CHIEF COMPLAINT: Left hip pain

PRESENT ILLNESS: The patient is a 51 year old male who has severe heterotropic
ossification with essential fusion of the left hip.  This has
caused him quite a great deal of discomfort.  He presents for
definitive treatment.

MEDICAL HISTORY: EtOH abuse
Pancreatitis
MRSA bacteremia
MRSA pneumonia
Alcoholic hepatitis
C diff
ARF
DT
PSVT
Respiratory failure s/p trach and PEG
DMII
High triglyceridemia

MEDICATION ON ADMISSION: Denies

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On discharge:
NAD
A+O
CTA b/l
RRR
Left hip incision: c/d/i, no erythema, no drainage
+[**Last Name (un) 938**]/FHL/AT/G/S
+SILT
+DP

FAMILY HISTORY: None

SOCIAL HISTORY: THe patient lives alone and has a chronic history of alcohol
abuse. He admits to 2 packs/day of smoking. He is cared for by
his brother.
Postoperative heterotopic calcification,Chronic pancreatitis,Delirium due to conditions classified elsewhere
Postop heterotopic calc,Chronic pancreatitis,Delirium d/t other cond
Admission Date:  [**2182-2-26**]              Discharge Date:   [**2182-3-12**]

Date of Birth:  [**2131-2-1**]             Sex:   M

Service: ORTHOPAEDICS

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 11261**]
Chief Complaint:
Left hip pain

Major Surgical or Invasive Procedure:
Left total hip arthroplasty with heterotopic bone excision
[**2182-2-26**]

History of Present Illness:
The patient is a 51 year old male who has severe heterotropic
ossification with essential fusion of the left hip.  This has
caused him quite a great deal of discomfort.  He presents for
definitive treatment.

Past Medical History:
EtOH abuse
Pancreatitis
MRSA bacteremia
MRSA pneumonia
Alcoholic hepatitis
C diff
ARF
DT
PSVT
Respiratory failure s/p trach and PEG
DMII
High triglyceridemia

Social History:
THe patient lives alone and has a chronic history of alcohol
abuse. He admits to 2 packs/day of smoking. He is cared for by
his brother.


Family History:
None

Physical Exam:
On discharge:
NAD
A+O
CTA b/l
RRR
Left hip incision: c/d/i, no erythema, no drainage
+[**Last Name (un) 938**]/FHL/AT/G/S
+SILT
+DP

Pertinent Results:
[**2182-2-26**] 08:22PM   GLUCOSE-99 UREA N-7 CREAT-0.4* SODIUM-140
POTASSIUM-3.9 CHLORIDE-111* TOTAL CO2-23 ANION GAP-10
[**2182-2-26**] 08:22PM   CALCIUM-7.2* PHOSPHATE-4.1 MAGNESIUM-2.0
[**2182-2-26**] 08:22PM   HCT-27.0*
[**2182-2-26**] 08:22PM   PLT COUNT-120*
[**2182-2-26**] 08:22PM   PT-12.4 PTT-28.0 INR(PT)-1.1
[**2182-2-26**] 02:28PM   HCT-26.1*
[**2182-2-26**] 02:28PM   PT-12.9 PTT-27.5 INR(PT)-1.1
[**2182-2-26**] 02:28PM   FIBRINOGE-163#
[**2182-2-26**] 11:30AM   GLUCOSE-126* UREA N-7 CREAT-0.4* SODIUM-142
POTASSIUM-4.0 CHLORIDE-110* TOTAL CO2-24 ANION GAP-12
[**2182-2-26**] 11:30AM   CALCIUM-7.3* PHOSPHATE-4.4 MAGNESIUM-1.2*
[**2182-2-26**] 11:30AM   HCT-30.1*#
[**2182-2-26**] 11:30AM   PT-12.6 INR(PT)-1.1
[**2182-2-26**] 10:14AM   TYPE-ART TIDAL VOL-600 O2-50 PO2-123* PCO2-43
PH-7.37 TOTAL CO2-26 BASE XS-0 INTUBATED-INTUBATED
VENT-CONTROLLED
[**2182-2-26**] 10:14AM   GLUCOSE-93 LACTATE-0.9 NA+-139 K+-3.9 CL--108
[**2182-2-26**] 10:14AM   HGB-10.5* calcHCT-32
[**2182-2-26**] 10:14AM   freeCa-1.06*
[**2182-2-26**] 09:16AM   TYPE-ART PO2-161* PCO2-40 PH-7.43 TOTAL
CO2-27 BASE XS-2 INTUBATED-INTUBATED
[**2182-2-26**] 09:16AM   GLUCOSE-98 LACTATE-1.3 NA+-140 K+-3.9 CL--102
[**2182-2-26**] 09:16AM   HGB-12.8* calcHCT-38 O2 SAT-95
[**2182-2-26**] 09:16AM   freeCa-1.19

Brief Hospital Course:
The patient was brought to the operating room on [**2182-2-26**] for a
left total hip replacement with heterotopic bone excision.  The
patient tolerated the procedure well.  He was extubated and
brought to the recovery room in satisfactory condition.  In the
PACU there was a lot of oozing from his incision which required
approximately [**3-1**] dressing changes per hour.  This was expected
because of the amount of bone exposed in the procedure.  He was
placed on serial hematocrits.  His systolic blood pressure was
in the 80s and 90s and his heart rate was in the 100s-110s.  The
patients urine output was in the low 20's.  This was despite
approximately 5 units crystalloid.  His hematocrit was 26 (It
had been 40 pre-op) and he was transfused one unit PRBC's.  It
was decided that the patient should be admitted to the SICU for
closer monitoring and management.  While in the SICU the patient
received 2 more units of PRBC's, bringing the Hct up to 27.  The
oozing from the incision slowed down considerably, his urine
output stablized, and his vitals stabilized.  The patient was
placed on a CIWA scale, thiamine, folic acid, because of his
history of alcohol abuse.  On POD#1 was transferred to the
floor.  He had some confusion requiring redirection from the
nursing staff.  He started pulling at his IV lines, so a sitter
was placed in his room and he was placed in soft restraints.  He
tolerated this fine.  He was also seen by the addiction
specialist RN.  It was recommended to give him Haldol PRN for
confusion and to continue with the CIWA scale.  His Hct was 25.7
on [**2182-2-28**] and he was transfused one unit PRBC's without
incident.  This brought his hematocrit up to 27.1.  On [**2182-3-1**] he
underwent radiation to his left hip to prevent further HO.  He
tolerated this well.  His confusion lessened each day.  He was
tapered off ativan and given valium as per Addiction services
recommendation.  He no longer required a sitter on [**2182-3-6**].  The
valium was tappered as well.  He remained in the hospital
because of rehab placement problems.  His incision looked good.
His lab results and vital signs remained stable.  He hospital
course was otherwise without incident.  He is being transferred
today to rehab in stable condition.

Medications on Admission:
Denies

Discharge Medications:
1. Diazepam 2 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily) for 1
days: please give [**2-10**].
2. Diazepam 2 mg Tablet Sig: 0.5 mg PO once a day for 1 days:
please give [**2-11**] .
3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
4. Aspirin 325 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
5. Diphenhydramine HCl 25 mg Capsule Sig: One (1) Capsule PO Q6H
(every 6 hours) as needed.
6. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2)
Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed.
7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
8. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed.
9. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
10. Multivitamin     Capsule Sig: One (1) Cap PO DAILY (Daily).

11. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

12. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
13. Nicotine 14 mg/24 hr Patch 24HR Sig: One (1) Patch 24HR
Transdermal DAILY (Daily).
14. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4-6H (every 4
to 6 hours) as needed.
15. Haloperidol 0.5 mg Tablet Sig: One (1) Tablet PO BID (2
times a day) as needed.


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 2558**] - [**Location (un) **]

Discharge Diagnosis:
Left heterotropic bone with essential hip fusion


Discharge Condition:
Stable


Discharge Instructions:
Please keep your incision clean and dry.  If you notice any
redness, swelling, discharge, pain, temperature >101.4, or
weight bearing of the left leg.  Continue with physical therapy.
 Take all medications as prescribed.  You need to take aspirin
325 mg twice daily.  Please follow up with Dr. [**Last Name (STitle) 7111**] as below.
Call with any questions.
Physical Therapy:
PWB LLE
Treatments Frequency:
Dry sterile dressing daily

Followup Instructions:
Provider: [**Name10 (NameIs) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 7145**] ORTHOPEDIC PRIVATE PRACTICE
Date/Time:[**2182-3-29**] 12:15



Completed by:[**2182-3-12**]
{'Postoperative heterotopic calcification,Chronic pancreatitis,Delirium due to conditions classified elsewhere'}


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: Left hip pain

PRESENT ILLNESS: The patient is a 51 year old male who has severe heterotropic
ossification with essential fusion of the left hip.  This has
caused him quite a great deal of discomfort.  He presents for
definitive treatment.

MEDICAL HISTORY: EtOH abuse
Pancreatitis
MRSA bacteremia
MRSA pneumonia
Alcoholic hepatitis
C diff
ARF
DT
PSVT
Respiratory failure s/p trach and PEG
DMII
High triglyceridemia

MEDICATION ON ADMISSION: Denies

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On discharge:
NAD
A+O
CTA b/l
RRR
Left hip incision: c/d/i, no erythema, no drainage
+[**Last Name (un) 938**]/FHL/AT/G/S
+SILT
+DP

FAMILY HISTORY: None

SOCIAL HISTORY: THe patient lives alone and has a chronic history of alcohol
abuse. He admits to 2 packs/day of smoking. He is cared for by
his brother. 

### Response:
{'Postoperative heterotopic calcification,Chronic pancreatitis,Delirium due to conditions classified elsewhere'}
