CHIEF COMPLAINT: 

PRESENT ILLNESS: Patient is a 78-year-old man
with non-small cell lung cancer with a history of left
main stem stent and surrounding fibrosis and scarring, status
post multiple removals, who presents now with dyspnea on
exertion.

MEDICAL HISTORY: 1. Non-small cell lung cancer, diagnosed in [**2159**], status post
radiation, Taxol, and carboplatin x6 months, Navelbine and
carboplatin x12 months in [**2160**] for increased PET activity.
Patient is status post stent placement in the left main stem
bronchus with migration, fibrosis, scarring, now 90% removed,
status post multiple rigid bronchoscopies.
2. Colon cancer, diagnosed in [**2158**], status post resection of
polyp with positive lymph nodes, recurrent in [**2163**], treated
with laser.
3. Pericardial effusion, status post window in [**2161**].
4. Gastroesophageal reflux disease.
5. Benign prostatic hypertrophy status post transurethral
resection of the prostate x2.
6. Appendectomy.
7. Hernia repair.

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillin which causes rash and hives.

PHYSICAL EXAM: 

FAMILY HISTORY: [**Name (NI) **] mother died of heart disease in
her 40s.  Father died at 54 of pneumonia and patient's sister
died of a cerebrovascular accident.

SOCIAL HISTORY: He is a retired General.  He lives in
[**State 108**].  He has a remote history of tobacco with a 60 pack
year history, but has not smoked for 20 years.  He drinks
approximately two drinks per week.  Denies illicit drug use.
Mechanical complication due to other implant and internal device, not elsewhere classified,Malignant neoplasm of other parts of bronchus or lung,Foreign body in main bronchus
Malfunc oth device/graft,Mal neo bronch/lung NEC,Foreign body bronchus
Admission Date:  [**2163-11-1**]     Discharge Date:  [**2163-11-7**]

Date of Birth:   [**2085-4-11**]     Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  Patient is a 78-year-old man
with non-small cell lung cancer with a history of left
main stem stent and surrounding fibrosis and scarring, status
post multiple removals, who presents now with dyspnea on
exertion.

The patient is status post chemotherapy and XRT with stent
placement in his left main stem bronchus.  This has migrated
and caused dyspnea on exertion on prior admissions.  Patient
underwent bronchoscopy in [**9-/2162**] which demonstrated moderate
narrowing and distortion in the takeoff in the right main
stem bronchus.  The metal stent in the left main stem
bronchus had moderate narrowing.  The patient underwent
dilation of the left main stem bronchus.

Since then, the patient has undergone multiple
bronchoscopies.  At baseline, he has clear white sputum, no
fever or chills, positive cough, worse on the left side.  The
patient denies chest pain, minimal night sweats.  His weight
has been stable.  GI review of systems was negative.  At
baseline, he can walk approximately 45 minutes and can climb
approximately three flights of stairs.  The patient does note
hemoptysis, mild hoarseness.

PAST MEDICAL HISTORY:
1. Non-small cell lung cancer, diagnosed in [**2159**], status post
radiation, Taxol, and carboplatin x6 months, Navelbine and
carboplatin x12 months in [**2160**] for increased PET activity.
Patient is status post stent placement in the left main stem
bronchus with migration, fibrosis, scarring, now 90% removed,
status post multiple rigid bronchoscopies.
2. Colon cancer, diagnosed in [**2158**], status post resection of
polyp with positive lymph nodes, recurrent in [**2163**], treated
with laser.
3. Pericardial effusion, status post window in [**2161**].
4. Gastroesophageal reflux disease.
5. Benign prostatic hypertrophy status post transurethral
resection of the prostate x2.
6. Appendectomy.
7. Hernia repair.

ALLERGIES:  Penicillin which causes rash and hives.

SOCIAL HISTORY:  He is a retired General.  He lives in
[**State 108**].  He has a remote history of tobacco with a 60 pack
year history, but has not smoked for 20 years.  He drinks
approximately two drinks per week.  Denies illicit drug use.

FAMILY HISTORY:  [**Name (NI) **] mother died of heart disease in
her 40s.  Father died at 54 of pneumonia and patient's sister
died of a cerebrovascular accident.

PHYSICAL EXAMINATION:  Temperature 97.6, heart rate 95-99,
blood pressure 110-125/78-60.  General:  Patient is in no
apparent distress.  Cardiovascular:  Regular rate and rhythm
with no murmurs, rubs, or gallops appreciated on examination.
Pulmonary:  Bilateral wheezes and rhonchi throughout.
Extremities:  No edema, warm, 1+ DP and PT pulses.
Neurologic:  Patient was alert and oriented times three.

HOSPITAL COURSE:  The patient was admitted for bronchoscopy.
He underwent flexible rigid bronchoscopy.  He underwent
balloon dilation of his lateral main stem bronchi to 12 mm in
maximum diameter.  He underwent therapeutic aspiration of
secretions in both lower lobes with lavage of sterile saline
until clear.  He underwent application of mitomycin-C, in his
right main stem bronchus.  Bronchoscopy revealed benign
bronchial stenosis secondary to radiation and stent placement
at outside hospital.

The patient was then admitted to the MICU service, at which
time he was intubated on assist control.  The patient was
treated with prednisone and antibiotics status post
bronchoscopy.  The patient did have an episode of
hypertension in the MICU, which was treated with IV saline
bolus.  However, overall, he was stable and was then
transferred to the Medicine floor for further management.

Patient was continued on a course of prednisone and
antibiotics.  He remained stable and was discharged home.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE DIAGNOSIS:  Left bronchial main stem scarring,
status post debridement.

DISCHARGE MEDICATIONS:
1. Finasteride 5 mg p.o. q.d.
2. Guaifenesin 600 mg b.i.d.
3. Metronidazole 500 mg t.i.d. x3 days.
4. Prednisone 40 mg x1 day.
5. Levofloxacin 500 mg q.d. x1 day.
6. Prevacid 30 mg p.o. q.d.
7. Aspirin 81 mg p.o. q.d.
8. Combivent two puffs q.i.d.



                          [**First Name8 (NamePattern2) **] [**First Name4 (NamePattern1) 1775**] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 1776**]

Dictated By:[**Last Name (NamePattern1) 9725**]

MEDQUIST36

D:  [**2164-2-15**]  14:49
T:  [**2164-2-15**]  14:51
JOB#:  [**Job Number 44222**]
{'Mechanical complication due to other implant and internal device, not elsewhere classified,Malignant neoplasm of other parts of bronchus or lung,Foreign body in main bronchus'}


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: Patient is a 78-year-old man
with non-small cell lung cancer with a history of left
main stem stent and surrounding fibrosis and scarring, status
post multiple removals, who presents now with dyspnea on
exertion.

MEDICAL HISTORY: 1. Non-small cell lung cancer, diagnosed in [**2159**], status post
radiation, Taxol, and carboplatin x6 months, Navelbine and
carboplatin x12 months in [**2160**] for increased PET activity.
Patient is status post stent placement in the left main stem
bronchus with migration, fibrosis, scarring, now 90% removed,
status post multiple rigid bronchoscopies.
2. Colon cancer, diagnosed in [**2158**], status post resection of
polyp with positive lymph nodes, recurrent in [**2163**], treated
with laser.
3. Pericardial effusion, status post window in [**2161**].
4. Gastroesophageal reflux disease.
5. Benign prostatic hypertrophy status post transurethral
resection of the prostate x2.
6. Appendectomy.
7. Hernia repair.

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillin which causes rash and hives.

PHYSICAL EXAM: 

FAMILY HISTORY: [**Name (NI) **] mother died of heart disease in
her 40s.  Father died at 54 of pneumonia and patient's sister
died of a cerebrovascular accident.

SOCIAL HISTORY: He is a retired General.  He lives in
[**State 108**].  He has a remote history of tobacco with a 60 pack
year history, but has not smoked for 20 years.  He drinks
approximately two drinks per week.  Denies illicit drug use. 

### Response:
{'Mechanical complication due to other implant and internal device, not elsewhere classified,Malignant neoplasm of other parts of bronchus or lung,Foreign body in main bronchus'}
