CHIEF COMPLAINT: Mastopexy/Panniculectomy/Thigh Lift

PRESENT ILLNESS: 38 yo female with morbid obesity s/p roux-en-y gastric bypass
and wt. loss now in for mastopexy, panniculectomy, medial thigh
and buttock lift.

MEDICAL HISTORY: Gastric Bypass [**3-/2162**]
OA
DJD
Morbid Obesity (lost approx 150lbs)
Low Back Pain, L4-L5 discectomy
Appy [**2139**]
Tonsillectomy, Adenoidectomy

MEDICATION ON ADMISSION: Flintstone Vitamins
Calcium
Vitron C
Flonase
Vitamin B12

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals 98.6, 88, 122/74, 100% RR 10
HEENT:  PERRLA, EOMI, anicteric sclera, MMM
Neck:  supple, no LAD, no thyromegaly
Cardiac: RRR
Lungs: CTAB
Abd: soft, NT/ND no HSM, no rebound or guarding

FAMILY HISTORY: Morbid Obesity, Asthma

SOCIAL HISTORY: No tobacco or illicits.  Rare ETOH use
Other specified hypertrophic and atrophic conditions of skin,Intestinal bypass or anastomosis status
Skin hypertro/atroph NEC,Intestinal bypass status
Admission Date:  [**2164-10-1**]              Discharge Date:   [**2164-10-4**]

Date of Birth:  [**2125-11-13**]             Sex:   F

Service: PLASTIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 10416**]
Chief Complaint:
Mastopexy/Panniculectomy/Thigh Lift


Major Surgical or Invasive Procedure:
Mastopexy/Panniculectomy/Thigh Lift


History of Present Illness:
38 yo female with morbid obesity s/p roux-en-y gastric bypass
and wt. loss now in for mastopexy, panniculectomy, medial thigh
and buttock lift.

Past Medical History:
Gastric Bypass [**3-/2162**]
OA
DJD
Morbid Obesity (lost approx 150lbs)
Low Back Pain, L4-L5 discectomy
Appy [**2139**]
Tonsillectomy, Adenoidectomy

Social History:
No tobacco or illicits.  Rare ETOH use

Family History:
Morbid Obesity, Asthma

Physical Exam:
Vitals 98.6, 88, 122/74, 100% RR 10
HEENT:  PERRLA, EOMI, anicteric sclera, MMM
Neck:  supple, no LAD, no thyromegaly
Cardiac: RRR
Lungs: CTAB
Abd: soft, NT/ND no HSM, no rebound or guarding

Pertinent Results:
[**2164-10-1**] 08:17PM BLOOD WBC-9.0 RBC-2.93* Hgb-8.9* Hct-26.4*
MCV-90 MCH-30.3 MCHC-33.6 RDW-15.8* Plt Ct-207
[**2164-10-3**] 07:50AM BLOOD WBC-8.7 RBC-2.58* Hgb-7.9* Hct-23.2*
MCV-90 MCH-30.8 MCHC-34.3 RDW-16.0* Plt Ct-177
[**2164-10-1**] 08:17PM BLOOD PT-13.9* PTT-23.3 INR(PT)-1.2*
[**2164-10-2**] 06:36AM BLOOD Calcium-8.3* Phos-3.0 Mg-1.6

Brief Hospital Course:
Pt was admitted and underwent panniculectomy in the OR.
Initially post-op patent was unable to extubate [**3-8**] narcotics
intraoperatively.  She was transferred from the OR to the MICU
and was extubated overnight.  In the OR she lost 800cc blood and
received 6400cc crystalloid.  On HD#2 patient remained afebrile.
 She was advanced to clear liquid diet which she tolerated well.
 On HD#3 her Foley and PCA pump were D/C'd and patient tolerated
oral regimen well.  She was advanced to a regular diet.  Pt
remained afebrile post-op.  She will Follow-up with Dr. [**Last Name (STitle) **] in
clinic.

Medications on Admission:
Flintstone Vitamins
Calcium
Vitron C
Flonase
Vitamin B12

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
2. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4-6H
(every 4 to 6 hours) as needed.
3. Fluticasone 50 mcg/Actuation Aerosol, Spray Sig: Two (2)
Spray Nasal DAILY (Daily).
4. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime)
as needed.
Disp:*30 Tablet(s)* Refills:*0*
5. 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*
6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*60 Tablet(s)* Refills:*0*
7. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*0*
8. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*0*
9. Cephalexin 500 mg Tablet Sig: One (1) Tablet PO Q6H (every 6
hours) for 10 days.
Disp:*40 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Mastopexy/Panniculectomy/Thigh Lift


Discharge Condition:
Good


Discharge Instructions:
You should continue antibiotics as long as you have a drain in
place.

You were admitted to the hospital for a
mastopexy/panniculectomy/thigh and gluteal lift.  You should
call your doctor or return to the ER should you experience any
of the following:
Severe increase in drainage or redness at incision sites
Severe Increase in pain from incision sites
Fever > 101
Severe pain to right leg
Numbness/Tingling/Paralysis of right leg
Severe Dizziness
Nausea/Vomiting
Severe Chest Pain/SOB
Any other symptoms that worry you.


Followup Instructions:
Please Follow-up in clinic with Dr. [**Last Name (STitle) **] in 1 week.  You should
call ([**Telephone/Fax (1) 10419**] to schedule an appointment.

Please follow-up with your primary care doctor in [**2-6**] weeks for
management of longterm medical care.



Completed by:[**2164-10-4**]
{'Other specified hypertrophic and atrophic conditions of skin,Intestinal bypass or anastomosis status'}


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: Mastopexy/Panniculectomy/Thigh Lift

PRESENT ILLNESS: 38 yo female with morbid obesity s/p roux-en-y gastric bypass
and wt. loss now in for mastopexy, panniculectomy, medial thigh
and buttock lift.

MEDICAL HISTORY: Gastric Bypass [**3-/2162**]
OA
DJD
Morbid Obesity (lost approx 150lbs)
Low Back Pain, L4-L5 discectomy
Appy [**2139**]
Tonsillectomy, Adenoidectomy

MEDICATION ON ADMISSION: Flintstone Vitamins
Calcium
Vitron C
Flonase
Vitamin B12

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals 98.6, 88, 122/74, 100% RR 10
HEENT:  PERRLA, EOMI, anicteric sclera, MMM
Neck:  supple, no LAD, no thyromegaly
Cardiac: RRR
Lungs: CTAB
Abd: soft, NT/ND no HSM, no rebound or guarding

FAMILY HISTORY: Morbid Obesity, Asthma

SOCIAL HISTORY: No tobacco or illicits.  Rare ETOH use 

### Response:
{'Other specified hypertrophic and atrophic conditions of skin,Intestinal bypass or anastomosis status'}
