (not a neurologist but an internal medicine specialist) and as per him, I have a B-complex deficiency and he gave me 30 tablets of B-complex. He feels that the tremor while talking or eating that I face is coincidental. However, he did tell me that if I was very anxious we could get an MRI done. Apart from this, I also get mild muscle twitches in the eye, face, and legs. And sometimes, I feel a shortness of breath and when I get very scared there is tightness in my throat. I actually read a lot about this on the net and to be very honest, I have become very scared after reading about brain tumor, multiple sclerosis, etc. I wanted a second opinion. My doctor said I am otherwise very healthy so I should just take the vitamins and focus on my work and other activities. But I cannot stop thinking about brain tumor and other neurological disorders. Should I get an MRI? Or is this something that is not serious? Please help.

Hello. I understand your concerns. From what you mentioned, you most likely have what is called benign fasciculation syn ChatDoctor. You should not worry, it is benign and you do not have to perform MRI or any other investigations. Do you feel anxious most of the time? Do you have a stressful life? Do you eat and sleep well? I suggest

### Instruction: Answer this question truthfully ###Input: Hello doctor,Two years ago, I suffered from a miscarriage and had undergone D and C. I am suffering from hypothyroidism and on Thyronorm 75 mg, and now the levels are normal. After six months of D and C, I got pregnant while on ovulation induction treatment, and unfortunately, that was an ectopic. My right tube is now blocked as I had undergone surgery. The tube is not removed, but the tube is blocked.It has been a year since I had surgery. I am trying to conceive, but I am not able to. My doctor put me on Letrozole, and it is my fourth cycle for it. During the first cycle, the ovulation was on left tube with ET 6.5 mm, and I did not conceive. Next two were on the right side, so no chance. Now again luckily it is on the left with ET 7.8 mm on day 16. What are my chances of conceiving, and is there a risk of ectopic again? My left tube is clear HSG test was done. Kindly explain to me. ### Response: Hello. No matter which side the ovulation occurs, the egg will fall into the peritoneal cavity and moves into the available open tube through which it enters the uterus. Since you had one ectopic pregnancy, you have a higher chance of repeat tubal pregnancy. But since HSG (hysterosalpingography) shows a patent tube, you also have a high chance of normal uterine pregnancy. The only chance is to have a pregnancy and have an early scan to confirm pregnancy inside uterus. I hope I have clarified your query, do write back if you have any more questions, for feedback. Take care.

Hello doctor,Two years ago, I suffered from a miscarriage and had undergone D and C. I am suffering from hypothyroidism and on Thyronorm 75 mg, and now the levels are normal. After six months of D and C, I got pregnant while on ovulation induction treatment, and unfortunately, that was an ectopic. My right tube is now blocked as I had undergone surgery. The tube is not removed, but the tube is blocked.It has been a year since I had surgery. I am trying to conceive, but I am not able to. My doctor put me on Letrozole, and it is my fourth cycle for it. During the first cycle, the ovulation was on left tube with ET 6.5 mm, and I did not conceive. Next two were on the right side, so no chance. Now again luckily it is on the left with ET 7.8 mm on day 16. What are my chances of conceiving, and is there a risk of ectopic again? My left tube is clear HSG test was done. Kindly explain to me.

Hello. No matter which side the ovulation occurs, the egg will fall into the peritoneal cavity and moves into the available open tube through which it enters the uterus. Since you had one ectopic pregnancy, you have a higher chance of repeat tubal pregnancy. But since HSG (hysterosalpingography) shows a patent tube, you also have a high chance of normal uterine pregnancy. The only chance is to have a pregnancy and have an early scan to confirm pregnancy inside uterus. I hope I have clarified your query, do write back if you have any more questions, for feedback. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 27 years old male. I was sitting in front of the computer for more than 10 hours per day for past one month. I have mild pain in my lower back, not a constant pain. the pain either left side or right side but the right side is more time the pain always shift its position. and while walking my right side bottom thigh got pulling pain at a step in and sometimes my lower limb feel pain. and I feel some weakness in the right leg and while I sit for Iong feel some numbness in my left bud and left bottom thigh.I have taken MRI and consulted the doctor, the doctor says lumbar spine looking normal. I consulted a radiology specialist and she said the hip and sacroiliac joint MRI essentially looks normal. The lumbar spine mild disc bulges causing radiating pain and numbness in the legs and feet described in detail as below ### Response: Hi, Welcome to Chat Doctor forum. I have seen your reports (attachment removed to protect patient identity). According to your complaints, I will suggest you few things. Do not sit in front of the computer for a long time not more than one hour after that at least walk for 2 to 3 minutes and you can get back to your work. Because of long-standing sitting in front of the computer, your shoulder muscles must be weakened. So, to strengthen your muscles you need to start exercises for that. Coming to your disc prolapse. You have symptoms for that if you have weakness in your legs then it requires surgery. Before that, I will prescribe nerve related tablets. Tablet Pregabalin 75 mg daily once after food for one month. For more information consult an orthopaedician and traumatologist online

Hello doctor,I am 27 years old male. I was sitting in front of the computer for more than 10 hours per day for past one month. I have mild pain in my lower back, not a constant pain. the pain either left side or right side but the right side is more time the pain always shift its position. and while walking my right side bottom thigh got pulling pain at a step in and sometimes my lower limb feel pain. and I feel some weakness in the right leg and while I sit for Iong feel some numbness in my left bud and left bottom thigh.I have taken MRI and consulted the doctor, the doctor says lumbar spine looking normal. I consulted a radiology specialist and she said the hip and sacroiliac joint MRI essentially looks normal. The lumbar spine mild disc bulges causing radiating pain and numbness in the legs and feet described in detail as below

Hi, Welcome to Chat Doctor forum. I have seen your reports (attachment removed to protect patient identity). According to your complaints, I will suggest you few things. Do not sit in front of the computer for a long time not more than one hour after that at least walk for 2 to 3 minutes and you can get back to your work. Because of long-standing sitting in front of the computer, your shoulder muscles must be weakened. So, to strengthen your muscles you need to start exercises for that. Coming to your disc prolapse. You have symptoms for that if you have weakness in your legs then it requires surgery. Before that, I will prescribe nerve related tablets. Tablet Pregabalin 75 mg daily once after food for one month. For more information consult an orthopaedician and traumatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I began presenting last fall with some chronic fatigue. The initial blood work showed low iron saturation without anemia. I have attached reports of the same. There were other endocrine-related findings as well. In the course of various endocrine-related treatments and corresponding blood work, I began iron supplementation in the form of ferrous sulfate 143 mg daily. I began this before the blood work was done. So, you can see that that the levels have increased. Subsequent testing, a month later, showed a decline despite continuing treatment. Most recently, you can see that the levels are back up. Note that the ferritin levels began a bit low around 27 ng/mL and had increased to 30 ng/mL.I have received a wide range of conflicting advice about whether low iron levels in the absence of anemia can cause fatigue. I have also received a range of conflicting advice about whether to continue iron supplementation. One doctor told me to continue taking the iron until the ferritin is up around 50 or so. Another said that would be unnecessary and to discontinue it and wait for three months to re-measure the blood work. It is all quite puzzling. Please help me to understand iron\\s role, if any, in fatigue in the absence of anemia. And help me to then understand the rationale for treatment or lack thereof. And finally, please give me some sense of when iron toxicity emerges in terms of blood work measurements and at what frequency one needs to check the iron levels during any supplementation. ### Response: Hello. You can consult an endocrinologist or a neurologist based on your reports, but iron medication need not be continued as per my opinion. For more information consult a hematologist online

Hello doctor,I began presenting last fall with some chronic fatigue. The initial blood work showed low iron saturation without anemia. I have attached reports of the same. There were other endocrine-related findings as well. In the course of various endocrine-related treatments and corresponding blood work, I began iron supplementation in the form of ferrous sulfate 143 mg daily. I began this before the blood work was done. So, you can see that that the levels have increased. Subsequent testing, a month later, showed a decline despite continuing treatment. Most recently, you can see that the levels are back up. Note that the ferritin levels began a bit low around 27 ng/mL and had increased to 30 ng/mL.I have received a wide range of conflicting advice about whether low iron levels in the absence of anemia can cause fatigue. I have also received a range of conflicting advice about whether to continue iron supplementation. One doctor told me to continue taking the iron until the ferritin is up around 50 or so. Another said that would be unnecessary and to discontinue it and wait for three months to re-measure the blood work. It is all quite puzzling. Please help me to understand iron\\s role, if any, in fatigue in the absence of anemia. And help me to then understand the rationale for treatment or lack thereof. And finally, please give me some sense of when iron toxicity emerges in terms of blood work measurements and at what frequency one needs to check the iron levels during any supplementation.

Hello. You can consult an endocrinologist or a neurologist based on your reports, but iron medication need not be continued as per my opinion. For more information consult a hematologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,How can I figure out my conception date? My last menstrual period was three months back. I had my dating ultrasound and it put the GA at 9 weeks and 3 days. Also there was a CRL measurement of 26.96. My due date based on LMP and ultrasound are different. Please answer. Also how many \"safe\" days are there after a period? ### Response: Hello. First of let me tell you that if your menses is coming every month with 2-3 days here or there then it is absolutely normal cycle. Now in normal cycle ovulation occurs in the middle of the cycle (around 12-18th day of cycle) when conception can actually happen. First 8 and last 8 days of your cycle are safe period in normal menses as there is no chance of pregnancy thus safe. Now pregnancy can happen in regular and irregular cycle both. And it is far more difficult to calculate the actual date of conception. Other than that it is easy to remember last date of menses and easy for calculation, so we are calculating pregnancy from last day of menses. In technical terms there are two age of pregnancy one is gestational age and other is embryonic age. Embryonic age is actual age from conception and gestational age is from last day of menstruation. So do not get confused. Lastly if your pregnancy is growing well that I can assume by your history then no need to worry and the due date according to last menstrual period is the date. Now what is importance of this date? It means if delivery pain starts near this date then let it happen. Do not interfere and if it does not start till date then induce pain with some method of induction.

Hello doctor,How can I figure out my conception date? My last menstrual period was three months back. I had my dating ultrasound and it put the GA at 9 weeks and 3 days. Also there was a CRL measurement of 26.96. My due date based on LMP and ultrasound are different. Please answer. Also how many \"safe\" days are there after a period?

Hello. First of let me tell you that if your menses is coming every month with 2-3 days here or there then it is absolutely normal cycle. Now in normal cycle ovulation occurs in the middle of the cycle (around 12-18th day of cycle) when conception can actually happen. First 8 and last 8 days of your cycle are safe period in normal menses as there is no chance of pregnancy thus safe. Now pregnancy can happen in regular and irregular cycle both. And it is far more difficult to calculate the actual date of conception. Other than that it is easy to remember last date of menses and easy for calculation, so we are calculating pregnancy from last day of menses. In technical terms there are two age of pregnancy one is gestational age and other is embryonic age. Embryonic age is actual age from conception and gestational age is from last day of menstruation. So do not get confused. Lastly if your pregnancy is growing well that I can assume by your history then no need to worry and the due date according to last menstrual period is the date. Now what is importance of this date? It means if delivery pain starts near this date then let it happen. Do not interfere and if it does not start till date then induce pain with some method of induction.

### Instruction: Answer this question truthfully ###Input: Hello doctor,First of all, thanks for this site and that you help people. Last year I had depression with anxiety episodes (diagnosed by the psychiatrist). I did not get any pills. I get well with some kind of psychological therapy. But this year I had several panic attack episodes and neurologist prescribed me Valium to get sublingual during the attack. Now I have some kind of fears, I am afraid when my heartbreaking arises, I am afraid of eating different foods (fear of intoxication), I am afraid of staying alone, etc. Too many fears in my life. I cannot live like this. Can you give me any advice, please? ### Response: Hi, Welcome to Chat Doctor forum. We are happy to help. From what you have described of your problem, it seems anxiety is a greater problem for you. It is good that you have improved only on psychological therapy but then whatever has been taught in psychological therapy, you need to continuously practice it at home. Please look up Jacobson\\s progressive muscular relaxation and practice it 3 to 4 times a day. This exercise will significantly help you gain some control over the somatic symptoms of your anxiety. As far as medicines are concerned, Valium is a medicine which will relieve anxiety to some extent but will make you feel sleepy. If you have been experiencing anxiety episodes every single day or at least 3 to 4 times a week, I would advise you to take Paxil 12.5 mg in the morning and gradually consult a psychiatrist to alter the dosages. But if you have been experiencing anxiety only in specific social situations and require medication only to suppress the anxiety for the time being without feeling sleepy, I would advise you to take tablet Etizola SOS.

Hello doctor,First of all, thanks for this site and that you help people. Last year I had depression with anxiety episodes (diagnosed by the psychiatrist). I did not get any pills. I get well with some kind of psychological therapy. But this year I had several panic attack episodes and neurologist prescribed me Valium to get sublingual during the attack. Now I have some kind of fears, I am afraid when my heartbreaking arises, I am afraid of eating different foods (fear of intoxication), I am afraid of staying alone, etc. Too many fears in my life. I cannot live like this. Can you give me any advice, please?

Hi, Welcome to Chat Doctor forum. We are happy to help. From what you have described of your problem, it seems anxiety is a greater problem for you. It is good that you have improved only on psychological therapy but then whatever has been taught in psychological therapy, you need to continuously practice it at home. Please look up Jacobson\\s progressive muscular relaxation and practice it 3 to 4 times a day. This exercise will significantly help you gain some control over the somatic symptoms of your anxiety. As far as medicines are concerned, Valium is a medicine which will relieve anxiety to some extent but will make you feel sleepy. If you have been experiencing anxiety episodes every single day or at least 3 to 4 times a week, I would advise you to take Paxil 12.5 mg in the morning and gradually consult a psychiatrist to alter the dosages. But if you have been experiencing anxiety only in specific social situations and require medication only to suppress the anxiety for the time being without feeling sleepy, I would advise you to take tablet Etizola SOS.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 38 years old. I am diabetic for the past three years and sugars are not always in control. I am taking medicine Euclide 80 mg and Galvus met 50/500 and Novomix 30 injection 10 units (injection only for few days). My issue is, post diabetes I am experiencing severe recurring yeast infection in vagina and itching in groin area and near anal area. Due to scratch the area has become sensitive and scars and cuts are there. There is burning sensation when the area comes in contact with water. I have tried all Clotrimazole creams (Dres V, Surfaz B, Candid, etc.), but no relief. Itching is severe at night and very uncomfortable. Please help which medicine or cream to apply to stop this infection everytime. I am unsure if that is eczema. Are there any tests which show what kind of infection is that? ### Response: Hi, Welcome to Chat Doctor forum. Diabetes is comorbidity that makes patients prone to fungal infections and some times there is a secondary bacterial infection too. I advise you to follow certain steps. 1. First step, proper sugar control. 2. Anti-diabetic diet and exercise. 3. Proper genital hygiene. 4. Use of clean cotton underwear. 5. Keeping the area clean and as ChatDoctor. 6. No tight clothing. 7. No talcum powder application. 8. Do not use regular soap and hot water to clean genital areas. Take Itraconazole 100 mg two times a day for two weeks, Luliconazole cream to be applied three to four times daily on area of infection after proper cleaning and

Hi doctor,I am 38 years old. I am diabetic for the past three years and sugars are not always in control. I am taking medicine Euclide 80 mg and Galvus met 50/500 and Novomix 30 injection 10 units (injection only for few days). My issue is, post diabetes I am experiencing severe recurring yeast infection in vagina and itching in groin area and near anal area. Due to scratch the area has become sensitive and scars and cuts are there. There is burning sensation when the area comes in contact with water. I have tried all Clotrimazole creams (Dres V, Surfaz B, Candid, etc.), but no relief. Itching is severe at night and very uncomfortable. Please help which medicine or cream to apply to stop this infection everytime. I am unsure if that is eczema. Are there any tests which show what kind of infection is that?

Hi, Welcome to Chat Doctor forum. Diabetes is comorbidity that makes patients prone to fungal infections and some times there is a secondary bacterial infection too. I advise you to follow certain steps. 1. First step, proper sugar control. 2. Anti-diabetic diet and exercise. 3. Proper genital hygiene. 4. Use of clean cotton underwear. 5. Keeping the area clean and as ChatDoctor. 6. No tight clothing. 7. No talcum powder application. 8. Do not use regular soap and hot water to clean genital areas. Take Itraconazole 100 mg two times a day for two weeks, Luliconazole cream to be applied three to four times daily on area of infection after proper cleaning and

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 43 year old female. I am thin build and have no health issues. I am a non-smoker and non-drinker. I do not have kids and not sexually active for the past 15 years.I had my hormone levels checked four months ago. The report showed no menopause and thyroid was fine. My two recent pap smears were also normal. I had a hormonal check as I missed my periods four months ago and since then I have had normal periods.Again, this time I have had cramps and brown or slightly red discharge, but no real periods. I have had two pelvic ultrasounds. The first one showed hemorrhagic ovarian cyst and this disappeared on the second ultrasound scan. But, the second once showed a cervical polyp. Ovaries were normal and there is no cancer, pcos or endometriosis.I am going to get the polyp removed after a month through hysteroscopy and D and C. Why have I missed my period? Why do I have cramps and no periods? Why was there brown discharge? Is cervical polyp the reason? My cycle is always 21 to 23 day and today is my 27th day. Please help. ### Response: Hi. This type of missed period could be due to ovarian cyst, which can also cause painful cramps with brownish spotting. Polyp can also cause pain with brownish spotting. If your hormonal profile is normal, then yes, you will get periods. Please get LH (luteinizing hormone) and FSH (follicle stimulation hormone) done to understand about delayed period if it reoccurs. Please share images of ultrasound and get back to an obstetrician and gynaecologist online Take care.

Hi doctor,I am a 43 year old female. I am thin build and have no health issues. I am a non-smoker and non-drinker. I do not have kids and not sexually active for the past 15 years.I had my hormone levels checked four months ago. The report showed no menopause and thyroid was fine. My two recent pap smears were also normal. I had a hormonal check as I missed my periods four months ago and since then I have had normal periods.Again, this time I have had cramps and brown or slightly red discharge, but no real periods. I have had two pelvic ultrasounds. The first one showed hemorrhagic ovarian cyst and this disappeared on the second ultrasound scan. But, the second once showed a cervical polyp. Ovaries were normal and there is no cancer, pcos or endometriosis.I am going to get the polyp removed after a month through hysteroscopy and D and C. Why have I missed my period? Why do I have cramps and no periods? Why was there brown discharge? Is cervical polyp the reason? My cycle is always 21 to 23 day and today is my 27th day. Please help.

Hi. This type of missed period could be due to ovarian cyst, which can also cause painful cramps with brownish spotting. Polyp can also cause pain with brownish spotting. If your hormonal profile is normal, then yes, you will get periods. Please get LH (luteinizing hormone) and FSH (follicle stimulation hormone) done to understand about delayed period if it reoccurs. Please share images of ultrasound and get back to an obstetrician and gynaecologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor, I am suffering from chronic gouty arthritis. It started ten plus years ago, and now progressed to every joint in my body with multiple joint attacks at once. I have contant pain in joints, even if there is no attack. The attacks jump from joint to joint nonstop. I have seen many doctors; they can only give me shots and prescription of Indomethacin, which is not working for me as it has been taken for more than 10 years.I have changed my diet to exclude a lot of food and drinks with sugar, purines, citrus, salt, etc. Right now, the pain is in my ankle, knees, and left arm (shoulder, rotator cuff, elbow, wrist, thumb, and neck). I have been very depressed and go to bed in pain and wake up in pain daily. My daily functions are limited. ### Response: Hi. I have gone through your history, and it is a bit unusual for a 40-year-old to have polyarticular gout, that is involving a lot of joints. Firstly, I would recommend you visit a Rheumatologist near you to sort it out. Meanwhile, first, we should rule out if it is gout only or some other form of arthritis, which are intermittent sorts like gout such as Palin ChatDoctor. I would like to know your last uric acid levels and if you have ever got rheumatoid factor (RF) and Anti-CCP (anti-cyclic citrullinated peptide) done. If it is gout, then Indomethacin is just going to help the attack. You need to start on proper medications. The treatment would be to start tablet Zycolchine (Colchicine) along with

Hello doctor, I am suffering from chronic gouty arthritis. It started ten plus years ago, and now progressed to every joint in my body with multiple joint attacks at once. I have contant pain in joints, even if there is no attack. The attacks jump from joint to joint nonstop. I have seen many doctors; they can only give me shots and prescription of Indomethacin, which is not working for me as it has been taken for more than 10 years.I have changed my diet to exclude a lot of food and drinks with sugar, purines, citrus, salt, etc. Right now, the pain is in my ankle, knees, and left arm (shoulder, rotator cuff, elbow, wrist, thumb, and neck). I have been very depressed and go to bed in pain and wake up in pain daily. My daily functions are limited.

Hi. I have gone through your history, and it is a bit unusual for a 40-year-old to have polyarticular gout, that is involving a lot of joints. Firstly, I would recommend you visit a Rheumatologist near you to sort it out. Meanwhile, first, we should rule out if it is gout only or some other form of arthritis, which are intermittent sorts like gout such as Palin ChatDoctor. I would like to know your last uric acid levels and if you have ever got rheumatoid factor (RF) and Anti-CCP (anti-cyclic citrullinated peptide) done. If it is gout, then Indomethacin is just going to help the attack. You need to start on proper medications. The treatment would be to start tablet Zycolchine (Colchicine) along with

### Instruction: Answer this question truthfully ###Input: Dear Doctor,I am suffering from anxiety and panic attacks for the last 3 years.I went to a neurologist 2 years back and he advised me to take REXIPRA 10 for 3 months, SOLTUS 50 for 6 months, HEMIDAP PLUS for 9 months & ZEPAM .5 for 12 months. Upon following these medications, I was improving but was not absolutely fine. And after 1 year I visited the same doctor again and he advised me to take ZEPAM .5, REXIPRA 5 & AMIXIDE.Now I am absolutely feeling restless, sleep deprived and very anxious.When I leave these medicine, I feel addicted and I am in immediate need of it.Absolute anxiety and nervousness, high pulse rate and high BP.I am not able to understand whether I am suffering from a neurological or a psychological problem.Should I consult a neurologist or a psychiatrist?25 years/ male, height 6 feet, weight 70 kg.Please help. ### Response: Hi. I read your query and understood your concern. As per your diagnosis of anxiety and panic attacks, there should be no doubt whether you need neurologist or psychiatrist. Both these conditions come under the domain of psychiatrist and they are more able to treat these conditions. Other than anxiety and panic attacks you have got addiction problem because of the wrong use of medicines. In my view there is no role of SOLTUS in case of anxiety and panic attacks. If you feel fine with an online psychiatry consultation session (via phone or video chat), then I will be happy to help you. You con contact me by either putting a detailed query or booking an online consultation.

Dear Doctor,I am suffering from anxiety and panic attacks for the last 3 years.I went to a neurologist 2 years back and he advised me to take REXIPRA 10 for 3 months, SOLTUS 50 for 6 months, HEMIDAP PLUS for 9 months & ZEPAM .5 for 12 months. Upon following these medications, I was improving but was not absolutely fine. And after 1 year I visited the same doctor again and he advised me to take ZEPAM .5, REXIPRA 5 & AMIXIDE.Now I am absolutely feeling restless, sleep deprived and very anxious.When I leave these medicine, I feel addicted and I am in immediate need of it.Absolute anxiety and nervousness, high pulse rate and high BP.I am not able to understand whether I am suffering from a neurological or a psychological problem.Should I consult a neurologist or a psychiatrist?25 years/ male, height 6 feet, weight 70 kg.Please help.

Hi. I read your query and understood your concern. As per your diagnosis of anxiety and panic attacks, there should be no doubt whether you need neurologist or psychiatrist. Both these conditions come under the domain of psychiatrist and they are more able to treat these conditions. Other than anxiety and panic attacks you have got addiction problem because of the wrong use of medicines. In my view there is no role of SOLTUS in case of anxiety and panic attacks. If you feel fine with an online psychiatry consultation session (via phone or video chat), then I will be happy to help you. You con contact me by either putting a detailed query or booking an online consultation.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am sure I have suspensory ligament tear or injury. I have slight pain and discomfort. My erection falls to one side when lying on my back and it also points downward when standing up. I do not have any past medical history. ### Response: Hi. As you have written that you have no past history of any significant condition, so I am sure there is no history of injury or pelvis bone fracture. It is highly unlikely for anyone to have suspensory ligament injury without a pelvic bone fracture. Penile normal anatomy is not that it stands straight at 90 degrees it always will deviate to one side. An injury which is common in the penis is penile fracture which happens during sexual intercourse but after that, there is no erection. Since you have an erection that is also not the possibility. As you have mentioned, you have a weak erection. To find the cause of it, further evaluation by means of blood test and sonography will be needed. But you should understand that erection strength and frequency decreases with age, erection which was present at the age of 20 will not be present at the age of 30. Still, if you are willing to undergo evaluation of the cause of erectile weakness you can let me know, I will tell you the required tests. If you are still sure that your condition is related to a suspensory ligament injury, an artificial erection test followed by a physical examination will be needed. This test is done by a urologist at his clinic where a small injection is given at the base of the penis to cause an erection, then penile anatomy is examined to see for any deformity. MRI pelvis is also an option to see for injury and its severity. Take care.

Hello doctor,I am sure I have suspensory ligament tear or injury. I have slight pain and discomfort. My erection falls to one side when lying on my back and it also points downward when standing up. I do not have any past medical history.

Hi. As you have written that you have no past history of any significant condition, so I am sure there is no history of injury or pelvis bone fracture. It is highly unlikely for anyone to have suspensory ligament injury without a pelvic bone fracture. Penile normal anatomy is not that it stands straight at 90 degrees it always will deviate to one side. An injury which is common in the penis is penile fracture which happens during sexual intercourse but after that, there is no erection. Since you have an erection that is also not the possibility. As you have mentioned, you have a weak erection. To find the cause of it, further evaluation by means of blood test and sonography will be needed. But you should understand that erection strength and frequency decreases with age, erection which was present at the age of 20 will not be present at the age of 30. Still, if you are willing to undergo evaluation of the cause of erectile weakness you can let me know, I will tell you the required tests. If you are still sure that your condition is related to a suspensory ligament injury, an artificial erection test followed by a physical examination will be needed. This test is done by a urologist at his clinic where a small injection is given at the base of the penis to cause an erection, then penile anatomy is examined to see for any deformity. MRI pelvis is also an option to see for injury and its severity. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My friend\\s sister died of lung cancer at the age of 28 years. No one in their family had lung carcinoma. Now he is afraid of any familial risk and occurrence. He is 30 years old now. Is there any investigation to find whether he is at risk or not? ### Response: Hello, Welcome to Chat Doctor forum. Lung cancer occurring at 28 years is unusual and he is right to be concerned regarding familial risk. As far as lung cancer is concerned, there is no specific gene or syn ChatDoctor. But studies have shown that if a family member who had lung cancer and was a non-smoker, the risk of lung cancer in them is high. There are genetic tests available which can detect such mutation and their risk of causing lung cancer. But these tests should be done in a patient who had cancer so we can identify the particular mutation. So that the relatives could be tested for the specific mutation. Most widely known mutation in such cases is EGFR (epidermal growth factor receptor), which can cause familial lung cancer. If his sister was tested for this and was negative then there is no further need for testing. So even if we do the test in your friend and find some abnormalities, we will not be sure of their significance. It will only add to the anxiety of your friend. What I would recommend right now is to adopt a healthy lifestyle and avoid known risk factors for lung cancer. As some researchers have shown that family history makes you seven to eight times more prone than a normal person if you continue to smoke. Also, if possible, I would like to see the histopathology report of his sister regarding type. For more information consult a medical oncologist online

Hello doctor,My friend\\s sister died of lung cancer at the age of 28 years. No one in their family had lung carcinoma. Now he is afraid of any familial risk and occurrence. He is 30 years old now. Is there any investigation to find whether he is at risk or not?

Hello, Welcome to Chat Doctor forum. Lung cancer occurring at 28 years is unusual and he is right to be concerned regarding familial risk. As far as lung cancer is concerned, there is no specific gene or syn ChatDoctor. But studies have shown that if a family member who had lung cancer and was a non-smoker, the risk of lung cancer in them is high. There are genetic tests available which can detect such mutation and their risk of causing lung cancer. But these tests should be done in a patient who had cancer so we can identify the particular mutation. So that the relatives could be tested for the specific mutation. Most widely known mutation in such cases is EGFR (epidermal growth factor receptor), which can cause familial lung cancer. If his sister was tested for this and was negative then there is no further need for testing. So even if we do the test in your friend and find some abnormalities, we will not be sure of their significance. It will only add to the anxiety of your friend. What I would recommend right now is to adopt a healthy lifestyle and avoid known risk factors for lung cancer. As some researchers have shown that family history makes you seven to eight times more prone than a normal person if you continue to smoke. Also, if possible, I would like to see the histopathology report of his sister regarding type. For more information consult a medical oncologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am in real pain for past 9 months and my doctor is clueless after several visits. After a period of 38.6 weeks in latent labor, I had a vacuum assisted vaginal delivery (first baby). No ultrasound was done the very day of admission. With crowning left medio-lateral episiotomy was given. Extension of 1.5 cm up to anal sphincter was given and sutured. I gave birth to 3.6 kg baby girl. After 2-3 days in hospital I kept complaining about excessive pain and burning in that suture compared to others. I was told that it was normal. After a month I could barely sit and feed my baby. In follow up doctor told me it was normal and healing. After 2 months it worsened again and I could feel a hard lump in left side below my vagina and near anus. It has been 9 months now after my delivery and every 4th day or once in a week I get the lump tender, warm and hardness in between my vagina and anus, along with discharge of pus or light color blood which is immensely painful. It keeps coming back always. I am getting weaker day by day. Mild fever, stiffness in legs, body ache, inability to move and sit when the pus forms until it discharges from a hole that has been there always. The same hole closes each time after discharge. Which doctor should I visit? Please help me urgently. What can this be? ### Response: Hi, Welcome to Chat Doctor forum. I have gone through your complaint. Episiotomy. Fistulogram. Abscess. Fistula. Fistulectomy with antibiotic coverage. Revert back after investigations to an internal medicine physician online.-

Hi doctor,I am in real pain for past 9 months and my doctor is clueless after several visits. After a period of 38.6 weeks in latent labor, I had a vacuum assisted vaginal delivery (first baby). No ultrasound was done the very day of admission. With crowning left medio-lateral episiotomy was given. Extension of 1.5 cm up to anal sphincter was given and sutured. I gave birth to 3.6 kg baby girl. After 2-3 days in hospital I kept complaining about excessive pain and burning in that suture compared to others. I was told that it was normal. After a month I could barely sit and feed my baby. In follow up doctor told me it was normal and healing. After 2 months it worsened again and I could feel a hard lump in left side below my vagina and near anus. It has been 9 months now after my delivery and every 4th day or once in a week I get the lump tender, warm and hardness in between my vagina and anus, along with discharge of pus or light color blood which is immensely painful. It keeps coming back always. I am getting weaker day by day. Mild fever, stiffness in legs, body ache, inability to move and sit when the pus forms until it discharges from a hole that has been there always. The same hole closes each time after discharge. Which doctor should I visit? Please help me urgently. What can this be?

Hi, Welcome to Chat Doctor forum. I have gone through your complaint. Episiotomy. Fistulogram. Abscess. Fistula. Fistulectomy with antibiotic coverage. Revert back after investigations to an internal medicine physician online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,This is regards to my urticaria problem. I had a chronic urticaria three years back, for which I underwent a course of Loratidine and Xyzal-M for close to one and a half years and was keeping well. All of a sudden, I had a severe outbreak of hives last week and was put on Dazit-M, Allegra 180 and Xyzal along with Methylprednisolone (8 mg).This time it is so severe and after three days it is not coming down. I need your advice on my current condition and if my medications are appropriate. ### Response: Hello. At the moment, you are having acute exacerbation precipitated by one of the exaggerating factors like artificial flavoring agents, any ChatDoctor. You have already been prescribed steroid which is Methylprednisolone for three days and some other antiallergic medicine as well. I will recommend you to be patient for one more week and continue the same medication. If in case there is no improvement, only then I will recommend having another short course of steroid. Meanwhile, I will ask you to please avoid readymade or take away meals, use bland products for washing, avoid perfumes deodorants, etc. I know this is difficult to do but avoid as much as you can. You can apply topical steroid lotion mixed with vaseline lotion in equal parts and then apply on your hives two times daily. Please continue with your oral medicine in addition to this. In case you have any breathing difficulty then see a doctor on an emergency basis. Next time please send a picture of the lesion as well to know the extent of disease too. Revert after a week to a dermatologist online Take care.

Hello doctor,This is regards to my urticaria problem. I had a chronic urticaria three years back, for which I underwent a course of Loratidine and Xyzal-M for close to one and a half years and was keeping well. All of a sudden, I had a severe outbreak of hives last week and was put on Dazit-M, Allegra 180 and Xyzal along with Methylprednisolone (8 mg).This time it is so severe and after three days it is not coming down. I need your advice on my current condition and if my medications are appropriate.

Hello. At the moment, you are having acute exacerbation precipitated by one of the exaggerating factors like artificial flavoring agents, any ChatDoctor. You have already been prescribed steroid which is Methylprednisolone for three days and some other antiallergic medicine as well. I will recommend you to be patient for one more week and continue the same medication. If in case there is no improvement, only then I will recommend having another short course of steroid. Meanwhile, I will ask you to please avoid readymade or take away meals, use bland products for washing, avoid perfumes deodorants, etc. I know this is difficult to do but avoid as much as you can. You can apply topical steroid lotion mixed with vaseline lotion in equal parts and then apply on your hives two times daily. Please continue with your oral medicine in addition to this. In case you have any breathing difficulty then see a doctor on an emergency basis. Next time please send a picture of the lesion as well to know the extent of disease too. Revert after a week to a dermatologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor, I am 26 years old, currently pregnant with my second child for 26 weeks and 5 days. I just left the doctor\\s office having done an anatomy ultrasound. The doctor said there is a little fluid around my baby\\s heart, but not to worry. I have been scheduled in three weeks for the same ultrasound and also have been scheduled I believe for an abnormalities test. Even though the doctor has told me not to worry I am just freaking out and have been crying all day. It would be nice if I could get an answer as to what may have caused small fluid around the heart? What would the worse outcome be and what I can do now with my everyday habits if that makes sense, as I will be stressing for three weeks about this? Any information would be helpful. ### Response: Hello. I understand your anxiety. Let me clear you some facts. A basic anomaly scan is done at 18-20 weeks and if that was normal, it shows that no structural anomalies are there. Secondly, this scan was done at 26 weeks and 5 days when the fetus is half developed. As far as the fluid is concerned around the heart, it is the pericardial fluid. The fluid inside the pericardial layer covering the heart to initiate smooth functioning. It is around 5 ml in adults with progression in pregnancy it would regress and my advise would follow it up with serial ultrasounds. Unfortunately, every day habits cannot make a difference. I would like to suggest you not to be worried and stress yourself. All is well. Just get three weekly serial ultrasounds to follow up on the fluid level. Baby\\s growth is not affected as I learnt.

Hello doctor, I am 26 years old, currently pregnant with my second child for 26 weeks and 5 days. I just left the doctor\\s office having done an anatomy ultrasound. The doctor said there is a little fluid around my baby\\s heart, but not to worry. I have been scheduled in three weeks for the same ultrasound and also have been scheduled I believe for an abnormalities test. Even though the doctor has told me not to worry I am just freaking out and have been crying all day. It would be nice if I could get an answer as to what may have caused small fluid around the heart? What would the worse outcome be and what I can do now with my everyday habits if that makes sense, as I will be stressing for three weeks about this? Any information would be helpful.

Hello. I understand your anxiety. Let me clear you some facts. A basic anomaly scan is done at 18-20 weeks and if that was normal, it shows that no structural anomalies are there. Secondly, this scan was done at 26 weeks and 5 days when the fetus is half developed. As far as the fluid is concerned around the heart, it is the pericardial fluid. The fluid inside the pericardial layer covering the heart to initiate smooth functioning. It is around 5 ml in adults with progression in pregnancy it would regress and my advise would follow it up with serial ultrasounds. Unfortunately, every day habits cannot make a difference. I would like to suggest you not to be worried and stress yourself. All is well. Just get three weekly serial ultrasounds to follow up on the fluid level. Baby\\s growth is not affected as I learnt.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 27 years old. I have PCOS and have been trying to conceive for four months. My gynecologist put me on 500 mg of Metformin thrice a day and 10 day cycle of Medroxyprogesterone at the beginning of each month to force ovulation. The medication is working exactly as it should. I get my period every month and I have lost weight with the Metformin. I went in for a follow up today and my doctor recommended that I sign up for an infertility study that she is doing. It requires hormone shots, extensive testing and in vitro fertilization every month for a period of four months. I have been going to the same gynecologist for many years and I know her pretty well. Let me just say that she has never seemed like she puts much thought into diagnosing and treating me. I had to practically beg her to test me for PCOS even though I have had very irregular periods and other symptoms for years. Now, she jumped straight to IVF treatment. I have heard of women staying on this course of treatment much longer and being able to conceive. In vitro is incredibly expensive. I am just worried that the only reason she recommended this is because she wants another participant in her study. Your advice on this subject would be appreciated. Thank you. ### Response: Hi. I can understand your situation. Please, do not be so hard on her. I am sure it is not that she is not interested in diagnosing or treating you. However, you can wait for some more time before straight away jumping for IVF (in vitro fertilization). I have given you the information, but participating or not in the trial is totally your decision. All the best. Take care.

Hi doctor,I am 27 years old. I have PCOS and have been trying to conceive for four months. My gynecologist put me on 500 mg of Metformin thrice a day and 10 day cycle of Medroxyprogesterone at the beginning of each month to force ovulation. The medication is working exactly as it should. I get my period every month and I have lost weight with the Metformin. I went in for a follow up today and my doctor recommended that I sign up for an infertility study that she is doing. It requires hormone shots, extensive testing and in vitro fertilization every month for a period of four months. I have been going to the same gynecologist for many years and I know her pretty well. Let me just say that she has never seemed like she puts much thought into diagnosing and treating me. I had to practically beg her to test me for PCOS even though I have had very irregular periods and other symptoms for years. Now, she jumped straight to IVF treatment. I have heard of women staying on this course of treatment much longer and being able to conceive. In vitro is incredibly expensive. I am just worried that the only reason she recommended this is because she wants another participant in her study. Your advice on this subject would be appreciated. Thank you.

Hi. I can understand your situation. Please, do not be so hard on her. I am sure it is not that she is not interested in diagnosing or treating you. However, you can wait for some more time before straight away jumping for IVF (in vitro fertilization). I have given you the information, but participating or not in the trial is totally your decision. All the best. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor, My 61 years old mother underwent vestibuloplasty for lower jaws. Since she arrived, it seems to be bleeding. I know blood and saliva mixed together will seem like bleeding than it actually is. We live in an isolated area. And reaching a doctor was not possible. Could you please let us know what to do to clot the blood for now? ### Response: Hello, Welcome to Chat Doctor forum. I understand your situation. Bleeding after vestibuloplasty or any oral surgical procedure is normal for the next two hours. There are certain instructions you can follow at home to stop bleeding. 1. Apply pressure to the surgical site. Place a thick cotton or gauze pad (probably from the first aid kit of your car) and ask your mother to bite it with pressure for the next 45 minutes. 2. Swallowing saliva. It will be difficult to swallow saliva with the blood taste. Saliva helps faster clotting. Avoid spitting which will increase bleeding and delay clotting. 3. Avoid disturbing the area frequently (to check for clotting). Leave it undisturbed. If the surgical area is disturbed after the clot formation, bleeding will start again. 4. Ask her not to disturb that area with the tongue. 5. Take some ice cubes in a ziplock. Wrap a clean cloth/ tissue over it. Give periodical and very gentle cold compress extra orally (not directly to the surgical site) after 45 minutes of gauze biting. You should seek emergency care if the bleeding is profuse even after three hours. Whereas, very mild bleeding is absolutely normal for today. And place an extra towel over the pillow before laying on the bed, which prevents pillow staining. I hope this helps.

Hello doctor, My 61 years old mother underwent vestibuloplasty for lower jaws. Since she arrived, it seems to be bleeding. I know blood and saliva mixed together will seem like bleeding than it actually is. We live in an isolated area. And reaching a doctor was not possible. Could you please let us know what to do to clot the blood for now?

Hello, Welcome to Chat Doctor forum. I understand your situation. Bleeding after vestibuloplasty or any oral surgical procedure is normal for the next two hours. There are certain instructions you can follow at home to stop bleeding. 1. Apply pressure to the surgical site. Place a thick cotton or gauze pad (probably from the first aid kit of your car) and ask your mother to bite it with pressure for the next 45 minutes. 2. Swallowing saliva. It will be difficult to swallow saliva with the blood taste. Saliva helps faster clotting. Avoid spitting which will increase bleeding and delay clotting. 3. Avoid disturbing the area frequently (to check for clotting). Leave it undisturbed. If the surgical area is disturbed after the clot formation, bleeding will start again. 4. Ask her not to disturb that area with the tongue. 5. Take some ice cubes in a ziplock. Wrap a clean cloth/ tissue over it. Give periodical and very gentle cold compress extra orally (not directly to the surgical site) after 45 minutes of gauze biting. You should seek emergency care if the bleeding is profuse even after three hours. Whereas, very mild bleeding is absolutely normal for today. And place an extra towel over the pillow before laying on the bed, which prevents pillow staining. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My symptoms are distinct white patches on the back of the throat, persistent swollen lymph node in the neck (for at least a week, possibly longer), slight soreness in throat near the node. No fever but have had headaches.Throat flared up in soreness about a week ago then subsided though lingered and lymph node has stayed swollen. Preceding this flare-up was a long period of post-nasal drip and feeling something thick in the back of the throat.Looking at photos of my throat from 2015, it looks like I had very similar white patches on the back of my throat then as well, so it is not clear if they are there permanently or chronically. I cannot find many images online that correspond to this particular shape and pattern of white blotches at the back of the throat. Please advise. I am a male of 39 years old. I take 100 mg Sumatriptan when needed. ### Response: Hello, Welcome to ChatDoctor. What you are seeing are enlarged lymphatic channels in the back of your throat. (attachment removed to protect patient identity). This condition is called cobblestone throat. It is a term we use to describe irritated throat with visible bumps and lumps at the back. Remember that these bumps are due to enlarged lymphatic tissue in the tonsils and adenoids. These are small pockets of tissue in the back of your throat which when you get irritated due to allergies, postnasal ChatDoctor. You do not have strep throat or fungal like picture. I would suggest trying anti-histamine and Tylenol for the next few weeks and see if it improves. If not consult an ENT. I hope this helps.

Hello doctor,My symptoms are distinct white patches on the back of the throat, persistent swollen lymph node in the neck (for at least a week, possibly longer), slight soreness in throat near the node. No fever but have had headaches.Throat flared up in soreness about a week ago then subsided though lingered and lymph node has stayed swollen. Preceding this flare-up was a long period of post-nasal drip and feeling something thick in the back of the throat.Looking at photos of my throat from 2015, it looks like I had very similar white patches on the back of my throat then as well, so it is not clear if they are there permanently or chronically. I cannot find many images online that correspond to this particular shape and pattern of white blotches at the back of the throat. Please advise. I am a male of 39 years old. I take 100 mg Sumatriptan when needed.

Hello, Welcome to ChatDoctor. What you are seeing are enlarged lymphatic channels in the back of your throat. (attachment removed to protect patient identity). This condition is called cobblestone throat. It is a term we use to describe irritated throat with visible bumps and lumps at the back. Remember that these bumps are due to enlarged lymphatic tissue in the tonsils and adenoids. These are small pockets of tissue in the back of your throat which when you get irritated due to allergies, postnasal ChatDoctor. You do not have strep throat or fungal like picture. I would suggest trying anti-histamine and Tylenol for the next few weeks and see if it improves. If not consult an ENT. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am male, 50 years old, 5\\5\", 155 lbs. About a month ago, I accidentally made a deep cut at the tip of a finger. The emergency room glued the finger closed. Seven days later, it split back open. It was no longer bleeding, despite being an open wound. I taped it back closed and was very cautious not to split it open again. The finger seemed to heal together. However, for the last 10 days, no additional healing or changes seem to have occurred. The finger appears mostly together, but the area that was sliced is inflamed and sensitive to the touch and does not seem to be improving any longer. Though the appearance is a bit inflamed (swollen/red), I am mainly concerned about the nerves which sting or hurt a little when the finger touches things on this spot. I would like to understand more about the nerve damage or issues that could be permanent with this injury. ### Response: Hi. I went through the files (attachment removed to protect patient identity). You seem to really have a bad wound. But you need not worry too much about the nerve damage in this part of your body as this area is naturally rich in blood and nerve supply. Though healing may take some time and area may remain sensitive to heat, cold, and touch but all will be fine within next two to three weeks as natural regeneration may take some time. The present condition of your wound looks satisfactory. And for the swelling, you need to do pressure bandage for few days or it will heal with time. Just apply Voltral gel (Diclofenac) and swelling will be better soon. For more information consult a dermatologist online Take care.

Hello doctor,I am male, 50 years old, 5\\5\", 155 lbs. About a month ago, I accidentally made a deep cut at the tip of a finger. The emergency room glued the finger closed. Seven days later, it split back open. It was no longer bleeding, despite being an open wound. I taped it back closed and was very cautious not to split it open again. The finger seemed to heal together. However, for the last 10 days, no additional healing or changes seem to have occurred. The finger appears mostly together, but the area that was sliced is inflamed and sensitive to the touch and does not seem to be improving any longer. Though the appearance is a bit inflamed (swollen/red), I am mainly concerned about the nerves which sting or hurt a little when the finger touches things on this spot. I would like to understand more about the nerve damage or issues that could be permanent with this injury.

Hi. I went through the files (attachment removed to protect patient identity). You seem to really have a bad wound. But you need not worry too much about the nerve damage in this part of your body as this area is naturally rich in blood and nerve supply. Though healing may take some time and area may remain sensitive to heat, cold, and touch but all will be fine within next two to three weeks as natural regeneration may take some time. The present condition of your wound looks satisfactory. And for the swelling, you need to do pressure bandage for few days or it will heal with time. Just apply Voltral gel (Diclofenac) and swelling will be better soon. For more information consult a dermatologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 31 weeks pregnant. I have been having contractions for six days straight now. They started at 20 minutes apart, then got closer. They have been two minutes apart lasting an average of 54 seconds for three days. They have not let up or have stopped. I went to the hospital and they said there has not been enough change in my cervix and sent me home and said not to come back unless I start bleeding. During the last checkup, I was 100% effaced, 2 cm, and 0 stations. I have been leaking clear fluid like crazy, but when I called they said it was probably a discharge. My legs and feet are very swollen. I know something is not right, but they refuse to run any tests because they believe it is false labor. What do I do? ### Response: Hello, Welcome to Chat Doctor forum. Braxton Hicks contractions do occur about six weeks prior to labor but are generally not associated with effacement. If they were real labor pains you should have started fetal descent from 0 stations by now as well. Now, if the intensity of the pains are increasing between contractions then they are true labor pains and if not they are false labor pains. Ladies tend to gain weight because of hemodilution and edema in pregnancy i.e. swelling of the feet, it is a normal part of pregnancy. Leaking per vaginum is again significant. If it looks like water and starts suddenly, I would request you to reach the nearest hospital as soon as possible. I would finally suggest you meet your gynecologist and request NST (nonstress test) for the fetus and examination of the cervix. I hope this helps.

Hello doctor,I am 31 weeks pregnant. I have been having contractions for six days straight now. They started at 20 minutes apart, then got closer. They have been two minutes apart lasting an average of 54 seconds for three days. They have not let up or have stopped. I went to the hospital and they said there has not been enough change in my cervix and sent me home and said not to come back unless I start bleeding. During the last checkup, I was 100% effaced, 2 cm, and 0 stations. I have been leaking clear fluid like crazy, but when I called they said it was probably a discharge. My legs and feet are very swollen. I know something is not right, but they refuse to run any tests because they believe it is false labor. What do I do?

Hello, Welcome to Chat Doctor forum. Braxton Hicks contractions do occur about six weeks prior to labor but are generally not associated with effacement. If they were real labor pains you should have started fetal descent from 0 stations by now as well. Now, if the intensity of the pains are increasing between contractions then they are true labor pains and if not they are false labor pains. Ladies tend to gain weight because of hemodilution and edema in pregnancy i.e. swelling of the feet, it is a normal part of pregnancy. Leaking per vaginum is again significant. If it looks like water and starts suddenly, I would request you to reach the nearest hospital as soon as possible. I would finally suggest you meet your gynecologist and request NST (nonstress test) for the fetus and examination of the cervix. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 29 years old. My last period was about two months back, and I had the bleeding for three days. I found out that I was pregnant about four weeks back. I had an ultrasound scan vaginally two days back, and the doctor did not find a fetus. She just found that I was five weeks and one day pregnant and not six weeks as we had thought. She has ordered an HCG test, and I have to go back to her next week. I am very much worried. I cannot even sleep. How normal is that the doctor does not see the embryo in the first five or six weeks? I love my baby already, and I cannot think of a miscarriage or ectopic pregnancy. Currently, I am taking prenatal vitamins. ### Response: Hi, Welcome to Chat Doctor forum. If she found that you are five plus one weeks pregnant, then that means she has found the gestational sac with some fetal tissue but no cardiac activity. I have to see the sonography report to comment on it. Usually, around four to five weeks, the fetal poles can be viewed. And around six weeks cardiac activity can be appreciated in the sonography. If not, then it can be a delayed pregnancy or there may be a decreased growth of the baby. There is nothing to worry about a delayed pregnancy. But, if there is a decrease in the growth of the baby, then it is a matter of concern. But you have to wait for a few weeks for confirmation. If the baby increases in size around six plus one weeks, then the baby is growing well, and there is no decreased growth. You do not have any choice other than to take medicines and wait for the next scan.

Hello doctor,I am 29 years old. My last period was about two months back, and I had the bleeding for three days. I found out that I was pregnant about four weeks back. I had an ultrasound scan vaginally two days back, and the doctor did not find a fetus. She just found that I was five weeks and one day pregnant and not six weeks as we had thought. She has ordered an HCG test, and I have to go back to her next week. I am very much worried. I cannot even sleep. How normal is that the doctor does not see the embryo in the first five or six weeks? I love my baby already, and I cannot think of a miscarriage or ectopic pregnancy. Currently, I am taking prenatal vitamins.

Hi, Welcome to Chat Doctor forum. If she found that you are five plus one weeks pregnant, then that means she has found the gestational sac with some fetal tissue but no cardiac activity. I have to see the sonography report to comment on it. Usually, around four to five weeks, the fetal poles can be viewed. And around six weeks cardiac activity can be appreciated in the sonography. If not, then it can be a delayed pregnancy or there may be a decreased growth of the baby. There is nothing to worry about a delayed pregnancy. But, if there is a decrease in the growth of the baby, then it is a matter of concern. But you have to wait for a few weeks for confirmation. If the baby increases in size around six plus one weeks, then the baby is growing well, and there is no decreased growth. You do not have any choice other than to take medicines and wait for the next scan.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 49 years old, moderately active, all biochemical parameters mid-range normal. Fasting sugar levels steady at 147 to 149, PP 159 to 250, drops to 80 to 105 at about 6 PM, after lunch at 1.30 to 2 PM. I am having (Glycomet Trio1 and Glycomet GP1) twice a day. Am unable to understand how to get these levels down to fasting. ### Response: Hi. I understand your concerns. Great fluctuations in blood sugar level are common in diabetics. Your treatment is suitable but it may require some small modifications. My advice in order to have better control is that you have to eat a small meal between the main meals. Stay strictly with the diabetic diet. You can miss one dose if you are not going to eat the meal or you are going to eat a very small amount of food. If you tolerate Metformin well, I suggest that you increase the dose to 1000 twice daily after food and decrease the dose of Glimipride as Metformin decrease the sugar level back to normal but not causing hypoglycemia like Glimipride (after consulting your physician). Measuring HbA1c will give us a good idea about how the blood sugar was controlled over the last three months. I need to know about your meals timings and your medications timings . Do you take both medications twice, so that you are taking four tablets in total or you take one in the morning and the other in the evening? So you take only two tablets? Please provide me with your feedback. For further advice, please do not hesitate to send follow up query.

Hello doctor,I am 49 years old, moderately active, all biochemical parameters mid-range normal. Fasting sugar levels steady at 147 to 149, PP 159 to 250, drops to 80 to 105 at about 6 PM, after lunch at 1.30 to 2 PM. I am having (Glycomet Trio1 and Glycomet GP1) twice a day. Am unable to understand how to get these levels down to fasting.

Hi. I understand your concerns. Great fluctuations in blood sugar level are common in diabetics. Your treatment is suitable but it may require some small modifications. My advice in order to have better control is that you have to eat a small meal between the main meals. Stay strictly with the diabetic diet. You can miss one dose if you are not going to eat the meal or you are going to eat a very small amount of food. If you tolerate Metformin well, I suggest that you increase the dose to 1000 twice daily after food and decrease the dose of Glimipride as Metformin decrease the sugar level back to normal but not causing hypoglycemia like Glimipride (after consulting your physician). Measuring HbA1c will give us a good idea about how the blood sugar was controlled over the last three months. I need to know about your meals timings and your medications timings . Do you take both medications twice, so that you are taking four tablets in total or you take one in the morning and the other in the evening? So you take only two tablets? Please provide me with your feedback. For further advice, please do not hesitate to send follow up query.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 26 year old married woman. I have missed my period. When I tested using a Prega News kit, the result was positive. I do not like to have a baby now and I want to terminate my pregnancy with the help of MTP kit. Please advise me how and when to take medicine for termination. Do I need to take any other medicine with MTP? Please tell me in detail. I do not like to go hospital for this. Is it safe to get it done at home? ### Response: Hello. Firstly, your decision of not reporting to the doctor itself is very wrong and trying to abort at home is further wrong as MTP can lead to a lot of bleeding complications which you cannot manage at home after taking the medicine as a dosed protocol. The MTP kit (medical termination of pregnancy) is available in the market as unwanted, but the instruction to take the medication is not accurate for requirement of dose depends on the period of gestation first. Hence, it is necessary that you should undergo an ultrasound pelvis to locate the pregnancy first whether it is intrauterine or ectopic. Once intrauterine confirmed, then the tablets can be taken in a scheduled manner under your local gynecologist supervision in a sequential manner with Mifepristone first and then Misoprostol. Sometimes, Misoprostol has to be continued till 2000 microgram maximum dosage in case of failed abortion with the initial dosage, which may lead to surgical abortion or D and C (dilatation and curettage). So, it is recommended that you should meet your gynecologist first and do not attempt any home abortion. It is not safe at all. Take care.

Hi doctor,I am a 26 year old married woman. I have missed my period. When I tested using a Prega News kit, the result was positive. I do not like to have a baby now and I want to terminate my pregnancy with the help of MTP kit. Please advise me how and when to take medicine for termination. Do I need to take any other medicine with MTP? Please tell me in detail. I do not like to go hospital for this. Is it safe to get it done at home?

Hello. Firstly, your decision of not reporting to the doctor itself is very wrong and trying to abort at home is further wrong as MTP can lead to a lot of bleeding complications which you cannot manage at home after taking the medicine as a dosed protocol. The MTP kit (medical termination of pregnancy) is available in the market as unwanted, but the instruction to take the medication is not accurate for requirement of dose depends on the period of gestation first. Hence, it is necessary that you should undergo an ultrasound pelvis to locate the pregnancy first whether it is intrauterine or ectopic. Once intrauterine confirmed, then the tablets can be taken in a scheduled manner under your local gynecologist supervision in a sequential manner with Mifepristone first and then Misoprostol. Sometimes, Misoprostol has to be continued till 2000 microgram maximum dosage in case of failed abortion with the initial dosage, which may lead to surgical abortion or D and C (dilatation and curettage). So, it is recommended that you should meet your gynecologist first and do not attempt any home abortion. It is not safe at all. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am concerned because I have had a low WBC since after I had my son three years back. A year later, my WBC decreased to 4 and since then has continued to decrease but now I have a low granulocyte count of 1.7 which I have not had before. It is now 3.5 from recent CBC. My last draw was a year ago and it was 4.0. I have been as low as 3.6 in the past. I am a highly stressed person since after the birth of my son. I have been in school for my BSN and MSN and I am wondering this could be related to stress. My H+H is within normal limits with only a slight decrease in my HCT of 28.1. At the time of my CBC I was menstruating so I am attributing the low HCT to menstruation. The only symptom I have is fatigue. Otherwise, my PLT, RBC, HGB and other cell line are fine. Any advice would be greatly appreciated. Previously I have had anxiety and leukopenia. ### Response: Hello. According to the provided history, you are having low WBC count along with normal hemoglobin, platelet, and other values. But your WBC count is not much low and so not much alarming. Viral infection, hepatitis B, HIV, autoimmune disorder like SLE, enteric fever are some causes. According to examination, further workup can be planned according to need. But I need to check your differential WBC count and for that peripheral smear, examination report will be best. So provide your peripheral smear examination report to check it. Take care. For more information consult a hematologist online Take care.

Hello doctor,I am concerned because I have had a low WBC since after I had my son three years back. A year later, my WBC decreased to 4 and since then has continued to decrease but now I have a low granulocyte count of 1.7 which I have not had before. It is now 3.5 from recent CBC. My last draw was a year ago and it was 4.0. I have been as low as 3.6 in the past. I am a highly stressed person since after the birth of my son. I have been in school for my BSN and MSN and I am wondering this could be related to stress. My H+H is within normal limits with only a slight decrease in my HCT of 28.1. At the time of my CBC I was menstruating so I am attributing the low HCT to menstruation. The only symptom I have is fatigue. Otherwise, my PLT, RBC, HGB and other cell line are fine. Any advice would be greatly appreciated. Previously I have had anxiety and leukopenia.

Hello. According to the provided history, you are having low WBC count along with normal hemoglobin, platelet, and other values. But your WBC count is not much low and so not much alarming. Viral infection, hepatitis B, HIV, autoimmune disorder like SLE, enteric fever are some causes. According to examination, further workup can be planned according to need. But I need to check your differential WBC count and for that peripheral smear, examination report will be best. So provide your peripheral smear examination report to check it. Take care. For more information consult a hematologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I cry a lot even on little things on little words, loud voice tears come into my eyes too much. I face worst days of my life. I was happy suddenly everyone at home turns their behavior bad. I am little one of my siblings and my age is 22 years. From my childhood, everyone says I will cry and I start crying. Then I grew up. Now one at home scold me but then I fell in love, they disrespected me and they stopped my education and whom I love was not able to marry as his education is not complete he did not have any job. He was also very aggressive I needed love, care, attention but he fought with me to leave my friends five years. All this continues then now I gave up on him because I cannot bear my family worst behavior with me. He has his job now, he is little changed. He is loving me, we were planning how to make agree both of families for our wedding but yesterday he again talked about that days I broke up with him. But since childhood and these put bad memories in my mind so even on little things tears come into my eyes and everyone got fed up because of the tears. I want treatment of this, please. ### Response: Hello. Repetitive crying spells, mood swings, etc., could be due to some mood disturbance or this could be due to depression. This can be occurring due to some hormonal issue. All these should be evaluated properly. If you have low mood, lack of interest in anything, poor energy, fatigue, tiredness, etc., symptoms then these symptoms are occurring due to depression. Please visit a psychiatrist for opinion and treatment. Take care. For more information consult a psychiatrist online

Hello doctor,I cry a lot even on little things on little words, loud voice tears come into my eyes too much. I face worst days of my life. I was happy suddenly everyone at home turns their behavior bad. I am little one of my siblings and my age is 22 years. From my childhood, everyone says I will cry and I start crying. Then I grew up. Now one at home scold me but then I fell in love, they disrespected me and they stopped my education and whom I love was not able to marry as his education is not complete he did not have any job. He was also very aggressive I needed love, care, attention but he fought with me to leave my friends five years. All this continues then now I gave up on him because I cannot bear my family worst behavior with me. He has his job now, he is little changed. He is loving me, we were planning how to make agree both of families for our wedding but yesterday he again talked about that days I broke up with him. But since childhood and these put bad memories in my mind so even on little things tears come into my eyes and everyone got fed up because of the tears. I want treatment of this, please.

Hello. Repetitive crying spells, mood swings, etc., could be due to some mood disturbance or this could be due to depression. This can be occurring due to some hormonal issue. All these should be evaluated properly. If you have low mood, lack of interest in anything, poor energy, fatigue, tiredness, etc., symptoms then these symptoms are occurring due to depression. Please visit a psychiatrist for opinion and treatment. Take care. For more information consult a psychiatrist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have severe generalized anxiety that started 10 years ago and it has become very severe now. I have anxiety attacks, DPDR everyday, muscle stiffness, shaking hands and legs. I had changed four medicines, first on Sertraline no effect, then on Fluoxetine, it works only on specific region. It cures my DPDR, nothing else, then Venlafaxine for six months. It relieved my half GAD and now on Nexito 10 for 18 weeks. It works but not full. I am already having moderate anxiety. ### Response: Hello, Welcome to Chat Doctor forum. I can understand your problem. Anxiety in day to day situations, even without any cause is seen in generalised anxiety disorder. Nexito, Sertraline and Fluoxetine all are SSRI ChatDoctor. I personally prefer Escitalopram or Nexito for my patients. You are on 10 mg dose and are seeing some improvement but still not complete relief. One option for your persisting symptoms is to increase the dose of Escitalopram to 15 mg. This should provide more relief to your anxiety. Apart from this, addition of Buspirone is one another option. Buspirone if taken twice a day along with Escitalopram will help to reduce the residual anxiety and will also augment the actions of Escitalopram. You can talk with your doctor for this. Anxiety takes time to go and you should understand this. With proper medicines you will be alright. Do you have any unwanted thoughts which produce anxiety? Is there any ongoing stress that is aggravating anxiety? Any symptoms like low mood, bad thoughts, negative thoughts, poor motivation, etc.?

Hello doctor,I have severe generalized anxiety that started 10 years ago and it has become very severe now. I have anxiety attacks, DPDR everyday, muscle stiffness, shaking hands and legs. I had changed four medicines, first on Sertraline no effect, then on Fluoxetine, it works only on specific region. It cures my DPDR, nothing else, then Venlafaxine for six months. It relieved my half GAD and now on Nexito 10 for 18 weeks. It works but not full. I am already having moderate anxiety.

Hello, Welcome to Chat Doctor forum. I can understand your problem. Anxiety in day to day situations, even without any cause is seen in generalised anxiety disorder. Nexito, Sertraline and Fluoxetine all are SSRI ChatDoctor. I personally prefer Escitalopram or Nexito for my patients. You are on 10 mg dose and are seeing some improvement but still not complete relief. One option for your persisting symptoms is to increase the dose of Escitalopram to 15 mg. This should provide more relief to your anxiety. Apart from this, addition of Buspirone is one another option. Buspirone if taken twice a day along with Escitalopram will help to reduce the residual anxiety and will also augment the actions of Escitalopram. You can talk with your doctor for this. Anxiety takes time to go and you should understand this. With proper medicines you will be alright. Do you have any unwanted thoughts which produce anxiety? Is there any ongoing stress that is aggravating anxiety? Any symptoms like low mood, bad thoughts, negative thoughts, poor motivation, etc.?

### Instruction: Answer this question truthfully ###Input: Hello doctor,My partner had her periods last to last month. Sixteen days later, we had a sexual intercourse. But, there was neither penetration nor ejaculation. Being unsure about the seminal fluid discharge or coming in contact with her genitals, I gave her Unwanted 72 the next day which was within 48 hours. Later, she went through its general side effects but without withdrawal bleeding.Further, she got her periods last month which as per her was her usual bleeding except for the first day as it was little heavier than normal and it continued for four to five days.After a few days of her periods, she told me about feeling nausea, headache, dizziness and a discharge which continued for two to three days.Now, in this month she got her periods two days later which again was normal as per her and yesterday she again felt nauseated. Please help me. Is there anything to be worried about? Are there any pregnancy chances? She had a normal cycle of 28 days and she got vomiting two days before. Please help me with your advice. ### Response: Hello. As long as she is having regular periods of normal flow and quantity there is no need to worry. There is a complete absence of periods in pregnancy, sometimes early pregnancy bleeding known as implantation bleeding does occur but it is very light and lasts only a couple of days. Nausea and vomiting that she is experiencing are most likely due to hormonal imbalance due to the emergency contraceptive pill. Do not worry. However, if you are still very anxious you can do a pregnancy test with a sample of early morning urine and check the results. That should ease any remaining doubts. For more information consult an obstetrician and gynaecologist online

Hello doctor,My partner had her periods last to last month. Sixteen days later, we had a sexual intercourse. But, there was neither penetration nor ejaculation. Being unsure about the seminal fluid discharge or coming in contact with her genitals, I gave her Unwanted 72 the next day which was within 48 hours. Later, she went through its general side effects but without withdrawal bleeding.Further, she got her periods last month which as per her was her usual bleeding except for the first day as it was little heavier than normal and it continued for four to five days.After a few days of her periods, she told me about feeling nausea, headache, dizziness and a discharge which continued for two to three days.Now, in this month she got her periods two days later which again was normal as per her and yesterday she again felt nauseated. Please help me. Is there anything to be worried about? Are there any pregnancy chances? She had a normal cycle of 28 days and she got vomiting two days before. Please help me with your advice.

Hello. As long as she is having regular periods of normal flow and quantity there is no need to worry. There is a complete absence of periods in pregnancy, sometimes early pregnancy bleeding known as implantation bleeding does occur but it is very light and lasts only a couple of days. Nausea and vomiting that she is experiencing are most likely due to hormonal imbalance due to the emergency contraceptive pill. Do not worry. However, if you are still very anxious you can do a pregnancy test with a sample of early morning urine and check the results. That should ease any remaining doubts. For more information consult an obstetrician and gynaecologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,My uncle is suffering from breathing problems for ten days. Now the condition is that he cannot even inhale oxygen through the nose. He is inhaling through his mouth. And he is so weak that he cannot use the restroom by himself. Doctor adviced him to do echocardiography. The report shows the presence of fluid in the left lungs. We admitted him to the hospital immediately. Doctor removed the fluid of about 1.5 liters out of 5 liters, and the fluid is reddish. Again they did a CT scan, and they are telling that a lump is seen in the upper side of the left lung. They want to do a biopsy. But we do not want to do so because, if it is a malignancy, then we do not want to operate that. Please suggest what to do. ### Response: Hello, Welcome to Chat Doctor forum. As you said, your uncle is suffering from left pleural effusion with left lung cancer. According to your history, he is very symptomatic and needs ChatDoctor. Also, your doctor has rightly said that we must do a biopsy of the lump, to find out the exact type of cancer to start appropriate chemotherapy or radiotherapy as per the report. It is not necessary to do surgery all the time. But if he is having a recurrent collection of pleural fluid, then he might need a procedure called Pleurodesis to close the space around the lungs to prevent the recurrent filling of fluid. So it is up to the wish of the patient and relatives to start chemotherapy or not after the diagnosis of cancer is done. Otherwise, you can continue with only symptomatic (palliative) treatment and frequent tapping of fluid to relieve dyspnea. I hope this helps.

Hello doctor,My uncle is suffering from breathing problems for ten days. Now the condition is that he cannot even inhale oxygen through the nose. He is inhaling through his mouth. And he is so weak that he cannot use the restroom by himself. Doctor adviced him to do echocardiography. The report shows the presence of fluid in the left lungs. We admitted him to the hospital immediately. Doctor removed the fluid of about 1.5 liters out of 5 liters, and the fluid is reddish. Again they did a CT scan, and they are telling that a lump is seen in the upper side of the left lung. They want to do a biopsy. But we do not want to do so because, if it is a malignancy, then we do not want to operate that. Please suggest what to do.

Hello, Welcome to Chat Doctor forum. As you said, your uncle is suffering from left pleural effusion with left lung cancer. According to your history, he is very symptomatic and needs ChatDoctor. Also, your doctor has rightly said that we must do a biopsy of the lump, to find out the exact type of cancer to start appropriate chemotherapy or radiotherapy as per the report. It is not necessary to do surgery all the time. But if he is having a recurrent collection of pleural fluid, then he might need a procedure called Pleurodesis to close the space around the lungs to prevent the recurrent filling of fluid. So it is up to the wish of the patient and relatives to start chemotherapy or not after the diagnosis of cancer is done. Otherwise, you can continue with only symptomatic (palliative) treatment and frequent tapping of fluid to relieve dyspnea. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 40 years old, and my weight is 97 kilograms. I am a diabetic patient, and my A1C test showed a result of 9 %. I am taking Sitaglu Met 500 mg. It has not helped me. When I take it, within five minutes, my sugar level gets increased to 250 mg/dL and comes down again to 180 mg/dL or 190 mg/dL. Sometimes, it does not get reduced. My fasting blood sugar level is 180 mg/dL. I am thinking to change my medicines. Please suggest. ### Response: Hi, Welcome to Chat Doctor forum. Please verify the dose of Sitaglu Met. It is a combination medication. It has two medicines Sitagliptin and Metformin. Please mention whether you take 50 mg/500 mg or 50 mg/1000 mg dose. Please send a picture of it. Medication alone cannot control diabetes. Determining the type of diabetes is essential. There is a possibility that you may have type 1, so appropriate testing is required. You are overweight for your age, and the blood sugar is high. If your diabetic level is not controlled at this stage, it can lead to kidney problem and vision problem in two to three years. Both are irreversible once they get developed. Have control in your diet. If you are surely diagnosed with type 2, I can suggest you take Glucophage 1000 mg (Metformin) daily and Linagliptin injection. It is not insulin. It controls the blood sugar, and it helps to lose weight.

Hi doctor,I am 40 years old, and my weight is 97 kilograms. I am a diabetic patient, and my A1C test showed a result of 9 %. I am taking Sitaglu Met 500 mg. It has not helped me. When I take it, within five minutes, my sugar level gets increased to 250 mg/dL and comes down again to 180 mg/dL or 190 mg/dL. Sometimes, it does not get reduced. My fasting blood sugar level is 180 mg/dL. I am thinking to change my medicines. Please suggest.

Hi, Welcome to Chat Doctor forum. Please verify the dose of Sitaglu Met. It is a combination medication. It has two medicines Sitagliptin and Metformin. Please mention whether you take 50 mg/500 mg or 50 mg/1000 mg dose. Please send a picture of it. Medication alone cannot control diabetes. Determining the type of diabetes is essential. There is a possibility that you may have type 1, so appropriate testing is required. You are overweight for your age, and the blood sugar is high. If your diabetic level is not controlled at this stage, it can lead to kidney problem and vision problem in two to three years. Both are irreversible once they get developed. Have control in your diet. If you are surely diagnosed with type 2, I can suggest you take Glucophage 1000 mg (Metformin) daily and Linagliptin injection. It is not insulin. It controls the blood sugar, and it helps to lose weight.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 60-year-old female. I am not overweight. I exercise daily. I have episodes of enormous pain in my left thigh under the muscle. It does not look like muscle spasms. It seems to happen when I try to move my knee. It occurs mostly at night time when I am lying down or when I am sleeping. I have the pain for about 10 minutes. During these episodes, the pain starts within a minute and subsides within five seconds. The pain is severe. I am feeling exhausted. Sometimes it happens for a couple of times in a week, and it occurs in between the months too. It seems to get worse when I try to move.I have gone to many doctors and had done three MRI on my back. I have done X-rays, nerve tests, and ultrasound on both the legs. The results came negative. I do not have these episodes when I am at the doctor\\s office. What could be the reason for having this pain? What is the cause? Please suggest. ### Response: Hi, Welcome to Chat Doctor forum. I have reviewed your query. You can consider doing an epidural steroid injection for controlling the painful episodes. You should discuss the option with your physician for doing it. You can also have a hip joint issues. You can also consult an orthopedist for knowing the cause. I would recommend visiting a gynecologist for proper evaluation and try to have a second opinion on this issue. She would be in a better position to investigate you. There can be an infection or inflammation such as PID (pelvic inflammatory disease) or any other malformations related to female organs. It may also be a cause.

Hi doctor,I am a 60-year-old female. I am not overweight. I exercise daily. I have episodes of enormous pain in my left thigh under the muscle. It does not look like muscle spasms. It seems to happen when I try to move my knee. It occurs mostly at night time when I am lying down or when I am sleeping. I have the pain for about 10 minutes. During these episodes, the pain starts within a minute and subsides within five seconds. The pain is severe. I am feeling exhausted. Sometimes it happens for a couple of times in a week, and it occurs in between the months too. It seems to get worse when I try to move.I have gone to many doctors and had done three MRI on my back. I have done X-rays, nerve tests, and ultrasound on both the legs. The results came negative. I do not have these episodes when I am at the doctor\\s office. What could be the reason for having this pain? What is the cause? Please suggest.

Hi, Welcome to Chat Doctor forum. I have reviewed your query. You can consider doing an epidural steroid injection for controlling the painful episodes. You should discuss the option with your physician for doing it. You can also have a hip joint issues. You can also consult an orthopedist for knowing the cause. I would recommend visiting a gynecologist for proper evaluation and try to have a second opinion on this issue. She would be in a better position to investigate you. There can be an infection or inflammation such as PID (pelvic inflammatory disease) or any other malformations related to female organs. It may also be a cause.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have had this problem for 8 years with no proper solutions. Please help. Strange sensations, tiredness, feeling of heaviness in the arms and legs. Hands and feet become warm. I have an electrical shock like feeling in face. I have extreme fatigue, unsteadiness and muscle twitching in the arms and legs and my eye often twitches. Now my feet and hands itch like crazy. Feet are worse than the hands. I take Cymbalta, Lyrica and Levothyroxin. I have had MRIs of the spine and brain, nerve conductivity test, and many blood tests including heavy metals, HIV, syphilis, drug test, vitamin levels test, Lyme disease test, ANA and so many others.The doctors are not able to figure out what is wrong. I had about 25 hours of sleep only this whole week, because I have so much pain. When I do sleep I thrash all over the bed. Going this long without getting much sleep is not normal for me. I usually do get more sleep than this. When all this first started I got very sick, lost weight (about 40 lbs in two months) and laid on the couch for a year missing out on life because I was too exhausted and sick.I do not know if all these symptoms are related to one issue or more. The doctors thought I had MS, but no lesions. Please help me. Thank you! ### Response: Hi, Welcome to Chat Doctor forum. I read your query and understand your concerns. If your age and other description does not match with the above narration or if you have more questions feel free to write back to us. Consult a neurologist online for further help

Hello doctor,I have had this problem for 8 years with no proper solutions. Please help. Strange sensations, tiredness, feeling of heaviness in the arms and legs. Hands and feet become warm. I have an electrical shock like feeling in face. I have extreme fatigue, unsteadiness and muscle twitching in the arms and legs and my eye often twitches. Now my feet and hands itch like crazy. Feet are worse than the hands. I take Cymbalta, Lyrica and Levothyroxin. I have had MRIs of the spine and brain, nerve conductivity test, and many blood tests including heavy metals, HIV, syphilis, drug test, vitamin levels test, Lyme disease test, ANA and so many others.The doctors are not able to figure out what is wrong. I had about 25 hours of sleep only this whole week, because I have so much pain. When I do sleep I thrash all over the bed. Going this long without getting much sleep is not normal for me. I usually do get more sleep than this. When all this first started I got very sick, lost weight (about 40 lbs in two months) and laid on the couch for a year missing out on life because I was too exhausted and sick.I do not know if all these symptoms are related to one issue or more. The doctors thought I had MS, but no lesions. Please help me. Thank you!

Hi, Welcome to Chat Doctor forum. I read your query and understand your concerns. If your age and other description does not match with the above narration or if you have more questions feel free to write back to us. Consult a neurologist online for further help

### Instruction: Answer this question truthfully ###Input: Hello doctor,I was diagnosed with a candida albicans. I used emergency contraceptives as and then but I treated it with Ciprofloxacin antibiotic. I also started using cotton pants, took care of my vagina too. Then last month, I went to the clinic and retook the test hoping it would come out clean. Then they said I have a staphylococcus infection. It was moderate and I took the same antibiotics they prescribed. I did not have any symptoms but I treated it anyway. Then, earlier this month, I had catarrh which I also treated with an antibiotic. Now, I am four days late from seeing my period. I am very scared, I do not think I am pregnant because I check with a strip two days ago and it tested negative. I am just very scared because I feel it was the infection that is delaying my period and it is messing with my system inside. How dangerous are staphylococcus infections, and why have I not seen my period? ### Response: Hi, Welcom to ciliiq.com. You do not need to be scared. Vaginal infection should be taken care of, but these infections are not uncommon in sexually active females. So do not worry. If there are no symptoms, taking antibiotics every time may not be the right thing to do. Just maintain hygiene. Staphylococcus infection is also not an uncommon vaginal infection, sometimes even contamination from the surrounding areas while taking swab may show such a picture. Period delay due to this seems unlikely. Wait another week and recheck in the urine. If still negative, see a gynecologist who can examine you and find out the reason for it. It could be hormonal imbalance or a uterine or ovarian pathology. I hope this helps.

Hello doctor,I was diagnosed with a candida albicans. I used emergency contraceptives as and then but I treated it with Ciprofloxacin antibiotic. I also started using cotton pants, took care of my vagina too. Then last month, I went to the clinic and retook the test hoping it would come out clean. Then they said I have a staphylococcus infection. It was moderate and I took the same antibiotics they prescribed. I did not have any symptoms but I treated it anyway. Then, earlier this month, I had catarrh which I also treated with an antibiotic. Now, I am four days late from seeing my period. I am very scared, I do not think I am pregnant because I check with a strip two days ago and it tested negative. I am just very scared because I feel it was the infection that is delaying my period and it is messing with my system inside. How dangerous are staphylococcus infections, and why have I not seen my period?

Hi, Welcom to ciliiq.com. You do not need to be scared. Vaginal infection should be taken care of, but these infections are not uncommon in sexually active females. So do not worry. If there are no symptoms, taking antibiotics every time may not be the right thing to do. Just maintain hygiene. Staphylococcus infection is also not an uncommon vaginal infection, sometimes even contamination from the surrounding areas while taking swab may show such a picture. Period delay due to this seems unlikely. Wait another week and recheck in the urine. If still negative, see a gynecologist who can examine you and find out the reason for it. It could be hormonal imbalance or a uterine or ovarian pathology. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My 71 year old mother got a couple of ischemic strokes nearly two months ago. She was then given a strong blood thinning injection which led to a couple of blood vomits and a hemorrhage as well. During the hospitalization as well as afterward, she has been taking Pradaxa 110, etc. (prescription attached). She was hospitalized for about a month and relieved at the end of the month. Now, all went well until last week, when she complained of severe pain in the lower right limb. We did a CT aortogram (report attached) to identify the blockage since the limb was turning green and there was no pulse identified. The blockage was found to be behind the stomach area. She was operated on the same day and the clots were removed, but the cleaning happened on a dead vessel. Now, again after the blood thinning medication, there is another clot identified in today\\s MRI in the brain. The blood thickness has raised to 35 and so, an injection has been started. She went through a mitral valve replacement 12 years ago. She has undergone a knee replacement on the left leg and has got both her retinas replaced as well. I am requesting your advice to be able to stop the formations of the clots and blockages, which continue regardless. Any other advice or suggestion is welcome. ### Response: Hello, Welcome to Chat Doctor forum. I have gone through the files attached (attachment removed to protect patient identity). I strongly recommend she switch over to these medications and visit a cardiologist if you are not under the follow up of same. Hope this helps you and get back if you have any doubts. For more information consult a cardiologist online

Hello doctor,My 71 year old mother got a couple of ischemic strokes nearly two months ago. She was then given a strong blood thinning injection which led to a couple of blood vomits and a hemorrhage as well. During the hospitalization as well as afterward, she has been taking Pradaxa 110, etc. (prescription attached). She was hospitalized for about a month and relieved at the end of the month. Now, all went well until last week, when she complained of severe pain in the lower right limb. We did a CT aortogram (report attached) to identify the blockage since the limb was turning green and there was no pulse identified. The blockage was found to be behind the stomach area. She was operated on the same day and the clots were removed, but the cleaning happened on a dead vessel. Now, again after the blood thinning medication, there is another clot identified in today\\s MRI in the brain. The blood thickness has raised to 35 and so, an injection has been started. She went through a mitral valve replacement 12 years ago. She has undergone a knee replacement on the left leg and has got both her retinas replaced as well. I am requesting your advice to be able to stop the formations of the clots and blockages, which continue regardless. Any other advice or suggestion is welcome.

Hello, Welcome to Chat Doctor forum. I have gone through the files attached (attachment removed to protect patient identity). I strongly recommend she switch over to these medications and visit a cardiologist if you are not under the follow up of same. Hope this helps you and get back if you have any doubts. For more information consult a cardiologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 48 year old. I was never sick, I never go to a doctor. I do not take medications. I have worked out for 30 years five times a week. Nothing real heavy these days (treadmill three times a week - fast walking). Symptoms started about a month ago with intermittent dull stomach pain and mostly on the left side. It progressed to dull testicle pain - again mostly on the left side. It is usually not stomach and testicle at the same time. There are no noticeable lumps in the testicles - both feel the same to me, but the pain is more on the upper top of the testicle from what I can tell. I believe there are some tubes or cords there naturally and to me, it feels like the left side does feel more cordy (for lack of a better word). I have occasional groin tightness.Symptoms I do not have ### Response: Hello. As per me, there are two possibilities. This is quite common in people who do regular workout and exercises. I will only suggest you if possible get an ultrasound scrotum done. It will be normal only but just in case to rule out other things like varicocele. Regarding pain, I will not ask you to take any medication at present. Only thing is you should wear proper scrotal support, that is, you get special support for testis apart from underwear. That should be worn during workout and testis should not hang loose during a workout. Apart from this, I think nothing is to be done. If you go by internet, then there will be many causes listed and it will only confuse you more. For more information consult a urologist online Take care.

Hello doctor,I am a 48 year old. I was never sick, I never go to a doctor. I do not take medications. I have worked out for 30 years five times a week. Nothing real heavy these days (treadmill three times a week - fast walking). Symptoms started about a month ago with intermittent dull stomach pain and mostly on the left side. It progressed to dull testicle pain - again mostly on the left side. It is usually not stomach and testicle at the same time. There are no noticeable lumps in the testicles - both feel the same to me, but the pain is more on the upper top of the testicle from what I can tell. I believe there are some tubes or cords there naturally and to me, it feels like the left side does feel more cordy (for lack of a better word). I have occasional groin tightness.Symptoms I do not have

Hello. As per me, there are two possibilities. This is quite common in people who do regular workout and exercises. I will only suggest you if possible get an ultrasound scrotum done. It will be normal only but just in case to rule out other things like varicocele. Regarding pain, I will not ask you to take any medication at present. Only thing is you should wear proper scrotal support, that is, you get special support for testis apart from underwear. That should be worn during workout and testis should not hang loose during a workout. Apart from this, I think nothing is to be done. If you go by internet, then there will be many causes listed and it will only confuse you more. For more information consult a urologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My tooth has been filled and I went to the dentist and he took an x-ray and the filling was to close to to my nerve. He said he will have to do a root canal which I do not want to do. I was thinking of other ways to go around this because my nerve has nothing wrong in it. I do not think I should get one if my nerve is not infected. I was thinking he could just remove the filling and and replace it with a new one which makes sense. Anyway if we do a root canal he is going to drill in the filling anyway. So let me know if a root canal is the only option because I do not feel like going through that. ### Response: Hello, Welcome to Chat Doctor forum. It all depends on your symptoms. Why did you visit the dentist if the filling was already done? Are you experiencing any pain or discomfort in it? If yes, then unfortunately, there is no option left but root canal treatment for it, because it might have touched the roots almost. Secondly, after the removal of filling, re-filling at the same point will not be possible because if the pulp of root is near as it cannot bear any sort of filling directly on top of it. If it is done in this way it will simply cause huge swelling or throbbing pain will start so the only way to save a tooth is to clean the pulp i.e. nerves of root canal through this treatment and then put a cap on it. You may delay this treatment until you experience any symptoms of a root canal. Can you tell me about your symptoms and provide me with a radiograph? So I can tell you exactly what you can do best.

Hi doctor,My tooth has been filled and I went to the dentist and he took an x-ray and the filling was to close to to my nerve. He said he will have to do a root canal which I do not want to do. I was thinking of other ways to go around this because my nerve has nothing wrong in it. I do not think I should get one if my nerve is not infected. I was thinking he could just remove the filling and and replace it with a new one which makes sense. Anyway if we do a root canal he is going to drill in the filling anyway. So let me know if a root canal is the only option because I do not feel like going through that.

Hello, Welcome to Chat Doctor forum. It all depends on your symptoms. Why did you visit the dentist if the filling was already done? Are you experiencing any pain or discomfort in it? If yes, then unfortunately, there is no option left but root canal treatment for it, because it might have touched the roots almost. Secondly, after the removal of filling, re-filling at the same point will not be possible because if the pulp of root is near as it cannot bear any sort of filling directly on top of it. If it is done in this way it will simply cause huge swelling or throbbing pain will start so the only way to save a tooth is to clean the pulp i.e. nerves of root canal through this treatment and then put a cap on it. You may delay this treatment until you experience any symptoms of a root canal. Can you tell me about your symptoms and provide me with a radiograph? So I can tell you exactly what you can do best.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had a random urine test for pheochromocytoma and I think my PCP is reading wrong. I went to the lab and gave an ambiguous report confusing people. She did say fourfold elevation normetanephrine and four-fold elevation u-metanephrine. I do have episodic severe hypertension attacks, palor, sweating, BP up to 256/131 mmHg for 20 minutes or so. Only very occasionally have these attacks. As a 50 year old I never had sustained high blood pressure but now I do and am on large doses of medicines. Do I have elevated lab work and what do you think it means? U-metanephrine total QST 196 range 149 to 603. U-normetanephrine QST 148 range 108 to 524. U-epinephrine QST was below reportable range. Rest of numbers seem normal. What is your opinion? ### Response: Hi, Welcome to Chat Doctor forum. I understand your results showed raised urinary metanephrines but the other metabolites were within normal range. This could still indicate pheochromocytoma. I must say that your symptoms are quite suggestive of pheochromocytoma although not exclusively in favor of it. I need to know if you also get panic attacks and whether you have any other disorders associated with your thyroid or parathyroid glands, as that would pretty much go in favor of this diagnosis. Let me know so that I can advise some tests which would confirm the diagnosis so that adequate treatment can be initiated. For more information consult a general practitioner online

Hello doctor,I had a random urine test for pheochromocytoma and I think my PCP is reading wrong. I went to the lab and gave an ambiguous report confusing people. She did say fourfold elevation normetanephrine and four-fold elevation u-metanephrine. I do have episodic severe hypertension attacks, palor, sweating, BP up to 256/131 mmHg for 20 minutes or so. Only very occasionally have these attacks. As a 50 year old I never had sustained high blood pressure but now I do and am on large doses of medicines. Do I have elevated lab work and what do you think it means? U-metanephrine total QST 196 range 149 to 603. U-normetanephrine QST 148 range 108 to 524. U-epinephrine QST was below reportable range. Rest of numbers seem normal. What is your opinion?

Hi, Welcome to Chat Doctor forum. I understand your results showed raised urinary metanephrines but the other metabolites were within normal range. This could still indicate pheochromocytoma. I must say that your symptoms are quite suggestive of pheochromocytoma although not exclusively in favor of it. I need to know if you also get panic attacks and whether you have any other disorders associated with your thyroid or parathyroid glands, as that would pretty much go in favor of this diagnosis. Let me know so that I can advise some tests which would confirm the diagnosis so that adequate treatment can be initiated. For more information consult a general practitioner online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 22 years old, and I have no trouble in getting an erection during masturbation or foreplay. However, when I try to have sex, I cannot maintain a tough erection while during foreplay and masturbation. At some point, I feel getting softer. I have an erection right up until the end of penetration then I start to go limp. I once had the head of my penis inside her, and I accidentally removed it, and my erection was quickly lost, and without removing the condom, it is hard to get it back. ### Response: Hello. You have mentioned two essential things while describing your problem. Number one, you can achieve a proper erection and number two, you are a virgin. Keeping these facts in consideration, I would like you to know that you do not have any erectile dysfunction. The problem appears to be related to the unconscious and conscious anxiety that a person has typically while having sex for the first time. When a male is getting ready for his first ever sex he is preoccupied with the thoughts about the outcome of the forthcoming sexual act ,e.g. whether you will be able to maintain erection during sex, whether or not the partner will notice my weaknesses and lack of experience, whether the experience is going to be satisfactory or not, whether or not you will be able to last long, whether you will be looking good or ugly without clothes, etc. Such thoughts increase anxiety, and insecurity, which ultimately results in loss of erection while penetrating. Getting comfortable with the partner will help. Viagra although does not help in psychological erectile dysfunction still it is going to help you by maintaining a solid erection during penetration and thereby will boost up your confidence. Take care.

Hello doctor,I am 22 years old, and I have no trouble in getting an erection during masturbation or foreplay. However, when I try to have sex, I cannot maintain a tough erection while during foreplay and masturbation. At some point, I feel getting softer. I have an erection right up until the end of penetration then I start to go limp. I once had the head of my penis inside her, and I accidentally removed it, and my erection was quickly lost, and without removing the condom, it is hard to get it back.

Hello. You have mentioned two essential things while describing your problem. Number one, you can achieve a proper erection and number two, you are a virgin. Keeping these facts in consideration, I would like you to know that you do not have any erectile dysfunction. The problem appears to be related to the unconscious and conscious anxiety that a person has typically while having sex for the first time. When a male is getting ready for his first ever sex he is preoccupied with the thoughts about the outcome of the forthcoming sexual act ,e.g. whether you will be able to maintain erection during sex, whether or not the partner will notice my weaknesses and lack of experience, whether the experience is going to be satisfactory or not, whether or not you will be able to last long, whether you will be looking good or ugly without clothes, etc. Such thoughts increase anxiety, and insecurity, which ultimately results in loss of erection while penetrating. Getting comfortable with the partner will help. Viagra although does not help in psychological erectile dysfunction still it is going to help you by maintaining a solid erection during penetration and thereby will boost up your confidence. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My daughter has been experiencing severe back pain, arm stiffness with grip loss, shooting pains down legs when the heel is put to floor and vision blurring when sitting in the car for long periods, for over two years following spinal anesthesia for C-section. MRI scans show nothing and she is taking a maximum dosage of Endone. She now has vascular issues with bilateral inflammation and swelling in lower legs. She has been to a pain specialist and neurologist who have no answers. She is losing hope and trying to care for four children. Can you please offer us some answers? ### Response: Hello, Welcome to Chat Doctor forum. I understand your concern and would explain that her symptoms (especially the grip loss in her arms and blurring vision) are not related to a lumbar spine disorder. A brain disorder (intracranial hypotension) or a cervical myelopathy could explain some of her symptoms. Intracranial hypotension could be a complication of local anesthesia, but you should know that it usually leads to a headache and blurring vision or nausea when standing up or sitting and the symptoms usually improve with lying down. So, it seems that her symptoms are not typical of this disorder too. Coming to this point, it is necessary to perform a brain MRI study and a cervical spine MRI study. The bilateral inflammation and swelling in her legs do not seem to be related to any neurological disorder. For this reason, it is important to perform inflammation tests (complete blood count, PCR, sedimentation rate) and a Doppler ultrasound of the leg vessels to investigate for chronic venous insufficiency. A cardiac ultrasound is necessary to exclude possible heart failure as a possible cause of increased fluid retention. Hope you will find this answer helpful. For more information consult a neurologist online

Hello doctor,My daughter has been experiencing severe back pain, arm stiffness with grip loss, shooting pains down legs when the heel is put to floor and vision blurring when sitting in the car for long periods, for over two years following spinal anesthesia for C-section. MRI scans show nothing and she is taking a maximum dosage of Endone. She now has vascular issues with bilateral inflammation and swelling in lower legs. She has been to a pain specialist and neurologist who have no answers. She is losing hope and trying to care for four children. Can you please offer us some answers?

Hello, Welcome to Chat Doctor forum. I understand your concern and would explain that her symptoms (especially the grip loss in her arms and blurring vision) are not related to a lumbar spine disorder. A brain disorder (intracranial hypotension) or a cervical myelopathy could explain some of her symptoms. Intracranial hypotension could be a complication of local anesthesia, but you should know that it usually leads to a headache and blurring vision or nausea when standing up or sitting and the symptoms usually improve with lying down. So, it seems that her symptoms are not typical of this disorder too. Coming to this point, it is necessary to perform a brain MRI study and a cervical spine MRI study. The bilateral inflammation and swelling in her legs do not seem to be related to any neurological disorder. For this reason, it is important to perform inflammation tests (complete blood count, PCR, sedimentation rate) and a Doppler ultrasound of the leg vessels to investigate for chronic venous insufficiency. A cardiac ultrasound is necessary to exclude possible heart failure as a possible cause of increased fluid retention. Hope you will find this answer helpful. For more information consult a neurologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,The molar on the left side of my mouth was filled last year and right now it hurts really bad. I took Tylenol and Motrin, but none of them help. I cannot remember if I pulled out that molar a while ago or if it still needs to be pulled. It is not really loose, but I can move it around. If I try to pull it out I am afraid that it will be my permanent tooth. The pain started last week. I do not know what to do. I talked to my dentist and he said that he did not see anything wrong with it but, for some reason, the pain is still going. I cannot sleep at night and it gives me ear pain. ### Response: Hi. I have read through your complaint and the relevant details. Firstly, I would like to tell you that ear pain, pain during night, and the looseness you feel in the tooth are all the signs of a deeply infected tooth. Secondly, it is not necessary to be for the same filled molar to give you trouble. The pain might be from the same molar or could be due to a different tooth on the same side. I would not be able to arrive at a correct diagnosis until at least I see a picture of your teeth in that row. It seems you take pain killers for the same and there is nothing more I could prescribe (considering your age). The only way to immediate pain relief would be an active dental treatment for the affected tooth as soon as possible. It cannot be cured just with pain killers or any other medications. I advise you to see the dentist with an emergency appointment and look upon the issue. If you do not ad ChatDoctor. Thanks.

Hi doctor,The molar on the left side of my mouth was filled last year and right now it hurts really bad. I took Tylenol and Motrin, but none of them help. I cannot remember if I pulled out that molar a while ago or if it still needs to be pulled. It is not really loose, but I can move it around. If I try to pull it out I am afraid that it will be my permanent tooth. The pain started last week. I do not know what to do. I talked to my dentist and he said that he did not see anything wrong with it but, for some reason, the pain is still going. I cannot sleep at night and it gives me ear pain.

Hi. I have read through your complaint and the relevant details. Firstly, I would like to tell you that ear pain, pain during night, and the looseness you feel in the tooth are all the signs of a deeply infected tooth. Secondly, it is not necessary to be for the same filled molar to give you trouble. The pain might be from the same molar or could be due to a different tooth on the same side. I would not be able to arrive at a correct diagnosis until at least I see a picture of your teeth in that row. It seems you take pain killers for the same and there is nothing more I could prescribe (considering your age). The only way to immediate pain relief would be an active dental treatment for the affected tooth as soon as possible. It cannot be cured just with pain killers or any other medications. I advise you to see the dentist with an emergency appointment and look upon the issue. If you do not ad ChatDoctor. Thanks.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 46 years old male, weighing 67 kg, height 176 cm. Current symptoms are weight loss (lost about 5 kg in one month), feeling hot. Sweating, problems falling asleep, difficulty focusing on one task, forgetfulness, change in bowel habits (experiencing loose motion sometimes), palpitations, nervousness, fatigue, heat intolerance (not able to hold hot objects like hot teacup). The blood test results show thyroid-stimulating hormone (TSH) 0.008 milli-international units per liter of blood (mIU/L), triiodothyronine (T3) 2.3 ng/ml, thyroxine (total T4) 17.8 \\xb5g/dL, thyroid scan result is suggestive of thyroiditis. ### Response: Hello. From what you have mentioned and from the reports you have attached (attachment removed to protect patient identity), it appears that you have thyroiditis. Your results show that you have hyperthyroidism but not so bad but your scan results suggest thyroiditis which needs no treatment, so, therefore, you have two choices, either you wait and watch till your thyroid gland recovers from this crisis by taking bed rest and Aspirin. Or you take anti-thyroid medications if you had a high pulse rate but since you are not having any high pulse rate it would be better not to take any ChatDoctor. My personal advice would be to wait and repeat your thyroid function test after two weeks. Till that time we can be sure whether treatment is necessary or not. Till that time take strict bed rest. Keep a watch on your pulse rate and blood pressure.

Hello doctor,I am 46 years old male, weighing 67 kg, height 176 cm. Current symptoms are weight loss (lost about 5 kg in one month), feeling hot. Sweating, problems falling asleep, difficulty focusing on one task, forgetfulness, change in bowel habits (experiencing loose motion sometimes), palpitations, nervousness, fatigue, heat intolerance (not able to hold hot objects like hot teacup). The blood test results show thyroid-stimulating hormone (TSH) 0.008 milli-international units per liter of blood (mIU/L), triiodothyronine (T3) 2.3 ng/ml, thyroxine (total T4) 17.8 \\xb5g/dL, thyroid scan result is suggestive of thyroiditis.

Hello. From what you have mentioned and from the reports you have attached (attachment removed to protect patient identity), it appears that you have thyroiditis. Your results show that you have hyperthyroidism but not so bad but your scan results suggest thyroiditis which needs no treatment, so, therefore, you have two choices, either you wait and watch till your thyroid gland recovers from this crisis by taking bed rest and Aspirin. Or you take anti-thyroid medications if you had a high pulse rate but since you are not having any high pulse rate it would be better not to take any ChatDoctor. My personal advice would be to wait and repeat your thyroid function test after two weeks. Till that time we can be sure whether treatment is necessary or not. Till that time take strict bed rest. Keep a watch on your pulse rate and blood pressure.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I just got my wisdom teeth pulled out. All four of them. I cannot open my mouth all the way to even stick my toothbrush to brush my teeth. What should I do? I got them pulled a few days back and just been brushing the front and sides of my teeth and using a Qtip to wash the back teeth. Another concern I have is that my back teeth have white pus on the top of them. I believe it is the scab from the extraction, it is on my other teeth and I am worried should I try ripping them off. I do not want to hurt myself though or should I just leave it alone? Will it cause any problem like make bacteria grow? Should I try rinsing my mouth out with salt until I can properly brush my teeth? ### Response: Hey. That is perfect you got rid of all your wisdom teeth at once. Now you are facing some temporary postoperative difficulties that will end soon and you will be relieved. It will take most likely a week to open your mouth properly, so it is fine if you cannot brush teeth at back. After a few days, you will be able to do the proper cleaning. Regarding the white scab, it is the dead tissue formed that is not much harmful, it will shred away itself during this phase of healing if you are doing your rinses properly. Take a cup of lukewarm water and add 1/4th teaspoon of salt in it and do its mouth rinses five times a day. It is mandatory for two weeks. If you will skip it then some re-infection in the bone can happen which is very painful. So, it is better to be safe than sorry. Hopefully, everything will be good soon.

Hello doctor,I just got my wisdom teeth pulled out. All four of them. I cannot open my mouth all the way to even stick my toothbrush to brush my teeth. What should I do? I got them pulled a few days back and just been brushing the front and sides of my teeth and using a Qtip to wash the back teeth. Another concern I have is that my back teeth have white pus on the top of them. I believe it is the scab from the extraction, it is on my other teeth and I am worried should I try ripping them off. I do not want to hurt myself though or should I just leave it alone? Will it cause any problem like make bacteria grow? Should I try rinsing my mouth out with salt until I can properly brush my teeth?

Hey. That is perfect you got rid of all your wisdom teeth at once. Now you are facing some temporary postoperative difficulties that will end soon and you will be relieved. It will take most likely a week to open your mouth properly, so it is fine if you cannot brush teeth at back. After a few days, you will be able to do the proper cleaning. Regarding the white scab, it is the dead tissue formed that is not much harmful, it will shred away itself during this phase of healing if you are doing your rinses properly. Take a cup of lukewarm water and add 1/4th teaspoon of salt in it and do its mouth rinses five times a day. It is mandatory for two weeks. If you will skip it then some re-infection in the bone can happen which is very painful. So, it is better to be safe than sorry. Hopefully, everything will be good soon.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My gynecologist removed most of a polyp in her office with a local anesthetic and NSAID shot. However bits are still attached to the uterine wall because she was afraid of puncturing wall if I move. I had a colonoscopy with Propofol and had only had a bit of dizziness when I stood up, but it gone within a minute or two (I actually could have driven myself home). I had wanted to do without anesthetic, but the doctor said there was no way to get a local that far up. However, my gynecologist is afraid I could still move under Propofol and wants a general anesthetic. I only get to talk to an anesthesiologist at the hospital where once I schedule a surgery so I want to find out about perhaps using an epidural or spinal anesthetic. Basically, I want the least amount of anesthetic that will allow me to stay awake but keep my legs from moving. I have a high tolerance for pain. So, can I get some thoughts on this.I am currently taking Levothyroxine sodium 50 mcg and some vitamin supplements. ### Response: Hello, Welcome to Chat Doctor forum. Regarding your query, your surgery can be done under spinal or epidural anesthesia. It is a much safer option than general anesthesia. You will be pain-free for hours after surgery. You will be absolutely awake during surgery and will not be able to move your legs even a bit. The only thing is you will not be discharged on the same day of surgery which is not a big issue. So in my opinion, unless spinal anesthesia is contraindicated for you, ask your anesthetist if spinal anesthesia is feasible. Do not worry everything will be fine.

Hello doctor,My gynecologist removed most of a polyp in her office with a local anesthetic and NSAID shot. However bits are still attached to the uterine wall because she was afraid of puncturing wall if I move. I had a colonoscopy with Propofol and had only had a bit of dizziness when I stood up, but it gone within a minute or two (I actually could have driven myself home). I had wanted to do without anesthetic, but the doctor said there was no way to get a local that far up. However, my gynecologist is afraid I could still move under Propofol and wants a general anesthetic. I only get to talk to an anesthesiologist at the hospital where once I schedule a surgery so I want to find out about perhaps using an epidural or spinal anesthetic. Basically, I want the least amount of anesthetic that will allow me to stay awake but keep my legs from moving. I have a high tolerance for pain. So, can I get some thoughts on this.I am currently taking Levothyroxine sodium 50 mcg and some vitamin supplements.

Hello, Welcome to Chat Doctor forum. Regarding your query, your surgery can be done under spinal or epidural anesthesia. It is a much safer option than general anesthesia. You will be pain-free for hours after surgery. You will be absolutely awake during surgery and will not be able to move your legs even a bit. The only thing is you will not be discharged on the same day of surgery which is not a big issue. So in my opinion, unless spinal anesthesia is contraindicated for you, ask your anesthetist if spinal anesthesia is feasible. Do not worry everything will be fine.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 29 years old. Last year, I was diagnosed with adenomyosis after an ultrasound. Previously, I had undergone ovarian polyp removal. My gynecologist has told me that there is no problem with me to get pregnant. However, everything I read online says differently. We plan to start trying for baby by next month. Is there anything I can do to help with the process? I am just confused with my doctor\\s words, as we have waited a year and the disease has more likely spread. I have been taking progesterone since the diagnosis. I just want to prepare myself mentally before trying. Thank you. ### Response: Hi, Welcome to Chat Doctor forum. Firstly, let me tell you that sonography is not always suggestive of adenomyosis. It cannot diagnose it. For diagnosis, you have to send biopsy of the uterus. In adenomyosis there is pain before, during and after menses. There is also focal and diffuse type of adenomyosis. Whatever you read on the internet is about diffuse or generalized adenomyosis. A few things on focal adenomyosis are available because most of the time it goes undiagnosed or has very mild symptoms that do not hamper routine. So, just focus on the present and start trying for pregnancy. In fact, if you get pregnant and pregnancy goes up to term or near term, then there is a chance of cure from adenomyosis theoretically. If you do not have the symptoms of clear adenomyosis, then there is a chance that it is not adenomyosis. So, do not worry and take chance for a year. If you do not get pregnant, then consult a gynecologist as normal people.

Hello doctor,I am 29 years old. Last year, I was diagnosed with adenomyosis after an ultrasound. Previously, I had undergone ovarian polyp removal. My gynecologist has told me that there is no problem with me to get pregnant. However, everything I read online says differently. We plan to start trying for baby by next month. Is there anything I can do to help with the process? I am just confused with my doctor\\s words, as we have waited a year and the disease has more likely spread. I have been taking progesterone since the diagnosis. I just want to prepare myself mentally before trying. Thank you.

Hi, Welcome to Chat Doctor forum. Firstly, let me tell you that sonography is not always suggestive of adenomyosis. It cannot diagnose it. For diagnosis, you have to send biopsy of the uterus. In adenomyosis there is pain before, during and after menses. There is also focal and diffuse type of adenomyosis. Whatever you read on the internet is about diffuse or generalized adenomyosis. A few things on focal adenomyosis are available because most of the time it goes undiagnosed or has very mild symptoms that do not hamper routine. So, just focus on the present and start trying for pregnancy. In fact, if you get pregnant and pregnancy goes up to term or near term, then there is a chance of cure from adenomyosis theoretically. If you do not have the symptoms of clear adenomyosis, then there is a chance that it is not adenomyosis. So, do not worry and take chance for a year. If you do not get pregnant, then consult a gynecologist as normal people.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had a CBC (complete blood count) done yesterday and it came back with elevated WBC of 13500, with neutrophils 9000 (more or less), ESR 36, and close to normal lymphocytes. My urine sample was negative. I had a severe eye infection that lasted about 10 days and started clearing up really nicely yesterday. When I had the blood work done, I was crying for an hour due to unrelated massive stress factors. I have severe anxiety and I am going through a rough time, I am hardly ever at ease. I am mentioning this because I read stress can be a factor.I am worried because my levels are elevated and I show no signs of infection apart from the eye (which still has a little pus). I do not go out due to COVID-19 at all. Food is delivered and handled in a very safe way, packages are disinfected and I have no contact with anyone. I am puzzled as to where an infection could come from. My doctor thinks it is a bacterial infection and has put me on antibiotics. I am very worried about cancer. Should I be? ### Response: Hello. Following is my opinion for your asked question. Your total count and neutrophils are elevated. So it could be due to bacterial infection or stress as per provided history. You can complete the course of antibiotics. Meanwhile, try to reduce stress and anxiety by yoga, exercise, breathing exercises, etc. You can be prescribed anti-anxiety medication for stress. It does not seem to be cancer according to history provided. However, kindly attach your all reports so that I can check it and can give you detailed comments. Take care.

Hello doctor,I had a CBC (complete blood count) done yesterday and it came back with elevated WBC of 13500, with neutrophils 9000 (more or less), ESR 36, and close to normal lymphocytes. My urine sample was negative. I had a severe eye infection that lasted about 10 days and started clearing up really nicely yesterday. When I had the blood work done, I was crying for an hour due to unrelated massive stress factors. I have severe anxiety and I am going through a rough time, I am hardly ever at ease. I am mentioning this because I read stress can be a factor.I am worried because my levels are elevated and I show no signs of infection apart from the eye (which still has a little pus). I do not go out due to COVID-19 at all. Food is delivered and handled in a very safe way, packages are disinfected and I have no contact with anyone. I am puzzled as to where an infection could come from. My doctor thinks it is a bacterial infection and has put me on antibiotics. I am very worried about cancer. Should I be?

Hello. Following is my opinion for your asked question. Your total count and neutrophils are elevated. So it could be due to bacterial infection or stress as per provided history. You can complete the course of antibiotics. Meanwhile, try to reduce stress and anxiety by yoga, exercise, breathing exercises, etc. You can be prescribed anti-anxiety medication for stress. It does not seem to be cancer according to history provided. However, kindly attach your all reports so that I can check it and can give you detailed comments. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have been struggling with skin problems since I was a baby. I was told I have eczema and not allowed to eat things like tin food and my body gets itchy when I play in the grass and after taking a bath. I get a rash, teary eyes, runny nose, when seasons change my skin gets dry too especially in winter. Now as a 25-year-old female my skin tone is uneven, my face is worse, at times my lips and eyelids swell up and I am not sure why. I have recently been using some products for a month and I still see no difference. Which skin repair products can you recommend? ### Response: Hi, Welcome to Chat Doctor forum. You are suffering from atopic dermatitis. You have a family history of atopy. You have all the symptoms of atopy that is runny nose, eyes problem and now swelling. It is a condition in which a person has an inherent tendency of being allergic to so many things. We have a natural moisturizing factor in our skin but that factor is missing in atopic individuals. That is why skin is very ChatDoctor. It is affected by different climatic conditions, whether change, clothing, infections. In some people it can get better with age, in others it continues for long periods. You have to avoid the factors that aggravate your condition and I will also suggest you take opinion from an eye specialist as well. Your medications are correct. The main thing is to moisturize the skin. Atopic dermatitis. Atopic dermatitis. Apply white soft Paraffin plus liquid Paraffin and apply over body 3 to 4 times a day, take antihistamine tablet, mild steroid preparation like Hy

Hi doctor,I have been struggling with skin problems since I was a baby. I was told I have eczema and not allowed to eat things like tin food and my body gets itchy when I play in the grass and after taking a bath. I get a rash, teary eyes, runny nose, when seasons change my skin gets dry too especially in winter. Now as a 25-year-old female my skin tone is uneven, my face is worse, at times my lips and eyelids swell up and I am not sure why. I have recently been using some products for a month and I still see no difference. Which skin repair products can you recommend?

Hi, Welcome to Chat Doctor forum. You are suffering from atopic dermatitis. You have a family history of atopy. You have all the symptoms of atopy that is runny nose, eyes problem and now swelling. It is a condition in which a person has an inherent tendency of being allergic to so many things. We have a natural moisturizing factor in our skin but that factor is missing in atopic individuals. That is why skin is very ChatDoctor. It is affected by different climatic conditions, whether change, clothing, infections. In some people it can get better with age, in others it continues for long periods. You have to avoid the factors that aggravate your condition and I will also suggest you take opinion from an eye specialist as well. Your medications are correct. The main thing is to moisturize the skin. Atopic dermatitis. Atopic dermatitis. Apply white soft Paraffin plus liquid Paraffin and apply over body 3 to 4 times a day, take antihistamine tablet, mild steroid preparation like Hy

### Instruction: Answer this question truthfully ###Input: Hi doctor,My father, who is 57 years old, was suggested to go for AVR (valve replacement). His weight is 74 kg. What are the procedures followed for valve replacement? Is there any consequence after the surgery? Can he lead a normal life after surgery? Which valve do we need to choose irrespective of cost? How many days does he need bed rest? My father has high BP, and always it ranges around 170/80. ### Response: Hi, Welcome to Chat Doctor forum. Thanks for writing in to us. I have read through your query in detail. Please find my observations below. The valve replacement surgery is usually done using open heart surgery technique, and the surgeon connects the blood vessels to a heart-lung machine and then stops the heart. After this step, an incision is made into the aorta and using careful precision the aortic valve will get replaced. This operation is 98 percent successful. For people less than 65 years, the valve implanted is a mechanical valve, and this is because a mechanical valve will work for many years. In patients older than 65 years, a biological valve is used. He can lead a near normal healthy life. He has to follow up with his doctor regularly and be on medications for a long time. He will be in the hospital for a week and should not be on bed rest. Only thing is he must avoid physical exertion after surgery and take strict precautions for three months after surgery. The blood pressure will get controlled with medicines and doctors make it a point that operation is not risky due to that. Regular medication has to be taken and should get echocardiography as instructed by the surgeon and cardiologist.

Hi doctor,My father, who is 57 years old, was suggested to go for AVR (valve replacement). His weight is 74 kg. What are the procedures followed for valve replacement? Is there any consequence after the surgery? Can he lead a normal life after surgery? Which valve do we need to choose irrespective of cost? How many days does he need bed rest? My father has high BP, and always it ranges around 170/80.

Hi, Welcome to Chat Doctor forum. Thanks for writing in to us. I have read through your query in detail. Please find my observations below. The valve replacement surgery is usually done using open heart surgery technique, and the surgeon connects the blood vessels to a heart-lung machine and then stops the heart. After this step, an incision is made into the aorta and using careful precision the aortic valve will get replaced. This operation is 98 percent successful. For people less than 65 years, the valve implanted is a mechanical valve, and this is because a mechanical valve will work for many years. In patients older than 65 years, a biological valve is used. He can lead a near normal healthy life. He has to follow up with his doctor regularly and be on medications for a long time. He will be in the hospital for a week and should not be on bed rest. Only thing is he must avoid physical exertion after surgery and take strict precautions for three months after surgery. The blood pressure will get controlled with medicines and doctors make it a point that operation is not risky due to that. Regular medication has to be taken and should get echocardiography as instructed by the surgeon and cardiologist.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have had abnormal pap tests for the past four years. Now I am having really thick light brown mucus discharge almost daily. The last one this morning was bigger than a quarter. What could this be? ### Response: Hi. I understand your concern. At the age of 29 years, I would want to know what the abnormality in PAP smear was? I hope it is LSIL (low-grade squamous intra epithelial lesion) or ASCUS (atypical squamous cells of undetermined significance) or only mild dysplasia. Any of these findings are suggestive of only some infection in the cervix creating some changes in the lining of the cervical canal. This only warrants follow up and repeated PAP smear evaluation. These infections on the cervix can cause small ulcerations, which would appear like a raw wound. Once the raw surface if formed, the secretions from the underlying cervix increases. Just like in common cold secretion from the nostrils increase, cervical secretions also increase. The sudden appearance of excessive brown discharge can follow any local insult like recent sex, or recent periods or local trauma by a tampon or even urinary infection. But it is not to be worried about. If it is been a year since last PAP smear or at least six months have a repeated smear. You may need local antibiotic treatment. If the cervical erosion is significant and the abnormality you are experiencing in PAP is more than what I mentioned, then you may need excision of the ulcer with cryotherapy or electrotherapy or chemical. But at this young age of 29 years and as the doctor has put you follow up for four years, I bet you belong to low-risk stage. Nothing to worry about. Just simple treatment of local medication will do.

Hi doctor,I have had abnormal pap tests for the past four years. Now I am having really thick light brown mucus discharge almost daily. The last one this morning was bigger than a quarter. What could this be?

Hi. I understand your concern. At the age of 29 years, I would want to know what the abnormality in PAP smear was? I hope it is LSIL (low-grade squamous intra epithelial lesion) or ASCUS (atypical squamous cells of undetermined significance) or only mild dysplasia. Any of these findings are suggestive of only some infection in the cervix creating some changes in the lining of the cervical canal. This only warrants follow up and repeated PAP smear evaluation. These infections on the cervix can cause small ulcerations, which would appear like a raw wound. Once the raw surface if formed, the secretions from the underlying cervix increases. Just like in common cold secretion from the nostrils increase, cervical secretions also increase. The sudden appearance of excessive brown discharge can follow any local insult like recent sex, or recent periods or local trauma by a tampon or even urinary infection. But it is not to be worried about. If it is been a year since last PAP smear or at least six months have a repeated smear. You may need local antibiotic treatment. If the cervical erosion is significant and the abnormality you are experiencing in PAP is more than what I mentioned, then you may need excision of the ulcer with cryotherapy or electrotherapy or chemical. But at this young age of 29 years and as the doctor has put you follow up for four years, I bet you belong to low-risk stage. Nothing to worry about. Just simple treatment of local medication will do.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My husband had a deep filling in his upper second to last molar (left side). About several hours later, he started having discomfort and taking Tylenol and Ibuprofen interchangeably. Now, it has been the second day with severe pain and his cheek is swollen. And the gum over the tooth is in pain but not swollen, and it is a throbbing type of pain. We have no access to the dentist. Please help. ### Response: Hello, Welcome to Chat Doctor forum. In this condition the tooth should not be filled and instead, root canal should be done. As the filling was near the pulp, pulpal irritation is causing the pain. Take tablet Amoxiclav (Amoxicillin and Clavulanic acid) 625 mg one tablet twice daily for five days, Zerodol SP (Aceclofenac, Paracetamol, and Serratiopeptidase) one tablet twice daily for five days, capsule Pan D (Pantoprazole) twice daily before meals for five days, Betadine mouthwash gargle in lukewarm water. If nothing is available right now warm saline gargle will also help for the time being. Take the medication, your husband would be relieved. Do not worry, but I will advise to get the filling out by your local dentist. And your husband needs a root canal. Kindly upload an image of the tooth along with the affected area. Treatment was not done properly. Should have gone with a root canal. Removal of filling and root canal procedure. Upload an image and x-ray available. Your husband will be fine once he gets the medication. But as you both are travelling even warm saline gargle two or three times will help.

Hi doctor,My husband had a deep filling in his upper second to last molar (left side). About several hours later, he started having discomfort and taking Tylenol and Ibuprofen interchangeably. Now, it has been the second day with severe pain and his cheek is swollen. And the gum over the tooth is in pain but not swollen, and it is a throbbing type of pain. We have no access to the dentist. Please help.

Hello, Welcome to Chat Doctor forum. In this condition the tooth should not be filled and instead, root canal should be done. As the filling was near the pulp, pulpal irritation is causing the pain. Take tablet Amoxiclav (Amoxicillin and Clavulanic acid) 625 mg one tablet twice daily for five days, Zerodol SP (Aceclofenac, Paracetamol, and Serratiopeptidase) one tablet twice daily for five days, capsule Pan D (Pantoprazole) twice daily before meals for five days, Betadine mouthwash gargle in lukewarm water. If nothing is available right now warm saline gargle will also help for the time being. Take the medication, your husband would be relieved. Do not worry, but I will advise to get the filling out by your local dentist. And your husband needs a root canal. Kindly upload an image of the tooth along with the affected area. Treatment was not done properly. Should have gone with a root canal. Removal of filling and root canal procedure. Upload an image and x-ray available. Your husband will be fine once he gets the medication. But as you both are travelling even warm saline gargle two or three times will help.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 35 years old and my weight is 56 kg. My daughter is 3 years 3 months old. My doctor advised me to take one Femilon tablet daily from the first day of my period for contraception purpose. Last day of my period was 22nd of last month. At 21st night of this month, I felt that my period has started and took one tablet at bedtime. But, yesterday and today I got only spotting and the period has not started properly. I am continuing the tablet regularly at night for the last two days. Should I continue to take the tablet regularly till completion of the pack of 21? Will protection start from the first month or do we have to use extra protection like a condom? Should I start taking a fresh pack on the first day of every period? ### Response: Hello. This is a hormonal contraceptive pill which could reduce the amount of menstrual bleeding. This will occur in this cycle as well as probably in all your next cycles and this is entirely normal. The recommendation is to continue the pills for 21 days throughout and then wait for 7 days. Again, start a fresh pack from the 8th day. From the second pack onward, you need not have to wait for the commencement of the cycle. You can start the next pack after a gap of 7 days irrespective of cycle. Continue the pills as advised. Start the next pack as I have told and yes, you will have a full protection after seven days of commencement of pills. So, for the first week, use barrier contraception like condom and later you need not take an extra precaution as you will be a regular user.

Hi doctor,I am 35 years old and my weight is 56 kg. My daughter is 3 years 3 months old. My doctor advised me to take one Femilon tablet daily from the first day of my period for contraception purpose. Last day of my period was 22nd of last month. At 21st night of this month, I felt that my period has started and took one tablet at bedtime. But, yesterday and today I got only spotting and the period has not started properly. I am continuing the tablet regularly at night for the last two days. Should I continue to take the tablet regularly till completion of the pack of 21? Will protection start from the first month or do we have to use extra protection like a condom? Should I start taking a fresh pack on the first day of every period?

Hello. This is a hormonal contraceptive pill which could reduce the amount of menstrual bleeding. This will occur in this cycle as well as probably in all your next cycles and this is entirely normal. The recommendation is to continue the pills for 21 days throughout and then wait for 7 days. Again, start a fresh pack from the 8th day. From the second pack onward, you need not have to wait for the commencement of the cycle. You can start the next pack after a gap of 7 days irrespective of cycle. Continue the pills as advised. Start the next pack as I have told and yes, you will have a full protection after seven days of commencement of pills. So, for the first week, use barrier contraception like condom and later you need not take an extra precaution as you will be a regular user.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 25 years old and I weigh 75 kg. To cure my persistent moderate body acne and KP of past 10 years which was not responding well with topical treatment, the dermatologist put me on Isotretinoin course starting with a dose of 5 mg. Along with this, he has also prescribed AHA Revitalizing Lotion 20% (Glycolic Acid) to help with the acne scars and the KP bumps, Salyzap body spray and Spongy-Sal for washing. Is it okay to use this AHA Lotion while on Isotretinoin? I ask this because it said in the pamphlet that no cosmetic procedures can be had on the skin while on this medication. Please help. ### Response: Hello. Regarding the dose of Isotretinoin, it can go up to 20 mg easily. There is no serious side effect except for ChatDoctor. With regards to Glycolic Acid 20% lotion, I will suggest you use it for short period first then increase it slowly. Concomitant use of Isotretinoin and Glycolic Acid 20% will be ideal although there is a relative contraindication for use of both simultaneously. But we perform Peels with even Glycolic acid 35% to 50% with Isotretinoin and we do not have any side effects. Because we give Isotretinoin in lower doses and you are taking just 5 mg which is very low. So, I do not see any problem. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. For more information consult a dermatologist online

Hello doctor,I am 25 years old and I weigh 75 kg. To cure my persistent moderate body acne and KP of past 10 years which was not responding well with topical treatment, the dermatologist put me on Isotretinoin course starting with a dose of 5 mg. Along with this, he has also prescribed AHA Revitalizing Lotion 20% (Glycolic Acid) to help with the acne scars and the KP bumps, Salyzap body spray and Spongy-Sal for washing. Is it okay to use this AHA Lotion while on Isotretinoin? I ask this because it said in the pamphlet that no cosmetic procedures can be had on the skin while on this medication. Please help.

Hello. Regarding the dose of Isotretinoin, it can go up to 20 mg easily. There is no serious side effect except for ChatDoctor. With regards to Glycolic Acid 20% lotion, I will suggest you use it for short period first then increase it slowly. Concomitant use of Isotretinoin and Glycolic Acid 20% will be ideal although there is a relative contraindication for use of both simultaneously. But we perform Peels with even Glycolic acid 35% to 50% with Isotretinoin and we do not have any side effects. Because we give Isotretinoin in lower doses and you are taking just 5 mg which is very low. So, I do not see any problem. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. For more information consult a dermatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I just found out I was pregnant a couple of weeks ago. I smoke weed. I am slowly trying to stop. I have about seven months left of my pregnancy. If I was to cut way back and stop completely at five months of my pregnancy would I and the baby be clean when I deliver? ### Response: Hi. We need to worry about what the baby is facing now and not about what will happen after you stop. All the components of smoke, the bad air (carbon dioxide), tar, the chemicals in the smoke, which may vary with what you are smoking are all powerful vasoconstrictors. I mean they narrow the blood vessels, so they reduce the blood flow to the baby. If we could go back I would have advised you to stop it the moment you got pregnant. Late better than never. Every\\x80\\x8bday baby is growing, so the requirement of blood flow is increasing as the baby\\s vital organs are growing and getting blood for that. So if the flow is compromised even a day, we do not know if any damage has occurred. This may not be visible on any scan, but it would be safe to immediately stop smoking and start having lots of highly nutritious food with lots of sugars, juices. Do yoga or breathing exercises, in short, improve the supply of nutrition and oxygen to the baby as these two are the secrets of a healthy and active baby. Hope I have made it clear. Baby will not have any of it in its body, but the damage caused by the smoke will be seen in the baby\\s body. For your baby\\s sake do try to stop it today or as soon as possible.

Hello doctor,I just found out I was pregnant a couple of weeks ago. I smoke weed. I am slowly trying to stop. I have about seven months left of my pregnancy. If I was to cut way back and stop completely at five months of my pregnancy would I and the baby be clean when I deliver?

Hi. We need to worry about what the baby is facing now and not about what will happen after you stop. All the components of smoke, the bad air (carbon dioxide), tar, the chemicals in the smoke, which may vary with what you are smoking are all powerful vasoconstrictors. I mean they narrow the blood vessels, so they reduce the blood flow to the baby. If we could go back I would have advised you to stop it the moment you got pregnant. Late better than never. Every\\x80\\x8bday baby is growing, so the requirement of blood flow is increasing as the baby\\s vital organs are growing and getting blood for that. So if the flow is compromised even a day, we do not know if any damage has occurred. This may not be visible on any scan, but it would be safe to immediately stop smoking and start having lots of highly nutritious food with lots of sugars, juices. Do yoga or breathing exercises, in short, improve the supply of nutrition and oxygen to the baby as these two are the secrets of a healthy and active baby. Hope I have made it clear. Baby will not have any of it in its body, but the damage caused by the smoke will be seen in the baby\\s body. For your baby\\s sake do try to stop it today or as soon as possible.

### Instruction: Answer this question truthfully ###Input: Hello doctor,A part of my skin has become extremely sensitive for no apparent reason. The skin does not look different at all, and it seems to literally be the skin and nothing deeper or muscular. It is an area roughly 10 cm by 10 cm (~5\\x80\\x9d) on the front of my upper right thigh, the bottom of the area is around where my boxers end. I can clearly outline it by tracing my fingers up my thigh. If I just stand still, I cannot really feel it. Lightly tracing my fingers over it, even through my pants it hurts a fair bit. Rubbing and such hurts more. But applying a lot of pressure straight down does not make it hurt particularly more than the initial touch. Light-fast rubbing hurts the most. Walking or just moving also hurts because my clothes interact with the area. The pain feels sort of like burning, or like touching a burned part of your skin. It started two weeks ago, got worse over the first few days and now I am not sure if it is still getting slowly worse (more painful) or if it is just bothering me more and more. Any ideas? ### Response: Hello, Welcome to Chat Doctor forum. Please provide a clear photograph for better understanding. With the description given it can be frictional dermatitis or tinea if it is itching. If there is no itching and only burning sensation, avoid friction of both legs by wearing suitable clothes and apply some moisturizers or aloe vera cream. If there is itching, try Miconazole cream 2 % for 10 days and see if there is any improvement. If there is a visual photograph then we can give better advice.

Hello doctor,A part of my skin has become extremely sensitive for no apparent reason. The skin does not look different at all, and it seems to literally be the skin and nothing deeper or muscular. It is an area roughly 10 cm by 10 cm (~5\\x80\\x9d) on the front of my upper right thigh, the bottom of the area is around where my boxers end. I can clearly outline it by tracing my fingers up my thigh. If I just stand still, I cannot really feel it. Lightly tracing my fingers over it, even through my pants it hurts a fair bit. Rubbing and such hurts more. But applying a lot of pressure straight down does not make it hurt particularly more than the initial touch. Light-fast rubbing hurts the most. Walking or just moving also hurts because my clothes interact with the area. The pain feels sort of like burning, or like touching a burned part of your skin. It started two weeks ago, got worse over the first few days and now I am not sure if it is still getting slowly worse (more painful) or if it is just bothering me more and more. Any ideas?

Hello, Welcome to Chat Doctor forum. Please provide a clear photograph for better understanding. With the description given it can be frictional dermatitis or tinea if it is itching. If there is no itching and only burning sensation, avoid friction of both legs by wearing suitable clothes and apply some moisturizers or aloe vera cream. If there is itching, try Miconazole cream 2 % for 10 days and see if there is any improvement. If there is a visual photograph then we can give better advice.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I was diagnosed with type II diabetes five years back. I have maintained good sugar control. Currently, I am taking Trulicity 1.5 weekly, Lantus nightly and 2000 mg of Metformin with my evening meal.Toward the end of last year, my diet was not good, as I was eating a lot of carbohydrates and I was also a little irregular in taking my medicines. About a week and a half ago, I got vigilant again about eating a low-carbohydrate diet and taking my medicines regularly.My blood sugar got as high as 380 mg/dl during this period. In the week and a half since I have gotten back on track, I have seen my sugars starting to trend downward. I have had readings as low as 164 mg/dl and the highest in the last few days was around 250 mg/dl.I am wondering if it typically takes a while for blood sugar to return to acceptable levels, once they have become as elevated as mine. And, do you think I need additional medication in order to achieve that? ### Response: Hello, Welcome to Chat Doctor forum. Since you have started proper diet control, your blood sugar levels are getting better and better day by day. Yes, it does take some time to get back to normal once you are careful about your diet and exercise. You can check your HbA1c levels now and after three months to get an accurate account of how well your blood sugar is controlled, once you are back on track. If it does not work out then we can review again in three months for further management. For more information consult an endocrinologist online

Hello doctor,I was diagnosed with type II diabetes five years back. I have maintained good sugar control. Currently, I am taking Trulicity 1.5 weekly, Lantus nightly and 2000 mg of Metformin with my evening meal.Toward the end of last year, my diet was not good, as I was eating a lot of carbohydrates and I was also a little irregular in taking my medicines. About a week and a half ago, I got vigilant again about eating a low-carbohydrate diet and taking my medicines regularly.My blood sugar got as high as 380 mg/dl during this period. In the week and a half since I have gotten back on track, I have seen my sugars starting to trend downward. I have had readings as low as 164 mg/dl and the highest in the last few days was around 250 mg/dl.I am wondering if it typically takes a while for blood sugar to return to acceptable levels, once they have become as elevated as mine. And, do you think I need additional medication in order to achieve that?

Hello, Welcome to Chat Doctor forum. Since you have started proper diet control, your blood sugar levels are getting better and better day by day. Yes, it does take some time to get back to normal once you are careful about your diet and exercise. You can check your HbA1c levels now and after three months to get an accurate account of how well your blood sugar is controlled, once you are back on track. If it does not work out then we can review again in three months for further management. For more information consult an endocrinologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,My wife delivered a baby boy two months prematurely and he was underweight (1.210 kg). The reason was almost nil movement of the fetus and very less fluid in the fetus (3.5 to 4).After the delivery, the doctor said that all the other parameters of the baby like the height of the baby, the size of the head and heart, etc. are normal except for the weight, low blood count, and high sugar level. So, he was given blood.Initially, the sugar level was beyond 500. So, the doctor put him on continuous insulin. Due to this, his sugar level came down but, it was never below 150. So the doctor said that he might have diabetes. Since the last two days, he is given insulin injection at intervals instead of continuously. Even though at mornings, the sugar level is in the range of 140 to 180, at evenings, it jumps to 250 to 350. However, today it jumped to 484. All the other tests like USG of stomach and head were conducted but, found to be normal. The doctor also tested a fluid from his spine but, all were normal. There is no infection and no hearing problem. He is otherwise normal. He is active, cries and moves like normal babies. But, I am worried. What is going on? ### Response: Hello, Welcome to Chat Doctor forum. For now, taking care of sepsis is of prime importance. If it is sepsis-related or prematurity-related, it will improve with time. For more information consult a paediatrician online

Hello doctor,My wife delivered a baby boy two months prematurely and he was underweight (1.210 kg). The reason was almost nil movement of the fetus and very less fluid in the fetus (3.5 to 4).After the delivery, the doctor said that all the other parameters of the baby like the height of the baby, the size of the head and heart, etc. are normal except for the weight, low blood count, and high sugar level. So, he was given blood.Initially, the sugar level was beyond 500. So, the doctor put him on continuous insulin. Due to this, his sugar level came down but, it was never below 150. So the doctor said that he might have diabetes. Since the last two days, he is given insulin injection at intervals instead of continuously. Even though at mornings, the sugar level is in the range of 140 to 180, at evenings, it jumps to 250 to 350. However, today it jumped to 484. All the other tests like USG of stomach and head were conducted but, found to be normal. The doctor also tested a fluid from his spine but, all were normal. There is no infection and no hearing problem. He is otherwise normal. He is active, cries and moves like normal babies. But, I am worried. What is going on?

Hello, Welcome to Chat Doctor forum. For now, taking care of sepsis is of prime importance. If it is sepsis-related or prematurity-related, it will improve with time. For more information consult a paediatrician online

### Instruction: Answer this question truthfully ###Input: Hi doctor,This is for my dad. He has epilepsy and is now 52 years old. Last Saturday, he went on his normal routine of getting ready but did not know what happened and he walked out of the house without any clothes. When we asked him if he was okay, he said yes. But after the whole episode, when we asked him if he knew what he did, he said no. We do think that his epilepsy is triggered by less sleep and the only medication he takes is Gabapentin. We think that he is getting depressed because he has a loss of appetite, loss of weight, slowness in activity, concentration problem and occasional mood swings. His current neurologist does not do anything and all he does is keep doing a blood test each time. ### Response: Hi, Welcome to Chat Doctor forum. Thank you for your question. History of epilepsy and intermittent episodes of confusion with loss of memory of the episode (amnesia) is concerning for seizures. For the workup of seizures, he should get routine brain wave testing (EEG - electroencephalogram) or a long-term EEG monitoring to identify any abnormal brain discharges which can cause a seizure. Other things to look at it is head imaging like CT head or MRI brain (if not done already) as it is not uncommon for elderly patients to have blood collection around the brain (subdural hematoma) to present with altered awareness or confusion. I agree with blood tests as an initial test to look for metabolic encephalopathy due to deranged blood electrolytes level and body metabolites such as BUN (blood urea nitrogen), ammonia, etc. Please do not hesitate to reply if you have any other questions or concerns.

Hi doctor,This is for my dad. He has epilepsy and is now 52 years old. Last Saturday, he went on his normal routine of getting ready but did not know what happened and he walked out of the house without any clothes. When we asked him if he was okay, he said yes. But after the whole episode, when we asked him if he knew what he did, he said no. We do think that his epilepsy is triggered by less sleep and the only medication he takes is Gabapentin. We think that he is getting depressed because he has a loss of appetite, loss of weight, slowness in activity, concentration problem and occasional mood swings. His current neurologist does not do anything and all he does is keep doing a blood test each time.

Hi, Welcome to Chat Doctor forum. Thank you for your question. History of epilepsy and intermittent episodes of confusion with loss of memory of the episode (amnesia) is concerning for seizures. For the workup of seizures, he should get routine brain wave testing (EEG - electroencephalogram) or a long-term EEG monitoring to identify any abnormal brain discharges which can cause a seizure. Other things to look at it is head imaging like CT head or MRI brain (if not done already) as it is not uncommon for elderly patients to have blood collection around the brain (subdural hematoma) to present with altered awareness or confusion. I agree with blood tests as an initial test to look for metabolic encephalopathy due to deranged blood electrolytes level and body metabolites such as BUN (blood urea nitrogen), ammonia, etc. Please do not hesitate to reply if you have any other questions or concerns.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My mother is 68 years old. Her weight is 75 kg and height is 165 cm. She has severe right leg pain from behind the knee and around the calf muscle, especially in the nerves. She has varicose veins on her thighs and has had continuous pain for nearly 35 years following her third pregnancy. She is a homemaker and does all her work herself, she feels tired every two hours to the extent where she cannot lift her leg anymore. A half an hour relaxation will give her energy to get back on her legs. She is doing yoga to manage this pain without any medication.Currently, the nerve pain keeps changing from one place to another and varies randomly. It increases when she has a hot water bath or hot water foot massage and walks as a part of her routine exercise. She also feels like there is a bubble, which keeps moving. Sometimes, she is unable to walk or walk with a help of the stick very slowly. She is applying oil on her leg, but has found no relief. She is on Topdip 5 mg for BP, B complex and Neurobion tablets. She had a kidney stone last year and removed it by taking ayurveda medication. Her thyroid and sugar levels are normal, but have vitamin D deficiency. So, she has started taking Vitamin D supplements. She is a vegetarian and will not consume any junk food or sweets. Please suggest some advice to get relief from the pain. ### Response: Hi I do understand your concern. It is not possible to make conclusions with limited information, but you can do the following things for her to get pain relief. Revert back with the report to a neurologist online

Hi doctor,My mother is 68 years old. Her weight is 75 kg and height is 165 cm. She has severe right leg pain from behind the knee and around the calf muscle, especially in the nerves. She has varicose veins on her thighs and has had continuous pain for nearly 35 years following her third pregnancy. She is a homemaker and does all her work herself, she feels tired every two hours to the extent where she cannot lift her leg anymore. A half an hour relaxation will give her energy to get back on her legs. She is doing yoga to manage this pain without any medication.Currently, the nerve pain keeps changing from one place to another and varies randomly. It increases when she has a hot water bath or hot water foot massage and walks as a part of her routine exercise. She also feels like there is a bubble, which keeps moving. Sometimes, she is unable to walk or walk with a help of the stick very slowly. She is applying oil on her leg, but has found no relief. She is on Topdip 5 mg for BP, B complex and Neurobion tablets. She had a kidney stone last year and removed it by taking ayurveda medication. Her thyroid and sugar levels are normal, but have vitamin D deficiency. So, she has started taking Vitamin D supplements. She is a vegetarian and will not consume any junk food or sweets. Please suggest some advice to get relief from the pain.

Hi I do understand your concern. It is not possible to make conclusions with limited information, but you can do the following things for her to get pain relief. Revert back with the report to a neurologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,Currently, I am 14 weeks pregnant with my second baby. I am attaching my NT and double marker report for your reference. I have a 5-year-old son and no abortion in the past. I have conceived naturally both times. My doctor has asked me to do either NIPT or CVS and I am not sure if I really need to do any. She has asked me to take Ecospirin 150 immediately if not doing CVS else start after CVS.I have some queries. Do I really need to go for either NIPT or CVS? Or I can forgo these tests? Should I take Ecospirin 150 as my previous pregnancy did not have any complications and at present also I am in good condition with no health issues (also I don\\t drink and smoke)? Are there any issues with my beta HCG and Papp-a value? Do you see any other concerns in my report? Please reply. ### Response: Hi, Welcome to Chat Doctor forum. I have seen the report. (attachment removed to protect patient identity). Now every laboratory has its own calculation methods to come to a risk ratio after the test. b-HCG and PAPP-A levels are also different at different times of pregnancy and also has some effects of weight and age on it. This is a genetic screening test. And we do this test to find out what is the risk of this pregnancy having a congenital abnormal baby. (Specifically Down's, Edward, Turner, and Patau syn ChatDoctor. This risk ratio has cut off values. Means trisomy 21 (Down's) has a risk ratio of 1

Hi doctor,Currently, I am 14 weeks pregnant with my second baby. I am attaching my NT and double marker report for your reference. I have a 5-year-old son and no abortion in the past. I have conceived naturally both times. My doctor has asked me to do either NIPT or CVS and I am not sure if I really need to do any. She has asked me to take Ecospirin 150 immediately if not doing CVS else start after CVS.I have some queries. Do I really need to go for either NIPT or CVS? Or I can forgo these tests? Should I take Ecospirin 150 as my previous pregnancy did not have any complications and at present also I am in good condition with no health issues (also I don\\t drink and smoke)? Are there any issues with my beta HCG and Papp-a value? Do you see any other concerns in my report? Please reply.

Hi, Welcome to Chat Doctor forum. I have seen the report. (attachment removed to protect patient identity). Now every laboratory has its own calculation methods to come to a risk ratio after the test. b-HCG and PAPP-A levels are also different at different times of pregnancy and also has some effects of weight and age on it. This is a genetic screening test. And we do this test to find out what is the risk of this pregnancy having a congenital abnormal baby. (Specifically Down's, Edward, Turner, and Patau syn ChatDoctor. This risk ratio has cut off values. Means trisomy 21 (Down's) has a risk ratio of 1

### Instruction: Answer this question truthfully ###Input: Hello doctor,Me and my wife had sex on 12th January and she took ipill on 13th January.She had her periods on 21st January.We again had sex on 25th January and 10th February with protection (condoms).On the 10th evening some spotting started and it stopped on 17th February.The spotting was dark brownish color when it started and ended with bright red color.There are no signs of pregnancy till now.Can this be the side effect of ipill or is there a chance of pregnancy? ### Response: Hello. The bleeding due to menses on 21st January after ipill confirmatively rules out pregnancy which could have occurred due to sex on 13th January. The repeat sexual intercourse held on 25th January (she was in her safe period and hence pregnancy is unlikely) and then 10th February (this time she was in her fertile period) might result in pregnancy. But you have had protected sexual intercourse. Chances of pregnancy are minimal and the spotting is unlikely to be an implantation bleed. The spotting is more likely to be a breakthrough bleeding which is possibly due to the side effects of ipill which is known to cause irregularity in menses for the next 2 cycles. However, the best way to confirm or negate pregnancy would be to opt for a serum beta hCG test. This test if positive shall confirm pregnancy and if the levels are less than 1, then pregnancy is ruled out completely. This shall allay your anxiety. Revert back to an obstetrician and gynaecologist online for further follow up Take care.

Hello doctor,Me and my wife had sex on 12th January and she took ipill on 13th January.She had her periods on 21st January.We again had sex on 25th January and 10th February with protection (condoms).On the 10th evening some spotting started and it stopped on 17th February.The spotting was dark brownish color when it started and ended with bright red color.There are no signs of pregnancy till now.Can this be the side effect of ipill or is there a chance of pregnancy?

Hello. The bleeding due to menses on 21st January after ipill confirmatively rules out pregnancy which could have occurred due to sex on 13th January. The repeat sexual intercourse held on 25th January (she was in her safe period and hence pregnancy is unlikely) and then 10th February (this time she was in her fertile period) might result in pregnancy. But you have had protected sexual intercourse. Chances of pregnancy are minimal and the spotting is unlikely to be an implantation bleed. The spotting is more likely to be a breakthrough bleeding which is possibly due to the side effects of ipill which is known to cause irregularity in menses for the next 2 cycles. However, the best way to confirm or negate pregnancy would be to opt for a serum beta hCG test. This test if positive shall confirm pregnancy and if the levels are less than 1, then pregnancy is ruled out completely. This shall allay your anxiety. Revert back to an obstetrician and gynaecologist online for further follow up Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 40 years old. I have been suffering from heavy menstrual flow for the past 11 to 12 months. I had a heavy flow with clots for the last two months. Now, I have been menstruating for the past 10 days with heavy flow and clots. It started exactly at the cycle period date and continued for five days and again on the seventh day, it started again with heavy flow. I have had a cyst, high levels of prolactin which have been treated during this period. Last month my doctor recommended the endometrium biopsy but the report was normal and the diagnosis was late secretary endometrium. My current medications include Ovuloc, Femilon, Meprate 10 mg two times a day, Iron tablet, and pause MF (on SOS basis). Can you please advice? ### Response: Hi, Welcome to Chat Doctor forum. Your biopsy report is good. The medicines you are taking are also good. But instead of taking hormones daily I recommend that you put in a hormone-releasing intrauterine device called Mirena. That remains in your uterus without problem. Delivers the hormones where they are actually needed, cutting down the side effects of excessive hormone intake plus you get rid of the daily responsibility of taking your pills. However, as per the ultrasound finding of a bulky uterus, you may have adenomyosis which is causing this abnormal uterine bleeding. Adenomyosis is a condition that affects the wall of your uterus. Unfortunately, it does not respond well to hormonal treatment. Please get an MRI of the pelvis done. If that shows adenomyosis you may still try Mirena but if that is ineffective, you may even need surgery.

Hi doctor,I am 40 years old. I have been suffering from heavy menstrual flow for the past 11 to 12 months. I had a heavy flow with clots for the last two months. Now, I have been menstruating for the past 10 days with heavy flow and clots. It started exactly at the cycle period date and continued for five days and again on the seventh day, it started again with heavy flow. I have had a cyst, high levels of prolactin which have been treated during this period. Last month my doctor recommended the endometrium biopsy but the report was normal and the diagnosis was late secretary endometrium. My current medications include Ovuloc, Femilon, Meprate 10 mg two times a day, Iron tablet, and pause MF (on SOS basis). Can you please advice?

Hi, Welcome to Chat Doctor forum. Your biopsy report is good. The medicines you are taking are also good. But instead of taking hormones daily I recommend that you put in a hormone-releasing intrauterine device called Mirena. That remains in your uterus without problem. Delivers the hormones where they are actually needed, cutting down the side effects of excessive hormone intake plus you get rid of the daily responsibility of taking your pills. However, as per the ultrasound finding of a bulky uterus, you may have adenomyosis which is causing this abnormal uterine bleeding. Adenomyosis is a condition that affects the wall of your uterus. Unfortunately, it does not respond well to hormonal treatment. Please get an MRI of the pelvis done. If that shows adenomyosis you may still try Mirena but if that is ineffective, you may even need surgery.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My dad had a scraping of his bladder two months ago, it was extremely painful afterward, supposed to be a day surgery, he had to spend next two days in the hospital, with horrific bladder spasms. When he came home, he has had numerous, constant UTIs and also a kidney infection more weeks going to the hospital for IV antibiotics, and now again on antibiotics at home for another UTI. His bladder cancer is in the earliest of stages.His surgeon most likely wants to scrape 1 or 2 more times. He said he maybe got 70 percent of it the first time. I do not wish to my dad to go through more pain and complications. What can you recommend? Should he be monitored and if it gets into the wall later have his bladder removed? ### Response: Hello, Welcome to Chat Doctor forum. The bladder spasm could be due to infection, coexisting enlarged prostate, or any intra-bladder chemo medicine given after surgery. Treating his disease is the first step. Urine cultures will help. Giving anticholinergics is next step to relax the bladder. The third will be to do a uroflow if not done and treat his prostate if there is any obstruction to flow. You may send any reports if you have them. Removing the bladder is a valuable exercise and is the last resort for superficial tumors. For deep tumors or recurrent tumors, there is no other option but the removal of bladder or radiotherapy. Better to preserve the bladder and treat tumor endoscopically if it is not deep or aggressive. For symptomatic relief, you may ask for Pyridium tablets (Phenazopyridine) or Amitryptylline as a temporary measure to reduce the burning.

Hello doctor,My dad had a scraping of his bladder two months ago, it was extremely painful afterward, supposed to be a day surgery, he had to spend next two days in the hospital, with horrific bladder spasms. When he came home, he has had numerous, constant UTIs and also a kidney infection more weeks going to the hospital for IV antibiotics, and now again on antibiotics at home for another UTI. His bladder cancer is in the earliest of stages.His surgeon most likely wants to scrape 1 or 2 more times. He said he maybe got 70 percent of it the first time. I do not wish to my dad to go through more pain and complications. What can you recommend? Should he be monitored and if it gets into the wall later have his bladder removed?

Hello, Welcome to Chat Doctor forum. The bladder spasm could be due to infection, coexisting enlarged prostate, or any intra-bladder chemo medicine given after surgery. Treating his disease is the first step. Urine cultures will help. Giving anticholinergics is next step to relax the bladder. The third will be to do a uroflow if not done and treat his prostate if there is any obstruction to flow. You may send any reports if you have them. Removing the bladder is a valuable exercise and is the last resort for superficial tumors. For deep tumors or recurrent tumors, there is no other option but the removal of bladder or radiotherapy. Better to preserve the bladder and treat tumor endoscopically if it is not deep or aggressive. For symptomatic relief, you may ask for Pyridium tablets (Phenazopyridine) or Amitryptylline as a temporary measure to reduce the burning.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I just want to consult about my skin condition that happens annually. Every year, my hands has this condition where it will itch and form rashes with liquid inside then skin itself. Most of the time, it starts on December then end on February, however it differs every year. This year it started on March and up to now. I experience this every year, as in yearly so I assumed it is normal. It is not hereditary, I assume, because none of my family members is experiencing it other than me.My mother told me that maybe it is because of cold weather which I agreed. It is there for the past 11 years. I have never consulted any professionals about it since it does not look severe. However, I am curious what is this condition called. ### Response: Hi, Welcome to Chat Doctor forum. Seasonal itch and swelling over the exterior parts of the palms, soles ear, nose occur due to a type of cold allergy called perniosis orchilblains. Lesions for increased itchy sweling occurs mainly during the start of cold weather and end of the cold weather when there is temperature change in the environment. I am not sure which part you are living in as you have not mention. Treatment for this is avoidance of cold exposure, wearing warm clothes. Calcium dobesilate gel twice daily. Diltiazem 30 mg tablet BD for 2 weeks during the lesions. For itching you use Loratadine10 mg once daily for two weeks or whenever there is itching. Apply aloevera moisturizing cream over the hands multiple times with rubbing of the hands and feet and the parts so that good circulation bring warm blood flows into those area.

Hello doctor,I just want to consult about my skin condition that happens annually. Every year, my hands has this condition where it will itch and form rashes with liquid inside then skin itself. Most of the time, it starts on December then end on February, however it differs every year. This year it started on March and up to now. I experience this every year, as in yearly so I assumed it is normal. It is not hereditary, I assume, because none of my family members is experiencing it other than me.My mother told me that maybe it is because of cold weather which I agreed. It is there for the past 11 years. I have never consulted any professionals about it since it does not look severe. However, I am curious what is this condition called.

Hi, Welcome to Chat Doctor forum. Seasonal itch and swelling over the exterior parts of the palms, soles ear, nose occur due to a type of cold allergy called perniosis orchilblains. Lesions for increased itchy sweling occurs mainly during the start of cold weather and end of the cold weather when there is temperature change in the environment. I am not sure which part you are living in as you have not mention. Treatment for this is avoidance of cold exposure, wearing warm clothes. Calcium dobesilate gel twice daily. Diltiazem 30 mg tablet BD for 2 weeks during the lesions. For itching you use Loratadine10 mg once daily for two weeks or whenever there is itching. Apply aloevera moisturizing cream over the hands multiple times with rubbing of the hands and feet and the parts so that good circulation bring warm blood flows into those area.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 30-year-old woman. I am having OCD since I was 12 years old. I have a strong fear of an event that happened a couple of years ago when a psychiatrist told me that I have a borderline disorder and have no fantasy. I was trying to ask her for years to say me the opposite as a compulsion. She refused to do that, I am not sure if it is because she did not want to change her opinion or it is because she did not want to satisfy my compulsion. My mother was encouraging me to do these kinds of compulsions as she thought it is going to get worse. It was a bad thing as she was validating my fears in this way. I just realized these things now so I started to confront my fears about what the psychiatrist said to me. But I ran into another one which is about what if my mother is right and if I am confronting my fears it is going to get worse. What do you think? ### Response: Hello, Welcome to Chat Doctor forum. My first question is whether you are currently on medication for OCD or not. If your obsessions are bothering you that much, first you need to start medications because the content of your obsessions is a second factor when it comes to treatment, first we need to focus on not having an obsession which will be possible with medication. Secondly about your compulsion to have a second opinion, what you can do is find a therapist which will help you and teach you techniques to overcome this need. CBT is a great tool in that way . Enabling an obsession is never a good idea, you need to learn ways to cope up with them without acting on it.

Hi doctor,I am a 30-year-old woman. I am having OCD since I was 12 years old. I have a strong fear of an event that happened a couple of years ago when a psychiatrist told me that I have a borderline disorder and have no fantasy. I was trying to ask her for years to say me the opposite as a compulsion. She refused to do that, I am not sure if it is because she did not want to change her opinion or it is because she did not want to satisfy my compulsion. My mother was encouraging me to do these kinds of compulsions as she thought it is going to get worse. It was a bad thing as she was validating my fears in this way. I just realized these things now so I started to confront my fears about what the psychiatrist said to me. But I ran into another one which is about what if my mother is right and if I am confronting my fears it is going to get worse. What do you think?

Hello, Welcome to Chat Doctor forum. My first question is whether you are currently on medication for OCD or not. If your obsessions are bothering you that much, first you need to start medications because the content of your obsessions is a second factor when it comes to treatment, first we need to focus on not having an obsession which will be possible with medication. Secondly about your compulsion to have a second opinion, what you can do is find a therapist which will help you and teach you techniques to overcome this need. CBT is a great tool in that way . Enabling an obsession is never a good idea, you need to learn ways to cope up with them without acting on it.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a bump on my labia , it does not hurt and it is not too big but I have had one before so because it is reoccurring. I am a bit nervous. It is close to where I shave so I am hoping it is just a dull razor issue or a pimple but the fact that I had it before is concerning to me. I have not tried to pop it and it does not look like it is filled with pus or anything, it is also flesh colored.I know it is hard to give me a diagnosis since you cannot see me, but I was wondering for some insight on what this could be because I know self-diagnosing myself is not the right thing to do. I do plan on seeing a doctor but seeing with the virus going on right now I cannot make an appointment so this is my only hope to get some kind of answer to ease my mind for the time being. ### Response: Hi. Thanks for the query. I can understand your concern. According to your history, there is a possibility that the lesion you described could be a Bartholin,s cyst. But as you mentioned by direct examination only we can make the exact diagnosis. Now at this situation what you can do is, if it is painful please go for some analgesic ChatDoctor. You can take a sitz bath with lukewarm water and with few ml of disinfectant liquid like Dettol. With this the symptoms of inflammation can be relieved and size of the lesion can be decreased. You can do this twice a day for three days. If the lesion persists or recurs you may need to consult a local gynecologist for examination and treatment. I hope this helps.

Hello doctor,I have a bump on my labia , it does not hurt and it is not too big but I have had one before so because it is reoccurring. I am a bit nervous. It is close to where I shave so I am hoping it is just a dull razor issue or a pimple but the fact that I had it before is concerning to me. I have not tried to pop it and it does not look like it is filled with pus or anything, it is also flesh colored.I know it is hard to give me a diagnosis since you cannot see me, but I was wondering for some insight on what this could be because I know self-diagnosing myself is not the right thing to do. I do plan on seeing a doctor but seeing with the virus going on right now I cannot make an appointment so this is my only hope to get some kind of answer to ease my mind for the time being.

Hi. Thanks for the query. I can understand your concern. According to your history, there is a possibility that the lesion you described could be a Bartholin,s cyst. But as you mentioned by direct examination only we can make the exact diagnosis. Now at this situation what you can do is, if it is painful please go for some analgesic ChatDoctor. You can take a sitz bath with lukewarm water and with few ml of disinfectant liquid like Dettol. With this the symptoms of inflammation can be relieved and size of the lesion can be decreased. You can do this twice a day for three days. If the lesion persists or recurs you may need to consult a local gynecologist for examination and treatment. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 36 years old. I have a problem on the right side of the large intestine. I have four babies with cesarean surgeries. My youngest baby is 13 years old. My uterus was removed five years ago due to rasoli. After this operation, I felt pain in my anus and a year later I was alright but later on my mother suddenly passed away. Due to sorrowness, I felt pain in my stomach and a pull in my belly. Followed by I had constipation and piles (no bleeding). Now whatever I eat or with empty belly I feel heavier on the right side of the large intestine. After eating something I feel that it has blocked due to any hindrance. I thought it may due to eating beef or meat but now doctors say that my large intestine is infected and even using medicines show no improvement. My hunger is normal but I have constipation and little pain in the right intestine with a large amount of urine with crystals in it. Please suggest medication. ### Response: Hello, Welcome to Chat Doctor forum. I have reviewed your situation. For confirmation, what is going on, you need to visit to a gastroenterologist and get booked for upper and lower GI (gastrointestinal) endoscopy. But reading at your situation, it looks you have both acidity problem and constipation. Till you meet some gastroenterologist, you can take capsule Nexium 40 mg (Esomeprazole) once a day before meal, and Isphagol husk two teaspoons in a glass of water, keep it for four hours and then take it. If you still feel symptoms, you can follow us. So we can upgrade the treatment. I hope this helps.

Hello doctor,I am 36 years old. I have a problem on the right side of the large intestine. I have four babies with cesarean surgeries. My youngest baby is 13 years old. My uterus was removed five years ago due to rasoli. After this operation, I felt pain in my anus and a year later I was alright but later on my mother suddenly passed away. Due to sorrowness, I felt pain in my stomach and a pull in my belly. Followed by I had constipation and piles (no bleeding). Now whatever I eat or with empty belly I feel heavier on the right side of the large intestine. After eating something I feel that it has blocked due to any hindrance. I thought it may due to eating beef or meat but now doctors say that my large intestine is infected and even using medicines show no improvement. My hunger is normal but I have constipation and little pain in the right intestine with a large amount of urine with crystals in it. Please suggest medication.

Hello, Welcome to Chat Doctor forum. I have reviewed your situation. For confirmation, what is going on, you need to visit to a gastroenterologist and get booked for upper and lower GI (gastrointestinal) endoscopy. But reading at your situation, it looks you have both acidity problem and constipation. Till you meet some gastroenterologist, you can take capsule Nexium 40 mg (Esomeprazole) once a day before meal, and Isphagol husk two teaspoons in a glass of water, keep it for four hours and then take it. If you still feel symptoms, you can follow us. So we can upgrade the treatment. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I received a couple of faint positive pregnancy tests two weeks ago. Then, I went to my primary physician for another urine test, which came out as negative. Later, I felt some cramping on and off all day on my left side. The cramps were similar to premenstrual cramps along with sore nipples, increased saliva, and sense of taste, absent-mindedness, forgetfulness, very noticeable fatigue, occasional backache and headache, indigestion, burps and frequent urination. I was anxious and read about ectopic pregnancies and decided to test that night. It was a darker line than the previous tests and the result was pretty fast. When I tested the next morning, it was even darker and the result came very quickly. Then, two digital tests a couple of days after being positive. What can be the reason for my pain? Can it occur from a corpus luteum cyst and pregnancy? Is it safe to say that I am pregnant because of the tests becoming darker? Or were they possibly all false positives? I feel like the cramps are a bit more spaced out and less frequent now. Also, there has been no bleeding. I have my first OB/GYN appointment scheduled 15 days from now, but I am hoping for a little insight. I am currently on Vitex capsules 400 mg, GNC prenatal vitamins and Fish oil pills. Thank you. ### Response: Hello, Welcome to Chat Doctor forum. Serum beta hCG and USG early pregnancy to rule out ectopic and confirm cardiac activity. 1. Intrauterine pregnancy.2. Ectopic pregnancy. Revert back with the reports to an obstetrician and gynaecologist online.-

Hi doctor,I received a couple of faint positive pregnancy tests two weeks ago. Then, I went to my primary physician for another urine test, which came out as negative. Later, I felt some cramping on and off all day on my left side. The cramps were similar to premenstrual cramps along with sore nipples, increased saliva, and sense of taste, absent-mindedness, forgetfulness, very noticeable fatigue, occasional backache and headache, indigestion, burps and frequent urination. I was anxious and read about ectopic pregnancies and decided to test that night. It was a darker line than the previous tests and the result was pretty fast. When I tested the next morning, it was even darker and the result came very quickly. Then, two digital tests a couple of days after being positive. What can be the reason for my pain? Can it occur from a corpus luteum cyst and pregnancy? Is it safe to say that I am pregnant because of the tests becoming darker? Or were they possibly all false positives? I feel like the cramps are a bit more spaced out and less frequent now. Also, there has been no bleeding. I have my first OB/GYN appointment scheduled 15 days from now, but I am hoping for a little insight. I am currently on Vitex capsules 400 mg, GNC prenatal vitamins and Fish oil pills. Thank you.

Hello, Welcome to Chat Doctor forum. Serum beta hCG and USG early pregnancy to rule out ectopic and confirm cardiac activity. 1. Intrauterine pregnancy.2. Ectopic pregnancy. Revert back with the reports to an obstetrician and gynaecologist online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,2 years and 6 months old with abnormal CBC test results (two tests seven weeks apart). First tested because of enlarged lymph node (only one side) in neck. Node has reduced in size to what appears normal. Low MCHC (just barely outside range of 32.0 to 36.0) 31.3. Low NE % of 26.1 Auto diff with range 43.0 to 65.0, high LY % 62.7 with range 20.5 to 45.5, high EO % 3.9 with range .9 to 2.9. Highly # 6.2 with range of 1.0 to 5.5. What does this indicate? I have read all the horrible possibilities. Is it possible these are indicative of something not serious? ### Response: Hello. Your CBC report is suggestive of lymphocytosis (attachment removed to protect patient identity). The common cause for lymphocytosis is viral infection. The enlarged lymph node could be due to that. Now, your enlarged node return to normal size as per history, so suggestive of infective etiology. You might be feared about leukemia like condition. But in blood cancer, total count is very much high like more than 50000. So, it is not suggestive of blood cancer. However, if you have persistent lymphocytosis, then it is advisable to investigate with peripheral smear examination report for further work up. It will be able to help in identifying any abnormal cells, if present like atypical lymphocytes, blast, etc. You can consult your pediatrician for detailed physical examination.

Hello doctor,2 years and 6 months old with abnormal CBC test results (two tests seven weeks apart). First tested because of enlarged lymph node (only one side) in neck. Node has reduced in size to what appears normal. Low MCHC (just barely outside range of 32.0 to 36.0) 31.3. Low NE % of 26.1 Auto diff with range 43.0 to 65.0, high LY % 62.7 with range 20.5 to 45.5, high EO % 3.9 with range .9 to 2.9. Highly # 6.2 with range of 1.0 to 5.5. What does this indicate? I have read all the horrible possibilities. Is it possible these are indicative of something not serious?

Hello. Your CBC report is suggestive of lymphocytosis (attachment removed to protect patient identity). The common cause for lymphocytosis is viral infection. The enlarged lymph node could be due to that. Now, your enlarged node return to normal size as per history, so suggestive of infective etiology. You might be feared about leukemia like condition. But in blood cancer, total count is very much high like more than 50000. So, it is not suggestive of blood cancer. However, if you have persistent lymphocytosis, then it is advisable to investigate with peripheral smear examination report for further work up. It will be able to help in identifying any abnormal cells, if present like atypical lymphocytes, blast, etc. You can consult your pediatrician for detailed physical examination.

### Instruction: Answer this question truthfully ###Input: Hello doctor,Before five years, I was tested for thyroid. The result was TSH at 3.45. Five months later, my symptoms were getting worse, and my doctor rechecked me after five months TSH was 7.40, and free T4 was 0.9. I was diagnosed with hypothyroidism. Which would explain my weight gain, hair loss, fatigue, etc.Why was there a change in my TSH? She put me on 100 mcg of Levothyroxin and 500 mg of Metformin, and I had two ultrasounds of my ovaries (outside and inside), and they were fine. She also told me my Prolactin levels were at 31.4. What does that mean? She told me to come back in six weeks to get it all retested then promptly went on vacation. ### Response: Hello, Welcome to Chat Doctor forum. Elevated Prolactin means the concentration of Prolactin hormones in your blood is high. Prolactin is a hormone secreted by the pituitary in the brain. It controls the action of sex hormones. It can be elevated due to problems either in your pituitary or in your ovaries. You require an evaluation for that. TSH (thyroid-stimulating hormone) values keep changing even in normal persons. It depends on physical activity, the rate of metabolism in the body. When tested initially, you might have been in the starting stage of hypothyroidism, and hence the TSH value came normal. After a few months, the hypothyroidism progressed, and hence your TSH got raised. I hope this answers your query. Any clarifications or questions feel free to ask. I am happy to help you.

Hello doctor,Before five years, I was tested for thyroid. The result was TSH at 3.45. Five months later, my symptoms were getting worse, and my doctor rechecked me after five months TSH was 7.40, and free T4 was 0.9. I was diagnosed with hypothyroidism. Which would explain my weight gain, hair loss, fatigue, etc.Why was there a change in my TSH? She put me on 100 mcg of Levothyroxin and 500 mg of Metformin, and I had two ultrasounds of my ovaries (outside and inside), and they were fine. She also told me my Prolactin levels were at 31.4. What does that mean? She told me to come back in six weeks to get it all retested then promptly went on vacation.

Hello, Welcome to Chat Doctor forum. Elevated Prolactin means the concentration of Prolactin hormones in your blood is high. Prolactin is a hormone secreted by the pituitary in the brain. It controls the action of sex hormones. It can be elevated due to problems either in your pituitary or in your ovaries. You require an evaluation for that. TSH (thyroid-stimulating hormone) values keep changing even in normal persons. It depends on physical activity, the rate of metabolism in the body. When tested initially, you might have been in the starting stage of hypothyroidism, and hence the TSH value came normal. After a few months, the hypothyroidism progressed, and hence your TSH got raised. I hope this answers your query. Any clarifications or questions feel free to ask. I am happy to help you.

### Instruction: Answer this question truthfully ###Input: Hi doctor,Please help me in understanding a few things. I had one sexual incidence with an unknown HIV status lady. Although it was protected, I do not know the status of the condom after sex. Then, I had 2 CMIA tests. First test by 24.5 weeks and the second test by 25.5 weeks. Both were having the index of 0.14 and 0.08 with nonreactivity. I am attaching the reports for the reference.Are my reports conclusively negative? Do I need any further test? Is CMIA equally good as 4th generation ELISA? In my case whether it was tested for both Antibodies and P24 Antigen or not? What is the false negative chance using CMIA? Is CMIA better than Rapid kit test? ### Response: Hi, Welcome to Chat Doctor forum. Thanks for your query and I will try to clear your doubts. CMIA tests done at 24.5 and 25.5 weeks are nonreactive. It implies that you are not infected. CMIA TEST is only 4th generation tests, and Elisa tests are 3rd generation. The only test which is better than CMIA duo is RNA PCR TEST, and however, it is not required in your case. CMIA detects both p24 and antibodies. It is to find out infection at earliest possible days like say three weeks after exposure. And, this test is conclusive after 12 weeks so as in your case. It is 99.9% accurate and false negative chances are low, and after 12 weeks those are negligible. CMIA is definitely better than rapid tests.

Hi doctor,Please help me in understanding a few things. I had one sexual incidence with an unknown HIV status lady. Although it was protected, I do not know the status of the condom after sex. Then, I had 2 CMIA tests. First test by 24.5 weeks and the second test by 25.5 weeks. Both were having the index of 0.14 and 0.08 with nonreactivity. I am attaching the reports for the reference.Are my reports conclusively negative? Do I need any further test? Is CMIA equally good as 4th generation ELISA? In my case whether it was tested for both Antibodies and P24 Antigen or not? What is the false negative chance using CMIA? Is CMIA better than Rapid kit test?

Hi, Welcome to Chat Doctor forum. Thanks for your query and I will try to clear your doubts. CMIA tests done at 24.5 and 25.5 weeks are nonreactive. It implies that you are not infected. CMIA TEST is only 4th generation tests, and Elisa tests are 3rd generation. The only test which is better than CMIA duo is RNA PCR TEST, and however, it is not required in your case. CMIA detects both p24 and antibodies. It is to find out infection at earliest possible days like say three weeks after exposure. And, this test is conclusive after 12 weeks so as in your case. It is 99.9% accurate and false negative chances are low, and after 12 weeks those are negligible. CMIA is definitely better than rapid tests.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 6 months pregnant now. Before pregnancy, I have been suffering through allergic rhinitis (sneezing and dry coughing). But as my pregnancy started, I got a cough with white phlegm. I wanted to avoid medicines during the first three months of pregnancy but due to late night coughing and phlegm I went to see a gynecologist. At first, she tried to control my cough through a mild cough syrup with ivy leaves but cough does not go away.Then my gynecologist asked me to visit a pulmonologist after a detailed checkup I was diagnosed with bronchial asthma. He advised me to take Budesonide with Formoterol dry powder inhaler and Montelukast sodium. I am feeling better nowadays. I do not have a cough now. I do visit my gynecologist for a monthly checkup and she knows that I am taking dry powder inhaler for bronchial asthma. This month my gynecologist advised me to take Rejuva tablet that contains vitamin D and K, it is a kind of nutritional supplement for bone health and Fiore-f tablet for iron deficiency. My Hb is 9 nowadays.My question is ### Response: Hi. You should continue bronchial asthma medicines. As it is required to control your symptoms and to make you healthy. If you do not take it then the effect on baby can be worse than while you are taking. As baby growth is fine do not worry about it. Iron and calcium are also minimum requirements during pregnancy and if you do not take it and your Hb is down during delivery then it can be very dangerous if you bleed more. So it is required during pregnancy. And, mostly it will not have any effect on bronchial asthma.

Hello doctor,I am 6 months pregnant now. Before pregnancy, I have been suffering through allergic rhinitis (sneezing and dry coughing). But as my pregnancy started, I got a cough with white phlegm. I wanted to avoid medicines during the first three months of pregnancy but due to late night coughing and phlegm I went to see a gynecologist. At first, she tried to control my cough through a mild cough syrup with ivy leaves but cough does not go away.Then my gynecologist asked me to visit a pulmonologist after a detailed checkup I was diagnosed with bronchial asthma. He advised me to take Budesonide with Formoterol dry powder inhaler and Montelukast sodium. I am feeling better nowadays. I do not have a cough now. I do visit my gynecologist for a monthly checkup and she knows that I am taking dry powder inhaler for bronchial asthma. This month my gynecologist advised me to take Rejuva tablet that contains vitamin D and K, it is a kind of nutritional supplement for bone health and Fiore-f tablet for iron deficiency. My Hb is 9 nowadays.My question is

Hi. You should continue bronchial asthma medicines. As it is required to control your symptoms and to make you healthy. If you do not take it then the effect on baby can be worse than while you are taking. As baby growth is fine do not worry about it. Iron and calcium are also minimum requirements during pregnancy and if you do not take it and your Hb is down during delivery then it can be very dangerous if you bleed more. So it is required during pregnancy. And, mostly it will not have any effect on bronchial asthma.