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### Instruction: Answer this question truthfully ###Input: Hello doctor,I am suffering from anxiety and social phobia. I consulted my psychiatrist to use either Citalopram or Mirtazapine. I doubt to take Citalopram because I know this causes sexual side effects more often than Mirtazapine does. However, regarding Mirtazapine, I read various things online that, because it is a norephedrine activator (SNRI) instead of SSRI, it can cause anxiety to become worse. I want a second opinion, if I were to use Mirtazapine, what is the recommended dose for anxiety and social phobia? ### Response: Hello, Welcome to Chat Doctor forum. 1. Both Citalopram and Mirtazapine are good choices for managing anxiety and social phobia. 2. If you are worried about sexual side effects, Mirtazapine will be a better choice. 3. Both Citalopram and Mirtazapine can take up to four weeks for the therapeutic benefits to become apparent. Some people can experience agitation and anxiety during the first week or so, but usually, it settles down. Mirtazapine has a sedative effect as well, so it should be beneficial. 4. The usual starting dose for Mirtazapine will be 15 mg once daily at bedtime. If needed depending on your response and tolerability, the dose can be titrated up to 30 mg or 45 mg per day. Medication can only be started after your doctor has ruled out any contraindications and should be able to monitor your response. 5. Finally, in addition to medication, you can also try psychological therapy and CBT (cognitive behavioral therapy) for anxiety. They are highly effective and help to prevent relapse after the medication is discontinued when you have improved. Usually, antidepressant medication needs to be continued at least for six months after you feel better. I hope this helps.

Hello doctor,I am suffering from anxiety and social phobia. I consulted my psychiatrist to use either Citalopram or Mirtazapine. I doubt to take Citalopram because I know this causes sexual side effects more often than Mirtazapine does. However, regarding Mirtazapine, I read various things online that, because it is a norephedrine activator (SNRI) instead of SSRI, it can cause anxiety to become worse. I want a second opinion, if I were to use Mirtazapine, what is the recommended dose for anxiety and social phobia?

Hello, Welcome to Chat Doctor forum. 1. Both Citalopram and Mirtazapine are good choices for managing anxiety and social phobia. 2. If you are worried about sexual side effects, Mirtazapine will be a better choice. 3. Both Citalopram and Mirtazapine can take up to four weeks for the therapeutic benefits to become apparent. Some people can experience agitation and anxiety during the first week or so, but usually, it settles down. Mirtazapine has a sedative effect as well, so it should be beneficial. 4. The usual starting dose for Mirtazapine will be 15 mg once daily at bedtime. If needed depending on your response and tolerability, the dose can be titrated up to 30 mg or 45 mg per day. Medication can only be started after your doctor has ruled out any contraindications and should be able to monitor your response. 5. Finally, in addition to medication, you can also try psychological therapy and CBT (cognitive behavioral therapy) for anxiety. They are highly effective and help to prevent relapse after the medication is discontinued when you have improved. Usually, antidepressant medication needs to be continued at least for six months after you feel better. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 30 year old male. My height is 5\\7\" and weight is 79 kg. I recently did some tests and the findings are as follows. Testosterone 239 ng/dL, HDL 24 mg/dL, VLDL 60 mg/dL, triglycerides 302 mg/dL, Vitamin D 29 ng/dL, Vitamin B12 164 pg/mL and HbA1c 5.2%. My BP is under control. I also have lower back pain due to loss of lordosis. I am now taking medicines for cholesterol and calcium. I have been masturbating quite frequently since age 16. I recently had sex for the first time and I ejaculated quite fast. My erection does not last long. I visited a local doctor and he observed my penis with a device and said my penis muscles are weak. What should be the ideal testosterone of a male my age? I intend to marry next year. Am I fertile? Are my sperms strong? Can I have a normal sex life? How to rectify the problem of weak penis muscle? ### Response: Hello, Welcome to Chat Doctor forum. Considering your age, the Normal Testosterone Levels should be around 270-1000 ng/dL. The report of yours shows lower levels. Obesity or overweight is one of the important reasons for low laboratory levels of testosterone. Semen analysis can tell if you can have a child or not. If your sperm count, morphology and anatomy are normal, then there would be no issue in having chil ChatDoctor. Ejaculation in a minute is considered as normal. No need to worry. With practice your time will increase. If you are getting good erections, then there would be no issue of muscles. If your erection is good, then no need to worry.

Hi doctor,I am a 30 year old male. My height is 5\\7\" and weight is 79 kg. I recently did some tests and the findings are as follows. Testosterone 239 ng/dL, HDL 24 mg/dL, VLDL 60 mg/dL, triglycerides 302 mg/dL, Vitamin D 29 ng/dL, Vitamin B12 164 pg/mL and HbA1c 5.2%. My BP is under control. I also have lower back pain due to loss of lordosis. I am now taking medicines for cholesterol and calcium. I have been masturbating quite frequently since age 16. I recently had sex for the first time and I ejaculated quite fast. My erection does not last long. I visited a local doctor and he observed my penis with a device and said my penis muscles are weak. What should be the ideal testosterone of a male my age? I intend to marry next year. Am I fertile? Are my sperms strong? Can I have a normal sex life? How to rectify the problem of weak penis muscle?

Hello, Welcome to Chat Doctor forum. Considering your age, the Normal Testosterone Levels should be around 270-1000 ng/dL. The report of yours shows lower levels. Obesity or overweight is one of the important reasons for low laboratory levels of testosterone. Semen analysis can tell if you can have a child or not. If your sperm count, morphology and anatomy are normal, then there would be no issue in having chil ChatDoctor. Ejaculation in a minute is considered as normal. No need to worry. With practice your time will increase. If you are getting good erections, then there would be no issue of muscles. If your erection is good, then no need to worry.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I was diagnosed with TID 14 years back. I will run out of Lantus before the next shipment arrives, but I have plenty of Novolog on hand. My daily dose is 32.5 units Lantus at 10 AM and 12.5 units at 8 PM, with a sliding scale for Novolog (typically 0 to 6 units). What dosage or schedule would you recommend for temporarily relying on Novolog only? ### Response: Hi, Welcome to Chat Doctor forum. I can tell you right away that your type 1 DM (diabetes mellitus) is not being managed correctly. Those who have type 1 DM cannot make it without basal insulin so insulin it has to be provided 24/7. You should be on balanced Lantus and scheduled Novolog (and not sliding scale of Novolog- Insulin aspart). You can take Novolog but it has to be every 3 to 4 hours, and it has to be scheduled. Also, you need to check your blood sugar every 3 to 4 hours before taking a shot, that is a must. You will run into very high or very low blood sugar and will see an erratic pattern, you will have to adjust the dose accordingly. Watch and check your ketones 2 to 3 times daily, should not stay without Lantus (Insulin glargine) for more than 24 hours. Novolog dose at least should be seven units every four hours (calculated from your current regimen you should need at least 1.8 units of Insulin every hour to survive). If feeling sick with nausea, vomiting, diarrhea, belly pain, blood sugar less than 70 or more than 300 you should go to ER or urgent care center. You are at high-risk ketoacidosis. For more information consult a diabetologist online

Hi doctor,I was diagnosed with TID 14 years back. I will run out of Lantus before the next shipment arrives, but I have plenty of Novolog on hand. My daily dose is 32.5 units Lantus at 10 AM and 12.5 units at 8 PM, with a sliding scale for Novolog (typically 0 to 6 units). What dosage or schedule would you recommend for temporarily relying on Novolog only?

Hi, Welcome to Chat Doctor forum. I can tell you right away that your type 1 DM (diabetes mellitus) is not being managed correctly. Those who have type 1 DM cannot make it without basal insulin so insulin it has to be provided 24/7. You should be on balanced Lantus and scheduled Novolog (and not sliding scale of Novolog- Insulin aspart). You can take Novolog but it has to be every 3 to 4 hours, and it has to be scheduled. Also, you need to check your blood sugar every 3 to 4 hours before taking a shot, that is a must. You will run into very high or very low blood sugar and will see an erratic pattern, you will have to adjust the dose accordingly. Watch and check your ketones 2 to 3 times daily, should not stay without Lantus (Insulin glargine) for more than 24 hours. Novolog dose at least should be seven units every four hours (calculated from your current regimen you should need at least 1.8 units of Insulin every hour to survive). If feeling sick with nausea, vomiting, diarrhea, belly pain, blood sugar less than 70 or more than 300 you should go to ER or urgent care center. You are at high-risk ketoacidosis. For more information consult a diabetologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am currently on Wellbutrin XL 150 mg per I am going to put up to 300 mg before I do so. Our pharmacy is currently out of 300 mg. They do have a generic brand which I do not like. In cases such as this, is it fine to take 2 doses of the 150 mg to make up the 300 mg? Or is that not possible? ### Response: Hello, Welcome to Chat Doctor forum. Wellbutrin XL ( Bupropion XL) can be increased to 300 mg XL once daily in the morning after you have been taking Wellbutrin XL for at least four days. The dose has to be increased gradually to minimize the risk of side effects like seizures. If Wellbutrin XL 300 mg is not available in the pharmacy, you can potentially take two doses of Wellbutrin XL 150 mg, taken together as once daily in the morning (giving you an effective dose of 300 mg once daily). Both pills should be swallowed as a whole and not crushed or chewed. You can switch to Wellbutrin XL 300 mg once it becomes available. Another easier option will be to try generic Bupropion XL 300 mg tablets as they contain the same active ingredient. I note that you mentioned you do not like it. Is it the medication effect or taste which is not to your liking? If you feel strongly against the generic version, you can take Wellbutrin XL preparation itself. Whichever option you choose, kindly discuss with your prescribing doctor as some pharmacies will not dispense unless the preparation and dosage are clearly mentioned in the prescription. It is important to have regular follow-ups with your prescribing doctor once the dosage is increased so that benefits and any potential side effects can be monitored. I hope this helps.

Hello doctor,I am currently on Wellbutrin XL 150 mg per I am going to put up to 300 mg before I do so. Our pharmacy is currently out of 300 mg. They do have a generic brand which I do not like. In cases such as this, is it fine to take 2 doses of the 150 mg to make up the 300 mg? Or is that not possible?

Hello, Welcome to Chat Doctor forum. Wellbutrin XL ( Bupropion XL) can be increased to 300 mg XL once daily in the morning after you have been taking Wellbutrin XL for at least four days. The dose has to be increased gradually to minimize the risk of side effects like seizures. If Wellbutrin XL 300 mg is not available in the pharmacy, you can potentially take two doses of Wellbutrin XL 150 mg, taken together as once daily in the morning (giving you an effective dose of 300 mg once daily). Both pills should be swallowed as a whole and not crushed or chewed. You can switch to Wellbutrin XL 300 mg once it becomes available. Another easier option will be to try generic Bupropion XL 300 mg tablets as they contain the same active ingredient. I note that you mentioned you do not like it. Is it the medication effect or taste which is not to your liking? If you feel strongly against the generic version, you can take Wellbutrin XL preparation itself. Whichever option you choose, kindly discuss with your prescribing doctor as some pharmacies will not dispense unless the preparation and dosage are clearly mentioned in the prescription. It is important to have regular follow-ups with your prescribing doctor once the dosage is increased so that benefits and any potential side effects can be monitored. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My lateral incisor #7 fractured at the gumline and will likely require a surgical extraction. Also, while a temporary filling was provided after removal of pulp pending a root canal, the root canal was not done for many months due to an insurance lapse, and the tooth became infected as well as surrounding bone. I have read that some dental surgeons advocate for the removal of the periodontal ligament during extraction to facilitate healing and the proliferation of new bone cells, and that this must be done explicitly with a bone burr. I have read that this is common practice for \"biologic\" dentists and biologic dental surgeons, and uncommon otherwise. My Med-Cal / Denti-Cal providers are not \"biologic\" dentists.I have four questions. 1) How important do you think the complete removal of the periodontal ligament really is? 2) If the extraction is surgical vs. simple, is it likely that the ligament would be removed anyway? Perhaps because some extra surrounding bone may need to be removed? 3) If removal of the tendon is not standard practice by the dental surgeon, can I request it and would they know what to do and not be offended?, and finally 4) If an implant is contemplated, would the region of the removed tooth and perhaps some surrounding bone immediately be packed with a bone substitute for socket preservation? Or would the infection need to clear first? ### Response: Hello, Welcome to Chat Doctor forum. There is nothing like \"Biological\" dentists as such, but you might be referring to Oral and Maxillofacial Surgeons. Anyway the removal of root stump of a lateral incisor is a simple procedure and any dentists should do it. There is no separate removal of periodontal ligament, which usually is resorbed by the wound healing itself. In any case, if you are planning implant you should not be removing any surrounding bone at all to get maximum implant attachment and minimal bone graft.

Hi doctor,My lateral incisor #7 fractured at the gumline and will likely require a surgical extraction. Also, while a temporary filling was provided after removal of pulp pending a root canal, the root canal was not done for many months due to an insurance lapse, and the tooth became infected as well as surrounding bone. I have read that some dental surgeons advocate for the removal of the periodontal ligament during extraction to facilitate healing and the proliferation of new bone cells, and that this must be done explicitly with a bone burr. I have read that this is common practice for \"biologic\" dentists and biologic dental surgeons, and uncommon otherwise. My Med-Cal / Denti-Cal providers are not \"biologic\" dentists.I have four questions. 1) How important do you think the complete removal of the periodontal ligament really is? 2) If the extraction is surgical vs. simple, is it likely that the ligament would be removed anyway? Perhaps because some extra surrounding bone may need to be removed? 3) If removal of the tendon is not standard practice by the dental surgeon, can I request it and would they know what to do and not be offended?, and finally 4) If an implant is contemplated, would the region of the removed tooth and perhaps some surrounding bone immediately be packed with a bone substitute for socket preservation? Or would the infection need to clear first?

Hello, Welcome to Chat Doctor forum. There is nothing like \"Biological\" dentists as such, but you might be referring to Oral and Maxillofacial Surgeons. Anyway the removal of root stump of a lateral incisor is a simple procedure and any dentists should do it. There is no separate removal of periodontal ligament, which usually is resorbed by the wound healing itself. In any case, if you are planning implant you should not be removing any surrounding bone at all to get maximum implant attachment and minimal bone graft.

### Instruction: Answer this question truthfully ###Input: Hello doctor, My mother is 53 years old. I have to discuss with you about my mother\\s heart problem. Two years ago, we get to know that she is suffering from heart disease so we consulted a reputed cardiologist. He examined her and said that the only treatment for her problem is bypass surgery and gave her some common medicines like Aspirin, Roseday, etc. She takes the medicines for some time and left them. But three months ago, she got common cold and consulted a local physician, but she did not feel any relief. She rapidly changes four doctors and take their prescribed medicines for sometime and then left them. It resulted in damage to her kidneys. She got swelling on her whole body, my father took her immediately to the cardiologist whom she visited two years ago. He again examined her and perform all tests and tell us that she is suffering from left ventricular dysfunction and his left ventricle is only 20 percent left. After hearing this she is in a great depression and always she is thinking about it and saying to everybody that her heart is working only 20 percent. I want you to tell me some solution to this. She is weak and is also afraid of surgery. Is there any treatment that can be done with medicines alone? ### Response: Hello, Welcome to Chat Doctor forum. As far as I understand your mother is suffering from heart failure. Unfortunately, there is not too much to be done. A definite solution would be a heart transplant. Anyway, an optimization of her therapy can help improve her situation. So, I would recommend adding an ACEI (angiotensin-converting-inhibitor) Lisinopril, and Ramipril or ARB (angiotensin II receptor blocker), a diuretic to help improve the leg swelling Lasix and Hy ChatDoctor. Aldosterone antagonists Spironolactone, and a beta blocker in case of tachycardia. If these

Hello doctor, My mother is 53 years old. I have to discuss with you about my mother\\s heart problem. Two years ago, we get to know that she is suffering from heart disease so we consulted a reputed cardiologist. He examined her and said that the only treatment for her problem is bypass surgery and gave her some common medicines like Aspirin, Roseday, etc. She takes the medicines for some time and left them. But three months ago, she got common cold and consulted a local physician, but she did not feel any relief. She rapidly changes four doctors and take their prescribed medicines for sometime and then left them. It resulted in damage to her kidneys. She got swelling on her whole body, my father took her immediately to the cardiologist whom she visited two years ago. He again examined her and perform all tests and tell us that she is suffering from left ventricular dysfunction and his left ventricle is only 20 percent left. After hearing this she is in a great depression and always she is thinking about it and saying to everybody that her heart is working only 20 percent. I want you to tell me some solution to this. She is weak and is also afraid of surgery. Is there any treatment that can be done with medicines alone?

Hello, Welcome to Chat Doctor forum. As far as I understand your mother is suffering from heart failure. Unfortunately, there is not too much to be done. A definite solution would be a heart transplant. Anyway, an optimization of her therapy can help improve her situation. So, I would recommend adding an ACEI (angiotensin-converting-inhibitor) Lisinopril, and Ramipril or ARB (angiotensin II receptor blocker), a diuretic to help improve the leg swelling Lasix and Hy ChatDoctor. Aldosterone antagonists Spironolactone, and a beta blocker in case of tachycardia. If these

### Instruction: Answer this question truthfully ###Input: Hi doctor,My niece is 4 years old now. A year back we realized that she was not catching up how to speak and consulted an ENT doctor. Doctor performed few tests like BERA, OAE and hearing assessment. Then he confirmed that my niece is suffering from profound hearing loss. Doctor suggested hearing aids could help her in listening temporarily but advised cochlear implant as permanent solution. Though my niece grabbed very few words to speak with the help of hearing aids, she could not completely mingle with us. We still neither could digest the news nor can imagine that she wearing external devices for her entire life. Also that none of us or our ancestors had such problem.We consulted few more doctors for further confirmation and I browsed over the internet but everyone says cochlear implant is the only solution. We would like to take a final opinion from the doctors around the world before she goes under the surgery and hence drafting this. Can we have a hope that the problem could be different and doctor identifies the actual problem (if any) while operating the ear for cochlear implant? I figured out from few blogs that research is going on few devices which do not require wearing external device. Can you please let me know if they are available outside? If not, how many yet more years to pass to get those devices into the world and save many children with this problem? I have attached the BERA, OAE and hearing assessment reports for your reference. Please have a look at them and advice. Thank you very much for your valuable time and your help is definitely admirable and cannot be unnoticed. ### Response: Hi. Reports (attachment removed to protect patient identity) clearly explains about the problems. I clearly understand your concern and worries. CT and MRI scan for cochlear implant. 1. Speech therapy after cochlear implant, minimum three days in a week, only by speech language pathologist.2. Regular mapping by an audiologist.

Hi doctor,My niece is 4 years old now. A year back we realized that she was not catching up how to speak and consulted an ENT doctor. Doctor performed few tests like BERA, OAE and hearing assessment. Then he confirmed that my niece is suffering from profound hearing loss. Doctor suggested hearing aids could help her in listening temporarily but advised cochlear implant as permanent solution. Though my niece grabbed very few words to speak with the help of hearing aids, she could not completely mingle with us. We still neither could digest the news nor can imagine that she wearing external devices for her entire life. Also that none of us or our ancestors had such problem.We consulted few more doctors for further confirmation and I browsed over the internet but everyone says cochlear implant is the only solution. We would like to take a final opinion from the doctors around the world before she goes under the surgery and hence drafting this. Can we have a hope that the problem could be different and doctor identifies the actual problem (if any) while operating the ear for cochlear implant? I figured out from few blogs that research is going on few devices which do not require wearing external device. Can you please let me know if they are available outside? If not, how many yet more years to pass to get those devices into the world and save many children with this problem? I have attached the BERA, OAE and hearing assessment reports for your reference. Please have a look at them and advice. Thank you very much for your valuable time and your help is definitely admirable and cannot be unnoticed.

Hi. Reports (attachment removed to protect patient identity) clearly explains about the problems. I clearly understand your concern and worries. CT and MRI scan for cochlear implant. 1. Speech therapy after cochlear implant, minimum three days in a week, only by speech language pathologist.2. Regular mapping by an audiologist.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have been using birth control pill (Crisanta LS) from last 2.5 years.This month I started on 13, and I doubt I missed 1 or 2. After 13 days of starting the pill, had safe sex with a condom, but we doubt that it broke. To be safe, I took two dosages of Unwanted 72 the next day and stopped regular birth control. After eight days, I got bleeding, and it lasted for five days (same number of days as my regular period after stopping pills every month). What was that bleeding? Was that my normal bleeding or withdrawal? I am confused as this was near to expected period. Then, I did HPT, and it came to be negative. What are my chances of pregnancy? Does this bleeding confirm that I am not pregnant?Somebody suggested that I can start my regular birth control pills and I started. After 10 days, I got my full abdomen ultrasound done. It indicates that no focal lesion was seen and endometrial thickness is 4 mm. Uterus size is 88 mm - 43 mm - 42 mm. Do the thickness and report confirm that I am not pregnant? What is the normal thickness at this stage if I am pregnant? Also, the doctor suggested me to stop birth control pill until I get my regular period. Is that correct? When should I expect my next period? As I had regular birth control pill for 10 days, will it affect my next period? ### Response: Hello. What you experienced was a with ChatDoctor. So, it is normal. There is no pregnancy at all, as is confirmed in the ultrasound pelvis with ET being 4 mm. ET would have been more than 16 mm with decidual reaction if you had been pregnant. Latest bleeding becomes your LMP now (last menstrual period).

Hi doctor,I have been using birth control pill (Crisanta LS) from last 2.5 years.This month I started on 13, and I doubt I missed 1 or 2. After 13 days of starting the pill, had safe sex with a condom, but we doubt that it broke. To be safe, I took two dosages of Unwanted 72 the next day and stopped regular birth control. After eight days, I got bleeding, and it lasted for five days (same number of days as my regular period after stopping pills every month). What was that bleeding? Was that my normal bleeding or withdrawal? I am confused as this was near to expected period. Then, I did HPT, and it came to be negative. What are my chances of pregnancy? Does this bleeding confirm that I am not pregnant?Somebody suggested that I can start my regular birth control pills and I started. After 10 days, I got my full abdomen ultrasound done. It indicates that no focal lesion was seen and endometrial thickness is 4 mm. Uterus size is 88 mm - 43 mm - 42 mm. Do the thickness and report confirm that I am not pregnant? What is the normal thickness at this stage if I am pregnant? Also, the doctor suggested me to stop birth control pill until I get my regular period. Is that correct? When should I expect my next period? As I had regular birth control pill for 10 days, will it affect my next period?

Hello. What you experienced was a with ChatDoctor. So, it is normal. There is no pregnancy at all, as is confirmed in the ultrasound pelvis with ET being 4 mm. ET would have been more than 16 mm with decidual reaction if you had been pregnant. Latest bleeding becomes your LMP now (last menstrual period).

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a question relating to my deceased father. I obtained his medical records after his death. While searching through his records to gain a better understanding of what may happen to me, I found he was positive for the rheumatoid factor and had been diagnosed with ankylosing spondylitis. However, the HLA-B27 gene test was negative. I brought this to my rheumatologist and she told me she thought he had something else, but would not elaborate. Does anyone have an idea of what she may thought because she still has not told me? Since then I have switched rheumatologists for that reason. My father passed away from leukemia brought on by myelodysplasia. I would like to know because doctors still have no idea what may be plaguing me. I have seen multiple doctors for my slightly high CK levels. I have been tested for myelodysplasia, rheumatoid arthritis, multiple muscle diseases, sarcoidosis, and many more. I have not received any answers as of yet. ### Response: Hello. Well, I do not think you should be worried about anything. Firstly rheumatoid factor is not transmitted genetically unlike HLA- B27 (human leucocyte antigen). Secondly, it can be positive in a lot of people but does not cause any symptoms. Thirdly, you have been tested so far and it has all been negative. Leukemia does carry a family history but you can get your blood checked every six months. One thing you need to understand is, there are no medications as such which can you take which can prevent autoimmune diseases. If it has to happen, it would or else not. But yes, stress would definitely make things worse. So I would suggest just take it easy since you have had negative tests and enjoy your life. Keep a regular health check. Eat healthily and exercise regularly. You have not got any answers since you are healthy. I hope this helps.

Hello doctor,I have a question relating to my deceased father. I obtained his medical records after his death. While searching through his records to gain a better understanding of what may happen to me, I found he was positive for the rheumatoid factor and had been diagnosed with ankylosing spondylitis. However, the HLA-B27 gene test was negative. I brought this to my rheumatologist and she told me she thought he had something else, but would not elaborate. Does anyone have an idea of what she may thought because she still has not told me? Since then I have switched rheumatologists for that reason. My father passed away from leukemia brought on by myelodysplasia. I would like to know because doctors still have no idea what may be plaguing me. I have seen multiple doctors for my slightly high CK levels. I have been tested for myelodysplasia, rheumatoid arthritis, multiple muscle diseases, sarcoidosis, and many more. I have not received any answers as of yet.

Hello. Well, I do not think you should be worried about anything. Firstly rheumatoid factor is not transmitted genetically unlike HLA- B27 (human leucocyte antigen). Secondly, it can be positive in a lot of people but does not cause any symptoms. Thirdly, you have been tested so far and it has all been negative. Leukemia does carry a family history but you can get your blood checked every six months. One thing you need to understand is, there are no medications as such which can you take which can prevent autoimmune diseases. If it has to happen, it would or else not. But yes, stress would definitely make things worse. So I would suggest just take it easy since you have had negative tests and enjoy your life. Keep a regular health check. Eat healthily and exercise regularly. You have not got any answers since you are healthy. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 34 year old male. I had anxiety issues since childhood. I have been jumping from one idea to another for a long time but it has been three years I have an issue with frequent urination. It started in a bad time for me when I was obsessing that I have HIV. No burning, just slight urethra burning. I went to a urologist. He told me nothing was wrong, maybe an overactive bladder. I go to the toilet every two hours or three. I never knew what was wrong, but I started to obsess over it and it got worse to a place that my mind is in urination 24/7. I almost gave up until I went on a vacation and during that vacation, I forgot about it totally. The frequency was gone and even the burning urethra. Also, I had to remove my wisdom teeth and when I did, I was so occupied thinking about it that I forgot about urination and I noticed that I do not use the bathroom like I used to. But, I got back obsessing about it again and it got to a point that I urinate a lot of high volumes every hour. It comes suddenly and goes on its own. I use to get those episodes every few months when I had stress but since I got the fear it might never go away I get it almost daily now. I do not know what to do. Can anxiety cause polyuria like this clear urine when I am stressed? ### Response: Hello. I read your query and understand your concerns. First of all, I like to state that the stress and anxiety can affect almost every organ of the body and polyuria is not an exception. In other words, yes the stress can cause almost all the symptoms narrated in your query. Secondly, I would like to assure you that this is only stress and nothing more. The statement is based on the following facts

Hello doctor,I am a 34 year old male. I had anxiety issues since childhood. I have been jumping from one idea to another for a long time but it has been three years I have an issue with frequent urination. It started in a bad time for me when I was obsessing that I have HIV. No burning, just slight urethra burning. I went to a urologist. He told me nothing was wrong, maybe an overactive bladder. I go to the toilet every two hours or three. I never knew what was wrong, but I started to obsess over it and it got worse to a place that my mind is in urination 24/7. I almost gave up until I went on a vacation and during that vacation, I forgot about it totally. The frequency was gone and even the burning urethra. Also, I had to remove my wisdom teeth and when I did, I was so occupied thinking about it that I forgot about urination and I noticed that I do not use the bathroom like I used to. But, I got back obsessing about it again and it got to a point that I urinate a lot of high volumes every hour. It comes suddenly and goes on its own. I use to get those episodes every few months when I had stress but since I got the fear it might never go away I get it almost daily now. I do not know what to do. Can anxiety cause polyuria like this clear urine when I am stressed?

Hello. I read your query and understand your concerns. First of all, I like to state that the stress and anxiety can affect almost every organ of the body and polyuria is not an exception. In other words, yes the stress can cause almost all the symptoms narrated in your query. Secondly, I would like to assure you that this is only stress and nothing more. The statement is based on the following facts

### Instruction: Answer this question truthfully ###Input: Hello doctor,I found I am vitamin D deficient for the past five months. My vitamin D3 level was 7.04 (too low). So the doctor prescribed DV 60K once a week for two months and then once in a month. I am having this medicine for three months. I was fine and had no pain. Now already I took 15 pills in a period of three months. Now I am having pain all over the body. Hand pain, joint pain, and lower leg pain, even I took rest but it is still there. I did blood work. Everything looks fine and within normal range except high cholesterol. My calcium level is good 10.1 mg/dl. I feel tired and fatigued all the time. I got watery stools for the past three months, I know this is not diarrhea. My stool is clear and no WBC in it. My urine is clear. I got a gland on the floor of teeth and a small lymph node in the neck. I completed an antibiotic course for it, but they are not going to its original size.My question is why am I having pain all the over the body even when I am having a high dose of vitamin D (DV 60K)? My calcium level is good but why I feel bone pain? Why I am having watery stools? I am vitamin D deficient so do I have cancer? ### Response: Hi. See muscle pain or joint pains, watery motions are some of the side effects of vitamin D. These symptoms can also be seen in thyroid problems or diabetes. You have mentioned that your blood reports are fine, but have you been tested for thyroid and diabetes? No, definitely it is not cancer so relax. My advice to you is to take vitamin D once in two months instead of monthly once. Get exposed to bright sunlight. Repeat vitamin D test after two months. Take care.

Hello doctor,I found I am vitamin D deficient for the past five months. My vitamin D3 level was 7.04 (too low). So the doctor prescribed DV 60K once a week for two months and then once in a month. I am having this medicine for three months. I was fine and had no pain. Now already I took 15 pills in a period of three months. Now I am having pain all over the body. Hand pain, joint pain, and lower leg pain, even I took rest but it is still there. I did blood work. Everything looks fine and within normal range except high cholesterol. My calcium level is good 10.1 mg/dl. I feel tired and fatigued all the time. I got watery stools for the past three months, I know this is not diarrhea. My stool is clear and no WBC in it. My urine is clear. I got a gland on the floor of teeth and a small lymph node in the neck. I completed an antibiotic course for it, but they are not going to its original size.My question is why am I having pain all the over the body even when I am having a high dose of vitamin D (DV 60K)? My calcium level is good but why I feel bone pain? Why I am having watery stools? I am vitamin D deficient so do I have cancer?

Hi. See muscle pain or joint pains, watery motions are some of the side effects of vitamin D. These symptoms can also be seen in thyroid problems or diabetes. You have mentioned that your blood reports are fine, but have you been tested for thyroid and diabetes? No, definitely it is not cancer so relax. My advice to you is to take vitamin D once in two months instead of monthly once. Get exposed to bright sunlight. Repeat vitamin D test after two months. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have an issue with gum disease. There is a swollen gum present on my back tooth. It hurts when I touch it. It is not seen in front of my tooth. It is present inside my mouth. I have pain in the left jaw. Please help. ### Response: Hi, Welcome to Chat Doctor forum. I have gone through the image (attachment removed to protect patient identity). It looks like a periodontal abscess (infection of the gums and tissues surrounding the teeth). As you have braces (molar band specifically), it can also cause it. Another possibility is gingivitis. Again the reason is the same. The third reason can be due to dental caries (but your image does not show any evidence of caries or cavities). To confirm it, a clinical examination and intra-oral X-ray is needed. You will need a professional cleaning (scaling). For pain, you can take Aceclofenac 100 mg once in the morning and once in the night after food, take Pantoprazole 40 mg once in the night before taking food (only if you have acidity as it can aggravate the acidity). You can take Amoxicillin CV (Clavulanic acid) for five days one tablet in the morning and one at night. Finish this antibiotic course for five days even if the symptoms subside. If you are allergic to any medicine, stop taking them. Let me know so that I can alter the medication. But, I prefer taking antibiotics only after the clinical examination and X-ray. Do not worry. Consult your dentist. You will be fine. Maintain oral hygiene and since you are wearing braces, be more careful with oral health. Follow the instructions given by your dentist. Do lukewarm saltwater gargling. Is there any other swelling below the angle of your jaw or any pus or blood discharge from the swelling? Or are there any other symptoms present?

Hi doctor,I have an issue with gum disease. There is a swollen gum present on my back tooth. It hurts when I touch it. It is not seen in front of my tooth. It is present inside my mouth. I have pain in the left jaw. Please help.

Hi, Welcome to Chat Doctor forum. I have gone through the image (attachment removed to protect patient identity). It looks like a periodontal abscess (infection of the gums and tissues surrounding the teeth). As you have braces (molar band specifically), it can also cause it. Another possibility is gingivitis. Again the reason is the same. The third reason can be due to dental caries (but your image does not show any evidence of caries or cavities). To confirm it, a clinical examination and intra-oral X-ray is needed. You will need a professional cleaning (scaling). For pain, you can take Aceclofenac 100 mg once in the morning and once in the night after food, take Pantoprazole 40 mg once in the night before taking food (only if you have acidity as it can aggravate the acidity). You can take Amoxicillin CV (Clavulanic acid) for five days one tablet in the morning and one at night. Finish this antibiotic course for five days even if the symptoms subside. If you are allergic to any medicine, stop taking them. Let me know so that I can alter the medication. But, I prefer taking antibiotics only after the clinical examination and X-ray. Do not worry. Consult your dentist. You will be fine. Maintain oral hygiene and since you are wearing braces, be more careful with oral health. Follow the instructions given by your dentist. Do lukewarm saltwater gargling. Is there any other swelling below the angle of your jaw or any pus or blood discharge from the swelling? Or are there any other symptoms present?

### Instruction: Answer this question truthfully ###Input: Hello doctor,My mother aged 49 years old was diagnosed with a fibrocystic disease of breast seven years back and was subsequently operated. Since then, she has got a cyst in both breasts. Last year, she was got USG done, and the doctor found fibroadenoma along with cyst BI-RADS (2 to 3) in the left breast. The doctor asked her to review after 6 to 12 months. Recently, she discovered a lump in her left armpit which is small and can be felt only after touching. Is it anything serious? Also, please tell that does these diseases cause an increase in chances of breast cancer. She also has a fibroid in the uterus, and for that, the doctor prescribed Sevista 60 tablet twice a week, and he said that fibroadenoma would go after taking Sevista. ### Response: Hello, Welcome to Chat Doctor forum. Based on the report (attachment removed to protect patient identity), fibrocystic disease of breast and fibroid uterus, both of them are due to hormones, mainly estrogen. When using Sevista (Ormeloxifene), the fibroid in the uterus will decrease. For breast condition, BI-RAD 2 to 3 means it is was a benign (it can regress) condition (not cancer). Treatment depends on menopause. If she has not attained menopause, then she has to use Sevista. If she has attained menopause, after some time, Sevista can be stopped. With menopause, the fibroid can disappear. Fibrocyst of the breast may persist, but malignancy is very rare. At present, no need to worry. Frequent six months or yearly once monitoring with ultrasound is enough. Further treatment depends on whether she had excessive bleeding (menstruation), her calcium levels, family history of breast or other cancer. For more information consult an internal medicine physician online

Hello doctor,My mother aged 49 years old was diagnosed with a fibrocystic disease of breast seven years back and was subsequently operated. Since then, she has got a cyst in both breasts. Last year, she was got USG done, and the doctor found fibroadenoma along with cyst BI-RADS (2 to 3) in the left breast. The doctor asked her to review after 6 to 12 months. Recently, she discovered a lump in her left armpit which is small and can be felt only after touching. Is it anything serious? Also, please tell that does these diseases cause an increase in chances of breast cancer. She also has a fibroid in the uterus, and for that, the doctor prescribed Sevista 60 tablet twice a week, and he said that fibroadenoma would go after taking Sevista.

Hello, Welcome to Chat Doctor forum. Based on the report (attachment removed to protect patient identity), fibrocystic disease of breast and fibroid uterus, both of them are due to hormones, mainly estrogen. When using Sevista (Ormeloxifene), the fibroid in the uterus will decrease. For breast condition, BI-RAD 2 to 3 means it is was a benign (it can regress) condition (not cancer). Treatment depends on menopause. If she has not attained menopause, then she has to use Sevista. If she has attained menopause, after some time, Sevista can be stopped. With menopause, the fibroid can disappear. Fibrocyst of the breast may persist, but malignancy is very rare. At present, no need to worry. Frequent six months or yearly once monitoring with ultrasound is enough. Further treatment depends on whether she had excessive bleeding (menstruation), her calcium levels, family history of breast or other cancer. For more information consult an internal medicine physician online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 32-year-old male with a weight of 58 kg and my height is 5 feet 3 inches. I have been married for six years. I have two children. I had yellowish like liquid discharge from my penis a year ago with burning while urinating. I consulted a urologist and he prescribed me Norflox 400 mg for one week and after which it went away. This month, I had pain in my scrotum in the right spermatic cord region above the testicle. My urologist told me to have sonography. My sonography report concluded \"diffuse thickening at the right spermatic cord region.\" Otherwise, the report is normal.The doctor prescribed me Cefixime 100 mg and an anti-inflammatory tablet for 10 days. My pain decreased about 60%. A week ago, I had masturbation and I had pain at the same place in the scrotum. I had taken a urine culture test and I have attached the report. My question is do I have sexually transmitted diseases or urinary tract infection? Can I please know what to do? What medicines should I take for a permanent cure? ### Response: Hello, Welcome to Chat Doctor forum. I have gone through your symptoms. You seem to be suffering from an infection in your spermatic cord that is the cause of your scrotal pain. This is treated with antibiotics but the duration of treatment is usually for two weeks or more. The pain you have on masturbation is due to the inflammation of the spermatic cord through which the sperms come out into the urethra. I would suggest you keep your scrotum elevated with a tight underwear for pain relief. It would also be necessary to make sure that the infection has been cleared by testing both urine and semen for infection as your symptoms are not resolved. For more information consult a urologist online

Hello doctor,I am a 32-year-old male with a weight of 58 kg and my height is 5 feet 3 inches. I have been married for six years. I have two children. I had yellowish like liquid discharge from my penis a year ago with burning while urinating. I consulted a urologist and he prescribed me Norflox 400 mg for one week and after which it went away. This month, I had pain in my scrotum in the right spermatic cord region above the testicle. My urologist told me to have sonography. My sonography report concluded \"diffuse thickening at the right spermatic cord region.\" Otherwise, the report is normal.The doctor prescribed me Cefixime 100 mg and an anti-inflammatory tablet for 10 days. My pain decreased about 60%. A week ago, I had masturbation and I had pain at the same place in the scrotum. I had taken a urine culture test and I have attached the report. My question is do I have sexually transmitted diseases or urinary tract infection? Can I please know what to do? What medicines should I take for a permanent cure?

Hello, Welcome to Chat Doctor forum. I have gone through your symptoms. You seem to be suffering from an infection in your spermatic cord that is the cause of your scrotal pain. This is treated with antibiotics but the duration of treatment is usually for two weeks or more. The pain you have on masturbation is due to the inflammation of the spermatic cord through which the sperms come out into the urethra. I would suggest you keep your scrotum elevated with a tight underwear for pain relief. It would also be necessary to make sure that the infection has been cleared by testing both urine and semen for infection as your symptoms are not resolved. For more information consult a urologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor, I am 29 years old, male, unmarried. I was doing masturbation for 10 years. I became so addicted to it that every day I was doing it and sometimes I am doing it more than once a day. I know it is dangerous to my health. So, in between, I have controlled for some time and then I break my rule myself. This time, I have decided I will do it only once a month and decided to not watch any sexual videos. I had ASD issue in heart, it has been closed by device last month. Now I am alright but having Aspirin tablet once a day by doctor\\s prescription. Nowadays, my sperm automatically comes out (I could see in my inner). And my semen amount has become very low and decreased in density. Nowadays it looks like water. I am afraid because within six months my marriage. I know I have done a very big mistake. Please help me. And I promise I will not do this again. ### Response: Hello, Welcome to Chat Doctor forum. I would like to tell you that masturbation is a safe and healthy habit. Most of the males masturbate and this is normal. Masturbation does not cause any weakness or loss of fertility or any other harmful effects. Even if you masturbate daily even then that is normal. You have stopped masturbation and are not engaged in sexual intercourse with anyone so spontaneous leak or nocturnal emissions will occur normally. This is a normal physiological response of the body to get rid of the semen formed in the body. This is not a reason for weakness. Everything is in your head only. You can masturbate once to twice a week and in some days the problem will be solved and the concentration of semen will become better. No need to worry about that. Just remember this is normal and you have not made any mistake. For more information consult a sexologist online

Hi doctor, I am 29 years old, male, unmarried. I was doing masturbation for 10 years. I became so addicted to it that every day I was doing it and sometimes I am doing it more than once a day. I know it is dangerous to my health. So, in between, I have controlled for some time and then I break my rule myself. This time, I have decided I will do it only once a month and decided to not watch any sexual videos. I had ASD issue in heart, it has been closed by device last month. Now I am alright but having Aspirin tablet once a day by doctor\\s prescription. Nowadays, my sperm automatically comes out (I could see in my inner). And my semen amount has become very low and decreased in density. Nowadays it looks like water. I am afraid because within six months my marriage. I know I have done a very big mistake. Please help me. And I promise I will not do this again.

Hello, Welcome to Chat Doctor forum. I would like to tell you that masturbation is a safe and healthy habit. Most of the males masturbate and this is normal. Masturbation does not cause any weakness or loss of fertility or any other harmful effects. Even if you masturbate daily even then that is normal. You have stopped masturbation and are not engaged in sexual intercourse with anyone so spontaneous leak or nocturnal emissions will occur normally. This is a normal physiological response of the body to get rid of the semen formed in the body. This is not a reason for weakness. Everything is in your head only. You can masturbate once to twice a week and in some days the problem will be solved and the concentration of semen will become better. No need to worry about that. Just remember this is normal and you have not made any mistake. For more information consult a sexologist online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 45 year old male. My height is 184 cm and weight is 97 kg. I had a cervical spine x-ray and was diagnosed with cervical spondylosis. I also have mild CAD and severe sleep apnea.Due to intermittent chest pain and breathlessness on exertion, CAD was suspected. After positive TMT, I had an angiogram. The angiogram found many minor blocks and no major blocks. The diagnosis was minor coronary atherosclerotic disease and systemic hypertension. The treatment is by medical management.I have been feeling a constriction in my neck (tightness) exactly in the throat region while walking. This happens only while walking and goes away as soon as I stop. I have been advised to consult an orthopaedician to see if the neck constriction while walking can be due to spondylosis. I occasionally have lower back pain and numbness in hand (palm) and also weak hand grip.Some months back I felt significantly light-headed and had difficulty in balancing. After some tests, I was diagnosed with uncompensated vestibular lesion. After some medication, it improved a bit. Now again I find the lightheadedness and balancing issues i.e, I feel as though I may faint but actually not.My queries are ### Response: Hi. Tightness and neck pain can be due to cervical spondylosis. The lightheadedness and balancing issues can also occur due to spondylosis. Spondylosis is not so severe on x-ray (attachment removed to protect patient identity), it is of mild grade. If your hand grip is weak, it is better to get an MRI to see for any nerve compression. For treatment initially take some analgesics and anti-inflammatory with nerve stimulating ChatDoctor. MRI cervical spine Revert back with the MRI report to an orthopaedician and traumatologist online.-

Hi doctor,I am a 45 year old male. My height is 184 cm and weight is 97 kg. I had a cervical spine x-ray and was diagnosed with cervical spondylosis. I also have mild CAD and severe sleep apnea.Due to intermittent chest pain and breathlessness on exertion, CAD was suspected. After positive TMT, I had an angiogram. The angiogram found many minor blocks and no major blocks. The diagnosis was minor coronary atherosclerotic disease and systemic hypertension. The treatment is by medical management.I have been feeling a constriction in my neck (tightness) exactly in the throat region while walking. This happens only while walking and goes away as soon as I stop. I have been advised to consult an orthopaedician to see if the neck constriction while walking can be due to spondylosis. I occasionally have lower back pain and numbness in hand (palm) and also weak hand grip.Some months back I felt significantly light-headed and had difficulty in balancing. After some tests, I was diagnosed with uncompensated vestibular lesion. After some medication, it improved a bit. Now again I find the lightheadedness and balancing issues i.e, I feel as though I may faint but actually not.My queries are

Hi. Tightness and neck pain can be due to cervical spondylosis. The lightheadedness and balancing issues can also occur due to spondylosis. Spondylosis is not so severe on x-ray (attachment removed to protect patient identity), it is of mild grade. If your hand grip is weak, it is better to get an MRI to see for any nerve compression. For treatment initially take some analgesics and anti-inflammatory with nerve stimulating ChatDoctor. MRI cervical spine Revert back with the MRI report to an orthopaedician and traumatologist online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,I got cervical neuropathy 10 days back. Got MRI 6 days back. On bed rest, analgesics, got Depomedrol 80 mg shot, Pregabalin, Methycobalamine and oral Medrol. Have not got any muscular weakness or UMN signs. Mild parasthesia in thumb and index finger of right hand. Pain has decreased by around 30-40 percent since it started 10 days back and I am not taking any NSAIDS for last 2 days. I have got a few concerns.Do these changes occur at this age (43 years)? How bad are the degenerative changes? Any need of surgical intervention? How much time usually it takes for complete resolution of acute episode? Is it going to be a trouble in future as well? I mean repeat episodes or further complications. What should be the life style changes after resolution of acute episode (you know the nature of a pediatrician's job)? If at all surgery is required in future (further canal stenosis causing cord compression), how risky is the surgery and how are the results? ### Response: Hi. I have gone through your medical history and the attached reports in detail (attachment removed to protect patient identity). It does not seem to be a serious matter at present. Yes neuropathies are common at this age. Usually, it takes around 3 to 4 weeks for an acute episode to resolve depending on the symptoms. If proper care is taken (avoiding use of pillow, avoiding lifting heavy weights, neck exercises) usually symptoms do not recur. At present there is no need of surgery. You are doing pretty well and recovering fast. Use cervical soft collar and take analgesics for atleast 10 days. Get a repeat MRI after 3 months. Well, decompression surgery is risky and has side-effects and should better be avoided. Take care.

Hello doctor,I got cervical neuropathy 10 days back. Got MRI 6 days back. On bed rest, analgesics, got Depomedrol 80 mg shot, Pregabalin, Methycobalamine and oral Medrol. Have not got any muscular weakness or UMN signs. Mild parasthesia in thumb and index finger of right hand. Pain has decreased by around 30-40 percent since it started 10 days back and I am not taking any NSAIDS for last 2 days. I have got a few concerns.Do these changes occur at this age (43 years)? How bad are the degenerative changes? Any need of surgical intervention? How much time usually it takes for complete resolution of acute episode? Is it going to be a trouble in future as well? I mean repeat episodes or further complications. What should be the life style changes after resolution of acute episode (you know the nature of a pediatrician's job)? If at all surgery is required in future (further canal stenosis causing cord compression), how risky is the surgery and how are the results?

Hi. I have gone through your medical history and the attached reports in detail (attachment removed to protect patient identity). It does not seem to be a serious matter at present. Yes neuropathies are common at this age. Usually, it takes around 3 to 4 weeks for an acute episode to resolve depending on the symptoms. If proper care is taken (avoiding use of pillow, avoiding lifting heavy weights, neck exercises) usually symptoms do not recur. At present there is no need of surgery. You are doing pretty well and recovering fast. Use cervical soft collar and take analgesics for atleast 10 days. Get a repeat MRI after 3 months. Well, decompression surgery is risky and has side-effects and should better be avoided. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,Approximately one week ago, I had my wisdom teeth removed. On my lower left, I have a dry socket, which I am getting treated for via packing (at least I think that is what it is called). On the right side, healing is just fine, however, I noticed some white stuff lodged in the gum. I am not sure if it is food or scar tissue because when I tried to get it out with a toothpick, it did not come out very easily, so I left it alone. Is this food or scar tissue? It is mildly bothersome.I brush my teeth but know to be careful around the surgical sites so they do not get irritated. It seems like a lot of plaque builds up back there because of this, and I am not quite sure what to do. Also, there is a very small spot of red gums on the front side of my second molar. I put a bit of mouthwash on it with a toothpick and left it alone.I have two questions, what is the whitish stuff that feels like food trapped in my healing gum socket? And what is this small patch of irritated gum on my second molar? Any help is appreciated.I am currently on Celexa (for depression), 600 mg of Ibuprofen (for wisdom tooth pain). ### Response: Hi. As it is just one week of wisdom teeth extraction, the white stuff seems to be most probably healing tissue only. It is a normal appearance of healing tissue post-extraction. A white patch of irritated gum can be due to injury or ulceration that can be due to accidental injury with the extraction instrument or can be due to injury with a toothbrush or any hard food. You can apply Chlorhexidine gel over it. Do warm saline gargles, antiseptic mouthwash gargles and brush your teeth twice a day for keeping plaque and deposits less accumulated. I hope this helps.

Hello doctor,Approximately one week ago, I had my wisdom teeth removed. On my lower left, I have a dry socket, which I am getting treated for via packing (at least I think that is what it is called). On the right side, healing is just fine, however, I noticed some white stuff lodged in the gum. I am not sure if it is food or scar tissue because when I tried to get it out with a toothpick, it did not come out very easily, so I left it alone. Is this food or scar tissue? It is mildly bothersome.I brush my teeth but know to be careful around the surgical sites so they do not get irritated. It seems like a lot of plaque builds up back there because of this, and I am not quite sure what to do. Also, there is a very small spot of red gums on the front side of my second molar. I put a bit of mouthwash on it with a toothpick and left it alone.I have two questions, what is the whitish stuff that feels like food trapped in my healing gum socket? And what is this small patch of irritated gum on my second molar? Any help is appreciated.I am currently on Celexa (for depression), 600 mg of Ibuprofen (for wisdom tooth pain).

Hi. As it is just one week of wisdom teeth extraction, the white stuff seems to be most probably healing tissue only. It is a normal appearance of healing tissue post-extraction. A white patch of irritated gum can be due to injury or ulceration that can be due to accidental injury with the extraction instrument or can be due to injury with a toothbrush or any hard food. You can apply Chlorhexidine gel over it. Do warm saline gargles, antiseptic mouthwash gargles and brush your teeth twice a day for keeping plaque and deposits less accumulated. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor, After shaving my face six days ago, I saw a big red bump on the right side of my nose above the mustache. At first, I thought it might be a pimple. Last week, I felt something wrong on my throat and visited a doctor. Doctor said lymph node inflammation and prescribed me Penicillin. Doctor did not ask me anything about that red bump in my mustache area at that time. I have been suffering from mild fever as well after my lymph inflammation. Right now I am worried again since the red bump on my mustache becomes large, and from two or three openings drains watery liquid when I tried to squeeze it. It is really painful and irritates a lot. I am worried about HSV 1 since it is near my mouth. I am having mild fever and lymph infection. I am not in sexual contact for the last seven years. What is your suggestion? What might cause this problem? ### Response: Hello, Welcome to ChatDoctor. Two broad differential diagnoses are folliculitis or HSV 1 (herpes simplex virus) infection (most likely). I would want you to know that we all are exposed to HSV-1 and it could spread without sexual contact. It stays in the ganglion (nerve endings) and pops up when your immunity goes down. It is also known as fever blister. My feeling is that since you were about to come down with the sore throat, which seems like strep throat, you had a reactivation of the HSV-1 and got these lesions. As you feel better they will subside, you may use Acyclovir if you want but usually, we treat the underlying cause and you are receiving the antibiotics for sore throat. Please do not squeeze it. You can use any anti-inflammatory agent for pain and fever like Acetaminophen. You can also try topical steroids like Desonide. I hope this helps. Take care.

Hi doctor, After shaving my face six days ago, I saw a big red bump on the right side of my nose above the mustache. At first, I thought it might be a pimple. Last week, I felt something wrong on my throat and visited a doctor. Doctor said lymph node inflammation and prescribed me Penicillin. Doctor did not ask me anything about that red bump in my mustache area at that time. I have been suffering from mild fever as well after my lymph inflammation. Right now I am worried again since the red bump on my mustache becomes large, and from two or three openings drains watery liquid when I tried to squeeze it. It is really painful and irritates a lot. I am worried about HSV 1 since it is near my mouth. I am having mild fever and lymph infection. I am not in sexual contact for the last seven years. What is your suggestion? What might cause this problem?

Hello, Welcome to ChatDoctor. Two broad differential diagnoses are folliculitis or HSV 1 (herpes simplex virus) infection (most likely). I would want you to know that we all are exposed to HSV-1 and it could spread without sexual contact. It stays in the ganglion (nerve endings) and pops up when your immunity goes down. It is also known as fever blister. My feeling is that since you were about to come down with the sore throat, which seems like strep throat, you had a reactivation of the HSV-1 and got these lesions. As you feel better they will subside, you may use Acyclovir if you want but usually, we treat the underlying cause and you are receiving the antibiotics for sore throat. Please do not squeeze it. You can use any anti-inflammatory agent for pain and fever like Acetaminophen. You can also try topical steroids like Desonide. I hope this helps. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 28-year-old female. I have always had a small, raised, symmetrical mole on the right side of my chin. It has always been very benign and had a hair growing out of it that I consistently plucked. About two weeks ago, I noticed a small, shiny whiteish bump on the mole and called my dermatologist. Because of the holidays, I could not get an appointment anytime soon and still have another week to wait. Over the last couple of days, the mole has gotten bigger though it has stayed symmetrical and is still slightly smaller than a pencil eraser. It is slightly more raised and it stings to touch. I also realized that it has been a month or two since I had to pluck any hair. None has grown.I have had a zit on this mole a couple times but this does not really look like the previous moles. I am conscious it could be another more severe zit or maybe a cyst but I am very nervous that it is cancer. I had a couple of moles removed in childhood that were not quite suspicious but that the dermatologist removed just to be safe. My mother has had several basal cell cancers removed. I spent many summers in my youth outside and am worried that this is melanoma or nodular melanoma even though it is not dark. ### Response: Hello, Welcome to Chat Doctor forum. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). It looks to be a pretty benign nevus to me. Well defined, uniform colored, small, rough to oval, and symmetrical. I think the nevus perhaps has an ingrown hair and the resulting inflammation has caused it to swell up and sting a little. I suggest you apply a topical antibiotic either Neosporin ointment or Mupirocin 2 % ointment, twice daily for a few days. Regards. For more information consult a dermatologist online

Hi doctor,I am a 28-year-old female. I have always had a small, raised, symmetrical mole on the right side of my chin. It has always been very benign and had a hair growing out of it that I consistently plucked. About two weeks ago, I noticed a small, shiny whiteish bump on the mole and called my dermatologist. Because of the holidays, I could not get an appointment anytime soon and still have another week to wait. Over the last couple of days, the mole has gotten bigger though it has stayed symmetrical and is still slightly smaller than a pencil eraser. It is slightly more raised and it stings to touch. I also realized that it has been a month or two since I had to pluck any hair. None has grown.I have had a zit on this mole a couple times but this does not really look like the previous moles. I am conscious it could be another more severe zit or maybe a cyst but I am very nervous that it is cancer. I had a couple of moles removed in childhood that were not quite suspicious but that the dermatologist removed just to be safe. My mother has had several basal cell cancers removed. I spent many summers in my youth outside and am worried that this is melanoma or nodular melanoma even though it is not dark.

Hello, Welcome to Chat Doctor forum. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). It looks to be a pretty benign nevus to me. Well defined, uniform colored, small, rough to oval, and symmetrical. I think the nevus perhaps has an ingrown hair and the resulting inflammation has caused it to swell up and sting a little. I suggest you apply a topical antibiotic either Neosporin ointment or Mupirocin 2 % ointment, twice daily for a few days. Regards. For more information consult a dermatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have had back pain for the last 12 years. I had an l5 s1 disc herniation and later diagnosed with severe lumbar spinal stenosis at l4 l5 as well. My back pain is more critical than the leg pain. However, I have persistent calf and foot spasms and cramping (especially in bed and at night). I am able to exercise and lift heavy objects, but not able to walk more than a mile at a time. I believe the stenosis is more of an issue right now than the disc herniation, and my MRI confirms the disc is not as bad as it was years ago.I have done physical therapy, acupuncture, chiropractor, and epidural injections, but, my lower back pain remains an issue (especially when standing and walking for a long time). My doctors recommend a laminectomy, though I am scared that surgery may leave me in worse shape than I currently am. Can I have some advice? Should I go through with the laminectomy, or should I deal with the back pain since I have built a high tolerance for pain and can do most (but not all) activities? ### Response: Hello. You are quite aware of the condition and have managed to live with the issue, but as you say, you cannot walk not than a mile, but it does not seem to be your main issue. If you required to walk longer, then laminectomy will be the solution, but you need to get relief from back pain. I will hazard a guess that this is from local instability, faceted, or discal. I will say that because that is usually the reason for back pain in patients with disc issues. Lumbar canal stenosis will not often give rise to back pain. I will recommend that you discuss this with your doctor and perhaps go for laminectomy and pedicle screw stabilization as this will help relieve both issues.

Hello doctor,I have had back pain for the last 12 years. I had an l5 s1 disc herniation and later diagnosed with severe lumbar spinal stenosis at l4 l5 as well. My back pain is more critical than the leg pain. However, I have persistent calf and foot spasms and cramping (especially in bed and at night). I am able to exercise and lift heavy objects, but not able to walk more than a mile at a time. I believe the stenosis is more of an issue right now than the disc herniation, and my MRI confirms the disc is not as bad as it was years ago.I have done physical therapy, acupuncture, chiropractor, and epidural injections, but, my lower back pain remains an issue (especially when standing and walking for a long time). My doctors recommend a laminectomy, though I am scared that surgery may leave me in worse shape than I currently am. Can I have some advice? Should I go through with the laminectomy, or should I deal with the back pain since I have built a high tolerance for pain and can do most (but not all) activities?

Hello. You are quite aware of the condition and have managed to live with the issue, but as you say, you cannot walk not than a mile, but it does not seem to be your main issue. If you required to walk longer, then laminectomy will be the solution, but you need to get relief from back pain. I will hazard a guess that this is from local instability, faceted, or discal. I will say that because that is usually the reason for back pain in patients with disc issues. Lumbar canal stenosis will not often give rise to back pain. I will recommend that you discuss this with your doctor and perhaps go for laminectomy and pedicle screw stabilization as this will help relieve both issues.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 33-year-old male, Hispanic, non-smoker, exercise regularly. No significant health issues. I am 1.76 m and 68 kg. For three days, I had really bad pain on a wisdom tooth (lower right) that has erupted years ago but never really gave any problems. But this was bad, really bad. I was waking up with fever and heartbeat rate of 90 to 95 whereas I am usually 55 to 60.I went to the dentist, he cleaned the area, took an X-ray and gave me Amoxicillin and Clavulanate Potassium tablets (875 mg and 125 mg, respectively) twice a day for five days plus Paracetamol or Ibuprofen for the pain. I think he referred to this as pericoronitis. This is my fourth day of treatment and the area is a lot less swollen and tooth pain has pretty much gone. However, the part that has me worried is that I am still waking up with fever and a very fast heartbeat plus throbbing headaches. Is this normal? ### Response: Hi. I have gone through your question. I can understand your concern. Yes, as per your signs and symptoms it looks like pericoronitis. I think the treatment he or she has started is not the ideal one. After five days of treatment, I think it should have been gone. If you can upload a picture of your X-ray and teeth involved in the mouth, I can provide you with a better treatment plan. Because periodontitis is infected by anaerobic bacteria and will not respond to Amoxiclav (Amoxicillin and Clavulanic acid) that effectively. You also need to use mouthwash H2O2 (Hy ChatDoctor. For that, I need to know if you have any

Hello doctor,I am a 33-year-old male, Hispanic, non-smoker, exercise regularly. No significant health issues. I am 1.76 m and 68 kg. For three days, I had really bad pain on a wisdom tooth (lower right) that has erupted years ago but never really gave any problems. But this was bad, really bad. I was waking up with fever and heartbeat rate of 90 to 95 whereas I am usually 55 to 60.I went to the dentist, he cleaned the area, took an X-ray and gave me Amoxicillin and Clavulanate Potassium tablets (875 mg and 125 mg, respectively) twice a day for five days plus Paracetamol or Ibuprofen for the pain. I think he referred to this as pericoronitis. This is my fourth day of treatment and the area is a lot less swollen and tooth pain has pretty much gone. However, the part that has me worried is that I am still waking up with fever and a very fast heartbeat plus throbbing headaches. Is this normal?

Hi. I have gone through your question. I can understand your concern. Yes, as per your signs and symptoms it looks like pericoronitis. I think the treatment he or she has started is not the ideal one. After five days of treatment, I think it should have been gone. If you can upload a picture of your X-ray and teeth involved in the mouth, I can provide you with a better treatment plan. Because periodontitis is infected by anaerobic bacteria and will not respond to Amoxiclav (Amoxicillin and Clavulanic acid) that effectively. You also need to use mouthwash H2O2 (Hy ChatDoctor. For that, I need to know if you have any

### Instruction: Answer this question truthfully ###Input: Hello doctor, I have flown very often in the last few years. I forgot to wear earplugs and slept on a few flights recently. On the last two trips, I had multiple flights connecting. I noticed my ears did not stop popping after a few days. Since my last flight, my right ear has not cleared up. It used to be at night my ear would pop and get better during the day. Now my right ear has lost hearing, I would estimate about 50% and fluctuates between 50% to 75% during the day. When it is totally silent, I think I hear this tone in my right ear. I do not have headaches and can sleep fine. I have gingivitis and bleeding gums, and no other health issues. I was wondering if my ear is infected or not. I know whatever I have is connected to my frequent flying every two months for the last five years. I always wore earplugs and never had this before but forgot the last trip. Should I take antibiotic drops? I definitely have mucus in my sinus and I am not sneezing or coughing in any major way just and not sure if I am infected or not. Would antibiotic drops help me rule out infection? ### Response: Hello. Simply it is a eustachian tube dysfunction. Ear infection which needs an antibiotic must be accompanied by ear pain. Ear ChatDoctor. I think that you need an anti-edematous and anti-inflammatory like Alphintern tablets or Reparil tablets three times daily for a week plus corticosteroid tablets in the dose of 1 mg for each 1 kg of your body weight daily. For example, if you are 70 kg you need 70 mg of corticosteroid per day for 10 days.The most popular corticosteroid is called Prednisone tablets. Chewing gum will be useful for you.

Hello doctor, I have flown very often in the last few years. I forgot to wear earplugs and slept on a few flights recently. On the last two trips, I had multiple flights connecting. I noticed my ears did not stop popping after a few days. Since my last flight, my right ear has not cleared up. It used to be at night my ear would pop and get better during the day. Now my right ear has lost hearing, I would estimate about 50% and fluctuates between 50% to 75% during the day. When it is totally silent, I think I hear this tone in my right ear. I do not have headaches and can sleep fine. I have gingivitis and bleeding gums, and no other health issues. I was wondering if my ear is infected or not. I know whatever I have is connected to my frequent flying every two months for the last five years. I always wore earplugs and never had this before but forgot the last trip. Should I take antibiotic drops? I definitely have mucus in my sinus and I am not sneezing or coughing in any major way just and not sure if I am infected or not. Would antibiotic drops help me rule out infection?

Hello. Simply it is a eustachian tube dysfunction. Ear infection which needs an antibiotic must be accompanied by ear pain. Ear ChatDoctor. I think that you need an anti-edematous and anti-inflammatory like Alphintern tablets or Reparil tablets three times daily for a week plus corticosteroid tablets in the dose of 1 mg for each 1 kg of your body weight daily. For example, if you are 70 kg you need 70 mg of corticosteroid per day for 10 days.The most popular corticosteroid is called Prednisone tablets. Chewing gum will be useful for you.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I wear glasses with a minimal prescription of - .25 with slight astigmatism and + 2 reading. Recently, I got a new pair of progressive lenses. I am finding that my right eye cannot focus properly and it is always blurry. First, I thought that the prescription was wrong. But after making many attempts with my new lens, I was able to notice that my old progressive lens had an incorrect pupillary distance by 2 mm on my right eye. I wore that glasses for three years, and I was unaware.I am worried whether wearing glasses with PD by 2 mm so long have caused any adjustments in my right eye? Why is my eye blurry? I was wondering why my new lenses were not focussing correctly as they were present with a correct PD. Is it possible to retrain my eye to focus accurately? Can I start wearing a single vision lens which can help me for a while? ### Response: Hi. By going through your query, I can understand that you are suffering from intolerance to progressive lenses. It can be due to an increase in near vision with age. It is not due to incorrect PD (pupillary distance). If you work on a computer, intermediate vision glasses can provide you more comfort rather than progressive. Intermediate vision glasses gives the support of vision when they are used for indoor work and reading. For distant vision, you may choose to remove your glasses. In case, if both of your eyes are not working together (binocular vision defects), a change in IPD (interpupillary distance) may develop. In that case, few tests for binocular vision can help. Also, some types of cataract or glaucoma in early stage produces glass intolerance, and it leads to a frequent change of glasses in an older age group. A slit lamp examination and dilated fundus examination are advised to rule out the causes of glass intolerance. Take care.

Hi doctor,I wear glasses with a minimal prescription of - .25 with slight astigmatism and + 2 reading. Recently, I got a new pair of progressive lenses. I am finding that my right eye cannot focus properly and it is always blurry. First, I thought that the prescription was wrong. But after making many attempts with my new lens, I was able to notice that my old progressive lens had an incorrect pupillary distance by 2 mm on my right eye. I wore that glasses for three years, and I was unaware.I am worried whether wearing glasses with PD by 2 mm so long have caused any adjustments in my right eye? Why is my eye blurry? I was wondering why my new lenses were not focussing correctly as they were present with a correct PD. Is it possible to retrain my eye to focus accurately? Can I start wearing a single vision lens which can help me for a while?

Hi. By going through your query, I can understand that you are suffering from intolerance to progressive lenses. It can be due to an increase in near vision with age. It is not due to incorrect PD (pupillary distance). If you work on a computer, intermediate vision glasses can provide you more comfort rather than progressive. Intermediate vision glasses gives the support of vision when they are used for indoor work and reading. For distant vision, you may choose to remove your glasses. In case, if both of your eyes are not working together (binocular vision defects), a change in IPD (interpupillary distance) may develop. In that case, few tests for binocular vision can help. Also, some types of cataract or glaucoma in early stage produces glass intolerance, and it leads to a frequent change of glasses in an older age group. A slit lamp examination and dilated fundus examination are advised to rule out the causes of glass intolerance. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 21-year-old female, 129.14 lbs. Over a year ago, I was diagnosed with anorexia (eating disorder) by my initial counselor and I have been under-recovery for the same for over a year. During the course of my recovery, I had to change my therapist. The new therapist, recently, during one of our session told me that I do not have anorexia but just an eating disorder. However, all my symptoms are that of anorexia, restricting food intake, starving and inducing vomiting. I have lost my weight from 73 kg to 58 kg. I have been confused, immensely, since then regarding what illness do I really have?My query is can a person show symptoms of anorexia but not be anorexic? Can they just have an eating disorder? What is that even supposed to mean? I have also been diagnosed with PTSD, depression (mild), anxiety. I am currently on Flunile 50 mg, T-spenzo 1 mg. ### Response: Hello, Welcome to Chat Doctor forum. Anorexia is a type of eating disorder where the weight is 85 % or below the normal range. In addition to eating disorder symptoms like restricted food intake, self-induced vomiting, menstrual disturbances, etc., the body weight has to be 15% below normal to diagnose anorexia nervosa. Based on your reported weight and height, your body weight and BMI (body mass index) fall within the normal range. Perhaps that is why your counselor may have said it is an eating disorder and not anorexia nervosa. Irrespective of this technicality, it is important to get appropriate treatment to ad ChatDoctor. If you are still having self-induced vomiting discuss with your counselor /doctor about having a blood test and physical examination to ascertain your physical health status. I hope this helps.

Hi doctor,I am a 21-year-old female, 129.14 lbs. Over a year ago, I was diagnosed with anorexia (eating disorder) by my initial counselor and I have been under-recovery for the same for over a year. During the course of my recovery, I had to change my therapist. The new therapist, recently, during one of our session told me that I do not have anorexia but just an eating disorder. However, all my symptoms are that of anorexia, restricting food intake, starving and inducing vomiting. I have lost my weight from 73 kg to 58 kg. I have been confused, immensely, since then regarding what illness do I really have?My query is can a person show symptoms of anorexia but not be anorexic? Can they just have an eating disorder? What is that even supposed to mean? I have also been diagnosed with PTSD, depression (mild), anxiety. I am currently on Flunile 50 mg, T-spenzo 1 mg.

Hello, Welcome to Chat Doctor forum. Anorexia is a type of eating disorder where the weight is 85 % or below the normal range. In addition to eating disorder symptoms like restricted food intake, self-induced vomiting, menstrual disturbances, etc., the body weight has to be 15% below normal to diagnose anorexia nervosa. Based on your reported weight and height, your body weight and BMI (body mass index) fall within the normal range. Perhaps that is why your counselor may have said it is an eating disorder and not anorexia nervosa. Irrespective of this technicality, it is important to get appropriate treatment to ad ChatDoctor. If you are still having self-induced vomiting discuss with your counselor /doctor about having a blood test and physical examination to ascertain your physical health status. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I had wart-like growth on my foreskin. I consulted a doctor, who asked me to get a circumcision done. So I got the circumcision done. The biopsy result showed that they were viral warts (condyloma acuminatum), and the doctor gave me tablet Valtoval for a month. After going through the internet, I found out that viral warts are caused by HPV, so I stopped taking Valtoval, as it is used for herpes and not HPV. But now, I got a small wart-like lesion on my penis. I feel bad and frustrated, and I do not know what I need to do. Please help me. What do I need to do? I am going to get married next month. I am waiting for your response. Thanks. ### Response: Hello. I read your query and understand your concerns. You are right in saying that genital warts are caused by HPV (human papillomavirus), and even the biopsy of the excised skin confirmed the same. Although there are some reports that Valtoval (Valacyclovir) has some efficacy in HPV, it is largely inconclusive. Having said this, I think you need to opt for Imiquimod or Podophyllin as next mode of treatment. The former enhances your immune system, which helps in fighting from genital warts. In my own practice, I prefer this mode of treatment and find good results. I request you to discuss the use of Imiquimod with your doctor. At the same time, avoid unprotected sex with your potential partner now or in recent future, as it may transmit the disease to your partner. I must assure you that with Imiquimod, there is a good chance of remission of genital warts. I hope this helps you. Feel free to write back if you have more questions. Thanks and regards. For more information consult a sexologist online

Hi doctor,I had wart-like growth on my foreskin. I consulted a doctor, who asked me to get a circumcision done. So I got the circumcision done. The biopsy result showed that they were viral warts (condyloma acuminatum), and the doctor gave me tablet Valtoval for a month. After going through the internet, I found out that viral warts are caused by HPV, so I stopped taking Valtoval, as it is used for herpes and not HPV. But now, I got a small wart-like lesion on my penis. I feel bad and frustrated, and I do not know what I need to do. Please help me. What do I need to do? I am going to get married next month. I am waiting for your response. Thanks.

Hello. I read your query and understand your concerns. You are right in saying that genital warts are caused by HPV (human papillomavirus), and even the biopsy of the excised skin confirmed the same. Although there are some reports that Valtoval (Valacyclovir) has some efficacy in HPV, it is largely inconclusive. Having said this, I think you need to opt for Imiquimod or Podophyllin as next mode of treatment. The former enhances your immune system, which helps in fighting from genital warts. In my own practice, I prefer this mode of treatment and find good results. I request you to discuss the use of Imiquimod with your doctor. At the same time, avoid unprotected sex with your potential partner now or in recent future, as it may transmit the disease to your partner. I must assure you that with Imiquimod, there is a good chance of remission of genital warts. I hope this helps you. Feel free to write back if you have more questions. Thanks and regards. For more information consult a sexologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,My daughter is one month old. Her birth weight was 3.6 kg. After 15 days, she weighed 3.8 and then later she weighed 4.2 kg. Now, her current weight is 4.35 kg. She seems to pass drop by drop motion of about 15 to 20 times a day and she has some sharp pain followed by some intermittent pain while passing motions. We did a motion test today morning and I have attached the lab report. Is it something that has to be worried or is it normal? What can be done to cure her pain while passing the motion?We started giving syrup Ascazin 1 mL in the morning and in the night as per the recommendation of the doctor. Also, we reduced feed from 10 to 12 times a day to 7 to 8 times a day. Will this cure her pain or do we need to give any additional medications to her? Please advice. We are giving Ascazin syrup for the past one week. We are only breastfeeding from the beginning. There is no external milk. Please opine. ### Response: Hello. I have gone through the lab reports (attachment removed to protect patient identity). You need not worry. This is common in chil ChatDoctor. You need not reduce the amount of feeding nor you have to start any other medication. The report is also fine You just need to keep breastfeeding the baby. Avoid any external or formula milk. You can continue the same medication what you are giving. If the problem persists, just stop breast milk for a day and start a lactose-free supplement such as Zerolac or Nusobee. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Breastfeeding can be started once motions are normal. For more information consult a paediatrician online

Hello doctor,My daughter is one month old. Her birth weight was 3.6 kg. After 15 days, she weighed 3.8 and then later she weighed 4.2 kg. Now, her current weight is 4.35 kg. She seems to pass drop by drop motion of about 15 to 20 times a day and she has some sharp pain followed by some intermittent pain while passing motions. We did a motion test today morning and I have attached the lab report. Is it something that has to be worried or is it normal? What can be done to cure her pain while passing the motion?We started giving syrup Ascazin 1 mL in the morning and in the night as per the recommendation of the doctor. Also, we reduced feed from 10 to 12 times a day to 7 to 8 times a day. Will this cure her pain or do we need to give any additional medications to her? Please advice. We are giving Ascazin syrup for the past one week. We are only breastfeeding from the beginning. There is no external milk. Please opine.

Hello. I have gone through the lab reports (attachment removed to protect patient identity). You need not worry. This is common in chil ChatDoctor. You need not reduce the amount of feeding nor you have to start any other medication. The report is also fine You just need to keep breastfeeding the baby. Avoid any external or formula milk. You can continue the same medication what you are giving. If the problem persists, just stop breast milk for a day and start a lactose-free supplement such as Zerolac or Nusobee. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Breastfeeding can be started once motions are normal. For more information consult a paediatrician online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 32 year old female, and I weigh 57 kg. I am work in a bank, which keeps me out of home from 9 AM to 7 PM. I was diagnosed with PCOS, and I have a 1.5 mm intramural fibroid on the posterior wall of the uterus since two years. I am taking Glyciphage SR 500 since then, and it has kept my period as well as ovulation regular. My menstrual cycle is 28 to 31 days now. My husband is 33 years old, and he weighs 72 kg, and his job keeps him away from home for 12 hours. He is suffering from erectile dysfunction from last year. His semen analysis revealed slow sperm, and he has been on Edon and Maxoza since three months.We went for IUI last month, and my husband has 10 million motile sperm count. The fertility specialist at the clinic told it is too low for IUI and suggested IVF with ICSI since IUI is only time and money loss. Is it necessary to do IVF with ICSI in our case? Since I have PCOS, can I suffer from OHSS during IVF? I am a working woman, do I need to take long breaks from the job while going IVF treatment? Can I go for single embryo transfer? Is bed rest needed after embryo transfer or during the entire IVF procedure? ### Response: Hi. It is not necessary to go for IVF (in vitro fertilization). IVF has more success rate than IUI (intrauterine insemination) during infertility. I suggest trying IUI few more times, but chances of success are less. So, you have to take the decision. Nowadays with advanced methods and monitoring, chances of OHSS (ovarian hyperstimulation syn ChatDoctor. Take care.

Hi doctor,I am a 32 year old female, and I weigh 57 kg. I am work in a bank, which keeps me out of home from 9 AM to 7 PM. I was diagnosed with PCOS, and I have a 1.5 mm intramural fibroid on the posterior wall of the uterus since two years. I am taking Glyciphage SR 500 since then, and it has kept my period as well as ovulation regular. My menstrual cycle is 28 to 31 days now. My husband is 33 years old, and he weighs 72 kg, and his job keeps him away from home for 12 hours. He is suffering from erectile dysfunction from last year. His semen analysis revealed slow sperm, and he has been on Edon and Maxoza since three months.We went for IUI last month, and my husband has 10 million motile sperm count. The fertility specialist at the clinic told it is too low for IUI and suggested IVF with ICSI since IUI is only time and money loss. Is it necessary to do IVF with ICSI in our case? Since I have PCOS, can I suffer from OHSS during IVF? I am a working woman, do I need to take long breaks from the job while going IVF treatment? Can I go for single embryo transfer? Is bed rest needed after embryo transfer or during the entire IVF procedure?

Hi. It is not necessary to go for IVF (in vitro fertilization). IVF has more success rate than IUI (intrauterine insemination) during infertility. I suggest trying IUI few more times, but chances of success are less. So, you have to take the decision. Nowadays with advanced methods and monitoring, chances of OHSS (ovarian hyperstimulation syn ChatDoctor. Take care.

### Instruction: Answer this question truthfully ###Input: Hello,I've been having symptoms for a long time now, about 6 years. Something constant that I feel is a \\x80\\x9cpressure\\x80\\x9d or imbalance on the upper left side of my body. I get brainfog frequently. Other symptoms come and go. Sometimes my upper rib feels tight when inhaling, sometimes I get dizzy and heart races/palpates. I've had some exams done recently and found out I have an inflamed supraspinatus tendon. Since that, Ive tried doing exercises and stretches but they haven\\t helped that much. I've even tried palpating the tendon but it doesnt even feel tender. Recently I've tried doing some neck stretches and the next day my upper left shoulder went almost completely numb. One thing I feel I have to mention is before these symptoms starting appearing, I had an incident at the gym where I pushed too hard doing an exercise and something happened that my vision went dark and I had constant pain on shoulder/neck area for a few weeks.I apologize for the wall of text but I'm at a standstill. Whatever this is, it's keeping me from being able to function in everyday life. I'm currently a shell of my former self. ### Response: Hello, After going through the detail you provided, its clearly a symptom of jerk you felt at the gym while excercise. i advice you to stop doing any excercise related to shoulder or neck. take accelofenac paracetamol tablet twice a day fir 3 days and consult in person with any physiotherapist near you. you need personal attention and proper treatment. a physiotherapist will guide you during this time on how to perform excercise properly during pain and if needed he will apply IFT and ULTRASOUND to reduce pain and for relaxing muscles. stay safe. thank you.

Hello,I've been having symptoms for a long time now, about 6 years. Something constant that I feel is a \\x80\\x9cpressure\\x80\\x9d or imbalance on the upper left side of my body. I get brainfog frequently. Other symptoms come and go. Sometimes my upper rib feels tight when inhaling, sometimes I get dizzy and heart races/palpates. I've had some exams done recently and found out I have an inflamed supraspinatus tendon. Since that, Ive tried doing exercises and stretches but they haven\\t helped that much. I've even tried palpating the tendon but it doesnt even feel tender. Recently I've tried doing some neck stretches and the next day my upper left shoulder went almost completely numb. One thing I feel I have to mention is before these symptoms starting appearing, I had an incident at the gym where I pushed too hard doing an exercise and something happened that my vision went dark and I had constant pain on shoulder/neck area for a few weeks.I apologize for the wall of text but I'm at a standstill. Whatever this is, it's keeping me from being able to function in everyday life. I'm currently a shell of my former self.

Hello, After going through the detail you provided, its clearly a symptom of jerk you felt at the gym while excercise. i advice you to stop doing any excercise related to shoulder or neck. take accelofenac paracetamol tablet twice a day fir 3 days and consult in person with any physiotherapist near you. you need personal attention and proper treatment. a physiotherapist will guide you during this time on how to perform excercise properly during pain and if needed he will apply IFT and ULTRASOUND to reduce pain and for relaxing muscles. stay safe. thank you.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am suffering from inflammatory myopathy confirmed by EMG, NCS and biopsy with CPK 2300 range and SGOT, SGPT also were little higher. I have already taken five days 1 g Prednisone steroid injections and later was on oral steroid tablets Omnicortil for 1 to 1.5 months reducing doses gradually starting with 80 mg daily to bi-weekly reducing doses. Along with this, doctor had given Cellcept, 750 mg daily and Vitamin B12 and Vitamin D. Right after steroid that month only I feel little better improvement. After steroids effect or a month later like dilution, it goes away and I am back to my previous difficulty in walking and leg hitting floor condition since 2 to 3 years same.I was thinking inflammatory myopathy was cureable or atleast walking condition would be better and treatment would stay on. I do not see any options and want help in best advice for recovery. Completely confused now. I want other option and for mobility not hitting ground while walking or to have steady balance. Physiotherapy made me very fatigue that I had to stop. Any tablets for balance control or leg devices to help lift little upwards or muscle tightnening substances like enzyme powder Coq10 if any please suggest, any. ### Response: Hi, Welcome to Chat Doctor forum. To be very honest myopathy inflammatory in origin needs lifetime treatment. We just have steriods and other immunosuppressive therapy to control the disease progression. Definitely, Prednisolone works magically but since it has lots of side effects, we taper and reduce it to bare minimum. I would recommend to discuss with your doctor to put you on lowest possible dose of Methylprednisolone based on your symptoms and total CPK levels. Co enzyme Q10 has controversial role. If you can afford you may go ahead with it.

Hello doctor,I am suffering from inflammatory myopathy confirmed by EMG, NCS and biopsy with CPK 2300 range and SGOT, SGPT also were little higher. I have already taken five days 1 g Prednisone steroid injections and later was on oral steroid tablets Omnicortil for 1 to 1.5 months reducing doses gradually starting with 80 mg daily to bi-weekly reducing doses. Along with this, doctor had given Cellcept, 750 mg daily and Vitamin B12 and Vitamin D. Right after steroid that month only I feel little better improvement. After steroids effect or a month later like dilution, it goes away and I am back to my previous difficulty in walking and leg hitting floor condition since 2 to 3 years same.I was thinking inflammatory myopathy was cureable or atleast walking condition would be better and treatment would stay on. I do not see any options and want help in best advice for recovery. Completely confused now. I want other option and for mobility not hitting ground while walking or to have steady balance. Physiotherapy made me very fatigue that I had to stop. Any tablets for balance control or leg devices to help lift little upwards or muscle tightnening substances like enzyme powder Coq10 if any please suggest, any.

Hi, Welcome to Chat Doctor forum. To be very honest myopathy inflammatory in origin needs lifetime treatment. We just have steriods and other immunosuppressive therapy to control the disease progression. Definitely, Prednisolone works magically but since it has lots of side effects, we taper and reduce it to bare minimum. I would recommend to discuss with your doctor to put you on lowest possible dose of Methylprednisolone based on your symptoms and total CPK levels. Co enzyme Q10 has controversial role. If you can afford you may go ahead with it.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have MRSA and severe spinal stenosis. I was in hospital 8 months ago. Since leaving the hospital I have had rashes, burning, itchy and twitching in my face and neck areas. About 5 months after hospital visit I had severe burning feeling in muscles and major muscle atrophy and increasing muscle spasms. A MRI was done on my spine and 3 areas with severe spinal stenosis was found. I first thought it was autoimmune but bloodwork was negative. I then insisted to see an infectious disease doctor who just found MRSA in my nose.Is it possible the MRSA is in my spine causing this stenosis. I am 46 years old and very active and I have never had muscle or back pain and now all of a sudden neurologist is saying I have radiculopathy and MRI showing severe spinal stenosis in multiple places with significant symptoms. So after being active for 46 years I now have these back problems during an 8-month period where I have no activity? ### Response: Hello, Welcome to Chat Doctor forum. MRSA occurs asymptomatically as a carrier in many people. MRSA is not related to your spinal stenosis problem. Kindly tell the exact MRI report as if there are no hyper intensities in spinal cord we will not suspect autoimmune etiology also. Spinal stenosis is commonly caused by intervertebral disc prolapse which causes narrowing of spinal canal and produce symptoms like radiculopathy pain, neurogenic claudication and if severe can cause muscle atrophy. The occurrence of symptoms are not related to your hospitalization and minor symptoms might have been ignored previously. If spinal stenosis is severe, it requires surgery. Kindly consult neurosurgeon or spine surgeon for further management. Iif you are on in my no suppression therapy like steroids or if you are going for surgery then medication for MRSA carrier state may be required, discuss with your doctor regarding this and take antibiotics appropriately.

Hello doctor,I have MRSA and severe spinal stenosis. I was in hospital 8 months ago. Since leaving the hospital I have had rashes, burning, itchy and twitching in my face and neck areas. About 5 months after hospital visit I had severe burning feeling in muscles and major muscle atrophy and increasing muscle spasms. A MRI was done on my spine and 3 areas with severe spinal stenosis was found. I first thought it was autoimmune but bloodwork was negative. I then insisted to see an infectious disease doctor who just found MRSA in my nose.Is it possible the MRSA is in my spine causing this stenosis. I am 46 years old and very active and I have never had muscle or back pain and now all of a sudden neurologist is saying I have radiculopathy and MRI showing severe spinal stenosis in multiple places with significant symptoms. So after being active for 46 years I now have these back problems during an 8-month period where I have no activity?

Hello, Welcome to Chat Doctor forum. MRSA occurs asymptomatically as a carrier in many people. MRSA is not related to your spinal stenosis problem. Kindly tell the exact MRI report as if there are no hyper intensities in spinal cord we will not suspect autoimmune etiology also. Spinal stenosis is commonly caused by intervertebral disc prolapse which causes narrowing of spinal canal and produce symptoms like radiculopathy pain, neurogenic claudication and if severe can cause muscle atrophy. The occurrence of symptoms are not related to your hospitalization and minor symptoms might have been ignored previously. If spinal stenosis is severe, it requires surgery. Kindly consult neurosurgeon or spine surgeon for further management. Iif you are on in my no suppression therapy like steroids or if you are going for surgery then medication for MRSA carrier state may be required, discuss with your doctor regarding this and take antibiotics appropriately.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 26. I had dry cough from the 10th of last month and it did not go away completely. I was a smoker until the 2nd of last month and then gave up. I smoked for five years. Within the last few weeks, I must have smoked 10 cigarettes. My issue is whenever the temperature is cold, I cough and when it is sunny, I would not. I do not cough too much. It is once or twice in the morning and whole day nothing. Clear mucus and no medicine is required. I just drink hot water and everything becomes fine. Can you tell me what the problem is? I have no chest pain or throat discomfort. No weight loss. Whenever my stomach is gassy, I cough. Please help. I have smoked for five years. What is my cancer chance? ### Response: Hello. As you said that you have been smoking for five years and now have cough with clear mucus expectoration, it is most likely due to bronchitis. It is very common to have cough if you smoke more than five cigarettes per day. Also, because of cold weather, it gets aggravated and takes longer to heal. So, better is to stop smoking as you did rightly and take a good expectorant like syrup TusQ-X 10 ml (combination of Ambroxol, Guaifenesin, and Terbutaline) three times a day. Continue with salt water gargles and steam. It will help to loosen and liquefy the cough. If there is no relief even after seven days, better get your chest X-ray done from your family doctor and get treated accordingly. Usually smoking for five years at this age does not cause lung cancer but you should stop smoking. Smokers\\ cough because of bronchitis is very common. For more information consult an allergy specialist online Take care.

Hello doctor,I am 26. I had dry cough from the 10th of last month and it did not go away completely. I was a smoker until the 2nd of last month and then gave up. I smoked for five years. Within the last few weeks, I must have smoked 10 cigarettes. My issue is whenever the temperature is cold, I cough and when it is sunny, I would not. I do not cough too much. It is once or twice in the morning and whole day nothing. Clear mucus and no medicine is required. I just drink hot water and everything becomes fine. Can you tell me what the problem is? I have no chest pain or throat discomfort. No weight loss. Whenever my stomach is gassy, I cough. Please help. I have smoked for five years. What is my cancer chance?

Hello. As you said that you have been smoking for five years and now have cough with clear mucus expectoration, it is most likely due to bronchitis. It is very common to have cough if you smoke more than five cigarettes per day. Also, because of cold weather, it gets aggravated and takes longer to heal. So, better is to stop smoking as you did rightly and take a good expectorant like syrup TusQ-X 10 ml (combination of Ambroxol, Guaifenesin, and Terbutaline) three times a day. Continue with salt water gargles and steam. It will help to loosen and liquefy the cough. If there is no relief even after seven days, better get your chest X-ray done from your family doctor and get treated accordingly. Usually smoking for five years at this age does not cause lung cancer but you should stop smoking. Smokers\\ cough because of bronchitis is very common. For more information consult an allergy specialist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor, I am 24 years old. I had my kidney stone removed a year ago for causing mild hydronephrosis at my right kidney. During the treatment, I was exposed to full of radiation, abdominal CT scan, lithotripsy, fluoroscopy, and another fluoroscopy during stent insertion. I am not sure how the doctor manages the radiation. I did my treatment abroad and it is not really a well-developed country. He might not even care bout it. I studied some about radiation when I was in dental school so I am very scared of the side effects.So if I am to have another case of hydronephrosis, should I just remove the kidney rather than undergoing such radiation which may cause me high risk of future cancer? Because as you can see, I am still so young and I just started my career. What do you suggest? Do the pros outweigh the cons or vice versa? Is there another less risky treatment in terms of radiation? How about invasive treatment? Is the risk higher aside from the slow healing? And I am serious about the removal if indeed it has lower radiation risk, even though I know kidney is very important. Please suggest. ### Response: Hello. There are enough studies and literature which prove that though there is radiation exposure during CT (computed tomography) scan in the removal of kidney stone it is in low dose and chances of cancer do not increase. So do not worry about that. I do not think removing kidney to escape from radiation exposure is a good option. You should not think of that. If there is again stone formation then there is a treatment called ultrasound-guided lithotripsy (ESWL) which can break your stone from outside without any radiation exposure. So you can do ESWL (extracorporeal shock wave lithotripsy) if required later but no need to remove the kidney. Take care.

Hello doctor, I am 24 years old. I had my kidney stone removed a year ago for causing mild hydronephrosis at my right kidney. During the treatment, I was exposed to full of radiation, abdominal CT scan, lithotripsy, fluoroscopy, and another fluoroscopy during stent insertion. I am not sure how the doctor manages the radiation. I did my treatment abroad and it is not really a well-developed country. He might not even care bout it. I studied some about radiation when I was in dental school so I am very scared of the side effects.So if I am to have another case of hydronephrosis, should I just remove the kidney rather than undergoing such radiation which may cause me high risk of future cancer? Because as you can see, I am still so young and I just started my career. What do you suggest? Do the pros outweigh the cons or vice versa? Is there another less risky treatment in terms of radiation? How about invasive treatment? Is the risk higher aside from the slow healing? And I am serious about the removal if indeed it has lower radiation risk, even though I know kidney is very important. Please suggest.

Hello. There are enough studies and literature which prove that though there is radiation exposure during CT (computed tomography) scan in the removal of kidney stone it is in low dose and chances of cancer do not increase. So do not worry about that. I do not think removing kidney to escape from radiation exposure is a good option. You should not think of that. If there is again stone formation then there is a treatment called ultrasound-guided lithotripsy (ESWL) which can break your stone from outside without any radiation exposure. So you can do ESWL (extracorporeal shock wave lithotripsy) if required later but no need to remove the kidney. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My daughter is 6.5 years old. When she was 1, she had a seizure for a couple of times in two years, for which she took medicine and now she is off from medicine for the last three years. Now recently she was diagnosed with adenoids for which we are going homeopathy. My concern is she is right now 112 cm tall and 21 kg weight. I find her too short compared to her friends, my wife is only 5 feet tall and I myself is 5\\7\". Is this the reason she is not growing, since last 4 to 5 months her height is the same, or due to adenoids or medication which she took in the past?What should we do regarding her height? I want her to be at least 5\\4\", up to what age girls height can grow? She takes Pediasure, two eggs in terms of protein every day and four days a week swimming, is there anything special I can do? Kindly advise. ### Response: Hi, Welcome to Chat Doctor forum. Here are certain points of advise I would like to give you. Weight is absolutely normal for her age as per growth charts. As per the height mentioned (112 cm), the child is shorter as per other chil ChatDoctor. If the child\\s height had to be affected by adenoids the weight also would be effected but it is not. Girls grow in height up to the age of 14 to 16 years. The final height of the child should be close to 5 feet, 2 inches considering the parent\\s height. The current age of the child is 6 years so you have a time period of 8 to 9 years for height growth. There is no exercise or supplement specifically for height. However, it has been noted that chil

Hello doctor,My daughter is 6.5 years old. When she was 1, she had a seizure for a couple of times in two years, for which she took medicine and now she is off from medicine for the last three years. Now recently she was diagnosed with adenoids for which we are going homeopathy. My concern is she is right now 112 cm tall and 21 kg weight. I find her too short compared to her friends, my wife is only 5 feet tall and I myself is 5\\7\". Is this the reason she is not growing, since last 4 to 5 months her height is the same, or due to adenoids or medication which she took in the past?What should we do regarding her height? I want her to be at least 5\\4\", up to what age girls height can grow? She takes Pediasure, two eggs in terms of protein every day and four days a week swimming, is there anything special I can do? Kindly advise.

Hi, Welcome to Chat Doctor forum. Here are certain points of advise I would like to give you. Weight is absolutely normal for her age as per growth charts. As per the height mentioned (112 cm), the child is shorter as per other chil ChatDoctor. If the child\\s height had to be affected by adenoids the weight also would be effected but it is not. Girls grow in height up to the age of 14 to 16 years. The final height of the child should be close to 5 feet, 2 inches considering the parent\\s height. The current age of the child is 6 years so you have a time period of 8 to 9 years for height growth. There is no exercise or supplement specifically for height. However, it has been noted that chil

### Instruction: Answer this question truthfully ###Input: Hello doctor,My daughter who is 2.8 years old cried hard before two weeks and developed a hoarse voice the next day. It subsided in about three days. Before a week, I remember her throwing tantrums and crying hard for every small thing and again developed a hoarse voice. I gave warm water and honey, and it has subsided a lot.Sometimes her voice sounds normal, and when she screams or cries, I can still feel her voice is a little hoarse. Is this hoarseness due to crying or could be any other infection? I read that hoarseness could occur due to cancer. I am a paranoid mother who gets scared after reading the stuff. She does not have any cold, cough and eats normally.In spite of her hoarse voice, she is taking ice creams and cold stuff. If the hoarseness is due to any serious medical condition, would she have any accompanying symptoms? My main concern is cancer. What would be the symptoms of laryngeal cancer other than hoarseness? She is a very adamant kid and still screams if things do not go her way. Suggest remedies to get rid of hoarseness. Please remove my anxiety towards cancer. ### Response: Hello. Relax do not worry. She does not have laryngeal cancer (vocal cord cancer), it is a vocal cord abuse. It is due to screaming she is having hoarseness of voice, so it is temporary. Give her warm water and if she can gargle then let her do it with salt water gargle. Based on your history I can understand that she has a minor behavior issue, typical of a toddler. When she starts screaming then try to divert her attention, so you can stop her screaming. A positive note is that the child forgets quickly and so you can do it. If you still have some queries, then please visit ENT doctor and get her vocal cord checked.

Hello doctor,My daughter who is 2.8 years old cried hard before two weeks and developed a hoarse voice the next day. It subsided in about three days. Before a week, I remember her throwing tantrums and crying hard for every small thing and again developed a hoarse voice. I gave warm water and honey, and it has subsided a lot.Sometimes her voice sounds normal, and when she screams or cries, I can still feel her voice is a little hoarse. Is this hoarseness due to crying or could be any other infection? I read that hoarseness could occur due to cancer. I am a paranoid mother who gets scared after reading the stuff. She does not have any cold, cough and eats normally.In spite of her hoarse voice, she is taking ice creams and cold stuff. If the hoarseness is due to any serious medical condition, would she have any accompanying symptoms? My main concern is cancer. What would be the symptoms of laryngeal cancer other than hoarseness? She is a very adamant kid and still screams if things do not go her way. Suggest remedies to get rid of hoarseness. Please remove my anxiety towards cancer.

Hello. Relax do not worry. She does not have laryngeal cancer (vocal cord cancer), it is a vocal cord abuse. It is due to screaming she is having hoarseness of voice, so it is temporary. Give her warm water and if she can gargle then let her do it with salt water gargle. Based on your history I can understand that she has a minor behavior issue, typical of a toddler. When she starts screaming then try to divert her attention, so you can stop her screaming. A positive note is that the child forgets quickly and so you can do it. If you still have some queries, then please visit ENT doctor and get her vocal cord checked.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I went to the ER a week ago for abdominal pain. A pregnancy test was performed and it was negative. An ultrasound scan was performed and they found two heterogeneous ovarian cysts, one on the right is 1.5 cm and the other on the left is 1.4 cm. There were multiple simple cysts. My endometrial lining was 6 mm. They said everything else looked good. I have a history of ovarian cysts. Do heterogeneous cysts happen before or after ovulation? Do they impact menstruation? Also, what is the difference between heterogeneous and homogeneous ovarian cysts? ### Response: Hi, Welcome to Chat Doctor forum. First of all, 1.5 cm and 1.4 cm are a very small size for a cyst. Because, in every cycle around ovulation one of your ovary makes around 3 cm follicle (cyst). In a sonography, if it looks clear without any shadow in the cyst, then it is homogeneous and when something is found floating in the cyst as echoes (shadow), then it is called heterogeneous. Homogeneous have clear fluid. In heterogeneous cyst, the shadow may be due to blood, pus cells, epithelial cells, other debris, hormones, enzymes or turbid fluid. In 1.5 cm and 1.4 cm sized small cysts, it is not so much important that whether it is heterogeneous or homogeneous because it is mostly going to disappear around your period. Before ovulation, mostly follicles are with clear fluid. After ovulation, it may be homogeneous or heterogeneous with decreased size. Actually, it looks like disappearing follicle and not a cyst. A cyst can disturb your cycle only if it is of a bigger size and remains even after menstruation. Mostly it begins from unruptured follicle during ovulation and the size can be from 4 cm to 11 cm or even bigger in some case. This type of cyst requires treatment.

Hello doctor,I went to the ER a week ago for abdominal pain. A pregnancy test was performed and it was negative. An ultrasound scan was performed and they found two heterogeneous ovarian cysts, one on the right is 1.5 cm and the other on the left is 1.4 cm. There were multiple simple cysts. My endometrial lining was 6 mm. They said everything else looked good. I have a history of ovarian cysts. Do heterogeneous cysts happen before or after ovulation? Do they impact menstruation? Also, what is the difference between heterogeneous and homogeneous ovarian cysts?

Hi, Welcome to Chat Doctor forum. First of all, 1.5 cm and 1.4 cm are a very small size for a cyst. Because, in every cycle around ovulation one of your ovary makes around 3 cm follicle (cyst). In a sonography, if it looks clear without any shadow in the cyst, then it is homogeneous and when something is found floating in the cyst as echoes (shadow), then it is called heterogeneous. Homogeneous have clear fluid. In heterogeneous cyst, the shadow may be due to blood, pus cells, epithelial cells, other debris, hormones, enzymes or turbid fluid. In 1.5 cm and 1.4 cm sized small cysts, it is not so much important that whether it is heterogeneous or homogeneous because it is mostly going to disappear around your period. Before ovulation, mostly follicles are with clear fluid. After ovulation, it may be homogeneous or heterogeneous with decreased size. Actually, it looks like disappearing follicle and not a cyst. A cyst can disturb your cycle only if it is of a bigger size and remains even after menstruation. Mostly it begins from unruptured follicle during ovulation and the size can be from 4 cm to 11 cm or even bigger in some case. This type of cyst requires treatment.

### Instruction: Answer this question truthfully ###Input: Hi I am writing this because lately I have been having some issues lately related to my health and I was hoping to get some answers, advice and help because I want to stop the problem from getting worse and start getting better and i am a male and I'm 22 years old. Now one of the symptoms I've been having are headaches like they would happen imma say every couple days like it comes and goes like now I don\\t have a headache at the moment. Second symptom I had was nausea and I had it yesterday for a short period of time but I managed to eat something and I don't have it right now currently. Other symptoms I've been experiencing to like eye pain to that comes and goes but mainly in my left eye like twitching and tingling to,Little loss of balance when I get up out the bed I guess from resting for a certain period of time like now my balance is fine now but I have this Cold feeling in forehead and lips now which is new to me I never had it before so it\\s happening right now but yea and Little tingling feeling in throat And Tingling in private area that comes and goes. I was wondering if a neurologist can help me out here because I'm wondering if this is a nerve problem and how serious this is. Please ### Response: Hi , Welcome to ChatDoctor, I have analysed your complaints. You are suffering from Episodes of headache with nausea , which are not present every day. also having left eye pain and twisting with tingling, imbalance while getting up, tingling in throat and over genitals, coldness over forehead ... I would like to suggest to do some routine blood investigation tests and this symptoms seems like vitamin B12 deficiency or hypothyroidism. Are you Vegetarian? any history of weight gain, constipation? is there any addiction of alcohol or ChatDoctor. Vitamin B12 level Thyroid profile

Hi I am writing this because lately I have been having some issues lately related to my health and I was hoping to get some answers, advice and help because I want to stop the problem from getting worse and start getting better and i am a male and I'm 22 years old. Now one of the symptoms I've been having are headaches like they would happen imma say every couple days like it comes and goes like now I don\\t have a headache at the moment. Second symptom I had was nausea and I had it yesterday for a short period of time but I managed to eat something and I don't have it right now currently. Other symptoms I've been experiencing to like eye pain to that comes and goes but mainly in my left eye like twitching and tingling to,Little loss of balance when I get up out the bed I guess from resting for a certain period of time like now my balance is fine now but I have this Cold feeling in forehead and lips now which is new to me I never had it before so it\\s happening right now but yea and Little tingling feeling in throat And Tingling in private area that comes and goes. I was wondering if a neurologist can help me out here because I'm wondering if this is a nerve problem and how serious this is. Please

Hi , Welcome to ChatDoctor, I have analysed your complaints. You are suffering from Episodes of headache with nausea , which are not present every day. also having left eye pain and twisting with tingling, imbalance while getting up, tingling in throat and over genitals, coldness over forehead ... I would like to suggest to do some routine blood investigation tests and this symptoms seems like vitamin B12 deficiency or hypothyroidism. Are you Vegetarian? any history of weight gain, constipation? is there any addiction of alcohol or ChatDoctor. Vitamin B12 level Thyroid profile

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have worn braces for four years and finished my orthodontic treatment before five years. I am 20 years old. Since then my teeth have been healthy but I have been suffering from an eating disorder for three years and I am still in recovery. Two months ago one of my top central incisors started feeling slightly wobbly and after looking at it in the mirror I noticed the gums had receded by 2 mm compared to the pictures I had from last year. I saw my dentist who told me everything was fine but since then my tooth has become even more wobbly and my other top central incisor has started to wobble too. I had a look at all of my teeth today and realized that all of the gums had receded by 2-3 mm. I brush my teeth with a soft toothbrush and floss twice a day, and I use mouthwash every two days. I am very scared that my teeth are going to fall out because I can feel the roots being unstable when I chew food and I cannot bite into a sandwich or any other harder texture without feeling discomfort. Due to COVID-19, I am unable to see a dentist right now unless it is an urgent case causing a lot of pain. What should I do? ### Response: Hi. Nothing to panic as such. Your gums need complete scaling (cleaning) but due to COVID-19, you cannot have now. If the gums are swollen, you will definitely have a wobble feel. Do enforce brushing twice daily with normal paste and medium toothbrush. Use Betadine gargle thrice daily, Take tablet Oflox OZ 10 twice for five days and Becosules capsules once daily for five days. If you have an eating disorder you can try with probiotic sachets for five days preferably in the nights. Visit the dentist once the pandemic is over. Do salt water gargling twice daily.

Hello doctor,I have worn braces for four years and finished my orthodontic treatment before five years. I am 20 years old. Since then my teeth have been healthy but I have been suffering from an eating disorder for three years and I am still in recovery. Two months ago one of my top central incisors started feeling slightly wobbly and after looking at it in the mirror I noticed the gums had receded by 2 mm compared to the pictures I had from last year. I saw my dentist who told me everything was fine but since then my tooth has become even more wobbly and my other top central incisor has started to wobble too. I had a look at all of my teeth today and realized that all of the gums had receded by 2-3 mm. I brush my teeth with a soft toothbrush and floss twice a day, and I use mouthwash every two days. I am very scared that my teeth are going to fall out because I can feel the roots being unstable when I chew food and I cannot bite into a sandwich or any other harder texture without feeling discomfort. Due to COVID-19, I am unable to see a dentist right now unless it is an urgent case causing a lot of pain. What should I do?

Hi. Nothing to panic as such. Your gums need complete scaling (cleaning) but due to COVID-19, you cannot have now. If the gums are swollen, you will definitely have a wobble feel. Do enforce brushing twice daily with normal paste and medium toothbrush. Use Betadine gargle thrice daily, Take tablet Oflox OZ 10 twice for five days and Becosules capsules once daily for five days. If you have an eating disorder you can try with probiotic sachets for five days preferably in the nights. Visit the dentist once the pandemic is over. Do salt water gargling twice daily.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am having back pain. Six months ago I had S1 and L5 fusion. Normally, no surgery or anything. My doctor asked me to take rest. Then two months back I was again having pain in my back and no findings from my X-ray. Then I did an MRI four days back when I was having pain in my legs mainly in the thigh, calf, and foot. The pain is continuous. It is not resting for a minute, but the amount of pain varies sometimes a lot sometimes a little.I am 25 years old male. I was so active with all the sports activity and all, for last one year. After I bought my bike I stopped playing most of the sports, also the walking came down to below average because of the bike. Does the less walking have something to do with all that I am suffering? I had two to three accidents with my bike, but none of them were serious ones. I mean I did not get hurt badly. Just some scratches on my hand. So I am confused if the condition is done from a trauma. The doctors asked me to take one month rest and physiotherapy at this moment. Please suggest me what to do, I am really worried if it is sciatica or something even greater. I only want to heal the issue, recover from it completely even if that takes me one year or two. ### Response: Hi. Does the pain continue even when you lie down to sleep? Does the pain radiate to the legs? MRI report shows problems with the vertebrae (attachment removed to protect patient identity). But it would be better if you can get a second opinion for the vertebral pathology. Try tablet Lyrica (Pregabalin) 75 mg once daily for a month or so and tablet Diclofenac 50 mg one tablet for pain. For more information consult a neurologist online

Hello doctor,I am having back pain. Six months ago I had S1 and L5 fusion. Normally, no surgery or anything. My doctor asked me to take rest. Then two months back I was again having pain in my back and no findings from my X-ray. Then I did an MRI four days back when I was having pain in my legs mainly in the thigh, calf, and foot. The pain is continuous. It is not resting for a minute, but the amount of pain varies sometimes a lot sometimes a little.I am 25 years old male. I was so active with all the sports activity and all, for last one year. After I bought my bike I stopped playing most of the sports, also the walking came down to below average because of the bike. Does the less walking have something to do with all that I am suffering? I had two to three accidents with my bike, but none of them were serious ones. I mean I did not get hurt badly. Just some scratches on my hand. So I am confused if the condition is done from a trauma. The doctors asked me to take one month rest and physiotherapy at this moment. Please suggest me what to do, I am really worried if it is sciatica or something even greater. I only want to heal the issue, recover from it completely even if that takes me one year or two.

Hi. Does the pain continue even when you lie down to sleep? Does the pain radiate to the legs? MRI report shows problems with the vertebrae (attachment removed to protect patient identity). But it would be better if you can get a second opinion for the vertebral pathology. Try tablet Lyrica (Pregabalin) 75 mg once daily for a month or so and tablet Diclofenac 50 mg one tablet for pain. For more information consult a neurologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 28 year old female, I would like to know if multiple sclerosis is hereditary? My dad has it, and I am very nervous to inherit this disease. I have had two brain MRI\\s that have been normal, except for an incidental finding of a pineal gland cyst. I continue to worry about inheriting multiple sclerosis. I am a medical coder. So, I spend a great deal of time in front of the computer. This affects my vision, and I experience back and thigh pain. I am hoping this is due to sitting down all day. I also have a slight hand tremor. However, I am a very anxious person, and I type fast all day long. I wonder if typing all day could cause a hand tremor?I am very active and energetic. I exercise 5 days a week for an hour doing treadmill and stair climbing. I spent a great deal of time this weekend hunched over painting. I am wondering if this is what is causing my current thigh and back pain? I am also due to start my periods anytime. I am still worrying about inheriting multiple sclerosis. What are your thoughts on the possibility of still having multiple sclerosis with two negative brain MRI\\s? ### Response: Hi, Welcome to Chat Doctor forum. I understand your concern. It is clear that you are not having MS (Multiple sclerosis) as of date. None of your symptoms are typical of multiple sclerosis. Back and thigh pain is posture related and tremors are anxiety related. Repeated MRI\\s being normal further rules out this disease. Agreed that multiple sclerosis can be hereditary. If one of the parents is having multiple sclerosis, chances of the offspring having multiple sclerosis are 1 in 50. Since you are having no symptoms and your brain MRI is normal, you need not worry about it. Please be assured that you are fine.

Hello doctor,I am a 28 year old female, I would like to know if multiple sclerosis is hereditary? My dad has it, and I am very nervous to inherit this disease. I have had two brain MRI\\s that have been normal, except for an incidental finding of a pineal gland cyst. I continue to worry about inheriting multiple sclerosis. I am a medical coder. So, I spend a great deal of time in front of the computer. This affects my vision, and I experience back and thigh pain. I am hoping this is due to sitting down all day. I also have a slight hand tremor. However, I am a very anxious person, and I type fast all day long. I wonder if typing all day could cause a hand tremor?I am very active and energetic. I exercise 5 days a week for an hour doing treadmill and stair climbing. I spent a great deal of time this weekend hunched over painting. I am wondering if this is what is causing my current thigh and back pain? I am also due to start my periods anytime. I am still worrying about inheriting multiple sclerosis. What are your thoughts on the possibility of still having multiple sclerosis with two negative brain MRI\\s?

Hi, Welcome to Chat Doctor forum. I understand your concern. It is clear that you are not having MS (Multiple sclerosis) as of date. None of your symptoms are typical of multiple sclerosis. Back and thigh pain is posture related and tremors are anxiety related. Repeated MRI\\s being normal further rules out this disease. Agreed that multiple sclerosis can be hereditary. If one of the parents is having multiple sclerosis, chances of the offspring having multiple sclerosis are 1 in 50. Since you are having no symptoms and your brain MRI is normal, you need not worry about it. Please be assured that you are fine.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 69 year old male. I have suffered from many types of infections several times in my life from systemic candida infection, valley fever, fungus infections and so on. I also have RA, have experienced Reynauld\\s several times, I also have SLE and have tested positive for MCTD. I also have male boobs, wide hips and all around feminine shape. Three years ago, I had a mild myocardial infarction, veins are unobstructed, heart in good shape. I was on meds for about three years, to date no further coronary occurrences, no signs of heart problems. I am down to just aspirin and no additional meds. Currently, I have severe pain in my hand and finger joints and also, in the joints of my big toe on both feet.Recently, I came down with some sort of cold that has turned into bronchitis with a pain on my right side. My doctor has put me on a five-day antibiotic plan again. I had a late start into puberty, started shaving at the age of 25, had small testicles. I worked out with weights for years and was never able to \"muscle up\". I have small bones, long fingers, long legs, short torso. I have never been tested for Klinefelter\\s syndrome but have been suggested by several doctors that I may have been born with this condition XXY but they seem to be reluctant to test for it. Is it possible that I am not being treated for the right cause of my illnesses? I am not sure what to do at this point, help. ### Response: Hello, Welcome to Chat Doctor forum. Repeated infections with different organisms including fungal infection indicate severe immune deficiency which could be due to the steroid therapy you take for MCTD (mixed connective tissue disease) or due to other condition like diabetes. So, please tell me the following

Hello doctor,I am a 69 year old male. I have suffered from many types of infections several times in my life from systemic candida infection, valley fever, fungus infections and so on. I also have RA, have experienced Reynauld\\s several times, I also have SLE and have tested positive for MCTD. I also have male boobs, wide hips and all around feminine shape. Three years ago, I had a mild myocardial infarction, veins are unobstructed, heart in good shape. I was on meds for about three years, to date no further coronary occurrences, no signs of heart problems. I am down to just aspirin and no additional meds. Currently, I have severe pain in my hand and finger joints and also, in the joints of my big toe on both feet.Recently, I came down with some sort of cold that has turned into bronchitis with a pain on my right side. My doctor has put me on a five-day antibiotic plan again. I had a late start into puberty, started shaving at the age of 25, had small testicles. I worked out with weights for years and was never able to \"muscle up\". I have small bones, long fingers, long legs, short torso. I have never been tested for Klinefelter\\s syndrome but have been suggested by several doctors that I may have been born with this condition XXY but they seem to be reluctant to test for it. Is it possible that I am not being treated for the right cause of my illnesses? I am not sure what to do at this point, help.

Hello, Welcome to Chat Doctor forum. Repeated infections with different organisms including fungal infection indicate severe immune deficiency which could be due to the steroid therapy you take for MCTD (mixed connective tissue disease) or due to other condition like diabetes. So, please tell me the following

### Instruction: Answer this question truthfully ###Input: Hello doctor,I need your advice, please. I am a 44-year-old working mother of three children and normally in great health. In the last 20 years, I have had about three visual migraines. There is no headache and I get back to normal 30 minutes later. This week, I had a visual migraine on Monday, felt a bit nauseous afterward for the rest of the day. I woke up on Tuesday and felt normal. Then about 8.30 AM started with another visual migraine. Then, I had a terrible headache and vomited. The right cheek and right arm went numb that lasted all day. I had another one on Wednesday and a fourth on Thursday. The thing that is worrying me is that I am still not back to normal. I could not remember people's names at work on Friday and felt totally spaced out and at times confused. I did not remember speaking to my mother on the phone this morning. In fact, I rang her and when she answered through the car speaker I had forgotten it was me that rang her. I saw my GP on Friday and she said no red flag symptoms but she has referred me to a neurologist as I have had multiple migraines and this is unusual. My appointment is on the 20th. The thing that I want to know is should I be going to the ER sooner for a scan? I know myself I am not behaving normally and my close family and friends have noticed. ### Response: Hello, Welcome to ChatDoctor. Your symptoms could be related to status migrainosus, which causes a temporary dysfunction of some brain regions related to persistent migraine attacks. For this reason I would recommend performing a brain MRI (which would be better compared to the CT scan) and some blood laboratory tests to investigate for possible causes which have triggered these frequent migraine attacks as follows

Hello doctor,I need your advice, please. I am a 44-year-old working mother of three children and normally in great health. In the last 20 years, I have had about three visual migraines. There is no headache and I get back to normal 30 minutes later. This week, I had a visual migraine on Monday, felt a bit nauseous afterward for the rest of the day. I woke up on Tuesday and felt normal. Then about 8.30 AM started with another visual migraine. Then, I had a terrible headache and vomited. The right cheek and right arm went numb that lasted all day. I had another one on Wednesday and a fourth on Thursday. The thing that is worrying me is that I am still not back to normal. I could not remember people's names at work on Friday and felt totally spaced out and at times confused. I did not remember speaking to my mother on the phone this morning. In fact, I rang her and when she answered through the car speaker I had forgotten it was me that rang her. I saw my GP on Friday and she said no red flag symptoms but she has referred me to a neurologist as I have had multiple migraines and this is unusual. My appointment is on the 20th. The thing that I want to know is should I be going to the ER sooner for a scan? I know myself I am not behaving normally and my close family and friends have noticed.

Hello, Welcome to ChatDoctor. Your symptoms could be related to status migrainosus, which causes a temporary dysfunction of some brain regions related to persistent migraine attacks. For this reason I would recommend performing a brain MRI (which would be better compared to the CT scan) and some blood laboratory tests to investigate for possible causes which have triggered these frequent migraine attacks as follows

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am not sure why I never bothered to ask these questions before now, but I suppose it is better late than never. I have what appears to be a single genital wart just below the head. I have had it since I was 16 years old. I went through five years in the military with this without any problems. I passed all the medical screenings and received all the vaccinations that were standard at the time. I have been out of the military for two years and still in relatively good condition. I do not have high blood pressure or any genetic propensity for any large health risks. I also can confirm that I do not have diabetes. Partner wise, I did not have sex for the first five to six years of having one, nor did I have any sexual contact to include oral. I did not notice any change once I started having sexual partners after. I was always careful to wear a condom though. I only am bringing it up now because I was asked today by my doctor (during a routine yearly visit) when the last time I had an HPV vaccine was and if I had one in the military. When I could not tell him he made me another appointment to see him to get a sample and a few other things.This single wart has never grown in size, become sensitive, multiplied, or shown any sign of life for lack of another way to put it. It is small enough that if I did not look for it at the underside of the head, I would not see it at all. Surely, a wart cannot just exist for a decade? ### Response: Hello, Welcome to Chat Doctor forum. A single wart cannot exist for such a long time. There has to be an increase in the number. Are you sure it is a genital wart? Were you diagnosed by a dermatologist? Clinical photographs would have helped. For more information consult a dermatologist online

Hello doctor,I am not sure why I never bothered to ask these questions before now, but I suppose it is better late than never. I have what appears to be a single genital wart just below the head. I have had it since I was 16 years old. I went through five years in the military with this without any problems. I passed all the medical screenings and received all the vaccinations that were standard at the time. I have been out of the military for two years and still in relatively good condition. I do not have high blood pressure or any genetic propensity for any large health risks. I also can confirm that I do not have diabetes. Partner wise, I did not have sex for the first five to six years of having one, nor did I have any sexual contact to include oral. I did not notice any change once I started having sexual partners after. I was always careful to wear a condom though. I only am bringing it up now because I was asked today by my doctor (during a routine yearly visit) when the last time I had an HPV vaccine was and if I had one in the military. When I could not tell him he made me another appointment to see him to get a sample and a few other things.This single wart has never grown in size, become sensitive, multiplied, or shown any sign of life for lack of another way to put it. It is small enough that if I did not look for it at the underside of the head, I would not see it at all. Surely, a wart cannot just exist for a decade?

Hello, Welcome to Chat Doctor forum. A single wart cannot exist for such a long time. There has to be an increase in the number. Are you sure it is a genital wart? Were you diagnosed by a dermatologist? Clinical photographs would have helped. For more information consult a dermatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have some health issues that I would like to address. I have depression, fatigue, low energy, tiredness, and red eyes when I wake up, and I feel exhausted after masturbation. I have a history of masturbating for eight to nine years since I was 12 years old. The first few years, I was continually masturbating with lots of pornography. I am now masturbating one to two times a week yet still feel exhausted and fatigued daily and even watch porn one to two times a week. I have trouble with morning wood maybe once a week. What can Homeopathy offer me to heal from masturbation and get back to being healthy? ### Response: Hello. I understand that you are concerned about various health issues, and it seems most of the symptoms are related to over masturbation. Masturbation at the teenage is prevalent. Homeopathy has a vast number of remedies to heal this issue. However remember that masturbation was is not bad, but overuse is something that causes health issues, twice or thrice a week is not bad.Homeopathic remedies will help you to deal with this habit, and you would be able to concentrate more on other things in life like a career or job, etc. Homeopathic remedies are prescribed after taking your mental, emotional and physical health in to the consideration. Based on the little information you provided here you can start Lycopodium 30c four pills once a day for five days. Then begin with Kali Phos 6x two tablets twice a day for 15 days.These pills and tablets usually dissolve as soon as you keep them over the tongue. Hence there is no need to swallow these with water or anything liquid. Kindly report back on15 days. I hope you start feeling better. Let me know if you have any questions. I would be happy to answer. Take care.

Hello doctor,I have some health issues that I would like to address. I have depression, fatigue, low energy, tiredness, and red eyes when I wake up, and I feel exhausted after masturbation. I have a history of masturbating for eight to nine years since I was 12 years old. The first few years, I was continually masturbating with lots of pornography. I am now masturbating one to two times a week yet still feel exhausted and fatigued daily and even watch porn one to two times a week. I have trouble with morning wood maybe once a week. What can Homeopathy offer me to heal from masturbation and get back to being healthy?

Hello. I understand that you are concerned about various health issues, and it seems most of the symptoms are related to over masturbation. Masturbation at the teenage is prevalent. Homeopathy has a vast number of remedies to heal this issue. However remember that masturbation was is not bad, but overuse is something that causes health issues, twice or thrice a week is not bad.Homeopathic remedies will help you to deal with this habit, and you would be able to concentrate more on other things in life like a career or job, etc. Homeopathic remedies are prescribed after taking your mental, emotional and physical health in to the consideration. Based on the little information you provided here you can start Lycopodium 30c four pills once a day for five days. Then begin with Kali Phos 6x two tablets twice a day for 15 days.These pills and tablets usually dissolve as soon as you keep them over the tongue. Hence there is no need to swallow these with water or anything liquid. Kindly report back on15 days. I hope you start feeling better. Let me know if you have any questions. I would be happy to answer. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 68-year-old male. I am currently on Gluformin G2 Forte for diabetes, Cinod-N 10/2.5 for BP and Olmezest 20. My lab report is from last week.HbA1c - 6.8.Uric acid - 7.41.Fructosamine - 299.7.eGFR - 83.APO B / APO A1 Ratio (APO B/A1) - 1.1.SGOT- 54.6.SGPT 59.9.Lipoprotein (A) LP (A) - 30.8.TSH - 6.07.Uri albumin/creatinine ratio (UA/C) - 68.5.25-OH Vitamin D (total) - 20.17.Any advice, please? ### Response: Hello. Your HbA1c is in good control and the other parameters are within the normal range. ACR is slightly high. You need to recheck the albumin-creatinine ratio after three months. Please repeat your uric acid levels after two weeks. If it is still high, you may need medication. In the meantime, continue all the medicines as you are taking. There is no need to worry. Do check your BP regularly and fasting blood sugar after two weeks and follow-up, please. As you are 68 years old, you need to take Aspirin tablet 75 mg for cardioprotection. Please add that to your regular medicine. I suggest tablet Ecosprin 75 mg one tablet once daily. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an internal medicine physician online

Hello doctor,I am a 68-year-old male. I am currently on Gluformin G2 Forte for diabetes, Cinod-N 10/2.5 for BP and Olmezest 20. My lab report is from last week.HbA1c - 6.8.Uric acid - 7.41.Fructosamine - 299.7.eGFR - 83.APO B / APO A1 Ratio (APO B/A1) - 1.1.SGOT- 54.6.SGPT 59.9.Lipoprotein (A) LP (A) - 30.8.TSH - 6.07.Uri albumin/creatinine ratio (UA/C) - 68.5.25-OH Vitamin D (total) - 20.17.Any advice, please?

Hello. Your HbA1c is in good control and the other parameters are within the normal range. ACR is slightly high. You need to recheck the albumin-creatinine ratio after three months. Please repeat your uric acid levels after two weeks. If it is still high, you may need medication. In the meantime, continue all the medicines as you are taking. There is no need to worry. Do check your BP regularly and fasting blood sugar after two weeks and follow-up, please. As you are 68 years old, you need to take Aspirin tablet 75 mg for cardioprotection. Please add that to your regular medicine. I suggest tablet Ecosprin 75 mg one tablet once daily. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an internal medicine physician online

### Instruction: Answer this question truthfully ###Input: Hello doctor,My girlfriend has been taking Microgynon 30 for two months, with two packages back to back. She took Microgynon for suppressing severe PMS. The medicine successfully suppressed the PMS, but there seem to be some side effects. She experienced some spotting for a week, and the other doctor told me that it is normal for a microgynon-taker.Her actual period started the very next day after stoppage of spotting (which is late for two weeks), and it has been lasting for 18 days. In the beginning, the volume is lower than average, but red blood is visible. In recent days, the volume keeps increasing, and it gets me worried about whether some issues are occurring. Should I take her to a gynecologist for a check-up or it is entirely reasonable for a microgynon-taker?We did not have any sexual intercourse before and in the case for an extremely rare accident, she took a pregnancy test, the result was negative. Therefore, pregnancy could be eliminated. She finished her second package of Microgynon around 6/4, and the next day, the blood volume started to increase. One more question, she has a third package of Microgynon and the gynecologist we saw said that she should begin the third package when the second period stops. Is this correct? ### Response: Hello. Your doctor is right in saying that this is normal with the medicine you are taking. Microgynon is progesterone. It is a hormone which builds up and helps in the growth of the inner layer or lining of the uterus called endometrium. Due to overgrowth sometimes the endometrium sheds off and appears as vaginal bleeding or periods. The ChatDoctor. She must take some iron supplements and wear a panty liner. For PMS (premenstrual syn Take care.

Hello doctor,My girlfriend has been taking Microgynon 30 for two months, with two packages back to back. She took Microgynon for suppressing severe PMS. The medicine successfully suppressed the PMS, but there seem to be some side effects. She experienced some spotting for a week, and the other doctor told me that it is normal for a microgynon-taker.Her actual period started the very next day after stoppage of spotting (which is late for two weeks), and it has been lasting for 18 days. In the beginning, the volume is lower than average, but red blood is visible. In recent days, the volume keeps increasing, and it gets me worried about whether some issues are occurring. Should I take her to a gynecologist for a check-up or it is entirely reasonable for a microgynon-taker?We did not have any sexual intercourse before and in the case for an extremely rare accident, she took a pregnancy test, the result was negative. Therefore, pregnancy could be eliminated. She finished her second package of Microgynon around 6/4, and the next day, the blood volume started to increase. One more question, she has a third package of Microgynon and the gynecologist we saw said that she should begin the third package when the second period stops. Is this correct?

Hello. Your doctor is right in saying that this is normal with the medicine you are taking. Microgynon is progesterone. It is a hormone which builds up and helps in the growth of the inner layer or lining of the uterus called endometrium. Due to overgrowth sometimes the endometrium sheds off and appears as vaginal bleeding or periods. The ChatDoctor. She must take some iron supplements and wear a panty liner. For PMS (premenstrual syn Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a hypertensive and diabetic, FBS 100 to 110, PPBS 120 to 130, HbA1c 5.3 (last measured), taking Glyciphage 1 gm, Telmisartan 40, and Amlodipine 5 mg. Clinical BP 150/100, just after clinic 125/78, at home 115/75. Fatty liver II, prostrate 25 CC (no problem urinating, no burning sensation, etc.,), lipids are under control.I would like to know how to reduce the fatty liver condition from II to I. Is any medicine available? I had suffered from hepatitis two times during childhood at 7 and 10 years of age. No smoking and drinking at all. No pain in the abdomen. The problem faced now are that for the past few days, I am suffering from excessive gas, bloating, and discomfort in the neck and food pipe, as if some air is trapped which is expelled as burps at times and relieved after I took PudinHara and Raciper plus (given to my wife when she was suffering from IBS). No difficulty swallowing food. But a light pain in the neck which is relieved with flushing out the air. Please advise for medication. I had experienced this condition in the past also say 2 to 3 years back and that time it was good using Omez for few days. I am having microalbuminuria sometimes. It is below (UACR values). ### Response: Hi. For the treatment of fatty liver, first of all, I need to know your liver function test. If you have your recent LFT report please attach it. If not done yet, please get it done and write back to me.

Hello doctor,I am a hypertensive and diabetic, FBS 100 to 110, PPBS 120 to 130, HbA1c 5.3 (last measured), taking Glyciphage 1 gm, Telmisartan 40, and Amlodipine 5 mg. Clinical BP 150/100, just after clinic 125/78, at home 115/75. Fatty liver II, prostrate 25 CC (no problem urinating, no burning sensation, etc.,), lipids are under control.I would like to know how to reduce the fatty liver condition from II to I. Is any medicine available? I had suffered from hepatitis two times during childhood at 7 and 10 years of age. No smoking and drinking at all. No pain in the abdomen. The problem faced now are that for the past few days, I am suffering from excessive gas, bloating, and discomfort in the neck and food pipe, as if some air is trapped which is expelled as burps at times and relieved after I took PudinHara and Raciper plus (given to my wife when she was suffering from IBS). No difficulty swallowing food. But a light pain in the neck which is relieved with flushing out the air. Please advise for medication. I had experienced this condition in the past also say 2 to 3 years back and that time it was good using Omez for few days. I am having microalbuminuria sometimes. It is below (UACR values).

Hi. For the treatment of fatty liver, first of all, I need to know your liver function test. If you have your recent LFT report please attach it. If not done yet, please get it done and write back to me.

### Instruction: Answer this question truthfully ###Input: Hello doctor,1. I went to a spa treatment and the lady therapist after the massage gave me a blow job, and I am worried, and I asked management and tested that girl for HIV.2. Both HIV screening and western blot tests were done on the day after the blow job, and she got both negative.3. But in the worst scenario, what if she is recently infected and it does not show up in screening or western blot?4. And what are the chances of transmitting HIV through oral sex (getting a blow job)?5. My main concern is on first, second, and the third day I have a fever with chills and from fourth day loose motions and temperature continuing.6. If a person immune system is a week, do symptoms show from the first day?7. And how much percentage I am safe. I know it is a long question, but please help me out. ### Response: Hello, Welcome to ChatDoctor. Do not worry about the percentage of transmission of HIV us very less through oral-genital contact. The rate of transmission in HIV positive patient through oral-genital route is 0.01 to 0.04 %. The risk of transmission is high in case of ulcers on the mucosa is active. Present symptoms may be due to some other viral fever or viral gastroenteritis. Few other viral infections like herpes or hepatitis or bacterial infections also transmitted through oral-genital route. So you may repeat the PCR for the virus after four weeks. Usually, it will be detectable between three days to four weeks. So take simple Paracetamol, ChatDoctor. Very less chances to be an HIV. Getting a blow job partner chances to get 0 to 0.01 %. But receptive partner (giving a blow job) chances of getting 0.0 to 0.04 %.

Hello doctor,1. I went to a spa treatment and the lady therapist after the massage gave me a blow job, and I am worried, and I asked management and tested that girl for HIV.2. Both HIV screening and western blot tests were done on the day after the blow job, and she got both negative.3. But in the worst scenario, what if she is recently infected and it does not show up in screening or western blot?4. And what are the chances of transmitting HIV through oral sex (getting a blow job)?5. My main concern is on first, second, and the third day I have a fever with chills and from fourth day loose motions and temperature continuing.6. If a person immune system is a week, do symptoms show from the first day?7. And how much percentage I am safe. I know it is a long question, but please help me out.

Hello, Welcome to ChatDoctor. Do not worry about the percentage of transmission of HIV us very less through oral-genital contact. The rate of transmission in HIV positive patient through oral-genital route is 0.01 to 0.04 %. The risk of transmission is high in case of ulcers on the mucosa is active. Present symptoms may be due to some other viral fever or viral gastroenteritis. Few other viral infections like herpes or hepatitis or bacterial infections also transmitted through oral-genital route. So you may repeat the PCR for the virus after four weeks. Usually, it will be detectable between three days to four weeks. So take simple Paracetamol, ChatDoctor. Very less chances to be an HIV. Getting a blow job partner chances to get 0 to 0.01 %. But receptive partner (giving a blow job) chances of getting 0.0 to 0.04 %.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 17-year-old female. I was diagnosed with Carpal Tunnel syndrome last year but the pain started before that. At that time my hand only hurt when it was bent to a certain position, and it hurts when I am on my fours or when push-up position. It did not hurt when my hand was squeezed or doing hand exercises.The doctor prescribed me with Etoricoxib (Arcoxia) 60 m which I took twice a day for a week and told me not to move my right hand. I tried not to use it as much as possible but since it was school time, it required me to use my hand. After the medication was over, I was not able to come back to the hospital (even though I was told to if the pain did not go away) and talk to my doctor about the condition of my hand.Now, my hand, specifically the palm of the thumb, started to hurt even if it was not bent or I am in a push-up position. It is more painful when it is squeezed. Our place is quarantined and I am sure getting appointments will be hard during this time, so I am trying to relieve the pain at home. But still, I want to have some instructions from the professional. I have 10 Arcoxia pills here at home, should I take it to relieve the pain? Should I follow the initial instructions of my doctor and take it twice every day or just take it whenever I feel pain? What should I do? ### Response: Hello. Please take the pain killer Etoricoxib only if you feel pain. Try to apply a wrist support belt. It will help your wrist to keep in position. Carpel tunnel syn ChatDoctor. MRI (magnetic resonance imaging) of the wrist. Nerve compression. Carpel tunnel syn

Hello doctor,I am a 17-year-old female. I was diagnosed with Carpal Tunnel syndrome last year but the pain started before that. At that time my hand only hurt when it was bent to a certain position, and it hurts when I am on my fours or when push-up position. It did not hurt when my hand was squeezed or doing hand exercises.The doctor prescribed me with Etoricoxib (Arcoxia) 60 m which I took twice a day for a week and told me not to move my right hand. I tried not to use it as much as possible but since it was school time, it required me to use my hand. After the medication was over, I was not able to come back to the hospital (even though I was told to if the pain did not go away) and talk to my doctor about the condition of my hand.Now, my hand, specifically the palm of the thumb, started to hurt even if it was not bent or I am in a push-up position. It is more painful when it is squeezed. Our place is quarantined and I am sure getting appointments will be hard during this time, so I am trying to relieve the pain at home. But still, I want to have some instructions from the professional. I have 10 Arcoxia pills here at home, should I take it to relieve the pain? Should I follow the initial instructions of my doctor and take it twice every day or just take it whenever I feel pain? What should I do?

Hello. Please take the pain killer Etoricoxib only if you feel pain. Try to apply a wrist support belt. It will help your wrist to keep in position. Carpel tunnel syn ChatDoctor. MRI (magnetic resonance imaging) of the wrist. Nerve compression. Carpel tunnel syn

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am attaching my recent ECGs along with readings of aerobic capacity and VO2 max. The VO2 max and aerobic capacity are estimated low as exercise was interrupted after five minutes in the speed of 2.3 Kmph whereas I could have gone on for at least five more minutes with speed of 3.5 Kmph. I have undergone stenting two years back. There were no symptoms but thallium stress test and then angiogram indicate a blockage. I am also attaching my ECGs of six months back when I have been advised a pacemaker. I did not follow the advice as my ejection fraction was 73% and I did not have any symptoms of blackout or fainting. I am currently on Crestor 5 mg, Telma 20 mg, occasional Asenapine 2.5 mg, Oxetol 1200 mg, Lamitor 300 mg plus some nutritional supplements.Can you tellIf there has been any improvement in the ECG.What would my aerobic capacity and VO2 max go up to if I was allowed 10 minutes of exercise on the treadmill reaching a speed of 3.,5?Any other observations or advice on your part. ### Response: Hello. I have gone through your history and your reports (attachment removed to protect patient identity). You are not symptomatic, ECG (echocardiogram) indicated a rhythm block. You are having a high-grade atrioventricular block which is the availability of the rhythm and not the blood flow. You have to assess the blood flow of heart by doing angiography. If the blood flow is good, the pacemaker will regularise your heartbeats. If there is a problem with the blood flow, it has to be tackled first as it can be a cause for this rhythm blockage. For more information consult a cardiologist online Take care.

Hello doctor,I am attaching my recent ECGs along with readings of aerobic capacity and VO2 max. The VO2 max and aerobic capacity are estimated low as exercise was interrupted after five minutes in the speed of 2.3 Kmph whereas I could have gone on for at least five more minutes with speed of 3.5 Kmph. I have undergone stenting two years back. There were no symptoms but thallium stress test and then angiogram indicate a blockage. I am also attaching my ECGs of six months back when I have been advised a pacemaker. I did not follow the advice as my ejection fraction was 73% and I did not have any symptoms of blackout or fainting. I am currently on Crestor 5 mg, Telma 20 mg, occasional Asenapine 2.5 mg, Oxetol 1200 mg, Lamitor 300 mg plus some nutritional supplements.Can you tellIf there has been any improvement in the ECG.What would my aerobic capacity and VO2 max go up to if I was allowed 10 minutes of exercise on the treadmill reaching a speed of 3.,5?Any other observations or advice on your part.

Hello. I have gone through your history and your reports (attachment removed to protect patient identity). You are not symptomatic, ECG (echocardiogram) indicated a rhythm block. You are having a high-grade atrioventricular block which is the availability of the rhythm and not the blood flow. You have to assess the blood flow of heart by doing angiography. If the blood flow is good, the pacemaker will regularise your heartbeats. If there is a problem with the blood flow, it has to be tackled first as it can be a cause for this rhythm blockage. For more information consult a cardiologist online Take care.

### Instruction: Answer this question truthfully ###Input: My head hurts, but only on the right side--specifically around the area of my temple. Sometimes, the headache spreads to my right eye. The pain in itself is tolerable but every time I lay down to sleep, it becomes more painful. Next to that, my stomach also hurts since the other day. I feel nauseous too. Earlier this morning, I experienced a weird thing. At breakfast, I was feeling nauseous. And then suddenly, my eyesight was blocked by this wall of black and white dots. My ears were ringing. I closed my eyes, thinking it was just an illusion, but when I opened my eyes the wall of black and white dots was still there. I felt really weird all over my body too. There was this tingling feeling on my limbs and when the wall of black and white dots finally cleared up a bit, I looked down and I was surprised when I felt the wetness between my legs. I urinated. I didn\\t even felt it until I saw the puddle below my feet. I felt like I blacked out. My blood pressure is 90/70. Temperature is 36.2. PR is 85 (resting). PI is 2.1 and blood oxygen saturation level is 97%. ### Response: Hello! Thank your for reaching outYour headache may be a of migraine type. I would recommend you take celecoxib 200 mg/tab, twice a day for pain and topimarate 25 mg/tab at bedtime for 1 week. I would then recommend further consult done after 1 week of taking topimarate. I would also recommend that you check your CBC to check for anemia and your serum electrolytes since you mentioned you blacked out. The results will help us understand your condition better. Is there anything else I can help you with?

My head hurts, but only on the right side--specifically around the area of my temple. Sometimes, the headache spreads to my right eye. The pain in itself is tolerable but every time I lay down to sleep, it becomes more painful. Next to that, my stomach also hurts since the other day. I feel nauseous too. Earlier this morning, I experienced a weird thing. At breakfast, I was feeling nauseous. And then suddenly, my eyesight was blocked by this wall of black and white dots. My ears were ringing. I closed my eyes, thinking it was just an illusion, but when I opened my eyes the wall of black and white dots was still there. I felt really weird all over my body too. There was this tingling feeling on my limbs and when the wall of black and white dots finally cleared up a bit, I looked down and I was surprised when I felt the wetness between my legs. I urinated. I didn\\t even felt it until I saw the puddle below my feet. I felt like I blacked out. My blood pressure is 90/70. Temperature is 36.2. PR is 85 (resting). PI is 2.1 and blood oxygen saturation level is 97%.

Hello! Thank your for reaching outYour headache may be a of migraine type. I would recommend you take celecoxib 200 mg/tab, twice a day for pain and topimarate 25 mg/tab at bedtime for 1 week. I would then recommend further consult done after 1 week of taking topimarate. I would also recommend that you check your CBC to check for anemia and your serum electrolytes since you mentioned you blacked out. The results will help us understand your condition better. Is there anything else I can help you with?

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 27-year-old female. I have been on Depo-Provera for six years. I am not taking any other medications. Lately, I have been experiencing severe mood swings and have not been myself. One minute I am dancing around the room and could not be happier, the next I am either crying or very angry. Normally, I do not cry and I am usually pretty laid back. I have also been getting dizzy mostly when I stand up or walk up the stairs. I have trouble sleeping and or sleeping too much. I am hungry all the time, however, when I do eat I feel nausea. I have done some research and have found that these symptoms are both common with the injection and also with pregnancy. How do I tell, if these are pregnancy symptoms or if it is because of the Depo shot? I did miss my last shot three months ago. Last month I took a home pregnancy test it came back negative. Will a home test be enough to tell if I am pregnant or not? ### Response: Hi. The home pregnancy test is fairly sensitive and very unlikely to miss pregnancy (except in very early pregnancy). If you suspect pregnancy strongly, you can repeat a home pregnancy test again after a week if period does not start. Most of your symptoms can be either due to indigestion or hormonal imbalance (hypothyroidism or estrogen deficiency). You can take antacids Pantoprazole for three to four days and see if symptoms resolve. If your symptoms do not resolve and pregnancy test comes negative, you can do TSH (thyroid-stimulating hormone) test to rule out hypothyroidism. As you have taken depot for a long time, estrogen deficiency is likely, which can cause all of your symptoms. If possible shift to oral pills for contraception for a few months to avoid the same. I hope this helps.

Hello doctor,I am a 27-year-old female. I have been on Depo-Provera for six years. I am not taking any other medications. Lately, I have been experiencing severe mood swings and have not been myself. One minute I am dancing around the room and could not be happier, the next I am either crying or very angry. Normally, I do not cry and I am usually pretty laid back. I have also been getting dizzy mostly when I stand up or walk up the stairs. I have trouble sleeping and or sleeping too much. I am hungry all the time, however, when I do eat I feel nausea. I have done some research and have found that these symptoms are both common with the injection and also with pregnancy. How do I tell, if these are pregnancy symptoms or if it is because of the Depo shot? I did miss my last shot three months ago. Last month I took a home pregnancy test it came back negative. Will a home test be enough to tell if I am pregnant or not?

Hi. The home pregnancy test is fairly sensitive and very unlikely to miss pregnancy (except in very early pregnancy). If you suspect pregnancy strongly, you can repeat a home pregnancy test again after a week if period does not start. Most of your symptoms can be either due to indigestion or hormonal imbalance (hypothyroidism or estrogen deficiency). You can take antacids Pantoprazole for three to four days and see if symptoms resolve. If your symptoms do not resolve and pregnancy test comes negative, you can do TSH (thyroid-stimulating hormone) test to rule out hypothyroidism. As you have taken depot for a long time, estrogen deficiency is likely, which can cause all of your symptoms. If possible shift to oral pills for contraception for a few months to avoid the same. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 26-year-old boy. I am suffering from stomach pain, cramps, and gastric problem. Before six years when I eat some food I got still more inflammation, pain, and cramps. The first year when I reported in the hospital I came to know that I have gastric ulcer, so I took the medication, and I got cured in about five months.But I am severely suffering from the same kind of cramps and pains for almost six years. Now when I went to the hospital, they said everything is normal. But the thing is I did not know that masturbation or any sexual feelings may cause it and I have never discussed about my sex life to doctors.Usually, I masturbate five to six times in a week continuously (not every week of the month). During this time I noticed whenever I do masturbation I get pains and cramps immediately after ejaculation. There are few days when I masturbate I get some relief to those pains and cramps. This is because I think I am not holding my breath while I masturbate. The problem now is my pain and cramps is still for six years. Please help me to come out of this painful life. ### Response: Hello, Welcome to Chat Doctor forum. I can understand your concern for your symptoms. The cramps, and pain during and after masturbation can be due to, 1. Renal calculi, do you have any abdominal pain? 2. Urinary tract infection may be a reason. Do you have burning or increased urination? 3. Epididymitis causing scrotal pain. 4. Diabetic neuropathy can cause such pain. Please get it confirmed by blood sugar test. 5. Improper methods of masturbation can also cause pain. I hope I have answered your query. If you have further doubts, I would be happy to help you.

Hello doctor,I am a 26-year-old boy. I am suffering from stomach pain, cramps, and gastric problem. Before six years when I eat some food I got still more inflammation, pain, and cramps. The first year when I reported in the hospital I came to know that I have gastric ulcer, so I took the medication, and I got cured in about five months.But I am severely suffering from the same kind of cramps and pains for almost six years. Now when I went to the hospital, they said everything is normal. But the thing is I did not know that masturbation or any sexual feelings may cause it and I have never discussed about my sex life to doctors.Usually, I masturbate five to six times in a week continuously (not every week of the month). During this time I noticed whenever I do masturbation I get pains and cramps immediately after ejaculation. There are few days when I masturbate I get some relief to those pains and cramps. This is because I think I am not holding my breath while I masturbate. The problem now is my pain and cramps is still for six years. Please help me to come out of this painful life.

Hello, Welcome to Chat Doctor forum. I can understand your concern for your symptoms. The cramps, and pain during and after masturbation can be due to, 1. Renal calculi, do you have any abdominal pain? 2. Urinary tract infection may be a reason. Do you have burning or increased urination? 3. Epididymitis causing scrotal pain. 4. Diabetic neuropathy can cause such pain. Please get it confirmed by blood sugar test. 5. Improper methods of masturbation can also cause pain. I hope I have answered your query. If you have further doubts, I would be happy to help you.

### Instruction: Answer this question truthfully ###Input: I have experienced a back injury which has lasted for two months but it has gotten better lately. The event happened when I had my back extended to max(backbend training) and it was just sore afterwards, but the next day the range of motions had been very limited which I couldn't do any extension nor flexion. I felt the pain and compression around the sides of my lower back and middle back when I flex and extension degrees was limited as I felt it was at the middle of the spine prevents me to do so. I have been doing research about this which can seemingly be QL muscle spasm, thoracolumbo joint syndrome, and have tried gentle stretches also even rested but still experience the pain or discomfort. ### Response: Hi, Welcome to Chat Doctor forum. Never try to stretch any body part or full body in a first. if given a try the same will happen. stretching needs to be done on regular while doing exercises and can be extend day by day not by once. anyways dont worry about the low back pain here i will suggest you exercises which at first you need to do slow without any pressure for a week. then after a can do little fast, this will improve your muscles strengthening of lower back. apply the ointment to the area of pain, cover it for about 10-15mins with a cloth, then clean it with warm water following hot water fermentation. then do the following exercises. all the above exercises to be done carefully atleast once a day for 10 days. do not put pressure if pain is severe. diclofenac ointment to be used twice a day. Take Accelofenac+ paracetamol ( Zerodol P) for three days. once a day. slowly the range of motion will increase after a week. untill then take rest properly and take care. follow up after a week. thank you.

I have experienced a back injury which has lasted for two months but it has gotten better lately. The event happened when I had my back extended to max(backbend training) and it was just sore afterwards, but the next day the range of motions had been very limited which I couldn't do any extension nor flexion. I felt the pain and compression around the sides of my lower back and middle back when I flex and extension degrees was limited as I felt it was at the middle of the spine prevents me to do so. I have been doing research about this which can seemingly be QL muscle spasm, thoracolumbo joint syndrome, and have tried gentle stretches also even rested but still experience the pain or discomfort.

Hi, Welcome to Chat Doctor forum. Never try to stretch any body part or full body in a first. if given a try the same will happen. stretching needs to be done on regular while doing exercises and can be extend day by day not by once. anyways dont worry about the low back pain here i will suggest you exercises which at first you need to do slow without any pressure for a week. then after a can do little fast, this will improve your muscles strengthening of lower back. apply the ointment to the area of pain, cover it for about 10-15mins with a cloth, then clean it with warm water following hot water fermentation. then do the following exercises. all the above exercises to be done carefully atleast once a day for 10 days. do not put pressure if pain is severe. diclofenac ointment to be used twice a day. Take Accelofenac+ paracetamol ( Zerodol P) for three days. once a day. slowly the range of motion will increase after a week. untill then take rest properly and take care. follow up after a week. thank you.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I was diagnosed with chlamydia trachomatis about six weeks ago. After that, I had some discharge and discomfort inside the urethra. They did a PCR test, and the diagnosis was Chlamydia trachomatis. The doctor gave me Azithromycin, I took six pills as a single dose. I still had discharge and discomfort after one week, so I went back. I had a sensitive reaction to Doxycycline before, it gives me strong oral thrush, very painful. So I told the doctor to give me something else. He gave me Levofloxacin 500 mg, once daily for two weeks. I still had discharge after that, although the discomfort was less pronounced. I tried to take Doxycycline, but after taking only one pill, 100 mg of Doxycycline, I immediately developed oral thrush (it was hard to speak and eat for 10 days) and itchy and painful fungus on my penis, so I stopped. Now after two weeks the oral thrush is gone, but I have discharge and discomfort again like in the beginning. What should I do? Is there another antibiotic I can use? Do I have to use Doxycycline and take antifungal medicine like Fluconazole at the same time? Kindly help. ### Response: Hi. Yes, if you can tolerate Doxycycline, you may combine it with Fluconazole. Fungal infection may have occurred as a coincidence. So it may not be due to Doxycycline itself. Another option is to try Cynomycin (Minocycline) 100 mg twice daily for 14 days. You may add an anti-inflammatory after consulting your doctor. If there is dysuria or straining in urine, add an alpha blocker like Tamsulosin. Take care. Please use a condom till your infection goes away. Take care.

Hello doctor,I was diagnosed with chlamydia trachomatis about six weeks ago. After that, I had some discharge and discomfort inside the urethra. They did a PCR test, and the diagnosis was Chlamydia trachomatis. The doctor gave me Azithromycin, I took six pills as a single dose. I still had discharge and discomfort after one week, so I went back. I had a sensitive reaction to Doxycycline before, it gives me strong oral thrush, very painful. So I told the doctor to give me something else. He gave me Levofloxacin 500 mg, once daily for two weeks. I still had discharge after that, although the discomfort was less pronounced. I tried to take Doxycycline, but after taking only one pill, 100 mg of Doxycycline, I immediately developed oral thrush (it was hard to speak and eat for 10 days) and itchy and painful fungus on my penis, so I stopped. Now after two weeks the oral thrush is gone, but I have discharge and discomfort again like in the beginning. What should I do? Is there another antibiotic I can use? Do I have to use Doxycycline and take antifungal medicine like Fluconazole at the same time? Kindly help.

Hi. Yes, if you can tolerate Doxycycline, you may combine it with Fluconazole. Fungal infection may have occurred as a coincidence. So it may not be due to Doxycycline itself. Another option is to try Cynomycin (Minocycline) 100 mg twice daily for 14 days. You may add an anti-inflammatory after consulting your doctor. If there is dysuria or straining in urine, add an alpha blocker like Tamsulosin. Take care. Please use a condom till your infection goes away. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 33 year old female. I am married. I have two sons. I was diagnosed with hypothyroidism over ten years ago and I am on medication. I am having a horrible time with pms over last few months. I used to have terrible headaches and irritability before few days of my periods. Now it has been two weeks as my period is ten days late. I am having the worst time in my life right now. My headache and the pressure drive me crazy. I am having hard time. I am getting into deep depression. I do not know how to get through this. I cannot stop crying. I have an appointment finally with an endocrinologist in two weeks. Whenever the thing gets worse my gp will increase the dosage of my medicine. My hair is falling out. I am not the same person at all anymore. I feel like this is killing me. Need some help. ### Response: Hi, Welcome to Chat Doctor forum. I went through your query and I can understand your condition. First of all, I need to know whether your hypothyroidism is under control or not. Kindly upload your recent TSH (thyroid stimulating hormone) report. Now we need to see whether your headache and irritability is due to your PMS (premenstrual syn ChatDoctor. Your endocrinologist will evaluate for that. But a simple way to know is to halt your periods for two months and observe what happens. Ask your general practitioner to prescribe you certain oral contraceptive pills. This shall halt your periods for a month or two and if you feel better then it is due to PMS. But if there is no improvement then other evaluations have to be done including your blood pressure testing, eye check up and if necessary brain scan. If there is an improvement then you can take the contraceptive pills for three to four months and then stop and observe.

Hi doctor,I am a 33 year old female. I am married. I have two sons. I was diagnosed with hypothyroidism over ten years ago and I am on medication. I am having a horrible time with pms over last few months. I used to have terrible headaches and irritability before few days of my periods. Now it has been two weeks as my period is ten days late. I am having the worst time in my life right now. My headache and the pressure drive me crazy. I am having hard time. I am getting into deep depression. I do not know how to get through this. I cannot stop crying. I have an appointment finally with an endocrinologist in two weeks. Whenever the thing gets worse my gp will increase the dosage of my medicine. My hair is falling out. I am not the same person at all anymore. I feel like this is killing me. Need some help.

Hi, Welcome to Chat Doctor forum. I went through your query and I can understand your condition. First of all, I need to know whether your hypothyroidism is under control or not. Kindly upload your recent TSH (thyroid stimulating hormone) report. Now we need to see whether your headache and irritability is due to your PMS (premenstrual syn ChatDoctor. Your endocrinologist will evaluate for that. But a simple way to know is to halt your periods for two months and observe what happens. Ask your general practitioner to prescribe you certain oral contraceptive pills. This shall halt your periods for a month or two and if you feel better then it is due to PMS. But if there is no improvement then other evaluations have to be done including your blood pressure testing, eye check up and if necessary brain scan. If there is an improvement then you can take the contraceptive pills for three to four months and then stop and observe.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have an important query about the contraceptive pill. On the 2nd, my girlfriend started her period. It is now the 16th. So, I believe she is in her ovulation phase. Since her period stopped, she has begun, for the very first time, taking the combined contraceptive pill consistently at 8 AM every morning. She took the pill yesterday morning. Last night, on the 15th of March, we had unprotected sex (we thought one night without condoms would be fine). However, this morning she was in a rush and forgot to take her pill for today. It is 2 ### Response: Hello. A morning-after pill is different from the regular oral contraceptive pills. Do you mean to say the daily pill or an additional morning-after pill? I need clarity on this. If you mean the regular pill, do not use the phrase morning-after pill as that means an emergency pill used only once or twice depending on the dose.If you meant the regular pills which seems so from your history, she need not have to worry if the delay in taking the pill has not been more than 24 hours. It is fine to have taken it a few hours late as long as she has not skipped the pill that day. There is no need to take an additional pill if she has not missed the day\\s pill. If the pills were started a week before the intercourse and she has taken them daily and not missed a single pill, the effectiveness in preventing a pregnancy is about 99 percent. Do remember that no contraceptive pill or method is hun ChatDoctor. There is nothing to worry as of now and let her continue taking the pills as usual at the regular time. Hope I have answered your doubts. For more information consult an obstetrician and gynaecologist online

Hello doctor,I have an important query about the contraceptive pill. On the 2nd, my girlfriend started her period. It is now the 16th. So, I believe she is in her ovulation phase. Since her period stopped, she has begun, for the very first time, taking the combined contraceptive pill consistently at 8 AM every morning. She took the pill yesterday morning. Last night, on the 15th of March, we had unprotected sex (we thought one night without condoms would be fine). However, this morning she was in a rush and forgot to take her pill for today. It is 2

Hello. A morning-after pill is different from the regular oral contraceptive pills. Do you mean to say the daily pill or an additional morning-after pill? I need clarity on this. If you mean the regular pill, do not use the phrase morning-after pill as that means an emergency pill used only once or twice depending on the dose.If you meant the regular pills which seems so from your history, she need not have to worry if the delay in taking the pill has not been more than 24 hours. It is fine to have taken it a few hours late as long as she has not skipped the pill that day. There is no need to take an additional pill if she has not missed the day\\s pill. If the pills were started a week before the intercourse and she has taken them daily and not missed a single pill, the effectiveness in preventing a pregnancy is about 99 percent. Do remember that no contraceptive pill or method is hun ChatDoctor. There is nothing to worry as of now and let her continue taking the pills as usual at the regular time. Hope I have answered your doubts. For more information consult an obstetrician and gynaecologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor, I am a 19-year-old female. I have been having bad headaches for about six months now. They happen in very specific areas (top right of my head, top left of the neck). I could probably trace a quarter-sized circle around the area of pain. The pain radiates down the side of my face and even into my neck and sometimes affects my vision. They hurt terribly. I thought I was having an aneurysm. I get the pain only once in a week or two. They usually were gone within the hour, and I am better with Excedrin Migraine, but sometimes the pain comes back. I do not drink alcohol, caffeine, smoke, or take any medication regularly. The pain does not seem to happen at a particular time of day or during my menstrual cycle. Please help. ### Response: Hello. From your symptoms, I feel that you are suffering from Migraine. A migraine is a form of headache which most commonly affects young females. It gets worse when you have stress, lack of sleep, or gets triggered by some particular food or smell. But the problem is, there is no test to confirm Migraine, it is a clinical diagnosis. Also, diagnosis can be confirmed if you respond to Migraine treatment very well. My suggestion is to start your Migraine treatment. You observe for two weeks, if you are finding a good relief, then you shall continue the same medications, and it would confirm Migraine as your diagnosis. But in these two weeks, if there is no improvement, then we shall evaluate for certain other causes like cervical radiculopathy, trigeminal Neuralgia, etc. So start tablet Sibelium (Flunarizine) 10 mg every night after dinner for one month. You can continue tablet Exce ChatDoctor. I hope this helps.

Hello doctor, I am a 19-year-old female. I have been having bad headaches for about six months now. They happen in very specific areas (top right of my head, top left of the neck). I could probably trace a quarter-sized circle around the area of pain. The pain radiates down the side of my face and even into my neck and sometimes affects my vision. They hurt terribly. I thought I was having an aneurysm. I get the pain only once in a week or two. They usually were gone within the hour, and I am better with Excedrin Migraine, but sometimes the pain comes back. I do not drink alcohol, caffeine, smoke, or take any medication regularly. The pain does not seem to happen at a particular time of day or during my menstrual cycle. Please help.

Hello. From your symptoms, I feel that you are suffering from Migraine. A migraine is a form of headache which most commonly affects young females. It gets worse when you have stress, lack of sleep, or gets triggered by some particular food or smell. But the problem is, there is no test to confirm Migraine, it is a clinical diagnosis. Also, diagnosis can be confirmed if you respond to Migraine treatment very well. My suggestion is to start your Migraine treatment. You observe for two weeks, if you are finding a good relief, then you shall continue the same medications, and it would confirm Migraine as your diagnosis. But in these two weeks, if there is no improvement, then we shall evaluate for certain other causes like cervical radiculopathy, trigeminal Neuralgia, etc. So start tablet Sibelium (Flunarizine) 10 mg every night after dinner for one month. You can continue tablet Exce ChatDoctor. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 58-year-old man and I had a CBC with differential 10 days ago. I donate blood about every two months. I have been taking daily Metamucil for about three months and testosterone shots. My level is 930. All other tests are quite normal except HDL cholesterol which is low. I stopped drinking alcohol three months ago and anion gap was 6. I am on 12.5 mg of Atenolol, Amlodipine 10 mg, Irbesartan 300 mg once per day for hypertension. My BP is 123/76.I had flu-like symptoms at first with no congestion two weeks ago. I have bad joint and muscle aches. That went away. Now, I have fatigue, slight shortness of breath with numb hands and feet at night in bed. I have experienced symptoms of fatigue, slight shortness of breath at rest, hands falling asleep when I wake up at night. Even though the RBC is normal, do you think that the lab test below indicates iron deficiency anemia?The results of the CBC are as follows ### Response: Hello, Welcome to Chat Doctor forum. From these test results, you appear to have microcytosis and hypochromia of the red blood cells. This is most commonly seen in iron deficiency anemia. I would suggest you take iron and folic acid tablets thrice daily after meals for at least a month. As for the numbness of hands and feet, this could be a sign of vitamin B12 deficiency. Are you a vegetarian? If so then this could be a reason for the numbness. The other symptoms that you have described are consistent with iron deficiency. I would also advise you to not donate blood until your blood iron levels and ferritin stores are normalized. For more information consult a hematologist online

Hello doctor,I am a 58-year-old man and I had a CBC with differential 10 days ago. I donate blood about every two months. I have been taking daily Metamucil for about three months and testosterone shots. My level is 930. All other tests are quite normal except HDL cholesterol which is low. I stopped drinking alcohol three months ago and anion gap was 6. I am on 12.5 mg of Atenolol, Amlodipine 10 mg, Irbesartan 300 mg once per day for hypertension. My BP is 123/76.I had flu-like symptoms at first with no congestion two weeks ago. I have bad joint and muscle aches. That went away. Now, I have fatigue, slight shortness of breath with numb hands and feet at night in bed. I have experienced symptoms of fatigue, slight shortness of breath at rest, hands falling asleep when I wake up at night. Even though the RBC is normal, do you think that the lab test below indicates iron deficiency anemia?The results of the CBC are as follows

Hello, Welcome to Chat Doctor forum. From these test results, you appear to have microcytosis and hypochromia of the red blood cells. This is most commonly seen in iron deficiency anemia. I would suggest you take iron and folic acid tablets thrice daily after meals for at least a month. As for the numbness of hands and feet, this could be a sign of vitamin B12 deficiency. Are you a vegetarian? If so then this could be a reason for the numbness. The other symptoms that you have described are consistent with iron deficiency. I would also advise you to not donate blood until your blood iron levels and ferritin stores are normalized. For more information consult a hematologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor, I got liposuction surgery last month. I was in the hospital for two days and then I was discharged. I come from a small town so I had to go a bit far from my hometown for the surgery. My doctor claims that he has 22 liters of fat removed from my body. My bodyweight before surgery was 90 kgs and post-surgery it was around 79. I got liposuction in my thighs buttocks abdomen and arms. I searched online and it says that this much amount of fat removal from one surgery is not healthy. To give an idea of my BMI my height is 5\\2\". The problem is it is already 21 days since surgery, and I have one of the drains which my surgeon kept open still draining, it started to drain post 7 days of surgery and it is on the back of my right thigh, and this is the third that opened since surgery but the two drains have already closed and clean, I still have swelling all over my body and I am facing a bit of problem in walking normally. Because of the lockdown in my city I am unable to meet my surgeon and get post-op care, but he suggested that any general surgeon can help me so I consulted a general surgeon in my town and he said everything is fine. Also, I have skin necrosis on my left thigh. I do not know what I should do? As I have read online that most of the patients get well after 21 days of surgery and here I am still going through drain let alone nowhere close to healing completely. ### Response: Hi, Welcome to Chat Doctor forum. ChatDoctor. I think you were done a tumescent type of liposuction. You do not have any immediate complications as per your description, so I think it was done nicely. But prolonged complications in

Hello doctor, I got liposuction surgery last month. I was in the hospital for two days and then I was discharged. I come from a small town so I had to go a bit far from my hometown for the surgery. My doctor claims that he has 22 liters of fat removed from my body. My bodyweight before surgery was 90 kgs and post-surgery it was around 79. I got liposuction in my thighs buttocks abdomen and arms. I searched online and it says that this much amount of fat removal from one surgery is not healthy. To give an idea of my BMI my height is 5\\2\". The problem is it is already 21 days since surgery, and I have one of the drains which my surgeon kept open still draining, it started to drain post 7 days of surgery and it is on the back of my right thigh, and this is the third that opened since surgery but the two drains have already closed and clean, I still have swelling all over my body and I am facing a bit of problem in walking normally. Because of the lockdown in my city I am unable to meet my surgeon and get post-op care, but he suggested that any general surgeon can help me so I consulted a general surgeon in my town and he said everything is fine. Also, I have skin necrosis on my left thigh. I do not know what I should do? As I have read online that most of the patients get well after 21 days of surgery and here I am still going through drain let alone nowhere close to healing completely.

Hi, Welcome to Chat Doctor forum. ChatDoctor. I think you were done a tumescent type of liposuction. You do not have any immediate complications as per your description, so I think it was done nicely. But prolonged complications in

### Instruction: Answer this question truthfully ###Input: Hello doctor,My primary care physician and his PA overlooked at least 10 years of consistently low hemoglobin and hematocrit levels. When recently had flu-like symptoms without any upper respiratory symptoms, I went to a new PCP who ordered the blood test. That PCP noted the low hemoglobin and hematocrit and had me repeat the tests six weeks later. Still small, she referred me to a gastroenterologist to check for bleeding. He had access to all of my blood tests for the last 12 years and was the one who pointed out that the levels had been low.He concluded that there was no blood loss. The PCP then referred me to a hematologist. I am waiting to be seen by him. Of note, I have been consistently exhausted with low energy and motivation. I also have a multiple-decade history of recurrent aphthous stomatitis that is worsening. My blood results also showed a Vitamin B-12 level in excess of 1000 and a healthy iron level. I am wondering what could be going on. Any thoughts or recommendations you may have would be much appreciated. ### Response: Hello, Welcome to the ChatDoctor. If hemoglobin level and hematocrit low than iron deficiency anemia could be possible, I need to know how much is your hemoglobin value. So kindly attach your CBC (complete blood count) report to give a further comment regarding that. The B12 can be high due to supplement intake, liver disease or kidney disease or myeloproliferative blood disorder. So apart from CBC, you can investigate with liver and kidney profile reports as well to exclude liver and kidney disease. If all comes clear than no need to worry because B12 is water-soluble vitamin readily excreted through kidney. Kindly attach your reports. I hope I have answered your question. Let me know if I can assist you further.

Hello doctor,My primary care physician and his PA overlooked at least 10 years of consistently low hemoglobin and hematocrit levels. When recently had flu-like symptoms without any upper respiratory symptoms, I went to a new PCP who ordered the blood test. That PCP noted the low hemoglobin and hematocrit and had me repeat the tests six weeks later. Still small, she referred me to a gastroenterologist to check for bleeding. He had access to all of my blood tests for the last 12 years and was the one who pointed out that the levels had been low.He concluded that there was no blood loss. The PCP then referred me to a hematologist. I am waiting to be seen by him. Of note, I have been consistently exhausted with low energy and motivation. I also have a multiple-decade history of recurrent aphthous stomatitis that is worsening. My blood results also showed a Vitamin B-12 level in excess of 1000 and a healthy iron level. I am wondering what could be going on. Any thoughts or recommendations you may have would be much appreciated.

Hello, Welcome to the ChatDoctor. If hemoglobin level and hematocrit low than iron deficiency anemia could be possible, I need to know how much is your hemoglobin value. So kindly attach your CBC (complete blood count) report to give a further comment regarding that. The B12 can be high due to supplement intake, liver disease or kidney disease or myeloproliferative blood disorder. So apart from CBC, you can investigate with liver and kidney profile reports as well to exclude liver and kidney disease. If all comes clear than no need to worry because B12 is water-soluble vitamin readily excreted through kidney. Kindly attach your reports. I hope I have answered your question. Let me know if I can assist you further.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I was suffering from minor Achilles tendinopathy and visited a physiotherapist today to get it checked. During the session, he performed some deep tissue massage on the calf (which was very tight) to relax it, which was very painful. After the massage, I experienced sharp pains while walking (which was not there beforehand), and when I brought this up with the physio, he said it was normal because it was the first time I had gotten deep tissue massage on that area.I have been icing the calf and resting, and while it has gotten a little better, it still hurts to walk. I have my exams tomorrow which I have to get to and other events on the weekend where I have to be (and will involve walking). I am worried about how I can see as I cannot walk at all. Is it normal to experience such pain after deep tissue massage to tight calf muscles, or did I sustain some injury (say a muscle strain or something similar) and need to get it checked out? ### Response: Hello, Welcome to Chat Doctor forum. I read your concern. Sometimes, usually, they try to break the trigger points, and it would have caused discomfort. The technique itself is pro-inflammatory techniques and will induce some more inflammation so that healing happens. So do not worry. Now, I request you to ice your calf frequently like once in two hours for 15 minutes as of now and stretch it properly things should settle down fast. Tomorrow morning you might feel a lot of stiffness in the calf, do not worry as you have to stretch your calf gently and roll your calf over a foam roller or if have somebody ask them to massage it for few seconds. Things will be fine. You can walk without pain. I hope this is helpful to you. Kindly revert in case you need any further information in this regard.

Hello doctor,I was suffering from minor Achilles tendinopathy and visited a physiotherapist today to get it checked. During the session, he performed some deep tissue massage on the calf (which was very tight) to relax it, which was very painful. After the massage, I experienced sharp pains while walking (which was not there beforehand), and when I brought this up with the physio, he said it was normal because it was the first time I had gotten deep tissue massage on that area.I have been icing the calf and resting, and while it has gotten a little better, it still hurts to walk. I have my exams tomorrow which I have to get to and other events on the weekend where I have to be (and will involve walking). I am worried about how I can see as I cannot walk at all. Is it normal to experience such pain after deep tissue massage to tight calf muscles, or did I sustain some injury (say a muscle strain or something similar) and need to get it checked out?

Hello, Welcome to Chat Doctor forum. I read your concern. Sometimes, usually, they try to break the trigger points, and it would have caused discomfort. The technique itself is pro-inflammatory techniques and will induce some more inflammation so that healing happens. So do not worry. Now, I request you to ice your calf frequently like once in two hours for 15 minutes as of now and stretch it properly things should settle down fast. Tomorrow morning you might feel a lot of stiffness in the calf, do not worry as you have to stretch your calf gently and roll your calf over a foam roller or if have somebody ask them to massage it for few seconds. Things will be fine. You can walk without pain. I hope this is helpful to you. Kindly revert in case you need any further information in this regard.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My baby is 36 days old. He is passing stool very frequently like 15 times with little or more motion but not very heavy in the last 48 hours. The stool was curdy yellowish color, not like runny or watery, no greenish, no blood, no bubbles. He had the same issue when he was 18 days old, and in between, he was healthy but again he kept going motion and redness spotted in anus area with small spots of skin peel.Baby sleeps well, does not cry, passes urine usually in a good number of times, and only mother breastfeeding every two hours. Please request your advice on how to stop this frequent motion and reason for this happening and is this normal? He also makes a noise like sounding from inside especially more during night time, having trouble while breathing due to a chest cold, so am giving Rinoclear saline drops three to six hours once depending on his nose block. Please advise why baby makes such noise, is it normal?I was feeding breast milk via bottle for four to five days when he was two weeks old since he was unable to suck through mother\\s nipple. I stopped bottle when I encountered this frequent motion and with my doctor\\s advice. ### Response: Hello, Welcome to Chat Doctor forum. I understand your concern. 1. Passing motion too often is a normal phenomenon in neonates (gastrocolic reflex). Make sure baby is passing adequate urine and playful. 2. Redness over the perianal region may be due to prolonged wetness over the part or due to cleaning the area by rubbing. Wear him a napkin and change immediately once wet, the purpose is to keep ChatDoctor. Cleaning not to be done by rubbing, it can peel the skin. 3. Try to keep the perianal region

Hello doctor,My baby is 36 days old. He is passing stool very frequently like 15 times with little or more motion but not very heavy in the last 48 hours. The stool was curdy yellowish color, not like runny or watery, no greenish, no blood, no bubbles. He had the same issue when he was 18 days old, and in between, he was healthy but again he kept going motion and redness spotted in anus area with small spots of skin peel.Baby sleeps well, does not cry, passes urine usually in a good number of times, and only mother breastfeeding every two hours. Please request your advice on how to stop this frequent motion and reason for this happening and is this normal? He also makes a noise like sounding from inside especially more during night time, having trouble while breathing due to a chest cold, so am giving Rinoclear saline drops three to six hours once depending on his nose block. Please advise why baby makes such noise, is it normal?I was feeding breast milk via bottle for four to five days when he was two weeks old since he was unable to suck through mother\\s nipple. I stopped bottle when I encountered this frequent motion and with my doctor\\s advice.

Hello, Welcome to Chat Doctor forum. I understand your concern. 1. Passing motion too often is a normal phenomenon in neonates (gastrocolic reflex). Make sure baby is passing adequate urine and playful. 2. Redness over the perianal region may be due to prolonged wetness over the part or due to cleaning the area by rubbing. Wear him a napkin and change immediately once wet, the purpose is to keep ChatDoctor. Cleaning not to be done by rubbing, it can peel the skin. 3. Try to keep the perianal region

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 35 years old. My period was a month back. It sustained for four days. I generally use 3 to 4 pads in my periods. I had sex 10 days later. On the very next day, I had two Ovral G at around 9 AM and there after 12 hours again two Ovral G tablets. I noticed my period 12 days later, though it lasted for four days, the period was less and usually, my period happens four days earlier. In this month, it was six days earlier. I did hCG beta blood test. I am sending you the report. Can I be pregnant or conceive? Please advise because I want to abort. I am an unmarried woman. Can the blood test be wrong? What laboratory test I should do to get to know whether the fetus is there beyond uterus (ectopic pregnancy) as I m 35+. When should I go for ultrasound vagina testing to get the true picture? After that I did not have any sex, so then again can I be pregnant and that could not be detected now and can be detected on later? ### Response: Hi, Welcome to Chat Doctor forum. The test result is <0.10 (attachment removed to protect patient identity) which means it is negative and you are not pregnant and your period was six days early this time. nothing else. Do not worry much. And if you still have doubt then do urine pregnancy test weekly for two weeks and if negative then there is no chance of pregnancy. Negative means a single line and positive means double line. You have to see the result within five minutes. No need to go for an ultrasound now. Do ChatDoctor. There is no pregnancy as Ovral G (Norgestrel and Ethinylestradiol) has worked this time.

Hello doctor,I am 35 years old. My period was a month back. It sustained for four days. I generally use 3 to 4 pads in my periods. I had sex 10 days later. On the very next day, I had two Ovral G at around 9 AM and there after 12 hours again two Ovral G tablets. I noticed my period 12 days later, though it lasted for four days, the period was less and usually, my period happens four days earlier. In this month, it was six days earlier. I did hCG beta blood test. I am sending you the report. Can I be pregnant or conceive? Please advise because I want to abort. I am an unmarried woman. Can the blood test be wrong? What laboratory test I should do to get to know whether the fetus is there beyond uterus (ectopic pregnancy) as I m 35+. When should I go for ultrasound vagina testing to get the true picture? After that I did not have any sex, so then again can I be pregnant and that could not be detected now and can be detected on later?

Hi, Welcome to Chat Doctor forum. The test result is <0.10 (attachment removed to protect patient identity) which means it is negative and you are not pregnant and your period was six days early this time. nothing else. Do not worry much. And if you still have doubt then do urine pregnancy test weekly for two weeks and if negative then there is no chance of pregnancy. Negative means a single line and positive means double line. You have to see the result within five minutes. No need to go for an ultrasound now. Do ChatDoctor. There is no pregnancy as Ovral G (Norgestrel and Ethinylestradiol) has worked this time.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I and my fiancee do use condoms but sometimes condoms cause me pain due to size issues. So, we get into an intercourse without it. Basically, I never came inside her but I wanted to get educated about the facts like how to avoid pregnancy if I came inside her? I mean what should be our first step? Even if I pull out, is there any chances that she will get pregnant? Which condom is a perfect fit for starters like us? Is there any natural ways too to make sure no sperm left inside? ### Response: Hello, Welcome to Chat Doctor forum. I shall answer your query in the order that you have asked. If you have had unprotected sex and have come inside her, and she is in her unsafe period, then the next best step to avoid pregnancy would be for her to opt for an emergency contraceptive pill like an I-pill or an Unwanted 72 pill within 72 hours of intercourse to avoid unplanned pregnancy. You have to understand that even pre-cum, which is ejaculated before the actual ejaculation occurs also contains live active motile sperms, which can also get her pregnant even if you follow the with ChatDoctor. So chances shall remain unless you ensure pre-cum control as well. The condom size is mentioned on the pack and one can decide that based on his penile length and thickness at full erection. There are standard size condoms available but that is completely user\\s preference. Natural ways like washing with water immediately or wiping with tissues do not help much, but if you can opt for a spermicidal vaginal cream before initiating intercourse mixed with a vaginal lubricant like KY jelly, then chances of pregnancy can be substantially decreased even with an unprotected intercourse episode. But you cannot ensure even after cleaning post ejaculation that the vaginal cavity has been cleaned off of all sperms completely.

Hi doctor,I and my fiancee do use condoms but sometimes condoms cause me pain due to size issues. So, we get into an intercourse without it. Basically, I never came inside her but I wanted to get educated about the facts like how to avoid pregnancy if I came inside her? I mean what should be our first step? Even if I pull out, is there any chances that she will get pregnant? Which condom is a perfect fit for starters like us? Is there any natural ways too to make sure no sperm left inside?

Hello, Welcome to Chat Doctor forum. I shall answer your query in the order that you have asked. If you have had unprotected sex and have come inside her, and she is in her unsafe period, then the next best step to avoid pregnancy would be for her to opt for an emergency contraceptive pill like an I-pill or an Unwanted 72 pill within 72 hours of intercourse to avoid unplanned pregnancy. You have to understand that even pre-cum, which is ejaculated before the actual ejaculation occurs also contains live active motile sperms, which can also get her pregnant even if you follow the with ChatDoctor. So chances shall remain unless you ensure pre-cum control as well. The condom size is mentioned on the pack and one can decide that based on his penile length and thickness at full erection. There are standard size condoms available but that is completely user\\s preference. Natural ways like washing with water immediately or wiping with tissues do not help much, but if you can opt for a spermicidal vaginal cream before initiating intercourse mixed with a vaginal lubricant like KY jelly, then chances of pregnancy can be substantially decreased even with an unprotected intercourse episode. But you cannot ensure even after cleaning post ejaculation that the vaginal cavity has been cleaned off of all sperms completely.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My query is regarding my relative who is suffering from carcinoma of cervix. I would kindly request you to advise us regarding the stage of cancer based on the biopsy, MRI and CT scan report which I have attached here for your reference. In her MRI report, there is a feature suggestive of carcinoma of the cervix with parametrial extension. In CT scan it gives an impression of bulky cervix with parametrial fat stranding along with a few subcentimeter sized parenchymal and subpleural nodes in the bilateral lower lobes. I would like to know whether the above mentioned reports are sufficient to identify the stage of cancer? She even advised to get vaginal examination done. Is a PET scan necessary in this case in order to get a clear view than CT scan? Kindly guide us. ### Response: Hi. I would like to assure you that everything is going to be fine soon. I have thoroughly gone through your case and the reports (attachment removed to protect patient identity) and can well understand your genuine concerns. 1. She has got cervical carcinoma.2. It is a well differentiated type of adenocarcinoma that is an invasive cancer. This is a less common type of cancer compared to the squamous carcinoma.3. According to the staging systems devised for cervical cancers (AJCC-American Joint Committee on Cancer, TNM- tumor, lymph node and metastasis and FIGO - International Federation of Gynecology and Obstetrics), the tumor in this patient had spread to the distant organs. Thus it shows the lung metastasis.4. It falls into stage IV of the cervical cancer.5. Consult her treating physician for clinical correlation as it is very important, since I do not have the complete case in front of me. 1. No need of PET scan in this case.2. Vagina is normal on MRI of pelvis, so no need to worry for vaginal examination.

Hi doctor,My query is regarding my relative who is suffering from carcinoma of cervix. I would kindly request you to advise us regarding the stage of cancer based on the biopsy, MRI and CT scan report which I have attached here for your reference. In her MRI report, there is a feature suggestive of carcinoma of the cervix with parametrial extension. In CT scan it gives an impression of bulky cervix with parametrial fat stranding along with a few subcentimeter sized parenchymal and subpleural nodes in the bilateral lower lobes. I would like to know whether the above mentioned reports are sufficient to identify the stage of cancer? She even advised to get vaginal examination done. Is a PET scan necessary in this case in order to get a clear view than CT scan? Kindly guide us.

Hi. I would like to assure you that everything is going to be fine soon. I have thoroughly gone through your case and the reports (attachment removed to protect patient identity) and can well understand your genuine concerns. 1. She has got cervical carcinoma.2. It is a well differentiated type of adenocarcinoma that is an invasive cancer. This is a less common type of cancer compared to the squamous carcinoma.3. According to the staging systems devised for cervical cancers (AJCC-American Joint Committee on Cancer, TNM- tumor, lymph node and metastasis and FIGO - International Federation of Gynecology and Obstetrics), the tumor in this patient had spread to the distant organs. Thus it shows the lung metastasis.4. It falls into stage IV of the cervical cancer.5. Consult her treating physician for clinical correlation as it is very important, since I do not have the complete case in front of me. 1. No need of PET scan in this case.2. Vagina is normal on MRI of pelvis, so no need to worry for vaginal examination.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I got blood work for recurrent chest pain. All was normal but my D-dimer was 1.28 ug/ml (normal below 0.50). Chest CT with contrast normal, doppler u/s both legs normal, abdomen/pelvic CT, as well as abdominal ultrasound normal. The doctor says do not worry about D-dimer but it was normal range a year ago. I had a hysterectomy, endometriosis excision or fallopian tubes removed five months ago and it resulted in an abscess and sepsis. I was hospitalized for a week but recovered. I have Hashimoto\\s but no treatment because my TSH is in a normal range. Should I continue to pursue the D-dimer? Currently, I am taking Lexapro 10 mg daily. ### Response: Hello, Welcome to Chat Doctor forum. I think we should retest D-dimer may be after few weeks, three to four weeks. This is to see the trend and confirm the elevated levels. The usual causes for elevation include DVT (deep vein thrombosis), pulmonary embolism, infection, stroke, trauma and rarely some cancerous conditions. Also, D-dimer rises with age. But, all your investigations are negative so ruling out the major and important causes for elevated D-dimer. I guess at this moment, you are totally asymptomatic, right? No fever or any evidence of infection, etc. The elevation from previous infection five months back should have settled by this time. You have undergone all possible test to rule out the causes for elevated D-dimer so I think there is no need to worry about it at this moment. So overall, I think, we should repeat the test after three to four weeks. Also, see if you have any symptoms or let me know if suffered from recent infection or trauma. For more information consult an internal medicine physician online

Hello doctor,I got blood work for recurrent chest pain. All was normal but my D-dimer was 1.28 ug/ml (normal below 0.50). Chest CT with contrast normal, doppler u/s both legs normal, abdomen/pelvic CT, as well as abdominal ultrasound normal. The doctor says do not worry about D-dimer but it was normal range a year ago. I had a hysterectomy, endometriosis excision or fallopian tubes removed five months ago and it resulted in an abscess and sepsis. I was hospitalized for a week but recovered. I have Hashimoto\\s but no treatment because my TSH is in a normal range. Should I continue to pursue the D-dimer? Currently, I am taking Lexapro 10 mg daily.

Hello, Welcome to Chat Doctor forum. I think we should retest D-dimer may be after few weeks, three to four weeks. This is to see the trend and confirm the elevated levels. The usual causes for elevation include DVT (deep vein thrombosis), pulmonary embolism, infection, stroke, trauma and rarely some cancerous conditions. Also, D-dimer rises with age. But, all your investigations are negative so ruling out the major and important causes for elevated D-dimer. I guess at this moment, you are totally asymptomatic, right? No fever or any evidence of infection, etc. The elevation from previous infection five months back should have settled by this time. You have undergone all possible test to rule out the causes for elevated D-dimer so I think there is no need to worry about it at this moment. So overall, I think, we should repeat the test after three to four weeks. Also, see if you have any symptoms or let me know if suffered from recent infection or trauma. For more information consult an internal medicine physician online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had protected sexual intercourse five months back. Now tested for STD and everything came back negative. I have a question around HSV. HSV index value for type 1 is 0.70 and type 2 is 0.23. It was a type specific IgG antibody test. Is this result conclusive? Or do I need to retake at any point of time in the future? Your response is most appreciated. ### Response: Hello, Welcome to Chat Doctor forum. For that above limited information as you have not mentioned your age and sex here which is very very important for any clinician and if the question is specific about some sexually transmitted disease, because pH of male and female genital organs are different, so all bacterial and viral flora growth can be different according to sex. As you have told that you have had protected intercourse five months back, so it always decreases the chances of STDs (sexually transmitted disease) in any partner and you also mentioned that all reports of your related to STD are negative so I think no need to worry now as you have crossed the incubation period of almost all sexually transmitted diseases (five months is a big time). For your query about the HSV index, I think it is negative (I could not comment on the specificity of IgG, however even if it is nonspecific no matters, cause your index values are negative). So do not worry, results are conclusive definitely (officially, index value greater than 1.1 is considered positive and index value below 0.9 indicates a negative result). If the IgG test is negative, and at least six months have passed from the time of possible infection, you do not have herpes. Number between 0.9 and 1.1 is equivocal. Antibody to HSV-2 may or may not be present. Do not worry. Eat healthy and stay healthy.

Hello doctor,I had protected sexual intercourse five months back. Now tested for STD and everything came back negative. I have a question around HSV. HSV index value for type 1 is 0.70 and type 2 is 0.23. It was a type specific IgG antibody test. Is this result conclusive? Or do I need to retake at any point of time in the future? Your response is most appreciated.

Hello, Welcome to Chat Doctor forum. For that above limited information as you have not mentioned your age and sex here which is very very important for any clinician and if the question is specific about some sexually transmitted disease, because pH of male and female genital organs are different, so all bacterial and viral flora growth can be different according to sex. As you have told that you have had protected intercourse five months back, so it always decreases the chances of STDs (sexually transmitted disease) in any partner and you also mentioned that all reports of your related to STD are negative so I think no need to worry now as you have crossed the incubation period of almost all sexually transmitted diseases (five months is a big time). For your query about the HSV index, I think it is negative (I could not comment on the specificity of IgG, however even if it is nonspecific no matters, cause your index values are negative). So do not worry, results are conclusive definitely (officially, index value greater than 1.1 is considered positive and index value below 0.9 indicates a negative result). If the IgG test is negative, and at least six months have passed from the time of possible infection, you do not have herpes. Number between 0.9 and 1.1 is equivocal. Antibody to HSV-2 may or may not be present. Do not worry. Eat healthy and stay healthy.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I tested negative for ANA but positive for anti-dsDNA. My GP diagnosed me with ankylosing spondylitis when I have many symptoms of lupus just not the rash. My sister also has lupus and did not test positive for ANA. She has seronegative lupus. I am under the impression that anti-dsDNA has nothing to do with ankylosing spondylitis. Is that correct?I am currently taking Gabapentin, Tizanidine, Naproxen, Levothyroxine. ### Response: Hi, Welcome to Chat Doctor forum. You are right. Anti-dsDNA antibodies are specific for SLE (systemic lupus erythematosus), especially if the titers are high. Ankylosing spondylitis does not give you any kind of antibodies. Anti-smith antibodies are the most highly specific antibodies for lupus, but only a small percentage of people with lupus have them. Did you get that test? But it is strange that your ANA (antinuclear antibody) was negative. Anti-dsDNA is a type of ANA. I believe it is a false positive. A normal sedimentation rate essentially rules out inflammatory pathology. Lupus is an inflammatory disease. To begin with, we need to know more about your symptoms. SLE is diagnosed based on the symptoms and signs along with laboratory tests. It is not diagnosed just on the basis of an antibody test. You can get false positive tests (positive test in the absence of disease). So please get back to me with details of your symptoms. Based on the information you gave, I do not think you have lupus. There are no blood tests that can diagnose ankylosing spondylitis (AS). HLA-B27 is more common in people with AS, but it is not diagnostic. AS diagnosis needs clinical and radiological criteria. I hope this helps.

Hello doctor,I tested negative for ANA but positive for anti-dsDNA. My GP diagnosed me with ankylosing spondylitis when I have many symptoms of lupus just not the rash. My sister also has lupus and did not test positive for ANA. She has seronegative lupus. I am under the impression that anti-dsDNA has nothing to do with ankylosing spondylitis. Is that correct?I am currently taking Gabapentin, Tizanidine, Naproxen, Levothyroxine.

Hi, Welcome to Chat Doctor forum. You are right. Anti-dsDNA antibodies are specific for SLE (systemic lupus erythematosus), especially if the titers are high. Ankylosing spondylitis does not give you any kind of antibodies. Anti-smith antibodies are the most highly specific antibodies for lupus, but only a small percentage of people with lupus have them. Did you get that test? But it is strange that your ANA (antinuclear antibody) was negative. Anti-dsDNA is a type of ANA. I believe it is a false positive. A normal sedimentation rate essentially rules out inflammatory pathology. Lupus is an inflammatory disease. To begin with, we need to know more about your symptoms. SLE is diagnosed based on the symptoms and signs along with laboratory tests. It is not diagnosed just on the basis of an antibody test. You can get false positive tests (positive test in the absence of disease). So please get back to me with details of your symptoms. Based on the information you gave, I do not think you have lupus. There are no blood tests that can diagnose ankylosing spondylitis (AS). HLA-B27 is more common in people with AS, but it is not diagnostic. AS diagnosis needs clinical and radiological criteria. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,My husband is 33 years old with a weight of 95 kg and 5 feet 9 inches height. He has been having pain in his scrotum and testis area for the past 6 to 7 years after every 2 to 3 days whenever he does not masturbate or does not have sexual intercourse. If he masturbates daily or has sex daily, the pain does not come but if he misses it for even two days the pain and heaviness come back which goes away only after ejaculation. We got married almost one and a half years back but he has been having this problem for a long time. He says it all started after a few years back whenever he would get aroused after watching porn and could not masturbate. He has not consulted any doctor yet. What could be the reason for his problem? I am worried. That pain and heaviness sometimes make walking difficult for him. ### Response: Hello. I can understand your concern. He has persistent testicular pain which develops usually when he does not masturbate or have sex. If the pain is persistent and is severe then that should be evaluated. The causes should be ruled out in order to make the diagnosis. Infection in testis should be ruled out first. Though any granuloma, torsion are other rare possibilities. Non-specific testicular pain is seen in a lot of individuals. His urine and semen analysis should be done. Scrotal ultrasound should also be done. This will grossly rule out possible causes. A prophylactic antibiotic course can be given if there is any mild infection or there are pus cells in semen. Doxycycline can be given for at least four weeks. Anti-inflammatory ChatDoctor. This should solve the problem. If the problem persists and all investigations come normal, then that pain could be due to some psychological reasons. Take care.

Hello doctor,My husband is 33 years old with a weight of 95 kg and 5 feet 9 inches height. He has been having pain in his scrotum and testis area for the past 6 to 7 years after every 2 to 3 days whenever he does not masturbate or does not have sexual intercourse. If he masturbates daily or has sex daily, the pain does not come but if he misses it for even two days the pain and heaviness come back which goes away only after ejaculation. We got married almost one and a half years back but he has been having this problem for a long time. He says it all started after a few years back whenever he would get aroused after watching porn and could not masturbate. He has not consulted any doctor yet. What could be the reason for his problem? I am worried. That pain and heaviness sometimes make walking difficult for him.

Hello. I can understand your concern. He has persistent testicular pain which develops usually when he does not masturbate or have sex. If the pain is persistent and is severe then that should be evaluated. The causes should be ruled out in order to make the diagnosis. Infection in testis should be ruled out first. Though any granuloma, torsion are other rare possibilities. Non-specific testicular pain is seen in a lot of individuals. His urine and semen analysis should be done. Scrotal ultrasound should also be done. This will grossly rule out possible causes. A prophylactic antibiotic course can be given if there is any mild infection or there are pus cells in semen. Doxycycline can be given for at least four weeks. Anti-inflammatory ChatDoctor. This should solve the problem. If the problem persists and all investigations come normal, then that pain could be due to some psychological reasons. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My 3.5 years old mild autistic son is nonverbal. The doctor has given Risperidone (Sizodon) and some vitamin supplements for the last six months. My son is under speech therapy also. As all the allopathy medicine has side effects, is there any safe and assured ayurveda treatment for this condition? To what extent can my son get improved? What is the probable time frame? My son is hyperactive. He cannot focus as there is some sensory issue. He avoids the unknown person, especially same aged children. He is very selective in food and does not chew a few foods. He does not like almost any fruit. His MRI, USG, ECG, allergy panel and blood count were normal. He was vitamin D deficient. ### Response: Hello, Welcome to Chat Doctor forum. I just read your query. As you have mentioned about autism, autism is a neurodevelopmental disorder. People start noticing the symptoms in their chil ChatDoctor. It might be due to some genetic problem, environmental issue, some infection during pregnancy like Rubella and sometimes no known reason can be ruled out with this problem. The other symptoms you have mentioned like hyperactivity, lack of focus and difficulty in interaction with other people are all associated with the same problem. The reason behind all this is that your son\\s neurological and behavioral development is not normal. Sometimes this problem improves up to a large extent with the help of medicine and other therapies. Sometimes, it can be there as such during a lifetime. No doctor or medicine can assure you about the exact time and the exact progress. But that does not mean you stop trying. Now coming to ayurveda medicine, there are prescribed many medicines in ayurveda which will help your baby up to a great extent. Genetic or environmental. Revert after a month to an ayurveda specialist online.-

Hi doctor,My 3.5 years old mild autistic son is nonverbal. The doctor has given Risperidone (Sizodon) and some vitamin supplements for the last six months. My son is under speech therapy also. As all the allopathy medicine has side effects, is there any safe and assured ayurveda treatment for this condition? To what extent can my son get improved? What is the probable time frame? My son is hyperactive. He cannot focus as there is some sensory issue. He avoids the unknown person, especially same aged children. He is very selective in food and does not chew a few foods. He does not like almost any fruit. His MRI, USG, ECG, allergy panel and blood count were normal. He was vitamin D deficient.

Hello, Welcome to Chat Doctor forum. I just read your query. As you have mentioned about autism, autism is a neurodevelopmental disorder. People start noticing the symptoms in their chil ChatDoctor. It might be due to some genetic problem, environmental issue, some infection during pregnancy like Rubella and sometimes no known reason can be ruled out with this problem. The other symptoms you have mentioned like hyperactivity, lack of focus and difficulty in interaction with other people are all associated with the same problem. The reason behind all this is that your son\\s neurological and behavioral development is not normal. Sometimes this problem improves up to a large extent with the help of medicine and other therapies. Sometimes, it can be there as such during a lifetime. No doctor or medicine can assure you about the exact time and the exact progress. But that does not mean you stop trying. Now coming to ayurveda medicine, there are prescribed many medicines in ayurveda which will help your baby up to a great extent. Genetic or environmental. Revert after a month to an ayurveda specialist online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a braces-related question. I wore the traditional metal braces on my upper jaw as a teen, 10 years ago. I wore the retainer for five years every night, and then I reduced it to one night per month after that, as instructed. My front four teeth shifted a lot (they are crowded, so it was a quite visible shift, some were pushed out, and some pushed back).The retainer could make a big difference in one night when I wore it, but I was advised to get a completely new brace. So a few days ago, I got a lingual brace on the front teeth (the social six). My concern now is the speed of shifting. A couple of hours after getting the braces, my teeth were significantly straighter (1 to 2 mm difference).A day after they look almost perfect, I was told I would be wearing the braces for six months to a year. How is such a drastic change possible so quickly, and is it healthy or normal? It hurts always, but it is not unbearable. And could I have used a new retainer instead of getting new braces then? I hope you can help with my worries. ### Response: Hello. All the movement and everything depends on the bone density in your oral cavity so no issues if it is going faster, it is a good sign that it is showing you benefits so soon. And braces and retainers each have their course of works so you should not be regretting on putting braces, there might be some issues your dentist would have observed through X-ray that is why she or he felt the need for braces. If you have been told six months, does not mean six months always, if there will be good results, it might be reduced to four to five months even. So go ahead confidently, your dentist is doing right.

Hello doctor,I have a braces-related question. I wore the traditional metal braces on my upper jaw as a teen, 10 years ago. I wore the retainer for five years every night, and then I reduced it to one night per month after that, as instructed. My front four teeth shifted a lot (they are crowded, so it was a quite visible shift, some were pushed out, and some pushed back).The retainer could make a big difference in one night when I wore it, but I was advised to get a completely new brace. So a few days ago, I got a lingual brace on the front teeth (the social six). My concern now is the speed of shifting. A couple of hours after getting the braces, my teeth were significantly straighter (1 to 2 mm difference).A day after they look almost perfect, I was told I would be wearing the braces for six months to a year. How is such a drastic change possible so quickly, and is it healthy or normal? It hurts always, but it is not unbearable. And could I have used a new retainer instead of getting new braces then? I hope you can help with my worries.

Hello. All the movement and everything depends on the bone density in your oral cavity so no issues if it is going faster, it is a good sign that it is showing you benefits so soon. And braces and retainers each have their course of works so you should not be regretting on putting braces, there might be some issues your dentist would have observed through X-ray that is why she or he felt the need for braces. If you have been told six months, does not mean six months always, if there will be good results, it might be reduced to four to five months even. So go ahead confidently, your dentist is doing right.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 31 years old and got married three years ago. This is my second pregnancy and I am currently 12 weeks pregnant. I had terminated my first pregnancy due to my bad health condition. I am a practicing architect and a teacher. My work schedule is about 9 to 10 working hours a day with a sedentary pattern.My first sonography was taken during my fourth week of pregnancy which showed that I have a septate uterus. During my eighth week, there was some bleeding observed in my vagina. On my gynecologist suggestion, I had another sonography which showed that everything was normal. Post that my doctor put me on bedrest for four weeks. I also had NT scan and dual marker blood test during my 12th week whose reports were normal. The doctor has recommended me to have a uterus stitched at 14 to 16 weeks.Please guide me as to what precautions should I take with respect to food and lifestyle? Since I have a successful architectural practice, I am under stress to complete the work on the given deadline. There has been a month backlog in work which may cause me severe financial issues. Is it advisable to return back to work with all the above complications? If yes, what precautions can I take? ### Response: Hello. With working job and pregnancy, it is a difficult task. First being pregnant you need to relax. Do not stress out. Stress even mental stress has ill effects on pregnancy. Also, your weight is on the higher side. As you crossed 12 weeks, do a minimal routine physical activity. In diet, eat more vegetable and fruits with ChatDoctor. Avoid junk, processed, fried food. Also, stitch, you can put for the betterment of pregnancy. As far as now, your pregnancy is more important than anything else.

Hello doctor,I am 31 years old and got married three years ago. This is my second pregnancy and I am currently 12 weeks pregnant. I had terminated my first pregnancy due to my bad health condition. I am a practicing architect and a teacher. My work schedule is about 9 to 10 working hours a day with a sedentary pattern.My first sonography was taken during my fourth week of pregnancy which showed that I have a septate uterus. During my eighth week, there was some bleeding observed in my vagina. On my gynecologist suggestion, I had another sonography which showed that everything was normal. Post that my doctor put me on bedrest for four weeks. I also had NT scan and dual marker blood test during my 12th week whose reports were normal. The doctor has recommended me to have a uterus stitched at 14 to 16 weeks.Please guide me as to what precautions should I take with respect to food and lifestyle? Since I have a successful architectural practice, I am under stress to complete the work on the given deadline. There has been a month backlog in work which may cause me severe financial issues. Is it advisable to return back to work with all the above complications? If yes, what precautions can I take?

Hello. With working job and pregnancy, it is a difficult task. First being pregnant you need to relax. Do not stress out. Stress even mental stress has ill effects on pregnancy. Also, your weight is on the higher side. As you crossed 12 weeks, do a minimal routine physical activity. In diet, eat more vegetable and fruits with ChatDoctor. Avoid junk, processed, fried food. Also, stitch, you can put for the betterment of pregnancy. As far as now, your pregnancy is more important than anything else.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am 24 years old. I am suffering from a neurological disease and due to this I am getting weak day by day. My toes are gone almost numb since last two years and the same things are now happening with the upper limbs. I had this disease from childhood, but in a progressive state. So, with time my health degraded constantly. It started affecting my lower limbs. Now, I cannot even walk or stand properly. Now, it started affecting my upper limb as well. I cannot lift heavy objects due to weakness in grip and cannot do any manipulation by fingers quickly such as typing, writing, etc. I have been treated in various hospitals since my childhood. Currently, it was predicted as vasculitis neuropathy and getting treatment accordingly. I have gone through various treatments till now, but unfortunately nothing worked. Now, my doctor suggested me an injection called Rituximab, which can possibly stop the growth of this disease. The two dosages of this injection are quite expensive and due to this we are worried that how much safer is this injection to me. Hence, I thought that I should take an opinion from you before taking this injection. Could you please suggest me your opinion by looking at my attached reports, Is there any possibility to cure this rare disease or at least to stop the growth of this disease? Should I go for this Rituximab injection? I know, it would be a challenging task, but please spend some time and share your thoughts. I have attached my reports, prescription and life history from childhood. Any suggestions would be really helpful to save my life. ### Response: Hi. I am here to help you. First and foremost, I would like to congratulate you for your excellent narration and detailed documentation of the prescriptions and reports (attachment removed to protect patient identity), which has enabled me to have a good understanding.

Hi doctor,I am 24 years old. I am suffering from a neurological disease and due to this I am getting weak day by day. My toes are gone almost numb since last two years and the same things are now happening with the upper limbs. I had this disease from childhood, but in a progressive state. So, with time my health degraded constantly. It started affecting my lower limbs. Now, I cannot even walk or stand properly. Now, it started affecting my upper limb as well. I cannot lift heavy objects due to weakness in grip and cannot do any manipulation by fingers quickly such as typing, writing, etc. I have been treated in various hospitals since my childhood. Currently, it was predicted as vasculitis neuropathy and getting treatment accordingly. I have gone through various treatments till now, but unfortunately nothing worked. Now, my doctor suggested me an injection called Rituximab, which can possibly stop the growth of this disease. The two dosages of this injection are quite expensive and due to this we are worried that how much safer is this injection to me. Hence, I thought that I should take an opinion from you before taking this injection. Could you please suggest me your opinion by looking at my attached reports, Is there any possibility to cure this rare disease or at least to stop the growth of this disease? Should I go for this Rituximab injection? I know, it would be a challenging task, but please spend some time and share your thoughts. I have attached my reports, prescription and life history from childhood. Any suggestions would be really helpful to save my life.

Hi. I am here to help you. First and foremost, I would like to congratulate you for your excellent narration and detailed documentation of the prescriptions and reports (attachment removed to protect patient identity), which has enabled me to have a good understanding.

### Instruction: Answer this question truthfully ###Input: Hi doctor,My wife has a normal regular menstrual cycle and her age is 35. I am attaching the estradiol (E2) hormone report of my wife. The blood serum sample was taken on the 23rd day of her menstrual cycle. The estradiol (E2) level is 179.48 pg/mL. We have been married since 3 years and have a 2 year old son. Actually, she has faced the problem of vaginal dryness lately. As it could be due to lower levels of estradiol or perimenopausal symptoms, so we got the estradiol level check done. Although, the report has a reference range, we do not know if this level of the corresponding day is optimal or not. Please advice on this. Kindly let us know regarding the estradiol levels in a healthy woman. ### Response: Hello, Welcome to Chat Doctor forum. There are two major types of estrogen, the female sex hormone. They are estradiol and estrone. In younger woman, the first one is in abundant quantity and the second one is in less. And near menopause, the level just reverses. It means there is more production of estrone at menopause. The normal estradiol level in the second half in perimenopausal age varies between 39 to 300 pg/mL and it varies from different times of cycle. A level below 30 is definitely about menopause. Now, her level is within normal limit. Vaginal ChatDoctor. I suggest you to measure the level of FSH (follicle stimulating hormone) to determine her menopausal status. However, at this estradiol level, she should not be advised for hormone replacement now. You may be benefited by the application of some gel or cream during intercourse.

Hi doctor,My wife has a normal regular menstrual cycle and her age is 35. I am attaching the estradiol (E2) hormone report of my wife. The blood serum sample was taken on the 23rd day of her menstrual cycle. The estradiol (E2) level is 179.48 pg/mL. We have been married since 3 years and have a 2 year old son. Actually, she has faced the problem of vaginal dryness lately. As it could be due to lower levels of estradiol or perimenopausal symptoms, so we got the estradiol level check done. Although, the report has a reference range, we do not know if this level of the corresponding day is optimal or not. Please advice on this. Kindly let us know regarding the estradiol levels in a healthy woman.

Hello, Welcome to Chat Doctor forum. There are two major types of estrogen, the female sex hormone. They are estradiol and estrone. In younger woman, the first one is in abundant quantity and the second one is in less. And near menopause, the level just reverses. It means there is more production of estrone at menopause. The normal estradiol level in the second half in perimenopausal age varies between 39 to 300 pg/mL and it varies from different times of cycle. A level below 30 is definitely about menopause. Now, her level is within normal limit. Vaginal ChatDoctor. I suggest you to measure the level of FSH (follicle stimulating hormone) to determine her menopausal status. However, at this estradiol level, she should not be advised for hormone replacement now. You may be benefited by the application of some gel or cream during intercourse.

### Instruction: Answer this question truthfully ###Input: Hi doctor, I am 30 years old. I have BRCA1 genetic mutation that is still undergoing more research as they are not sure of the exact risk yet. My mom had breast cancer at the age of 56 and her cousin had the same at the age of 46. They were both positive to hormonal therapy. Another cousin had ovarian cancer at the age of 49. They are all cancer-free now.I have a fibrocystic breast and one fibroadenoma confirmed with a biopsy three years ago. I had an ultrasound scan three months ago and found more cysts and nothing major to worry about. I had another ultrasound a week ago as I felt a new little lump. That lump turned out to be another cyst, but the doctor found another lump she had not seen three months before. It has regular borders and it is moveable but it has some vascularities. She says it cannot be a cyst and could be a fibroadenoma but it has to be confirmed by a biopsy which I will have next week.I know that sometimes triple-negative breast cancer lumps can be mistaken for fibroadenoma but how likely is that chance? I am feeling quite anxious and worried. With a fibrocystic breast is it possible to have a fibroadenoma appear this fast? Or is it possible that an ultrasound would have missed it last time? ### Response: Hi, Welcome to ChatDoctor. Since you have BRCA1 (breast cancer type 1) positive with a strong family history of breast cancer, there is always a risk of developing cancer. You need to have a regular followup. Ultrasound sometime may miss early changes. Since you have a high tendency of developing cancer you can undergo a complete mastectomy. It is a tough decision for you, but it is worth. Take care.

Hi doctor, I am 30 years old. I have BRCA1 genetic mutation that is still undergoing more research as they are not sure of the exact risk yet. My mom had breast cancer at the age of 56 and her cousin had the same at the age of 46. They were both positive to hormonal therapy. Another cousin had ovarian cancer at the age of 49. They are all cancer-free now.I have a fibrocystic breast and one fibroadenoma confirmed with a biopsy three years ago. I had an ultrasound scan three months ago and found more cysts and nothing major to worry about. I had another ultrasound a week ago as I felt a new little lump. That lump turned out to be another cyst, but the doctor found another lump she had not seen three months before. It has regular borders and it is moveable but it has some vascularities. She says it cannot be a cyst and could be a fibroadenoma but it has to be confirmed by a biopsy which I will have next week.I know that sometimes triple-negative breast cancer lumps can be mistaken for fibroadenoma but how likely is that chance? I am feeling quite anxious and worried. With a fibrocystic breast is it possible to have a fibroadenoma appear this fast? Or is it possible that an ultrasound would have missed it last time?

Hi, Welcome to ChatDoctor. Since you have BRCA1 (breast cancer type 1) positive with a strong family history of breast cancer, there is always a risk of developing cancer. You need to have a regular followup. Ultrasound sometime may miss early changes. Since you have a high tendency of developing cancer you can undergo a complete mastectomy. It is a tough decision for you, but it is worth. Take care.

### Instruction: Answer this question truthfully ###Input: Dear doctor,I want to test myself for HGH deficiency. Can you tell me a complete guide on how should I proceed? What tests should I do? After I have done them, can I post it here for a thorough examination from your doctors, so that they can tell me whether I am HGH deficient?I want to test that because I have hypothyroidism and I am taking Levothyroxine and my levels are now normal. They were not normal two years ago and I had severe symptoms of hypothyroidism (severe fatigue, severe muscle cramps, lethargy, brain focus problems, pretty much all of the symptoms of hypothyroidism).Moreover, I made tests back then and I saw that my somatoprin levels were a lot below the normal.My reasons for this testing is that I think that this hypothyroidism really has stunted my growth, and pretty much everything in my development. From 16 to 19 years, I have not treated my hypothyroidism and I just lagged behind in development compared to my peers.Now I just want to see if I can do anything. Maybe if I have HGH deficiency, I still could manage to grow a little with HGH replacement or something.My age is 21, I also have beta thalassemia minor. I do not have any other medical issues. ### Response: Hi, Welcome to Chat Doctor forum. You need to check IGF1 level (insulin-like growth factor 1), liver function and kidney function tests and hemoglobin level. Also please take an x-ray of your left elbow and left knee joint AP view (anteroposterior view) to assess the bone age, and to check whether ends of the bones still have room enough to allow growth or they have fused. Kindly mention your height and your parents\\ height. You may also send your latest thyroid reports.

Dear doctor,I want to test myself for HGH deficiency. Can you tell me a complete guide on how should I proceed? What tests should I do? After I have done them, can I post it here for a thorough examination from your doctors, so that they can tell me whether I am HGH deficient?I want to test that because I have hypothyroidism and I am taking Levothyroxine and my levels are now normal. They were not normal two years ago and I had severe symptoms of hypothyroidism (severe fatigue, severe muscle cramps, lethargy, brain focus problems, pretty much all of the symptoms of hypothyroidism).Moreover, I made tests back then and I saw that my somatoprin levels were a lot below the normal.My reasons for this testing is that I think that this hypothyroidism really has stunted my growth, and pretty much everything in my development. From 16 to 19 years, I have not treated my hypothyroidism and I just lagged behind in development compared to my peers.Now I just want to see if I can do anything. Maybe if I have HGH deficiency, I still could manage to grow a little with HGH replacement or something.My age is 21, I also have beta thalassemia minor. I do not have any other medical issues.

Hi, Welcome to Chat Doctor forum. You need to check IGF1 level (insulin-like growth factor 1), liver function and kidney function tests and hemoglobin level. Also please take an x-ray of your left elbow and left knee joint AP view (anteroposterior view) to assess the bone age, and to check whether ends of the bones still have room enough to allow growth or they have fused. Kindly mention your height and your parents\\ height. You may also send your latest thyroid reports.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am a 30 year old male working in a national insurance company. My height is 5 feet 11 inches and weight is 85 kg. I do not drink and I do not have any other habits. I eat mixed diet.I am married and have one baby girl (two years of age). I am leading a stressless life both at home and office. I am a very calm and smooth going person.My only concern is my health.I feel some pricking pain in the upper back side of the shoulder and left side of the chest. I feel very uncomfortable.I feel drowsy and unsteady throughout the day.When I am walking or sitting or sleeping I feel that I am pulling down to the ground and I feel extreme tiredness and pain in legs. At the same time, I feel air hunger and not able to breath comfortably.With all these pains and drowsiness I am doing my routine work.Also I feel pain in left side of head next to eye and I feel dull.Two years back I underwent MRI cervical spine, CT chest and one year back I underwent CT coronary angiogram. I was diagnosed with sliding hiatus hernia last month. I underwent appendicitis operation one year back. I am attaching my recent reports for your reference.As I am young, I am much worried about my present health condition. As I do not have the habit of regular exercise I keep gaining weight. I am not sure whether my diet is healthy and balanced. Please advice. ### Response: Hello, Welcome to Chat Doctor forum. I have reviewed all your reports (attachment removed to protect patient identity). You seem to be having GERD (Gastroesophageal Reflux Disease) due to hiatus hernia. The GERD might cause the chest and back pain. Get an ECG done to rule out any cardiac event. Stay healthy.

Hi doctor,I am a 30 year old male working in a national insurance company. My height is 5 feet 11 inches and weight is 85 kg. I do not drink and I do not have any other habits. I eat mixed diet.I am married and have one baby girl (two years of age). I am leading a stressless life both at home and office. I am a very calm and smooth going person.My only concern is my health.I feel some pricking pain in the upper back side of the shoulder and left side of the chest. I feel very uncomfortable.I feel drowsy and unsteady throughout the day.When I am walking or sitting or sleeping I feel that I am pulling down to the ground and I feel extreme tiredness and pain in legs. At the same time, I feel air hunger and not able to breath comfortably.With all these pains and drowsiness I am doing my routine work.Also I feel pain in left side of head next to eye and I feel dull.Two years back I underwent MRI cervical spine, CT chest and one year back I underwent CT coronary angiogram. I was diagnosed with sliding hiatus hernia last month. I underwent appendicitis operation one year back. I am attaching my recent reports for your reference.As I am young, I am much worried about my present health condition. As I do not have the habit of regular exercise I keep gaining weight. I am not sure whether my diet is healthy and balanced. Please advice.

Hello, Welcome to Chat Doctor forum. I have reviewed all your reports (attachment removed to protect patient identity). You seem to be having GERD (Gastroesophageal Reflux Disease) due to hiatus hernia. The GERD might cause the chest and back pain. Get an ECG done to rule out any cardiac event. Stay healthy.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 29 year old married female. I delivered my baby a year ago. I had post-spinal headache for three days in the hospital. Again, for the last eight months, I have been suffering with severe upper shoulder pain, neck pain and one-sided headache. It started with severe giddiness and nausea. I have consulted many neuro physicians and they prescribed me medicines for migraine along with antidepressants. But, I did not get any relief.A neurosurgeon told me to take Dolo for three weeks and Stalopam 10 mg. That too, did not help me. I got my MRI scan done and was diagnosed to have a small cyst (subependymoma) in my head, which doctors said as non-cancerous and not related to these headaches. I lifted heavy weights in my fourth month after my delivery and I had upper shoulder pain.Later, my neck and head pain started. I guess, pain in my upper shoulder muscle leads to neck pain and headache. Doctors say it as a migraine, but I am not sensitive to light. I started taking Vasograin since five days and feeling good for about 80%. Please help to come out of this terrible headache and muscle pain. ### Response: Hi. We are here to help you. You seem to be suffering from fibromyalgia (muscle pain and fatigue) Fibromyalgia can be associated with migraine headache that presents with one-sided headache. Also, following delivery, females do get these kind of pains and headache due to breastfeeding has led to vitamin D and calcium deficiency causing such pains. Now, I would recommend in such case a test for vitamin D and iron profile. Treatment recommendations would be Amitriptyline and Duloxetine for pain. Vitamin D and iron can be added later based on the reports. Take care.

Hello doctor,I am a 29 year old married female. I delivered my baby a year ago. I had post-spinal headache for three days in the hospital. Again, for the last eight months, I have been suffering with severe upper shoulder pain, neck pain and one-sided headache. It started with severe giddiness and nausea. I have consulted many neuro physicians and they prescribed me medicines for migraine along with antidepressants. But, I did not get any relief.A neurosurgeon told me to take Dolo for three weeks and Stalopam 10 mg. That too, did not help me. I got my MRI scan done and was diagnosed to have a small cyst (subependymoma) in my head, which doctors said as non-cancerous and not related to these headaches. I lifted heavy weights in my fourth month after my delivery and I had upper shoulder pain.Later, my neck and head pain started. I guess, pain in my upper shoulder muscle leads to neck pain and headache. Doctors say it as a migraine, but I am not sensitive to light. I started taking Vasograin since five days and feeling good for about 80%. Please help to come out of this terrible headache and muscle pain.

Hi. We are here to help you. You seem to be suffering from fibromyalgia (muscle pain and fatigue) Fibromyalgia can be associated with migraine headache that presents with one-sided headache. Also, following delivery, females do get these kind of pains and headache due to breastfeeding has led to vitamin D and calcium deficiency causing such pains. Now, I would recommend in such case a test for vitamin D and iron profile. Treatment recommendations would be Amitriptyline and Duloxetine for pain. Vitamin D and iron can be added later based on the reports. Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had unprotected sex with my boy friend two days before my actual period, at around 5pm. I took an i-pill within one hour after sex i.e, before 6 pm. It is three days more than my actual period date and I still have not got my periods. What are my chances of getting pregnant? Are there high risks involved in getting pregnant since I had unprotected sex 2 days before my period date? Should I do a pregnancy test? If yes then what tests should I do and when is the right time to do? What should I do? Please advise as I am worried. How many days should I wait, since today is the 3rd day and I still have not got my periods? Please help. ### Response: Hi, Welcome to Chat Doctor forum. Please do not be worried. You have done a right thing by taking i-pill within 72 hours of last sexual intercourse. You were not likely to menstruate on your actual due date simply because it takes about 5-7 days for bleeding to occur after taking i-pill. It is also a known side effect of i-pill that the following menses may be delayed or may be heavy. In case periods do not resume in the next 10 days, then you must do a urine pregnancy test to rule out pregnancy. If the test comes as negative, then please do not take any medication. Just wait for your periods to return, till then practise barrier contraception. If the test is positive which is unlikely though, keeping in mind that i-pill does not cause any congenital abnormalities in fetus, you would need to make an informed decision as to continue or terminate the pregnancy (which can be done by medical methods in early first trimester after ultrasound scan confirmation). Consult a gynaecologist online for further follow up

Hello doctor,I had unprotected sex with my boy friend two days before my actual period, at around 5pm. I took an i-pill within one hour after sex i.e, before 6 pm. It is three days more than my actual period date and I still have not got my periods. What are my chances of getting pregnant? Are there high risks involved in getting pregnant since I had unprotected sex 2 days before my period date? Should I do a pregnancy test? If yes then what tests should I do and when is the right time to do? What should I do? Please advise as I am worried. How many days should I wait, since today is the 3rd day and I still have not got my periods? Please help.

Hi, Welcome to Chat Doctor forum. Please do not be worried. You have done a right thing by taking i-pill within 72 hours of last sexual intercourse. You were not likely to menstruate on your actual due date simply because it takes about 5-7 days for bleeding to occur after taking i-pill. It is also a known side effect of i-pill that the following menses may be delayed or may be heavy. In case periods do not resume in the next 10 days, then you must do a urine pregnancy test to rule out pregnancy. If the test comes as negative, then please do not take any medication. Just wait for your periods to return, till then practise barrier contraception. If the test is positive which is unlikely though, keeping in mind that i-pill does not cause any congenital abnormalities in fetus, you would need to make an informed decision as to continue or terminate the pregnancy (which can be done by medical methods in early first trimester after ultrasound scan confirmation). Consult a gynaecologist online for further follow up

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have a two-year-old daughter. She suffers from a cough for the past 17 days. It is nonproductive, and it gets worse when lying down. During night time, it comes as a dry hacking cough. The illness started with nasal congestion, and quickly, it became a cough. There is no rash, no changes in bowel movements or urination, or energy level. She has undergone tonsillectomy and adenoidectomy before ten months for sleep apnea, and it was successful.She gets this problem for the past six months. She does not have a fever. We used steroids before these events. Now, her cough got worsened for the past two days. We consulted a pediatrician, and she was given with Prednisone 15 mg two times a day and Augmentin. I gave steroids to her.She woke up in the night and had vomiting two times. She had a fever of 104 degrees. She also had congestion. I consulted the pediatrician. Currently, she takes Zofran 4 mg, Ibuprofen 10 mg, and Augmentin. Does she have a new viral infection? Why does her cough got worsened? Is it due to a progressive lower respiratory bacterial infection? Is it due to a drug reaction to the steroid? ### Response: Hi. It is less likely to be a viral infection as the temperature is quite high. It may be a viral bug, and it can be worsened after the administration of the steroid. Do not give steroid without a prescription to the child. Do a respiratory PCR, and it helps to find the exact cause of the same. A cough may have worsened following the steroid probably, because, it can be an infectious disease to be treated by antibiotics. It may not be a ChatDoctor. Chil Take care.

Hi doctor,I have a two-year-old daughter. She suffers from a cough for the past 17 days. It is nonproductive, and it gets worse when lying down. During night time, it comes as a dry hacking cough. The illness started with nasal congestion, and quickly, it became a cough. There is no rash, no changes in bowel movements or urination, or energy level. She has undergone tonsillectomy and adenoidectomy before ten months for sleep apnea, and it was successful.She gets this problem for the past six months. She does not have a fever. We used steroids before these events. Now, her cough got worsened for the past two days. We consulted a pediatrician, and she was given with Prednisone 15 mg two times a day and Augmentin. I gave steroids to her.She woke up in the night and had vomiting two times. She had a fever of 104 degrees. She also had congestion. I consulted the pediatrician. Currently, she takes Zofran 4 mg, Ibuprofen 10 mg, and Augmentin. Does she have a new viral infection? Why does her cough got worsened? Is it due to a progressive lower respiratory bacterial infection? Is it due to a drug reaction to the steroid?

Hi. It is less likely to be a viral infection as the temperature is quite high. It may be a viral bug, and it can be worsened after the administration of the steroid. Do not give steroid without a prescription to the child. Do a respiratory PCR, and it helps to find the exact cause of the same. A cough may have worsened following the steroid probably, because, it can be an infectious disease to be treated by antibiotics. It may not be a ChatDoctor. Chil Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 29 year old female. I have been dealing with back pain for over seven years now. I have never been in any type of injury and had MRIs done of my brain, cervical, lumbar, and thoracic spine five years ago. They stated I had three bulging discs and an annular tear. My thoracic spine noted a few scattered hemangiomas and a questionable small vascular anomaly in the midthoracic vertebral body. This is where my pain hurts the most. On the cervical spine MRI, it stated that I had a narrowing of the canal with degenerative disc disease with no spinal cord abnormality. My MRI of the brain came back fine with some inflammation within the paranasal sinuses and moderate lymph nodes in the neck which may be suspicious for shotty adenopathy.My first positive ANA was four years ago with elevated antistreptolysin O Ab, but never have I had strep throat or ever been diagnosed or treated for it. I had my adenoids removed when I was young. My CBC was all normal except for a slightly deranged RBC and hematocrit levels that were lower than the normal range. My TSH was elevated at 5.870, but I believe I had that retested later on, and it was within normal limits. I was then referred to a rheumatologist due to the positive ANA and other symptoms that I was having. Their results concluded no elevation of dRVVT or a PTT and ruled Lupus screening negative due to my levels being within normal limits. My C3 is at 121, C4 is 31 and rheumatoid factor. ### Response: Hello, Welcome to Chat Doctor forum. I went through your post. You have not mentioned what you want to know and what your current problem is. Regards. For more information consult a rheumatologist online

Hello doctor,I am a 29 year old female. I have been dealing with back pain for over seven years now. I have never been in any type of injury and had MRIs done of my brain, cervical, lumbar, and thoracic spine five years ago. They stated I had three bulging discs and an annular tear. My thoracic spine noted a few scattered hemangiomas and a questionable small vascular anomaly in the midthoracic vertebral body. This is where my pain hurts the most. On the cervical spine MRI, it stated that I had a narrowing of the canal with degenerative disc disease with no spinal cord abnormality. My MRI of the brain came back fine with some inflammation within the paranasal sinuses and moderate lymph nodes in the neck which may be suspicious for shotty adenopathy.My first positive ANA was four years ago with elevated antistreptolysin O Ab, but never have I had strep throat or ever been diagnosed or treated for it. I had my adenoids removed when I was young. My CBC was all normal except for a slightly deranged RBC and hematocrit levels that were lower than the normal range. My TSH was elevated at 5.870, but I believe I had that retested later on, and it was within normal limits. I was then referred to a rheumatologist due to the positive ANA and other symptoms that I was having. Their results concluded no elevation of dRVVT or a PTT and ruled Lupus screening negative due to my levels being within normal limits. My C3 is at 121, C4 is 31 and rheumatoid factor.

Hello, Welcome to Chat Doctor forum. I went through your post. You have not mentioned what you want to know and what your current problem is. Regards. For more information consult a rheumatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I have a headache in my upper part of the head. I do not know if it is connected with my neck because I had stiff neck due to my sleeping position. Well I lay down to bed most of the time due to quarantine and after I had that stiff neck I had this. It is not actually a headache, I guess it is like irritation in my upper head. I do not know if it should be treated with a pain reliever. As it is not that severe I did not take it. ### Response: Hi, Welcome to ChatDoctor. I understand your concern. I need to know more about your headache. How and when does it start? Is it unilateral or both sides? Is it intermittent or continuous or any diurnal variation? Any aggravating or relieving factors? Light or noise sensitivity? Does it associate with nausea, vomiting, or blurring of vision? Did you have a history of migraines or asthma? Any history of fever or sinusitis? You should always note the red flags of headache such as sudden onset of headache, the onset of headache after 50 years of age, increased frequency or severity of headache, new onset of headache with an underlying medical condition, headache with concomitant systemic illness (fever and weight loss), focal neurologic signs or symptoms, blurring of vision. In that case, you need urgent evaluation. If they are absent, you need not be worried. Some times neck muscle tension stiffness may lead to headaches, as in your case. Simple Paracetamol or muscle relaxant will be useful. Adjust your sleeping position, try not to use high pillows. Another most common cause of headache is migraine. Simple Paracetamol at the onset of the headache will be helpful. Also, avoid triggers that lead to a headache. You should have adequate sleep, avoid stress, and take meals on time. I hope this helps.

Hello doctor,I have a headache in my upper part of the head. I do not know if it is connected with my neck because I had stiff neck due to my sleeping position. Well I lay down to bed most of the time due to quarantine and after I had that stiff neck I had this. It is not actually a headache, I guess it is like irritation in my upper head. I do not know if it should be treated with a pain reliever. As it is not that severe I did not take it.

Hi, Welcome to ChatDoctor. I understand your concern. I need to know more about your headache. How and when does it start? Is it unilateral or both sides? Is it intermittent or continuous or any diurnal variation? Any aggravating or relieving factors? Light or noise sensitivity? Does it associate with nausea, vomiting, or blurring of vision? Did you have a history of migraines or asthma? Any history of fever or sinusitis? You should always note the red flags of headache such as sudden onset of headache, the onset of headache after 50 years of age, increased frequency or severity of headache, new onset of headache with an underlying medical condition, headache with concomitant systemic illness (fever and weight loss), focal neurologic signs or symptoms, blurring of vision. In that case, you need urgent evaluation. If they are absent, you need not be worried. Some times neck muscle tension stiffness may lead to headaches, as in your case. Simple Paracetamol or muscle relaxant will be useful. Adjust your sleeping position, try not to use high pillows. Another most common cause of headache is migraine. Simple Paracetamol at the onset of the headache will be helpful. Also, avoid triggers that lead to a headache. You should have adequate sleep, avoid stress, and take meals on time. I hope this helps.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 22-year-old male. I played soccer throughout my teens competitively. Five years ago, I injured the muscle in my thigh, what I presume was a tear of which I sat out from sports for a week or two, however, was rushed back into playing by my mother who thought I was faking the injury. I injured the muscle again, and these proceeded to happen again once more, leading me to quit sports and focus on going to studies the following year.Currently now, whenever I stretch my thigh muscle by pulling my leg up behind me, I get a slight uncomfortable feel in my thigh muscle which I know is not normal, however, it is not painful enough to tell me to stop doing it. Furthermore, I have been in the gym and jogging where my muscle seems to be fine, but when I decide to sprint there is a 50 percent chance that I will get into discomfort again. However, it does not feel like a tear, but it will become numb for a few days and finally, if I go to kick a ball it is almost certain that the same result from sprinting will happen.I have recently started to stretch the muscle to try and see if I can regain its strength to allow me to do these few things again without worrying about hurting my muscles again. I am not sure what other things I can do to help this, such as different types of stretches, etc? ### Response: Hello, Welcome to Chat Doctor forum. I read your concern. In my opinion, you had a tear of your qua ChatDoctor. So there is a possibility that a scar formed on the tear area of the muscle leading to stiffness and numbness is due to any neural stiffness around the scar area. Possibly there will be nerve entrapment. Do not worry. All you have to do is

Hello doctor,I am a 22-year-old male. I played soccer throughout my teens competitively. Five years ago, I injured the muscle in my thigh, what I presume was a tear of which I sat out from sports for a week or two, however, was rushed back into playing by my mother who thought I was faking the injury. I injured the muscle again, and these proceeded to happen again once more, leading me to quit sports and focus on going to studies the following year.Currently now, whenever I stretch my thigh muscle by pulling my leg up behind me, I get a slight uncomfortable feel in my thigh muscle which I know is not normal, however, it is not painful enough to tell me to stop doing it. Furthermore, I have been in the gym and jogging where my muscle seems to be fine, but when I decide to sprint there is a 50 percent chance that I will get into discomfort again. However, it does not feel like a tear, but it will become numb for a few days and finally, if I go to kick a ball it is almost certain that the same result from sprinting will happen.I have recently started to stretch the muscle to try and see if I can regain its strength to allow me to do these few things again without worrying about hurting my muscles again. I am not sure what other things I can do to help this, such as different types of stretches, etc?

Hello, Welcome to Chat Doctor forum. I read your concern. In my opinion, you had a tear of your qua ChatDoctor. So there is a possibility that a scar formed on the tear area of the muscle leading to stiffness and numbness is due to any neural stiffness around the scar area. Possibly there will be nerve entrapment. Do not worry. All you have to do is

### Instruction: Answer this question truthfully ###Input: Hi doctor,I have been married for eight years, it was a love marriage, and things were fine initially. Three years back, my husband left his job to pursue his passion for becoming an entrepreneur, and I supported him in whichever way I could, both mentally and financially. But, things did not go as per the plan. He has always been a very confident person, who has always thought high of himself. So, because of all this, his weekly drinking habit got converted to daily drinking. It has been three years since we had any sexual relationship. When I try to confront him, it only ends up in an argument, and he tries to pull me down mentally. Things took an uglier turn when he verbally abused me, and I had to leave the room to protect me and my kid. He keeps abusing me mentally in front of our 5 year old son. It is very disturbing to see our kid being raised up like this. It has become a routine for my husband, although lately, he has become very sensitive about me. I told my father about this, and he asked me to come back home. My mother is suffering from blood cancer, and she will live only for 2 to 3 years more. She does not know about all this, if I leave everything today, I may loose my mother way too early. She will not be able to bear it. I am so mentally sick and irritated, and I do not know wat to do. My husband says that things will change. Is it advisable to forget everything and start fresh? My mind is saying no, but I cannot disturb my parents anymore. Please help. ### Response: Hi. I have read your query and understand your concerns. I hope this helps you. If you have more questions, feel free to write back to me. Thanks and regards.

Hi doctor,I have been married for eight years, it was a love marriage, and things were fine initially. Three years back, my husband left his job to pursue his passion for becoming an entrepreneur, and I supported him in whichever way I could, both mentally and financially. But, things did not go as per the plan. He has always been a very confident person, who has always thought high of himself. So, because of all this, his weekly drinking habit got converted to daily drinking. It has been three years since we had any sexual relationship. When I try to confront him, it only ends up in an argument, and he tries to pull me down mentally. Things took an uglier turn when he verbally abused me, and I had to leave the room to protect me and my kid. He keeps abusing me mentally in front of our 5 year old son. It is very disturbing to see our kid being raised up like this. It has become a routine for my husband, although lately, he has become very sensitive about me. I told my father about this, and he asked me to come back home. My mother is suffering from blood cancer, and she will live only for 2 to 3 years more. She does not know about all this, if I leave everything today, I may loose my mother way too early. She will not be able to bear it. I am so mentally sick and irritated, and I do not know wat to do. My husband says that things will change. Is it advisable to forget everything and start fresh? My mind is saying no, but I cannot disturb my parents anymore. Please help.

Hi. I have read your query and understand your concerns. I hope this helps you. If you have more questions, feel free to write back to me. Thanks and regards.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I hope you can help me with my anxiety. I am a 35-year-old female who has severe health anxiety and panic disorder with agoraphobia. I have been doing good until this past month. Then, I got sick and had a fever.My heart rate was high during the time of fever. I became extremely anxious about it and went out to buy pulse oxygen to keep an eye on it. WelI I think that was a bad idea. For example, when I am up around the house cleaning, it can hit 130. When I am walking into someplace I have anxiety it can get up to 140. And I feel it. Then I get more scared.I want to start walking with my mom. But I feel scared because it may increase my heart rate. I need some reassurance as I have stuck in this heart fear. Blood pressure generally runs 107/75 and resting heart rate is around 70.I weight 134 lbs (60 kg), and my height is 5\\3. Seven years ago I had an echocardiogram when my anxiety first started, and I wore a 30 days Holter monitor. All was good except some PVCs. I also had a stress test without contrast during that time that was also fine. I have always been scared to exercise because of the fear of my heart rate and thinking it will make me have a heart attack or go into cardiac arrest.Please, can you give me some reassurance? I came to know that I can duplicate any chest pain by pressing on the spot then snap out of thinking I have a heart attack. ### Response: Hello, Welcome to Chat Doctor forum. I passed carefully through your medical history. Considering your clinical symptoms and performed medical test I would explain as follows

Hello doctor,I hope you can help me with my anxiety. I am a 35-year-old female who has severe health anxiety and panic disorder with agoraphobia. I have been doing good until this past month. Then, I got sick and had a fever.My heart rate was high during the time of fever. I became extremely anxious about it and went out to buy pulse oxygen to keep an eye on it. WelI I think that was a bad idea. For example, when I am up around the house cleaning, it can hit 130. When I am walking into someplace I have anxiety it can get up to 140. And I feel it. Then I get more scared.I want to start walking with my mom. But I feel scared because it may increase my heart rate. I need some reassurance as I have stuck in this heart fear. Blood pressure generally runs 107/75 and resting heart rate is around 70.I weight 134 lbs (60 kg), and my height is 5\\3. Seven years ago I had an echocardiogram when my anxiety first started, and I wore a 30 days Holter monitor. All was good except some PVCs. I also had a stress test without contrast during that time that was also fine. I have always been scared to exercise because of the fear of my heart rate and thinking it will make me have a heart attack or go into cardiac arrest.Please, can you give me some reassurance? I came to know that I can duplicate any chest pain by pressing on the spot then snap out of thinking I have a heart attack.

Hello, Welcome to Chat Doctor forum. I passed carefully through your medical history. Considering your clinical symptoms and performed medical test I would explain as follows

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 30 years old male suffering from coccydynia for many years due to injury. I fell back on cement at that time. X-ray showed a hairline fracture. The doctor said it will heal. Use donut cushion but the pain did not relieve. My pain symptoms are localized pain only at coccyx area. I cannot sit directly on the surface with coccyx wedge cushion can sit for 30 minutes. Recently, I underwent dynamic coccyx X-rays and lumbar spine along with coccyx. MRI reports say mild retrolisthesis at the sacrococcygeal joint along with obtuse anterior angulation (120\\xb0) which is mildly increasing in sitting compared to standing. I have undergone physiotherapy, external and internal manipulation, a steroid with numbing agent injection directly on the coccyx painful area without live X-ray alternative medicine, no relief. So, by seeing my reports please reply what is my coccyx condition name, whether it is hypermobile or rigid. Surgery is the only solution or can I try proper chiropractic adjustments which I did not get done or ganglion impair block and RF ablation, Prolo or PRP injections are useful in my case which is chronic? Please reply in detail. ### Response: Hi, Welcome to Chat Doctor forum. Your condition is called coccydynia and usually, most of the patients improve with conservative treatment. You have also taken steroid injections which might have had given you relief for a few days. (Not mentioned in history but I am assuming). Surgery for the same is mostly not required. You can try for PRP injection. PRP (platelet-rich plasma) has been seen to cause healing as compared to steroid injections which only cause suppression of inflammation. For more information consult an orthopaedician and traumatologist online

Hello doctor,I am 30 years old male suffering from coccydynia for many years due to injury. I fell back on cement at that time. X-ray showed a hairline fracture. The doctor said it will heal. Use donut cushion but the pain did not relieve. My pain symptoms are localized pain only at coccyx area. I cannot sit directly on the surface with coccyx wedge cushion can sit for 30 minutes. Recently, I underwent dynamic coccyx X-rays and lumbar spine along with coccyx. MRI reports say mild retrolisthesis at the sacrococcygeal joint along with obtuse anterior angulation (120\\xb0) which is mildly increasing in sitting compared to standing. I have undergone physiotherapy, external and internal manipulation, a steroid with numbing agent injection directly on the coccyx painful area without live X-ray alternative medicine, no relief. So, by seeing my reports please reply what is my coccyx condition name, whether it is hypermobile or rigid. Surgery is the only solution or can I try proper chiropractic adjustments which I did not get done or ganglion impair block and RF ablation, Prolo or PRP injections are useful in my case which is chronic? Please reply in detail.

Hi, Welcome to Chat Doctor forum. Your condition is called coccydynia and usually, most of the patients improve with conservative treatment. You have also taken steroid injections which might have had given you relief for a few days. (Not mentioned in history but I am assuming). Surgery for the same is mostly not required. You can try for PRP injection. PRP (platelet-rich plasma) has been seen to cause healing as compared to steroid injections which only cause suppression of inflammation. For more information consult an orthopaedician and traumatologist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 76-year-old male. I have difficulty to fall asleep for more than two years. I started to take 0.25 mg of Restoril and 1 mg of Melatonin. As the days progressed, I increased my Restoril dosage gradually to 1.25 mg and Melatonin to 3 mg. Last night, I found it was not enough. In desperation, I took one tablet of Valium and slept until 10 a.m. I feel that Restoril may have lost its effect on me.Unfortunately, I do not have the courage to commit euthanasia. I do not know what to take tonight. Please advice. I had many serious ailments in my life describing them in detail is tedious. Shortly those ailments were Potts, acid-fast bacilli, and heart valve replacement. Please advice. ### Response: Hello, Welcome to Chat Doctor forum. It seems that you have tolerance for Restoril (Temazepam). We can increase the dose up to 30 mg before sleep. Kindly do not stop the medication abruptly. It should be stopped gradually over at least a period of two weeks. Also Valium (Diazepam) 10 mg before sleep can be used instead of Restoril not adding to it and the same precautions must be taken. I suggest you take Valium 10 mg or Restoril 30 mg before sleep. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to follow all good sleep hygiene. Provide me with all your medications and medical reports in order to exclude any secondary cause of insomnia such as hyperthyroidism or side effects of other medications Follow up after one week. I strongly recommend against euthanasia. For more information consult a general medicine physician online

Hello doctor,I am a 76-year-old male. I have difficulty to fall asleep for more than two years. I started to take 0.25 mg of Restoril and 1 mg of Melatonin. As the days progressed, I increased my Restoril dosage gradually to 1.25 mg and Melatonin to 3 mg. Last night, I found it was not enough. In desperation, I took one tablet of Valium and slept until 10 a.m. I feel that Restoril may have lost its effect on me.Unfortunately, I do not have the courage to commit euthanasia. I do not know what to take tonight. Please advice. I had many serious ailments in my life describing them in detail is tedious. Shortly those ailments were Potts, acid-fast bacilli, and heart valve replacement. Please advice.

Hello, Welcome to Chat Doctor forum. It seems that you have tolerance for Restoril (Temazepam). We can increase the dose up to 30 mg before sleep. Kindly do not stop the medication abruptly. It should be stopped gradually over at least a period of two weeks. Also Valium (Diazepam) 10 mg before sleep can be used instead of Restoril not adding to it and the same precautions must be taken. I suggest you take Valium 10 mg or Restoril 30 mg before sleep. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to follow all good sleep hygiene. Provide me with all your medications and medical reports in order to exclude any secondary cause of insomnia such as hyperthyroidism or side effects of other medications Follow up after one week. I strongly recommend against euthanasia. For more information consult a general medicine physician online

### Instruction: Answer this question truthfully ###Input: Hi doctor,I had hypothyroidism for 24 years. I also have Sjogren\\s syndrome, but I do not have autoimmune thyroid problems. I was taking .150 mcg of Levothyroxine for 23 years. Six months ago, my doctor told me that I have hyperthyroidism and lowered my dosage to .137 mcg. I had increased fatigue.Again she reduced it to .125 mcg, and I experienced extreme fatigue, weight gain, muscle weakness, and joint pain. I had increased sleeping for 20 hours on weekends. But still, my doctor told me that my TSH is high, and she reduced the dosage of Levothyroxine. My free T4 is normal. I have never tested T3. I am worried regarding the TSH. I had a TSH of 0.05 mIU/L before five months, 0.02 mIU/L before three months and 0.1 mIU/L before a month. Should I have to see an endocrinologist? Please help me. ### Response: Hi, Welcome to Chat Doctor forum. I have gone through the attachment (attachment removed to protect patient identity). Your TSH (thyroid stimulating hormone) is in the lower normal range, just near the border. The dosage of Levothyroxine has to be reduced. Try to maintain TSH around 2 mIU/L. Please test your FT4 (free thyroxine) levels. I believe that you experience fatigue due a secondary cause. Ask your doctor to get anemia workup done, get vitamin D, and calcium levels. Sjogren syn ChatDoctor. If your results have not shown any abnormalities, then it is better to consult a rheumatologist rather than seeing an endocrinologist in my opinion.

Hi doctor,I had hypothyroidism for 24 years. I also have Sjogren\\s syndrome, but I do not have autoimmune thyroid problems. I was taking .150 mcg of Levothyroxine for 23 years. Six months ago, my doctor told me that I have hyperthyroidism and lowered my dosage to .137 mcg. I had increased fatigue.Again she reduced it to .125 mcg, and I experienced extreme fatigue, weight gain, muscle weakness, and joint pain. I had increased sleeping for 20 hours on weekends. But still, my doctor told me that my TSH is high, and she reduced the dosage of Levothyroxine. My free T4 is normal. I have never tested T3. I am worried regarding the TSH. I had a TSH of 0.05 mIU/L before five months, 0.02 mIU/L before three months and 0.1 mIU/L before a month. Should I have to see an endocrinologist? Please help me.

Hi, Welcome to Chat Doctor forum. I have gone through the attachment (attachment removed to protect patient identity). Your TSH (thyroid stimulating hormone) is in the lower normal range, just near the border. The dosage of Levothyroxine has to be reduced. Try to maintain TSH around 2 mIU/L. Please test your FT4 (free thyroxine) levels. I believe that you experience fatigue due a secondary cause. Ask your doctor to get anemia workup done, get vitamin D, and calcium levels. Sjogren syn ChatDoctor. If your results have not shown any abnormalities, then it is better to consult a rheumatologist rather than seeing an endocrinologist in my opinion.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 23-year-old man. I have anxiety and depression but no immunodeficiency disorders or chronic diseases. First, I wanna know if my immune system is weakened and how likely am I to die of Coronavirus.Second, I have itchiness in my throat and shortness of breath. I always have it because of anxiety but now it is more persistent than before. I also feel a very subtle feeling of pain, burning sensation and itchiness in my chest. I did not go out during the past ten days and have not been in contact with someone with positive Covid. And I quit smoking past week. Down to one or zero cigarettes from 20 a day. Why am I feeling itchiness and pain and burning sensation? How likely am I to have Covid-19? And how likely am I to die from it? ### Response: Hello, Welcome to Chat Doctor forum. Anxiety can manifest itself in physical or psychological symptoms or both. The irritation sensation you are experiencing is a part of your anxiety. Also please do not believe the hype about covid. It has a low mortality rate, of 2-3 percent, that too mortality is very high in people above 60-70 years with other co-morbidities. You do not have any such disorders and you have not even been in contact with anyone, so do not worry. Please continue to take your medicines for anxiety if you are taking them, if not, please consider visiting a psychiatrist and get started on some low dose SSRI type of medicines. Also, if needed a low dose Benzodiazepines can be added temporarily. Also, please do some deep breathing exercises, or progressive muscle relaxation. You can also take some honey with water to reduce the itching in the throat and also try doing some gargles with lukewarm salt water.

Hello doctor,I am a 23-year-old man. I have anxiety and depression but no immunodeficiency disorders or chronic diseases. First, I wanna know if my immune system is weakened and how likely am I to die of Coronavirus.Second, I have itchiness in my throat and shortness of breath. I always have it because of anxiety but now it is more persistent than before. I also feel a very subtle feeling of pain, burning sensation and itchiness in my chest. I did not go out during the past ten days and have not been in contact with someone with positive Covid. And I quit smoking past week. Down to one or zero cigarettes from 20 a day. Why am I feeling itchiness and pain and burning sensation? How likely am I to have Covid-19? And how likely am I to die from it?

Hello, Welcome to Chat Doctor forum. Anxiety can manifest itself in physical or psychological symptoms or both. The irritation sensation you are experiencing is a part of your anxiety. Also please do not believe the hype about covid. It has a low mortality rate, of 2-3 percent, that too mortality is very high in people above 60-70 years with other co-morbidities. You do not have any such disorders and you have not even been in contact with anyone, so do not worry. Please continue to take your medicines for anxiety if you are taking them, if not, please consider visiting a psychiatrist and get started on some low dose SSRI type of medicines. Also, if needed a low dose Benzodiazepines can be added temporarily. Also, please do some deep breathing exercises, or progressive muscle relaxation. You can also take some honey with water to reduce the itching in the throat and also try doing some gargles with lukewarm salt water.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I got my front (upper 12 probably) tooth RCT done six months ago. The RCT was short because I experienced acute pain beyond that point. RCT is about 1.8 mm short. He then suggested getting apicoectomy because RCT was incomplete. From a second opinion, the other doctor recommended a re-RCT. What should I do? Do I need to get the surgical procedure done? I have no symptoms of pain in the tooth. My teeth are generally weak and hence a little pressure is felt. The tooth area is mildly sensitive, but I suspect it to be from other nearby infected tooth. ### Response: Hello. I have been through your query, and I can understand your concern. Endodontic treatment for any tooth when it is not completely done like in your case it is short. It might be that you cannot feel pain or have any other discomfort. But it is highly susceptible to the secondary infection in the root. I would highly recommend going for the re-RCT treatment as it will not require any major surgical procedure and the tooth will be saved as a whole (in retreatment only minimal tooth material is lost). However, sometimes if space is some mm short, then if the root canal is properly sealed, it might not lead to further secondary infection. But that is just one such case. So if you wanna wait for the symptoms, you can but I would suggest you go for re-RCT. Apicoectomy is more invasive and will remove a small unfilled lower portion of the tooth and then accordingly seal the apex of the root. This also is a way to seal off the apex for underfilled root canals in RCT. But re-RCT is more desirable for me if you would have been my patient. Also, maintain good oral hygiene and brush your teeth twice daily and floss regularly.

Hello doctor,I got my front (upper 12 probably) tooth RCT done six months ago. The RCT was short because I experienced acute pain beyond that point. RCT is about 1.8 mm short. He then suggested getting apicoectomy because RCT was incomplete. From a second opinion, the other doctor recommended a re-RCT. What should I do? Do I need to get the surgical procedure done? I have no symptoms of pain in the tooth. My teeth are generally weak and hence a little pressure is felt. The tooth area is mildly sensitive, but I suspect it to be from other nearby infected tooth.

Hello. I have been through your query, and I can understand your concern. Endodontic treatment for any tooth when it is not completely done like in your case it is short. It might be that you cannot feel pain or have any other discomfort. But it is highly susceptible to the secondary infection in the root. I would highly recommend going for the re-RCT treatment as it will not require any major surgical procedure and the tooth will be saved as a whole (in retreatment only minimal tooth material is lost). However, sometimes if space is some mm short, then if the root canal is properly sealed, it might not lead to further secondary infection. But that is just one such case. So if you wanna wait for the symptoms, you can but I would suggest you go for re-RCT. Apicoectomy is more invasive and will remove a small unfilled lower portion of the tooth and then accordingly seal the apex of the root. This also is a way to seal off the apex for underfilled root canals in RCT. But re-RCT is more desirable for me if you would have been my patient. Also, maintain good oral hygiene and brush your teeth twice daily and floss regularly.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I had elevated ALT levels between 50-130 for the past one and half years with slight enlargement. Recently, I have elevated AST levels. There is no hepatitis or inflammatory diseases, alcohol, drug use, or fatty liver, or Addison\\s.Liver biopsy showed inflammation, but a resolving process likely attributed to a year long Lyme disease treatment with various pharmaceuticals but discontinued two years ago. Liver enzymes dropped to 50 ALT, but have recently elevated to 130 ALT.At this point, there is no known cause. I was told to continue to wait and see. I would like to take a different approach and determine if there is something my hepatologist is not seeing. The current medications are Lamictal and Gabapentin, Trazodone. I had abdominal CT, abdominal MRI, liver biopsy, ultrasounds, and a significant amount of blood work. ### Response: Hi, Welcome to Chat Doctor forum. You should not wait. There is some cause that is creating an issue for the liver. It is continuously damaging your liver. Cause of hepatitis in your case could be ChatDoctor. All these three medications are reported to cause liver injury; though this is more common with Lamotrigine (1% case have hepatotoxicity) and less common with rest two and only described in case reports. To prove DILI, we need to rule out other treatable causes of liver disease, DILI is a diagnosis of exclusion. Most common causes are nonalcoholic fatty liver, alcohol, autoimmune hepatitis, hepatitis B&C, cholestatic and muscle disorders. We need to evaluate as soon as possible to prevent the further damage to the liver. First, we need to diagnose the liver disease. Secondly, we need to quantify the damage severity for prognostication. Probable cause

Hello doctor,I had elevated ALT levels between 50-130 for the past one and half years with slight enlargement. Recently, I have elevated AST levels. There is no hepatitis or inflammatory diseases, alcohol, drug use, or fatty liver, or Addison\\s.Liver biopsy showed inflammation, but a resolving process likely attributed to a year long Lyme disease treatment with various pharmaceuticals but discontinued two years ago. Liver enzymes dropped to 50 ALT, but have recently elevated to 130 ALT.At this point, there is no known cause. I was told to continue to wait and see. I would like to take a different approach and determine if there is something my hepatologist is not seeing. The current medications are Lamictal and Gabapentin, Trazodone. I had abdominal CT, abdominal MRI, liver biopsy, ultrasounds, and a significant amount of blood work.

Hi, Welcome to Chat Doctor forum. You should not wait. There is some cause that is creating an issue for the liver. It is continuously damaging your liver. Cause of hepatitis in your case could be ChatDoctor. All these three medications are reported to cause liver injury; though this is more common with Lamotrigine (1% case have hepatotoxicity) and less common with rest two and only described in case reports. To prove DILI, we need to rule out other treatable causes of liver disease, DILI is a diagnosis of exclusion. Most common causes are nonalcoholic fatty liver, alcohol, autoimmune hepatitis, hepatitis B&C, cholestatic and muscle disorders. We need to evaluate as soon as possible to prevent the further damage to the liver. First, we need to diagnose the liver disease. Secondly, we need to quantify the damage severity for prognostication. Probable cause

### Instruction: Answer this question truthfully ###Input: Hello doctor,My wife is 28 years old. Her weight is 128 kg and height is 5 feet 3 inches. She has got a constipation problem since last 5 years and she takes Smuth for this. Since last four days, she has been getting severe pain between vagina and anus and that area is swollen. Also, her anus opening is swollen. Yesterday, she was identified to have a small hemorrhoid. The pain is very severe. Please suggest an effective tablet for the pain relief and to cure hemorrhoid. She had Zerodol-SP, Ibuprofen and Chymoral plus, but of no use. Still, she has pain. Also, she takes Himalaya Eve for PCOS and Iron supplement. 10 years ago, she had the same problem. Please provide your valuable suggestion on medication. ### Response: Hi. I have gone through your query and can understand your concern for her health. As you have given every possible analgesic and the pain is not relieved, I think the hemorrhoid has strangulated. It means it is entrapped within the anal sphincter. I suggest tablet Acenac-P (combination of Aceclofenac and Paracetamol) along with tablet Chymoral forte (Trypsin and Chymotrypsin) twice a day for three days. Also, I suggest her apply Diltiact gel (Diltiazem) over the anal area and inside the anus with finger twice daily. I suggest you to consult a surgeon as soon as possible to avoid any complication. She may need some intervention. Also, I suggest you try sitz bath. Take a tub and add warm water in it and a few ChatDoctor. Tell her to sit in that tub for about 20 minutes. It will give some relief. Ask her to

Hello doctor,My wife is 28 years old. Her weight is 128 kg and height is 5 feet 3 inches. She has got a constipation problem since last 5 years and she takes Smuth for this. Since last four days, she has been getting severe pain between vagina and anus and that area is swollen. Also, her anus opening is swollen. Yesterday, she was identified to have a small hemorrhoid. The pain is very severe. Please suggest an effective tablet for the pain relief and to cure hemorrhoid. She had Zerodol-SP, Ibuprofen and Chymoral plus, but of no use. Still, she has pain. Also, she takes Himalaya Eve for PCOS and Iron supplement. 10 years ago, she had the same problem. Please provide your valuable suggestion on medication.

Hi. I have gone through your query and can understand your concern for her health. As you have given every possible analgesic and the pain is not relieved, I think the hemorrhoid has strangulated. It means it is entrapped within the anal sphincter. I suggest tablet Acenac-P (combination of Aceclofenac and Paracetamol) along with tablet Chymoral forte (Trypsin and Chymotrypsin) twice a day for three days. Also, I suggest her apply Diltiact gel (Diltiazem) over the anal area and inside the anus with finger twice daily. I suggest you to consult a surgeon as soon as possible to avoid any complication. She may need some intervention. Also, I suggest you try sitz bath. Take a tub and add warm water in it and a few ChatDoctor. Tell her to sit in that tub for about 20 minutes. It will give some relief. Ask her to

### Instruction: Answer this question truthfully ###Input: Hello doctor,About a week ago, I got off the lounge chair and felt a sharp pain in the back of my left ankle. The pain has not changed during the week. The whole ankle is still swollen. The pain has not changed, and it radiates from inside the heels up to my Achilles and into the lower back part of my leg. I can hardly walk. Three days ago I went to the hospital, wherein a portable ultrasound scan of the Achilles\\ tendon was performed, which revealed that it was still intact, but the doctors said it could be torn. About eight months back, I had an accident at the workplace and had torn my L5/S1 disc. And this had created a leaking disc and a bulge affecting the nerves in my legs. I had a nerve conduction test done, and the results were positive with nerve issues in my left leg, but I never had this pain before in this part of my foot. I have attached a photo of the back of my ankle, and you can see the Achilles\\ tendon is badly swollen. When it is strapped, it is a little better, but still painful. When it is unstrapped it is worse, and I can hardly walk on it. What do you think my injury is? Could it be related to my back and nerve injury? What treatment is available and what should I do now? ### Response: Hi, Welcome to Chat Doctor forum. Firstly, there is no attachment and hence I could not see the clinical picture. Injury around a week ago. 1. MRI scan.2. Blood investigations as advised.3. Ultrasound report and images (if possible). 1. Hyperuricemia.2. Infection. As advised. Revert back with clinical pictures and investigations reports to an orthopaedician and traumatologist online.-

Hello doctor,About a week ago, I got off the lounge chair and felt a sharp pain in the back of my left ankle. The pain has not changed during the week. The whole ankle is still swollen. The pain has not changed, and it radiates from inside the heels up to my Achilles and into the lower back part of my leg. I can hardly walk. Three days ago I went to the hospital, wherein a portable ultrasound scan of the Achilles\\ tendon was performed, which revealed that it was still intact, but the doctors said it could be torn. About eight months back, I had an accident at the workplace and had torn my L5/S1 disc. And this had created a leaking disc and a bulge affecting the nerves in my legs. I had a nerve conduction test done, and the results were positive with nerve issues in my left leg, but I never had this pain before in this part of my foot. I have attached a photo of the back of my ankle, and you can see the Achilles\\ tendon is badly swollen. When it is strapped, it is a little better, but still painful. When it is unstrapped it is worse, and I can hardly walk on it. What do you think my injury is? Could it be related to my back and nerve injury? What treatment is available and what should I do now?

Hi, Welcome to Chat Doctor forum. Firstly, there is no attachment and hence I could not see the clinical picture. Injury around a week ago. 1. MRI scan.2. Blood investigations as advised.3. Ultrasound report and images (if possible). 1. Hyperuricemia.2. Infection. As advised. Revert back with clinical pictures and investigations reports to an orthopaedician and traumatologist online.-

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am a 25-year-old male, around 199 cm tall and 85 kg weight. I have been playing sports when I was young (volleyball, tennis, and basketball) and I was fit for a long time. However, since I started with higher education (around six years ago), I tended to study in a semi-bent position in my bed. Recently, I started feeling a dull pain on the right side of the bottom of my spine, which persists until I either bend my spine upwards with a pillow or sleep.I also have to note that I sleep on my side, with a pillow between my knees. When I walk, this pain in the side of my spine increases (I do not feel any unbearable pain, it is just uncomfortable), but I feel a sensation from that spot in my spine to the bottom of my right leg (on the back side of it, mostly). Does this seem like a common issue? If so, please tell me what exercises I can do to prevent my spine from going bad? I am in a period of intense exams, and I need some advice on how to stop this pain? ### Response: Hello. I read your concern. I feel the pain what you describe is due to bad posture adapted all these days. It could be a neural pain due to any disc issue and may not be a worse prolapse. This may warrant a thorough examination of your spine and hip. As of now, I recommend you to do spine extension with pillows frequently, avoid the semi-bent posture which gives you the pain. Do certain glute and core stability exercises. Keep a lot of icing often like once in two hours. Please do revert back to me after two days and let me know the status of the pain. Take care.

Hello doctor,I am a 25-year-old male, around 199 cm tall and 85 kg weight. I have been playing sports when I was young (volleyball, tennis, and basketball) and I was fit for a long time. However, since I started with higher education (around six years ago), I tended to study in a semi-bent position in my bed. Recently, I started feeling a dull pain on the right side of the bottom of my spine, which persists until I either bend my spine upwards with a pillow or sleep.I also have to note that I sleep on my side, with a pillow between my knees. When I walk, this pain in the side of my spine increases (I do not feel any unbearable pain, it is just uncomfortable), but I feel a sensation from that spot in my spine to the bottom of my right leg (on the back side of it, mostly). Does this seem like a common issue? If so, please tell me what exercises I can do to prevent my spine from going bad? I am in a period of intense exams, and I need some advice on how to stop this pain?

Hello. I read your concern. I feel the pain what you describe is due to bad posture adapted all these days. It could be a neural pain due to any disc issue and may not be a worse prolapse. This may warrant a thorough examination of your spine and hip. As of now, I recommend you to do spine extension with pillows frequently, avoid the semi-bent posture which gives you the pain. Do certain glute and core stability exercises. Keep a lot of icing often like once in two hours. Please do revert back to me after two days and let me know the status of the pain. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,I am just recently divorced and I have children. I have not had any new sexual partners but last week I met a man and without planning it, by the weekend we had sex. I was under the influence of alcohol so my judgment was impaired. He performed oral sex on me (but I did not) and we rubbed genitals for ages to make him hard. He never penetrated me fully but his penis was around that area for a while and probably pushing around entry area. When we actually had sex, he used a condom and ejaculated into that. I am completely panicked. It is day six and I have got a sore throat, swollen lymph nodes and achy muscles and I am itchy all over. I went to the GP today and was tested for everything but in the meantime, I am going crazy. He is a bit of a stud and has had other women. Do you think I am at risk? ### Response: Hi. Receptive oral sex carries a risk of transmission of herpes simplex virus if he has a history of cold sores. Otherwise, it can be assumed to be safe. HIV is not a risk because saliva is not infectious. As far as rubbing genitals is concerned, if there was no penetration or any fluids exchanged (precum), then it carries a negligible risk of HIV though there is a risk of genital herpes and HPV especially since it was a prolonged rubbing. However, penetrative sex is not safe, and there is a risk of HIV and other STDs like herpes simplex virus infection, syphilis, gonorrhea, chlamydia, and HPV. You may take a full panel STD screening including genital herpes, gonorrhea, chlamydia, syphilis, and HIV, especially if you are not sure whether he penetrated and if he had precum. For more information consult a HIV AIDS specialist online Take care.

Hi doctor,I am just recently divorced and I have children. I have not had any new sexual partners but last week I met a man and without planning it, by the weekend we had sex. I was under the influence of alcohol so my judgment was impaired. He performed oral sex on me (but I did not) and we rubbed genitals for ages to make him hard. He never penetrated me fully but his penis was around that area for a while and probably pushing around entry area. When we actually had sex, he used a condom and ejaculated into that. I am completely panicked. It is day six and I have got a sore throat, swollen lymph nodes and achy muscles and I am itchy all over. I went to the GP today and was tested for everything but in the meantime, I am going crazy. He is a bit of a stud and has had other women. Do you think I am at risk?

Hi. Receptive oral sex carries a risk of transmission of herpes simplex virus if he has a history of cold sores. Otherwise, it can be assumed to be safe. HIV is not a risk because saliva is not infectious. As far as rubbing genitals is concerned, if there was no penetration or any fluids exchanged (precum), then it carries a negligible risk of HIV though there is a risk of genital herpes and HPV especially since it was a prolonged rubbing. However, penetrative sex is not safe, and there is a risk of HIV and other STDs like herpes simplex virus infection, syphilis, gonorrhea, chlamydia, and HPV. You may take a full panel STD screening including genital herpes, gonorrhea, chlamydia, syphilis, and HIV, especially if you are not sure whether he penetrated and if he had precum. For more information consult a HIV AIDS specialist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I used to have a long-term groin injury from playing badminton which caused jarring pain which ended up me having to stop for a while. I have not played badminton for four years so the groin injury subsided by whenever my groin is stretched it is always tender and has a lot less range of motion compared to the other side. I took up squash a year ago and have been playing at quite a good or intense level five times a week. In the last week, I have had quite a bad hip pain on the same side as my old groin injury. The groin injury has not come back (i.e. jarring, pain, etc.) since starting squash but it has still remained a bit tender when stretched with less range of motion than the other side. The hip pain has started getting bad at night three days ago and affecting my sleep so I have therefore stopped playing. I have been doing resistance band exercises I found online for adductors, abductors, etc., with stretching groin, hamstrings, etc., but has not got better (although it has only been three days). It is a dull ache for most of the day which only goes if I take Ibuprofen and does seem worse at night. The hip pain is fairly central but more on the outside. ### Response: Hello, Welcome to Chat Doctor forum. I have understood your concern about groin pain. See you need to give sufficiently enough time for healing of adductor muscles tendons, which is getting worsened by repeatedly stretching. No doubt that you need more range of motion, but the first choice is to promote healing and decrease the pain, so for that, you need to take physiotherapy treatment, like ultrasound with ice and laser therapy, which helps in healing. then gradually after 20 days, you may start with exercises. For more information consult a physiotherapist online

Hello doctor,I used to have a long-term groin injury from playing badminton which caused jarring pain which ended up me having to stop for a while. I have not played badminton for four years so the groin injury subsided by whenever my groin is stretched it is always tender and has a lot less range of motion compared to the other side. I took up squash a year ago and have been playing at quite a good or intense level five times a week. In the last week, I have had quite a bad hip pain on the same side as my old groin injury. The groin injury has not come back (i.e. jarring, pain, etc.) since starting squash but it has still remained a bit tender when stretched with less range of motion than the other side. The hip pain has started getting bad at night three days ago and affecting my sleep so I have therefore stopped playing. I have been doing resistance band exercises I found online for adductors, abductors, etc., with stretching groin, hamstrings, etc., but has not got better (although it has only been three days). It is a dull ache for most of the day which only goes if I take Ibuprofen and does seem worse at night. The hip pain is fairly central but more on the outside.

Hello, Welcome to Chat Doctor forum. I have understood your concern about groin pain. See you need to give sufficiently enough time for healing of adductor muscles tendons, which is getting worsened by repeatedly stretching. No doubt that you need more range of motion, but the first choice is to promote healing and decrease the pain, so for that, you need to take physiotherapy treatment, like ultrasound with ice and laser therapy, which helps in healing. then gradually after 20 days, you may start with exercises. For more information consult a physiotherapist online

### Instruction: Answer this question truthfully ###Input: Hello doctor,This query is regarding my baby boy's health. He is 18 months old and recently had his varicella shot last month. Last week, he suddenly started shouting in the middle of his sleep and kept scratching his forehead and neck region. When checked two mosquitoes were near him and had bitten him.Generally, he gets papular urticaria after any insect bite. But after three days, he got lesions all over his face, arms, and legs. Checked with my doctor and initially, it was ruled out as chickenpox along with insect bite allergy. But even after a week he still did not show improvement. The older ones are very slowly recovering. But everyday new lesions are coming up and he scratches like anything despite a lot of medications. Please help. His current medications are Aciclovir 2.5 ml thrice (completed the 5-day course), Azithral 5 ml (night only) for seven days, Xyzal 2 ml thrice daily. Now the doctor has started him on Omnacortil steroid medication and Kid pred 3.5 ml twice daily.Please suggest if we are treating him the right way. He weighs 10.5 kg. No fever, cold or body pain symptoms. ### Response: Hi. As per the history and pictures shown (attachment removed to protect patient identity), I would recommend to get the child evaluated for scabies if the above treatment does not work. Until then continue the treatment as going on. It appears to be fine as per my knowledge as I have not evaluated the child physically. If the treating doctor feels that it is scabies after examination, it would be advisable to use one dose only of Permethrin 5% on the body and 1% on the scalp. I hope this helps. Take care.

Hello doctor,This query is regarding my baby boy's health. He is 18 months old and recently had his varicella shot last month. Last week, he suddenly started shouting in the middle of his sleep and kept scratching his forehead and neck region. When checked two mosquitoes were near him and had bitten him.Generally, he gets papular urticaria after any insect bite. But after three days, he got lesions all over his face, arms, and legs. Checked with my doctor and initially, it was ruled out as chickenpox along with insect bite allergy. But even after a week he still did not show improvement. The older ones are very slowly recovering. But everyday new lesions are coming up and he scratches like anything despite a lot of medications. Please help. His current medications are Aciclovir 2.5 ml thrice (completed the 5-day course), Azithral 5 ml (night only) for seven days, Xyzal 2 ml thrice daily. Now the doctor has started him on Omnacortil steroid medication and Kid pred 3.5 ml twice daily.Please suggest if we are treating him the right way. He weighs 10.5 kg. No fever, cold or body pain symptoms.

Hi. As per the history and pictures shown (attachment removed to protect patient identity), I would recommend to get the child evaluated for scabies if the above treatment does not work. Until then continue the treatment as going on. It appears to be fine as per my knowledge as I have not evaluated the child physically. If the treating doctor feels that it is scabies after examination, it would be advisable to use one dose only of Permethrin 5% on the body and 1% on the scalp. I hope this helps. Take care.

### Instruction: Answer this question truthfully ###Input: Hi doctor,Over the past three months, I have been experiencing some penis problem. I have a consistent red rash on the front of my penis glans that can go away and come back daily. After sex or masturbation, the rash will get brighter and red, unraised dots (not itchy) will appear all over my glans and foreskin. They will usually disappear on their own within three to four days. My penis glans are also very dry and have a wrinkled look to it, and the foreskin can stick to the penis glans and have a \\bandaid\\ effect when retracting the foreskin down. However, by applying Vaseline twice a day I have noticed the dryness to subside, although the red rash will typically remain.I have been tested for STD\\s and have had a yeast swab test all come back negative. The doctor ruled out herpes by looking at it and said it was mild balanitis (inflammation of the glans). However, I have been washing with just warm water daily (ruling out any allergic reactions to soap) and keeping the area dry. This is more an esthetic issue than functional and it is ruining my confidence with my girlfriend. Why do I always get balanitis after sex or masturbation? The symptoms seem like yeast, but my swab test was negative. Please help. ### Response: Hello. I have noted your concern. On and off rash suggest that it is some sort of a skin condition like a noninfective balanitis, if not a yeast infection. Moreover, the swab test may sometimes reveal the yeast on a repeat test so that can be considered along with a fungal culture. I also request you to kindly upload an image of the affected area so that I am able to guide you better. Regards. For more information consult a dermatologist online Take care.

Hi doctor,Over the past three months, I have been experiencing some penis problem. I have a consistent red rash on the front of my penis glans that can go away and come back daily. After sex or masturbation, the rash will get brighter and red, unraised dots (not itchy) will appear all over my glans and foreskin. They will usually disappear on their own within three to four days. My penis glans are also very dry and have a wrinkled look to it, and the foreskin can stick to the penis glans and have a \\bandaid\\ effect when retracting the foreskin down. However, by applying Vaseline twice a day I have noticed the dryness to subside, although the red rash will typically remain.I have been tested for STD\\s and have had a yeast swab test all come back negative. The doctor ruled out herpes by looking at it and said it was mild balanitis (inflammation of the glans). However, I have been washing with just warm water daily (ruling out any allergic reactions to soap) and keeping the area dry. This is more an esthetic issue than functional and it is ruining my confidence with my girlfriend. Why do I always get balanitis after sex or masturbation? The symptoms seem like yeast, but my swab test was negative. Please help.

Hello. I have noted your concern. On and off rash suggest that it is some sort of a skin condition like a noninfective balanitis, if not a yeast infection. Moreover, the swab test may sometimes reveal the yeast on a repeat test so that can be considered along with a fungal culture. I also request you to kindly upload an image of the affected area so that I am able to guide you better. Regards. For more information consult a dermatologist online Take care.

### Instruction: Answer this question truthfully ###Input: Hello doctor,I am 18 years old female and sexually not active. A month back, I woke up and peed straight up blood. I went to the ER and was diagnosed a bladder infection/UTI. I was prescribed Bactrim and the next day woke up with a rash. It turns out I was allergic. So, the next day I started a new medicine and took it for a few days. The blood stopped, but I felt pain, so I went back to the ER. They told me my UTI was gone and to stop taking the medicine. A few days later, I saw blood when I wiped after peeing, but it looks like it was in my discharge. It went on a few times, and I went back to the ER three days ago and said that I was peeing blood again. So, I am worried. I have not gotten my period this month, and no, I am not pregnant. I am a virgin. They said it was not a UTI and I was fine. I have had no pain or anything. Just now I peed and when I wiped there was blood in my discharge. It is not a lot but still freaks me out. I cannot tell if it is my period or something else. I have never had this happen before. My mother said that it is spotting but makes no sense to me. ### Response: Hello. This is likely to be irregular shedding which can often occur in adolescence by mid-cycle in girls with secondary progesterone deficiency due to either delayed ovulation or stress-induced hormonal imbalances. You need to get a serum progesterone level done and if it is less than 21ng/dl by day 21 of your cycle, then you may need cyclical progesterone therapy. For more information consult an obstetrician and gynaecologist online

Hello doctor,I am 18 years old female and sexually not active. A month back, I woke up and peed straight up blood. I went to the ER and was diagnosed a bladder infection/UTI. I was prescribed Bactrim and the next day woke up with a rash. It turns out I was allergic. So, the next day I started a new medicine and took it for a few days. The blood stopped, but I felt pain, so I went back to the ER. They told me my UTI was gone and to stop taking the medicine. A few days later, I saw blood when I wiped after peeing, but it looks like it was in my discharge. It went on a few times, and I went back to the ER three days ago and said that I was peeing blood again. So, I am worried. I have not gotten my period this month, and no, I am not pregnant. I am a virgin. They said it was not a UTI and I was fine. I have had no pain or anything. Just now I peed and when I wiped there was blood in my discharge. It is not a lot but still freaks me out. I cannot tell if it is my period or something else. I have never had this happen before. My mother said that it is spotting but makes no sense to me.

Hello. This is likely to be irregular shedding which can often occur in adolescence by mid-cycle in girls with secondary progesterone deficiency due to either delayed ovulation or stress-induced hormonal imbalances. You need to get a serum progesterone level done and if it is less than 21ng/dl by day 21 of your cycle, then you may need cyclical progesterone therapy. For more information consult an obstetrician and gynaecologist online