CHIEF COMPLAINT: Morbid obesity

PRESENT ILLNESS: The patient is a 45 year old gentleman who has been suffering
with obesity since his teenage years.  He has been on multiple
attempts at weight
loss with a maximum of 110 pound weight loss with regain.
His current weight is 431 lb and he is being evaluated by
[**Hospital1 69**] Bariatric Program and
deemed a good candidate for surgical weight loss.

MEDICAL HISTORY: Morbid obesity.
Sleep apnea.
Hypertension.
Gastroesophageal reflux.
Osteoarthritis.

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Physical Exam: Weight 431 pounds. He is awake, alert, and
oriented. His neck is supple. His lungs are coarse bilaterally.
Heart: Regular rate and rhythm with no murmurs. His abdomen is
soft with upper midline incisions from previous surgery without
hernia. His extremities are with good range of motion and good
strength except for his knees, which is painful. He has
venostasis changes on his lower extremities.

FAMILY HISTORY: His father is alive with prostate cancer and accompanies him and

SOCIAL HISTORY: He smokes about one pack for the last 15 years; currently
promises to quit. He drinks alcohol for the last 20 years and
has recently cut back to 6 beers per week; again, he has
promised
to quit in preparation for surgery. He denies any drug abuse.
Morbid obesity,Accidental puncture or laceration during a procedure, not elsewhere classified,Unspecified sleep apnea,Unspecified essential hypertension,Esophageal reflux,Personal history of tobacco use
Morbid obesity,Accidental op laceration,Sleep apnea NOS,Hypertension NOS,Esophageal reflux,History of tobacco use
Admission Date:  [**2141-9-25**]              Discharge Date:   [**2141-9-28**]

Date of Birth:  [**2096-6-10**]             Sex:   M

Service: [**Doctor First Name 147**]

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 301**]
Chief Complaint:
Morbid obesity

Major Surgical or Invasive Procedure:
Open Roux-en-Y gastric bypass.


History of Present Illness:
The patient is a 45 year old gentleman who has been suffering
with obesity since his teenage years.  He has been on multiple
attempts at weight
loss with a maximum of 110 pound weight loss with regain.
His current weight is 431 lb and he is being evaluated by
[**Hospital1 69**] Bariatric Program and
deemed a good candidate for surgical weight loss.

Past Medical History:
Morbid obesity.
Sleep apnea.
Hypertension.
Gastroesophageal reflux.
Osteoarthritis.


Social History:
He smokes about one pack for the last 15 years; currently
promises to quit. He drinks alcohol for the last 20 years and
has recently cut back to 6 beers per week; again, he has
promised
to quit in preparation for surgery. He denies any drug abuse.


Family History:
His father is alive with prostate cancer and accompanies him and

is very supportive. Mother with congestive heart failure.


Physical Exam:
Physical Exam: Weight 431 pounds. He is awake, alert, and
oriented. His neck is supple. His lungs are coarse bilaterally.
Heart: Regular rate and rhythm with no murmurs. His abdomen is
soft with upper midline incisions from previous surgery without
hernia. His extremities are with good range of motion and good
strength except for his knees, which is painful. He has
venostasis changes on his lower extremities.


Brief Hospital Course:
Patient underwent open gastric bypass. He tolerated the
procedure well and was transported to the PACU. He spent the
first night in the PACU intubated due to decreased O2 saturation
and difficulty with manual ventilation. He received Heparin and
SCDs for DVT prophylaxis. He was successfully extubated on POD1.
He was started on Stage I diet, which he tolerated without
problems. On POD2, he was advanced to Stage II. Foley was
dc'ed.On POD3, he tolerated Stage III well; JP was removed. And,
he was deemed stable and suitable for discharge. He was not
given Actigall on discharge since he had his Gall Bladder out in
[**Month (only) 404**].


Discharge Medications:
1. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs
PO Q4-6H (every 4 to 6 hours) as needed.
Disp:*250 ML(s)* Refills:*0*
2. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: [**2-3**]
Teaspoons PO every 4-6 hours as needed for pain.
Disp:*250 mL* Refills:*0*
3. Ranitidine HCl 15 mg/mL Syrup Sig: Ten (10) cc PO BID (2
times a day) as needed for indigestion.
Disp:*300 cc* Refills:*2*
4. Flinstones multivitamin with Iron  Sig: One (1) chewable PO
once a day.
Disp:*120 chewables* Refills:*2*


Discharge Disposition:
Home

Discharge Diagnosis:
Morbid obesity.
Sleep apnea.
Hypertension.
Gastroesophageal reflux.
Osteoarthritis.


Discharge Condition:
Good

Discharge Instructions:
Please stay on stage 3 diet until follow-up.  Do not
self-advance diet, drink from a straw, or chew gum.  No heavy
lifting (>10lbs) for 6 weeks.  You may shower (no tub bathing or
swimming for 6 weeks) as long as no drainage from wound sites.
If there is clear drainage, cover wound and stop showering.
Please [**Name8 (MD) 138**] MD for temp >101.5, persistent nausea/vomiting or
pain, or drainage from wound.  Please crush all pills.

Followup Instructions:
In 3 weeks at [**Hospital 1560**] clinic.  Please call [**Telephone/Fax (1) 305**] for
appointment.



Completed by:[**2141-10-16**]
{'Morbid obesity,Accidental puncture or laceration during a procedure, not elsewhere classified,Unspecified sleep apnea,Unspecified essential hypertension,Esophageal reflux,Personal history of tobacco 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: Morbid obesity

PRESENT ILLNESS: The patient is a 45 year old gentleman who has been suffering
with obesity since his teenage years.  He has been on multiple
attempts at weight
loss with a maximum of 110 pound weight loss with regain.
His current weight is 431 lb and he is being evaluated by
[**Hospital1 69**] Bariatric Program and
deemed a good candidate for surgical weight loss.

MEDICAL HISTORY: Morbid obesity.
Sleep apnea.
Hypertension.
Gastroesophageal reflux.
Osteoarthritis.

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Physical Exam: Weight 431 pounds. He is awake, alert, and
oriented. His neck is supple. His lungs are coarse bilaterally.
Heart: Regular rate and rhythm with no murmurs. His abdomen is
soft with upper midline incisions from previous surgery without
hernia. His extremities are with good range of motion and good
strength except for his knees, which is painful. He has
venostasis changes on his lower extremities.

FAMILY HISTORY: His father is alive with prostate cancer and accompanies him and

SOCIAL HISTORY: He smokes about one pack for the last 15 years; currently
promises to quit. He drinks alcohol for the last 20 years and
has recently cut back to 6 beers per week; again, he has
promised
to quit in preparation for surgery. He denies any drug abuse. 

### Response:
{'Morbid obesity,Accidental puncture or laceration during a procedure, not elsewhere classified,Unspecified sleep apnea,Unspecified essential hypertension,Esophageal reflux,Personal history of tobacco use'}
