CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 62-year-old
right-handed gentleman who had a fall six to eight weeks
prior to admission and was brought to [**Hospital3 35151**] where an MRI showed a cord compression at the C1-C2
level.  The patient was transferred to [**Hospital1 190**], was evaluated by Dr. [**Last Name (STitle) 1327**], and was
discharged to rehabilitation with follow up for surgery.  The
patient was admitted on [**2169-7-4**] for surgery on [**2169-7-5**].

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Ankylosing spondylitis,Cervical spondylosis with myelopathy,Unspecified essential hypertension,Peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction,Unspecified analgesic and antipyretic causing adverse effects in therapeutic use
Ankylosing spondylitis,Cerv spondyl w myelopath,Hypertension NOS,Peptic ulcer NOS,Adv eff analgesic NOS
Admission Date:  [**2169-7-4**]       Discharge Date:  [**2169-7-13**]

Date of Birth:   [**2108-4-24**]       Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 62-year-old
right-handed gentleman who had a fall six to eight weeks
prior to admission and was brought to [**Hospital3 35151**] where an MRI showed a cord compression at the C1-C2
level.  The patient was transferred to [**Hospital1 190**], was evaluated by Dr. [**Last Name (STitle) 1327**], and was
discharged to rehabilitation with follow up for surgery.  The
patient was admitted on [**2169-7-4**] for surgery on [**2169-7-5**].

The patient has a long-standing history of rheumatoid
arthritis and cervical myelopathy secondary now to this
periodontoid mass and pannus with CMJ compression.  There was
also an intrinsic cord signal abnormality of C1 and C2.

PHYSICAL EXAMINATION:  On admission physical examination he
was awake, alert and oriented x 3 with fluent speech.  His
temperature was 97.9, blood pressure 116/70, heart rate 61,
respiratory rate 18, saturations 96% on room air.  His
deltoids were 4- on the right, 4 on the left, biceps 4- on
the right, 4 on the left, triceps 4- on the right and 4 on
the left, wrist extension was 4- on the right, 4+ on the
left, wrist flexion was 4 and 4 on the left and right, grasp
4- on the right, 4+ on the left, intrinsics were 2 and 2, IPs
were 4 on the right, 4+ on the left, quads 4+ bilaterally,
hamstrings 4 bilaterally, ATs 5 on the right, 4 on the left,
extensor hallucis longus 4+ on the right, 4+ on the left, and
plantar-flexion was 4+ bilaterally.  His reflexes were 3+
throughout.  He had negative Hoffmann.  Sensation was
decreased to light touch in his lower extremities.  He was
admitted for a preoperative evaluation.

HOSPITAL COURSE:  On [**2169-7-5**] he was taken to the operating
room and underwent a transoral resection of the odontoid and
associated rheumatoid pannus, and cervico-occipital fusion
without intraoperative complications.  Postoperatively the
patient was intubated and monitored in the intensive care
unit.  His vital signs were stable.  He was following
commands, opening his eyes, moving his hands.  His pupils
were equal, round and reactive to light.  His extraocular
movements were full.  He localized to light touch in all four
extremities with movement by commands.  His reflexes were 2
on the right side, 1 on the left in the knees, 4+ at the
ankles.  Smile was symmetric.  His vital signs were stable
and he was afebrile.

Postoperatively his motor examination was 3+ in the triceps,
4- in the biceps bilaterally, 4- in the triceps bilaterally,
4 in the wrist extension, 4 in the wrist flexion on the right
and 4+ on the left.  His IPs were 4+ bilaterally, quads 4,
hamstrings 4, ATs 4+, gastrocnemius 4+ and extensor hallucis
longus 4+ bilaterally.

He was extubated on [**2169-7-7**] which he tolerated.  He was
moving all extremities, ............... 4+/5 bilaterally in
the upper extremities, he had antigravity strength.  His
vital signs remained stable.  He continued to have a Hemovac
drain in place.

He was evaluated by physical therapy.  His Hemovac drain was
discontinued on [**2169-7-9**] and the patient was transferred to
the regular floor on [**2169-7-8**].  He was seen by physical
therapy and occupational therapy and found to require a short
rehabilitation stay prior to discharge to home.  He was
started on clear liquids on [**2169-7-10**] and then to full regular
diet on [**2169-7-12**], which he tolerated well, requiring frequent
pain medication for posterior neck and posterior head pain.
His other vital signs have remained stable.

DISCHARGE MEDICATIONS:
1. Percocet 1-2 tablets p.o. q. 4 hours p.r.n.
2. Famotidine 20 mg p.o. b.i.d.
3. Metoprolol 12.5 mg p.o. b.i.d.
4. Flexeril 10 mg p.o. t.i.d. p.r.n.
5. Heparin 5,000 units subcutaneous q. 12 hours.
6. Nicotine 21 mg topically q. day.
7. Tylenol 650 p.o./p.r. q. 4-6 hours p.r.n.

CONDITION ON DISCHARGE:  Stable with incision line clean, dry
and intact.

FOLLOW-UP PLANS:  He should follow up with Dr. [**Last Name (STitle) 1327**] in one
week for staple removal.





                            [**Name6 (MD) 1339**] [**Last Name (NamePattern4) 1340**], M.D.  [**MD Number(1) 1341**]

Dictated By:[**Last Name (NamePattern1) 344**]
MEDQUIST36

D:  [**2169-7-13**]  09:49
T:  [**2169-7-13**]  10:08
JOB#:  [**Job Number 36920**]


Admission Date:  [**2169-7-4**]       Discharge Date:  [**2169-7-14**]

Date of Birth:   [**2108-4-24**]       Sex:  M

Service:  #58

HISTORY OF PRESENT ILLNESS:  This is a 62 year-old right
handed male who had fallen six to eight weeks previous to
admission and was brought to an outside hospital where an MRI
done showed cord compression.  The patient felt weak and
unable to move.






                            [**Name6 (MD) 1339**] [**Last Name (NamePattern4) 1340**], M.D.  [**MD Number(1) 1341**]

Dictated By:[**Last Name (NamePattern4) 36958**]
MEDQUIST36

D:  [**2169-7-14**]  09:46
T:  [**2169-7-14**]  10:11
JOB#:  [**Job Number 36959**]
{'Ankylosing spondylitis,Cervical spondylosis with myelopathy,Unspecified essential hypertension,Peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction,Unspecified analgesic and antipyretic 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: 

PRESENT ILLNESS: The patient is a 62-year-old
right-handed gentleman who had a fall six to eight weeks
prior to admission and was brought to [**Hospital3 35151**] where an MRI showed a cord compression at the C1-C2
level.  The patient was transferred to [**Hospital1 190**], was evaluated by Dr. [**Last Name (STitle) 1327**], and was
discharged to rehabilitation with follow up for surgery.  The
patient was admitted on [**2169-7-4**] for surgery on [**2169-7-5**].

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Ankylosing spondylitis,Cervical spondylosis with myelopathy,Unspecified essential hypertension,Peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction,Unspecified analgesic and antipyretic causing adverse effects in therapeutic use'}
