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<s>[INST] I have sleep apnia and use a cpap . I should use it daily but I do not . About half of the time I snore very loud and half the time I do not snore at all . Often tired . I passed heart stress test 3 years ago . I pass annual fireman lung capacity-breathing test . Lungs look ok on xray , no copd . Dr says I have some heart enlargement but he said it is not critical . Take 40 mg Lipitor , cholesterol at 260 . I had pneumonia in 2008 . I am about 50 lbs overweight and cant seem to loose . 5' 11" , small frame , 245 lbs . Most fat around the belly . Had asthma as a child but no episodes in years that I know of . I breathe fine when sitting or slow walking . When I heavily exert I find it very hard to breathe . Sometimes gasp for breath . Especially when I exert quickly . I am a fireman , for 25 years now , so I must heavily exert from time to time . [/INST] thanks for asking your question i completely understand your question firstly you need to put a hold on smoking if u do , have a healthy diet like fibers , fruits and vegetables , have less of fatty diet , control on salt / sodium is a must .give stress on regular exercise/ walk apply cpap dailytake asthma medications regularlydont take alcoholconsult a pulmonologist and a cardiologist whi can addon some drugs to control the lipidsthanks feel free to ask more questions may god bless you with good health </s> |
<s>[INST] I think I have a panic disorder, caused by IBS (sudden urge to run to the toilet). I have spoken to my doctor and gave me some beta blockers. But I seem to not be getting over it, I try and get on the train on a morning but then I go dizzy, feel like I am going mad and go all warm. This only happens on a morning as I can get the a quiter train on an evening. But I could not get a later train or I no I would have a panic attack. What can I do to make this go away? [/INST] DearWe understand your concernsI went through your details. I suggest you not to worry much. Panic attack comes when people are anxious. (Other panic attacks are not as comparable to anxiety related panic attacks). You could be anxious about your IBS, or something else like your health. Taking beta blockers are not enough for anxiety and panic attacks. You need to visit a psychologists who shall provide you wit psychotherapy techniques.If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck. </s> |
<s>[INST] I was diagnosed with prostate cancer in 2009 and had a radical prostectomy completed, PSA dropped until 2014. after the increase I had hormone therapy (lupron) and radiation therapy. in late 2016 my PSA went up again, I had a bone scan which showed spread to the bones, lupron was started immediately, the PSA has gone from the high of 21 back to 6 in about 6 weeks. I am considering an Orchiectomy to eliminate the testosterone, and hope to prolong my life. I am 76, have had lung cancer surgically removed in 2008, no reoccurance, COPD and Emphesema. I am active, have a good quality of life and I am pain free. Recommendations? [/INST] yes go for orchiectomy. my advise is keep on taking treatment along with bone strengthening injections. though stage 4 prostate cancer patients do well in most of the cases </s> |
<s>[INST] I have a 10 yr old son that has high liver enzymes..he has ADHD and in the last 10 months has been on vyvanse..he was diagnosed at the age of 3 with ADHD and was on stratera for 5 yrs,and when we switched his meds to adderall xr ( was on it for 2 yrs) is when we found out his liver enzymes were high..his highest was 185 and his lowest was 60..we have been to a ped.GI and have had a liver biopsy done.. All they can figure out is that it s an unknown liver disease..they have tested for EVERYTHING...My son weighs 49 pounds and is 4 foot tall..we are curently waiting on more labs on all growth hormones (pituitary glands) and on his chromizomes.. My son needs his ADHD meds but his regular doc s want to wait a month n retest his emzymes before putting him back on it....But I can t wait that long...What else can a person test for to get answers on the high liver enzymes? He is on high calorie diet and the vyvanse breaks down in the kidnies.... [/INST] Hello,Liver enzymes, liver biopsy, pituitary hormones, chromosomal studies, etc., almost everything has been done and I don't think further investigations are needed. Vyvanse (Lisdexamfetamine) can cause hepatitis and increase liver enzymes hence your doctor is not starting that medicine. You should wait for reports for retest of enzymes.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad </s> |
<s>[INST] hi doctor my son is 1year 6months he is having irregular bowlmovements .for past 7 months we are giving medicine .started with piclin next evaq syrup along with laxsopeg powder now we are giving cremaffin syrup. wants to kno is there any sideeffects using these medicines for longer period. [/INST] thanks for asking I gone through your question. your 18 month old son is suffering from constipation. you have tried many medicine, and your concerned about side effect of medicine, I like to inform you that there is no major or long term side effect of above medicine. I what to share some fact about treatment of constipation1. Give more of fiber rich diet like cereal and vegetables and give less of milk if giving more then 250 ml per day 2.PEG ( active ingredient of laxsoped powder ) is treatment of choice for child hood constipation. the therapy may be required for 3-6 months. adjust the dose of PEG according to bowel movement. target is one soft stool per day. Never abruptly stop medicine. decrease the slowly over the period of week time. 3. If your kid use western type of commode then make sure that his foot should touch the ground , if feet not touching ground then your should use some stool , so the feet rest of stool hope i answer your querywish healthy family life </s> |
<s>[INST] Hi on Thursday i'm having a scan on my throat after i have had radium injected into my arm. after looking into this, i wonder why i havent had other test such as a biopsy on the lump first? is it because they suspect cancer, which is rife in our family.Thank you Leslea x [/INST] Certain lumps can be assessed through biopsy (by taking a sample), whilst the thyroid gland, found in your throat is best assessed on how active it is through this special type of scan.It will help indicate whether or not there is a cancer. </s> |
<s>[INST] Hello doctor,I did the blood test a few days ago, and the reports state that,1) Monocytes 0.19.2) Red cell distribution width 46.7.3) Platelet distribution width 21.4) Mean platelet volume 13.4.5) Platelet to large cell ratio 50.5.Kindly advice. [/INST] Hello. The test is not specific. You need to specify why it was done and what your symptoms are. The test indicates macrocytosis larger platelet than usual, red cell distribution width is higher than normal (11.5 to 14.5). This indicates that your bone marrow which produces all the blood cells such as red blood cells, platelets and granulocyte white blood cells (neutrophils, eosinophils, basophils) and monocyte is not getting enough vitamin B 12 (cyanocobalamin) and folic acid. I do not know are you anemic since there is no indication of red blood cell count there. The cause can be from not getting enough folic acid and vitamin B 12 in your diet, or your intestine does not absorb enough B 12 vitamin, a condition called pernicious anemia from lack of intrinsic factor needed for their absorption. You may be a vegetarian because if you eat enough meat, you would not be having folate and B 12 deficiency.You may have vitamin B12 and folic acid tablets. </s> |
<s>[INST] i have been having pressure in the chest , chest pain, left arm pain I have been really tired and went to the dr and was given a stress test showed abnormal but was told by dr that it could be a panic attack they did blood work heart enzymes were normal should d I get another opinion. I have been under a lot of stress lately. [/INST] Thanks for your question on Health Care Magic. I can understand your situation and problem. Cardiac enzymes are very sensitive and specific in determining cardiac diseases. Since you are having normal enzymes, no need to worry for heart diseases. You are also having stressful life. So possibility of stress and anxiety related symptoms is more. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s> |
<s>[INST] Hi, may I answer your health queries right now ? Please type your query her聽聽聽聽聽聽聽聽聽聽Hi, I'm 24 year old male, and I have tonsillitis. I have been prescribed Azithromycin 250mg with 3 refills. I have one more refill left. I think my tonsills got smaller by a few millimiters, but not much. And I seem to have chest pain once in a while where my heart is. Any idea if I'll be allright or should I consider getting my tonsills removed? [/INST] Hi...Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns...As per your complain chest pain seems to be a side effect of taking Azithromycin as it might cause stomach upset as well as hyperacidity and acid reflux which are common side effects of antibiotics..It does not seems to be due to tonsillitis and as your tonsils are responding to medication you need not to get them removed and once you stop the medication the chest pain will also subside..You can take antacids before meals and a capsule of Pantoprazole or Omeprazole empty stomach in the morning till the antibiotics are being taken..Drink plenty of water and take more of probiotics like Yoghurt in your diet..Hopefully the symptoms will resolve soon..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora. </s> |
<s>[INST] Hi I m 70 years old and have been battling depression for the past 20 years . I take 225 mg of Effexor and Welbutron yet I still have bouts of sadness and a lot of mood swings lately. My daughter believes I need a different medication but my doctor doesn t seem to know what to do for me. [/INST] Hello,Thanks for putting your query in HCM.I can understand what you are going through.If I had similar patient in my clinic i would have perhaps started him with mirtazapine 7.5mg and depending on requirement could have escalated upto 30mg.Since this medication has preferable profile for elderly population which improves not only sadness of mood but also appetite and sleep disturbances.Hope I have answered your query.If You have further query please dont hesitate to ask. </s> |
<s>[INST] Dear Doctor, Right Now im taking warfarin for the DVT which i have since 5 months. since last 2 months i cant eat and drink i feel sensitive pain and no problem in my teeth . but gums of the mouth all become reddish. could you please give me solution for that how can i get remedy for that and the same time i have to continue warfarin. Regards, KENNEDY [/INST] Hi, I read your problem. According to you problem, warfarin is an anticoagulant an an has side effect also. Reddish gums, bleeding from gums due to warfarin. don't eat spicy food. use topical anaesthetics that contain benzocaine, lidocaine, tetracaine will help to relief.Use antiseptic mouthwash also. I would advice you to visit your dentist to identify the problem and treat it accordingly. Have a nice time... take care </s> |
<s>[INST] I have had a mole since I was young. But recently I noticed that it has grown a little bigger. It is not round, and it is multi-colored . I am nervous that it may be skin cancer. I think I remember it being like this when i was younger as well, but I am really nervous about it being cancer. [/INST] Hi,Thanks for writing in.A mole is an area in the skin surface where there is an excess of pigment deposition. Our skin gets its color from melanin pigment present in the skin. In a dark skin person, there is a higher quantity of melanin produced by the cells on the skin surface. In a light colored person, the melanin produced by skin cells is less.When the melanin is secreted in higher quantity in a particular spot on the skin surface, this gives rise to a mole and there can also be associated increased cell growth. The multicolor nature in a mole is due to the variable concentration of pigments in it. A mole is benign in most cases. However if it develops sudden increase in size, appearance of hair on surface or pain sensation and ulcer formation then you should consult your doctor immediately. They will scrape the cells from mole surface if required and then confirm it it is a concern. Please do not worry. </s> |
<s>[INST] Hi I am suffering from very strong and uncontrollable pain and swelling in the left side of my abdomen . , this area is just below the left chest , this pain from past 4 years. I have shown a general mbbs doctor he asked me to go for CBP and cheat x ray, abdomen scan ultrasound . The report says everything is normal, to which said t might be muscular pain and insisted me to take few tablets and ointment for ten days, I have tried it for 10. Days but no changes what might be the cause of this pain ans swelling. ..? To which specialist doctor should I visit please let me know. Thank u. [/INST] Hi. Thanks for your question. Pain in the left hypochondrium may be due to various pathologies.But before coming to a definite diagnosis I will like to ask certain question's: What is your age? How is the pain? Is onset sudden gradual?How does pain aggravate and decrease? Is there associated Fever,Decreased appetite,vomiting,weakness,jaundice? How is your bladder and bowel habit? Does the pain aggravates with fatty food? What is the size of lump? Are you alcoholic? Any history of trauma to the area? I will advice you to have some investigations done: Complete blood count Serum Amylase and Lipase. For now I will advice you to continue the medications given by your doctor and inform me about the reports as soon as possible. Wish you best of health Best regards. </s> |
<s>[INST] My son had brain surgery on 12/5/2012, after the surgery he lost all movement in the left side( neck down), he is know in Spalding Rehab and starting to move his left side from the waist up his left leg still has no feeling. They want to send him home on the 5th January and I am scared to death I thought they weren t going to send him home until he was walking. Any advise [/INST] Hi, Thank you for posting your query. We need more details to answer your query better. This includes his diagnosis, MRI report and details of surgery performed. The loss of strength can be due to the disease or the surgery,and it indicates damage to the right half of brain. We expect gradual recovery of strength and the physiotherapy should be continued at home after discharge too. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist </s> |
<s>[INST] i HAVE A LATERAL DISC BULGE L3/4 AND SUFFER FROM RIGHT HANDED LEG PAIN AND HAVE BEEN NOW FOR 4 YEARS LATEST MRI SHOW NO CHANGE AND HAVE HAD SEVERAL INJECTIONS BUT WITH NO HELP, HAVE BEEN REFERRED TO SPINAL SURGEON, DO YOU THINK MY CHANCES OF SURGERY ARE GOOD AS DESPERATE TO LEAD A NORMAL LIFE BY THE WAY I AM 39 YEARS OLD [/INST] Dear sir as Spinal MRI shows no change and does not shoes lumbar stenosis you has nothing to be worrying.Syrgery will reliaf the pain.Maybe you can try lumbar cortico disc infiltration before surgery.Surgery has to be undertaken not for pain but if motor deficits or urinary complications are present.Wish you all the best </s> |
<s>[INST] hi. after drinking about 2 glasses of cocktails.. vodka mix. and 3 glasses of red wine.. my skin turn red with burning feel on my legs near my groins and on my breasts.. the red and burning feel lasts till the next day.. please explain this kind of reaction? thanks [/INST] Hi,This reaction is known as alcohol flush reaction.When we consume alcohol, it gets metabolized in body by liver enzymes into acetaldehyde and then into acetate.Some people( commonly chinese,japanese)have inability to convert this excess acetaldehtde into acetate leading to accumulation of this acetaldehyde into blood causing blood vessels to dilate more.And because of this,our skin turns red and slightly burning to touch till this substance clears from the blood by kidney.Best treatment is to curtail this alcohol consumptions.So,this is the brief explanation.Thanks </s> |