CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 69-year-old male with
past medical history of cervical spinal surgery in [**2153**] after
complaints of upper extremity sensory loss and shoulder and
neck pain.  The patient underwent elective surgery for
odontoid process removal and fusion of C3 level.  Patient
presented on [**2168-8-3**] complaining of bilateral numbness in
palmar area of his hands left greater than right x2-3 months
and has also been experiencing pain of the occipital region
projecting to the back bilaterally particularly after
coughing or taking asthma inhalers.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Cervical spondylosis with myelopathy,Chronic obstructive asthma, unspecified,Gout, unspecified
Cerv spondyl w myelopath,Chronic obst asthma NOS,Gout NOS
Admission Date:  [**2168-8-4**]     Discharge Date:  [**2168-8-15**]

Date of Birth:   [**2099-6-5**]     Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  This is a 69-year-old male with
past medical history of cervical spinal surgery in [**2153**] after
complaints of upper extremity sensory loss and shoulder and
neck pain.  The patient underwent elective surgery for
odontoid process removal and fusion of C3 level.  Patient
presented on [**2168-8-3**] complaining of bilateral numbness in
palmar area of his hands left greater than right x2-3 months
and has also been experiencing pain of the occipital region
projecting to the back bilaterally particularly after
coughing or taking asthma inhalers.

The patient was referred to Dr. [**Last Name (STitle) 1327**] on [**6-22**] with x-rays
of the neck and has presented for elective surgery.  On
admission, the patient's vital signs were stable.  He was
afebrile.

Neuro exam revealed 4+/5 muscular strength bilateral upper
extremities with a slight right drift.  Pupils are equal and
reactive to light.  Patient's sensory exam was decreased to
pin prick in the palmar distribution and decreased
proprioception in the left upper extremity.  Patient had a
soft tissue mass around the odontoid process compressing the
spinal cord, otherwise note of odontoid degenerative pannus.

Patient had transoral resection of the odontoid and
associated soft tissues on [**2168-8-5**].  Patient had a left
iliac crest graft during surgery as well.  Estimated blood
loss was 1200 cc.  Patient was transfused 2 units of packed
red blood cells in the OR.  Patient remained intubated in the
PACU, and was transferred to the ICU.  Patient remained
intubated on propofol drip status post surgery and ICU.

On [**2168-8-6**], the patient was opening eyes to voice, obeying
midline commands.  Right deltoids were [**3-9**], left [**3-9**], biceps
[**3-9**] bilaterally, triceps [**4-9**] on the right, [**3-9**] on the left.
Myelopathy and weakness was slightly worse status post
surgery.  Patient had central line placed on [**2168-8-6**] without
complications.

Iliac Hemovac drain was D/C'd on [**2168-8-7**].  Patient remained
on propofol drip and remained intubated.  The patient was
started on subQ Heparin.  Hemovac drain was D/C'd on
[**2168-8-9**].  Patient remained on Ancef for 72 hours after drain
D/C'd.

Patient extubated on [**2168-8-10**].  Tube feeds were then started
postextubation.  Patient pulled out feeding tube on [**2168-8-11**]
and was started on TPN.  The patient improved neurologically,
and was transferred to floor on [**2168-8-12**].  Patient was seen
by Physical Therapy on the floor.  Was moving all extremities
on [**2168-8-14**].  Triceps remained 4+ bilaterally.

Patient was D/C'd home with followup with Dr. [**Last Name (STitle) 1327**] on
[**8-23**] with prior x-rays and follow up with Dr. [**Last Name (STitle) 1906**]
in six weeks at [**Hospital1 336**].  Patient was D/C'd home on
ciprofloxacin one tablet twice a day for 10 days and
hydromorphone 2 mg tablets 1-4 tablets q.4-6h. p.o. prn.
Patient was taking adequate p.o. at time of discharge.



                          [**Name6 (MD) 1339**] [**Last Name (NamePattern4) 1340**], M.D.  [**MD Number(1) 1341**]

Dictated By:[**Last Name (NamePattern1) 27454**]

MEDQUIST36

D:  [**2168-9-12**]  12:30
T:  [**2168-9-14**]  05:17
JOB#:  [**Job Number 47846**]
{'Cervical spondylosis with myelopathy,Chronic obstructive asthma, unspecified,Gout, unspecified'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 69-year-old male with
past medical history of cervical spinal surgery in [**2153**] after
complaints of upper extremity sensory loss and shoulder and
neck pain.  The patient underwent elective surgery for
odontoid process removal and fusion of C3 level.  Patient
presented on [**2168-8-3**] complaining of bilateral numbness in
palmar area of his hands left greater than right x2-3 months
and has also been experiencing pain of the occipital region
projecting to the back bilaterally particularly after
coughing or taking asthma inhalers.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Cervical spondylosis with myelopathy,Chronic obstructive asthma, unspecified,Gout, unspecified'}
