CHIEF COMPLAINT: Dyspnea/ Stridor

PRESENT ILLNESS: 45M tracheoesophageal fistula repaired [**2087**] with multiple
tracheostomies, tracheomalacia,tracheal resection
[**2102**],tracheoplasty augmentation
with t-tube placement [**8-18**] now with stridor

MEDICAL HISTORY: Rheumatoid arthritis, Diabetes Mellitus 2, tracheoesophageal
fistula repaired [**2087**] with multiple tracheostomies,
tracheomalacia,tracheal resection [**2102**],tracheoplasty
augmentation
with t-tube plcement [**8-18**]

MEDICATION ON ADMISSION: glipizide 40'
aciphex 20'
clarinex
Percocet
Phenergan
Xopenex
albuterol
Pulmicort

ALLERGIES: Ibuprofen / Aspirin

PHYSICAL EXAM: Gen:NAD
CV: RRR
Chest:CTA Bilaterally
Ext:+ pulses, no edema
Wound:CDI

FAMILY HISTORY: F-
M- Alzheimers, bopolar
Sibling- thyroid disease.

SOCIAL HISTORY: Lives in  [**Location (un) 69402**],[**State 38104**] w/ wife. Referred to Airway
Center, [**Name8 (MD) **], MD, [**Name8 (MD) 952**], MD.
[**First Name (Titles) **] [**Last Name (Titles) **], ciggs or rec rx use
Chronic respiratory failure,Other postoperative infection,Obstructive chronic bronchitis with acute bronchitis,Unilateral paralysis of vocal cords or larynx, partial,Atrial fibrillation,Tracheoesophageal fistula, esophageal atresia and stenosis,Attention to tracheostomy,Disorders of bursae and tendons in shoulder region, unspecified,Other abnormal granulation tissue,Rheumatoid arthritis,Personal history of tuberculosis,Other specified disorders of pancreatic internal secretion,Adrenal cortical steroids causing adverse effects in therapeutic use
Chronic respiratory fail,Other postop infection,Obs chr bronc w ac bronc,Vocal paral unilat part,Atrial fibrillation,Cong esoph fistula/atres,Atten to tracheostomy,Rotator cuff synd NOS,Abnormal granulation NEC,Rheumatoid arthritis,Prsnl hst tuberculosis,Pancreatic disorder NEC,Adv eff corticosteroids
Admission Date:  [**2132-3-26**]              Discharge Date:   [**2132-5-7**]

Date of Birth:  [**2086-9-26**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Ibuprofen / Aspirin

Attending:[**Last Name (NamePattern1) 1561**]
Chief Complaint:
Dyspnea/ Stridor

Major Surgical or Invasive Procedure:
Y stent placement [**4-25**], #6 fenestrated cuffless trach placement


History of Present Illness:
45M tracheoesophageal fistula repaired [**2087**] with multiple
tracheostomies, tracheomalacia,tracheal resection
[**2102**],tracheoplasty augmentation
with t-tube placement [**8-18**] now with stridor


Past Medical History:
Rheumatoid arthritis, Diabetes Mellitus 2, tracheoesophageal
fistula repaired [**2087**] with multiple tracheostomies,
tracheomalacia,tracheal resection [**2102**],tracheoplasty
augmentation
with t-tube plcement [**8-18**]


Social History:
Lives in  [**Location (un) 69402**],[**State 38104**] w/ wife. Referred to Airway
Center, [**Name8 (MD) **], MD, [**Name8 (MD) 952**], MD.
[**First Name (Titles) **] [**Last Name (Titles) **], ciggs or rec rx use


Family History:
F-
M- Alzheimers, bopolar
Sibling- thyroid disease.

Physical Exam:
Gen:NAD
CV: RRR
Chest:CTA Bilaterally
Ext:+ pulses, no edema
Wound:CDI

Pertinent Results:
[**2132-3-25**] 08:15AM   GLUCOSE-214* UREA N-17 CREAT-1.0 SODIUM-138
POTASSIUM-4.1 CHLORIDE-104 TOTAL CO2-24 ANION GAP-14
[**2132-3-25**] 08:15AM   WBC-5.8 RBC-4.81# HGB-13.7*# HCT-38.7*#
MCV-80*# MCH-28.5 MCHC-35.5* RDW-14.0

Brief Hospital Course:
45M admitted with stridor found to tracheomalacia on bronch s/p
t-tube removal [**2132-3-26**].Tracheoplasty delayed secondary to desat
episode. on [**2132-4-2**] he underwent a flex bronch with
tracheobronchoplasty. Patient tolerated the procedure weel. On
POD 2 bronch showed some collapse of distal trachea.
Rheumatology was consulted secondary to shoulder pain and
suggested injection and paon control. He passed a video swallow
test on [**4-9**] and his diet was advanced. Respiratory therapy
followed him with trach care throughout his stay. A bronch on
[**4-15**] showed some granulation tissue on posterior wall and mid
trachea. Mr [**Known lastname 715**] was followed with serial bronch's which showed
a decrease in the granulation tissue. On [**4-25**] a y-stent was
placed with improvement in breathing. He did very well and was
discharged on [**5-7**].

Medications on Admission:
glipizide 40'
aciphex 20'
clarinex
Percocet
Phenergan
Xopenex
albuterol
Pulmicort

Discharge Medications:
1. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation
Q6H (every 6 hours) as needed.
Disp:*1 * Refills:*0*
2. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff
Inhalation [**Hospital1 **] (2 times a day).
Disp:*1 * Refills:*0*
3. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical
TID (3 times a day) as needed for pruritus.
Disp:*1 * Refills:*0*
4. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30)
ML PO Q6H (every 6 hours) as needed.
5. Diltiazem HCl 30 mg Tablet Sig: 1.5 Tablets PO QID (4 times a
day).
Disp:*180 Tablet(s)* Refills:*0*
6. Albuterol Sulfate 0.083 % Solution Sig: [**1-15**]  Inhalation Q6H
(every 6 hours) as needed.
Disp:*90 * Refills:*0*
7. Ipratropium Bromide 0.02 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours).
Disp:*90 * Refills:*0*
8. Nystatin 100,000 unit/g Cream Sig: One (1) Appl Topical [**Hospital1 **]
(2 times a day).
Disp:*1 * Refills:*0*
9. Fexofenadine 60 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day) as needed.
Disp:*120 Tablet(s)* Refills:*0*
10. Guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO BID (2 times
a day) as needed for stent management.
Disp:*400 ML(s)* Refills:*0*
11. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
Disp:*60 Tablet(s)* Refills:*0*
12. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
13. Linezolid 600 mg Tablet Sig: One (1) Tablet PO once a day
for 1 months.
Disp:*30 Tablet(s)* Refills:*0*
14. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets
PO every six (6) hours as needed for pain.
Disp:*75 Tablet(s)* Refills:*0*
15. Zofran 4 mg Tablet Sig: One (1) Tablet PO every eight (8)
hours as needed for nausea.
Disp:*15 Tablet(s)* Refills:*0*
16. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet,
Chewable PO four times a day.
Disp:*120 Tablet, Chewable(s)* Refills:*0*
17. NPH insulin
5 units NPH SQ with b-fast and dinner
18. humalog insulin
humalog insulin per sliding scale
19. Syringe with Needle, Insulin 3 mL 20 x 1  Syringe Sig: One
(1) Syringe Miscellaneous AS DIRECTED.
Disp:*120 Syringe* Refills:*0*
20. Roxicet 5-325 mg/5 mL Solution Sig: [**5-22**] mL PO every six (6)
hours as needed for pain.
Disp:*1200 mL* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Tracheomalacia, s/p tracheoplasty, complicated with necrosis of
the posterior membranous wall, s/p rigid bronch, T-tube removal
with trach cannulation, s/p Y stent placement [**4-25**] and #6
fenestrated cuffless trach


Discharge Condition:
Good


Discharge Instructions:
Call Dr.[**Name (NI) 1816**] office [**Telephone/Fax (1) 170**] if you develop chest pain,
shortness of breath, fever, chills, redness or drainage from
your incision/trach sites.
You may shower.
No tub bathing or swimming for 3-4 weeks.

Followup Instructions:
Call Dr.[**Name (NI) 1816**] office [**Telephone/Fax (1) 170**] for a follow up
appointment.



Completed by:[**2132-5-8**]
{'Chronic respiratory failure,Other postoperative infection,Obstructive chronic bronchitis with acute bronchitis,Unilateral paralysis of vocal cords or larynx, partial,Atrial fibrillation,Tracheoesophageal fistula, esophageal atresia and stenosis,Attention to tracheostomy,Disorders of bursae and tendons in shoulder region, unspecified,Other abnormal granulation tissue,Rheumatoid arthritis,Personal history of tuberculosis,Other specified disorders of pancreatic internal secretion,Adrenal cortical steroids causing adverse effects in therapeutic use'}


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: Dyspnea/ Stridor

PRESENT ILLNESS: 45M tracheoesophageal fistula repaired [**2087**] with multiple
tracheostomies, tracheomalacia,tracheal resection
[**2102**],tracheoplasty augmentation
with t-tube placement [**8-18**] now with stridor

MEDICAL HISTORY: Rheumatoid arthritis, Diabetes Mellitus 2, tracheoesophageal
fistula repaired [**2087**] with multiple tracheostomies,
tracheomalacia,tracheal resection [**2102**],tracheoplasty
augmentation
with t-tube plcement [**8-18**]

MEDICATION ON ADMISSION: glipizide 40'
aciphex 20'
clarinex
Percocet
Phenergan
Xopenex
albuterol
Pulmicort

ALLERGIES: Ibuprofen / Aspirin

PHYSICAL EXAM: Gen:NAD
CV: RRR
Chest:CTA Bilaterally
Ext:+ pulses, no edema
Wound:CDI

FAMILY HISTORY: F-
M- Alzheimers, bopolar
Sibling- thyroid disease.

SOCIAL HISTORY: Lives in  [**Location (un) 69402**],[**State 38104**] w/ wife. Referred to Airway
Center, [**Name8 (MD) **], MD, [**Name8 (MD) 952**], MD.
[**First Name (Titles) **] [**Last Name (Titles) **], ciggs or rec rx use 

### Response:
{'Chronic respiratory failure,Other postoperative infection,Obstructive chronic bronchitis with acute bronchitis,Unilateral paralysis of vocal cords or larynx, partial,Atrial fibrillation,Tracheoesophageal fistula, esophageal atresia and stenosis,Attention to tracheostomy,Disorders of bursae and tendons in shoulder region, unspecified,Other abnormal granulation tissue,Rheumatoid arthritis,Personal history of tuberculosis,Other specified disorders of pancreatic internal secretion,Adrenal cortical steroids causing adverse effects in therapeutic use'}
