CHIEF COMPLAINT: severe malacia of her posterior membranous wall of trachea
extending down bilateral mainstem bronchi.

PRESENT ILLNESS: The patient is a delightful 53-
year-old woman who has a 2-year history of progressive
dyspnea ultimately resulting in hospitalization. She was
found, on bronchoscopy, to have tracheobronchomalacia. Her
dyspnea was unresponsive to medical management.

MEDICAL HISTORY: multiple sclerosis, asthma, hyperchol, urinary incontinence,
tremor

MEDICATION ON ADMISSION: amantidine, amitriptlyine 50, Premarin, Ditropan XL, Lipitor 40,
Neurontin 800"', ASA, mvi, [**Doctor First Name **] 60

ALLERGIES: Penicillins / Sulfur

PHYSICAL EXAM: General: well appearing female with DOE
chest: symmetrical, bilat wheezes thru-out.
COR: RRR S1, S2
Abd: round, soft, NT, ND, +BS
extrem: no C/C/E
Neuro: A+OX3

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: lives w/ husband in ----------
Multiple sclerosis,Pulmonary collapse,Asthma, unspecified type, unspecified,Pure hypercholesterolemia
Multiple sclerosis,Pulmonary collapse,Asthma NOS,Pure hypercholesterolem
Admission Date:  [**2113-6-23**]              Discharge Date:   [**2113-7-1**]

Date of Birth:  [**2060-2-22**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Penicillins / Sulfur

Attending:[**Last Name (NamePattern1) 1561**]
Chief Complaint:
severe malacia of her posterior membranous wall of trachea
extending down bilateral mainstem bronchi.

Major Surgical or Invasive Procedure:
removal of Y stent and traecheobronchoplasty
serial bronchoscopies


History of Present Illness:
The patient is a delightful 53-
year-old woman who has a 2-year history of progressive
dyspnea ultimately resulting in hospitalization. She was
found, on bronchoscopy, to have tracheobronchomalacia. Her
dyspnea was unresponsive to medical management.

Past Medical History:
multiple sclerosis, asthma, hyperchol, urinary incontinence,
tremor

Social History:
lives w/ husband in ----------

Family History:
non-contributory

Physical Exam:
General: well appearing female with DOE
chest: symmetrical, bilat wheezes thru-out.
COR: RRR S1, S2
Abd: round, soft, NT, ND, +BS
extrem: no C/C/E
Neuro: A+OX3

Pertinent Results:
[**2113-6-23**] 10:29PM   TYPE-ART PO2-96 PCO2-37 PH-7.38 TOTAL CO2-23
BASE XS--2
[**2113-6-23**] 03:51PM   GLUCOSE-141* UREA N-11 CREAT-0.6 SODIUM-136
POTASSIUM-4.2 CHLORIDE-101 TOTAL CO2-22 ANION GAP-17
[**2113-6-23**] 03:51PM   WBC-13.5* HCT-33.6*

CXR:
FINDINGS: Since the previous examination, the right-sided chest
tube has been removed. There is no pneumothorax. Right partial
rib resection again seen. Heart size and mediastinal contours
within normal limits. Right pleural effusion and atelectasis
appear unchanged.
IMPRESSION: 1) No pneumothorax status post right-sided chest
tube removal. 2) Stable right pleural effusion and atelectasis.


Brief Hospital Course:
Pt. was admitted and taken to the OR on ^/16/06 for rigid
bronchoscopy and removal of Y stent followed by flexible bronch,
right posterolateral thoracotomy and tracheobronchoplast of
bilat mainstems. An epidural was placed for pain control w/ good
effect. Pt was extubated in the OR. admitted to the CSRU for
observation and care of critical airway. Pleural [**Doctor Last Name **] tubes w/
serosang drainage to sxn w/o air leak.
Bronchoscopy was performed on POD#1 notable for post intubation
edema and minimla secretions, minimal malacia. Blakes w/ minimal
output and were placed to bulb sxn.
POD#2 pt w/ temp spike on prophylactic vanco for tracheoplasty
mesh presevation x 7days. Pan cultured and po Levo added. CXR w/
RLL collapse -bronch'd for moderate secretions. Culture data all
negative- levo mainatined.
POD #3doing well pain controlled. [**Last Name (un) 1815**] liquid diet, ambulating.
repeat bronch w/ decreased swelling, minimal secretions.
POD#4 [**Doctor Last Name **] drain d/c'd. epidural d/c'd. afebrile.
POD#5 General malaise and chills. not feeling well. Neuro
consulted and r'd/o MS flare.
POD#6 feeling well. afebrile. couching up secretions. mainatined
on po levo/IV vanco, tolerating soft diet, ambulating
Addendum to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 66701**] hospital course above
Discharged on postoperative day 8 with her pain well controlled
on oral medications, to go with a prescription for levofloxacin
and to follow up with her pulmonologist in [**State **].


Medications on Admission:
amantidine, amitriptlyine 50, Premarin, Ditropan XL, Lipitor 40,
Neurontin 800"', ASA, mvi, [**Doctor First Name **] 60

Discharge Medications:
1. Gabapentin 400 mg Capsule Sig: Two (2) Capsule PO TID (3
times a day).
2. Conjugated Estrogens 1.25 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
3. Amantadine 100 mg Capsule Sig: One (1) Capsule PO DAILY
(Daily).
4. Amitriptyline 50 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
5. Guaifenesin 600 mg Tablet Sustained Release Sig: Two (2)
Tablet Sustained Release PO BID (2 times a day).
Disp:*120 Tablet Sustained Release(s)* Refills:*2*
6. Interferon Beta-1b  Subcutaneous
7. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every
24 hours) for 2 weeks.
Disp:*14 Tablet(s)* Refills:*0*
8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*80 Tablet(s)* Refills:*0*
9. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
10. Combivent 103-18 mcg/Actuation Aerosol Sig: [**1-9**]  Inhalation
twice a day.
Disp:*1 * Refills:*2*


Discharge Disposition:
Home

Discharge Diagnosis:
Tracheobronchealplasty


Discharge Condition:
good


Discharge Instructions:
Call Dr.[**Name (NI) 1816**] office [**Telephone/Fax (1) 170**] if you develop fever,
chills, redness or drainage from your surgical incision.

Followup Instructions:
follow up with your pulmonologist as directed by Dr. [**Last Name (STitle) 952**]
{'Multiple sclerosis,Pulmonary collapse,Asthma, unspecified type, unspecified,Pure hypercholesterolemia'}


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: severe malacia of her posterior membranous wall of trachea
extending down bilateral mainstem bronchi.

PRESENT ILLNESS: The patient is a delightful 53-
year-old woman who has a 2-year history of progressive
dyspnea ultimately resulting in hospitalization. She was
found, on bronchoscopy, to have tracheobronchomalacia. Her
dyspnea was unresponsive to medical management.

MEDICAL HISTORY: multiple sclerosis, asthma, hyperchol, urinary incontinence,
tremor

MEDICATION ON ADMISSION: amantidine, amitriptlyine 50, Premarin, Ditropan XL, Lipitor 40,
Neurontin 800"', ASA, mvi, [**Doctor First Name **] 60

ALLERGIES: Penicillins / Sulfur

PHYSICAL EXAM: General: well appearing female with DOE
chest: symmetrical, bilat wheezes thru-out.
COR: RRR S1, S2
Abd: round, soft, NT, ND, +BS
extrem: no C/C/E
Neuro: A+OX3

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: lives w/ husband in ---------- 

### Response:
{'Multiple sclerosis,Pulmonary collapse,Asthma, unspecified type, unspecified,Pure hypercholesterolemia'}
