CHIEF COMPLAINT: Left upper lobe lung cancer.

PRESENT ILLNESS: The patient is a 74-year-old male with a previously treated head
and neck cancer now with an enlarging nodule in the left upper
lobe.  Biopsy was
consistent with non-small-cell lung cancer.  The tumor was very
close to the inferior pulmonary vein, lower lobe bronchus, and
lower lobe PA and, given this location, we recommended an open
approach.

MEDICAL HISTORY: DM
HTN
T3 N0 M0 glottic squamous cell carcinoma s/p chemoradiation
therapy
spiculated nodule in the left upper lobe

MEDICATION ON ADMISSION: Metformin 500'', Omeprazole 20''

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: VS: T: 98.2  HR: 70's SR  BP: 120/52  Sats: 97% RA
General: 74 year-old male ambulating in halls in no apparent
distress
HEENT: normocephalic, mucus membranes moist
Neck: supple no lymphadenopathy
Card: RRR normal S1, S2 no murmur
Resp: clear breath sounds throughout
GI: benign
Extr: warm no edema
Incision: left thoracotomy site clean dry intact no erythema.
Lower back with 2 cm x 2 cm area of erythema
Neuro: awake,alert oriented.

FAMILY HISTORY: His father was taken to Siberia when the patient was a young
child and he does not know any details of his death or medical
history.  His mother died at age 85; perhaps from some sort of
cancer.  He has two sisters who are both living, age 75 and 76,
who are reasonably healthy.  He has three sons, age 48, 44, and
32.

SOCIAL HISTORY: He quit smoking three years ago after 150-pack-year history of
smoking.  He used to be a teacher in [**Country 5881**] and he came back
himself at the time of consultation.
Malignant neoplasm of upper lobe, bronchus or lung,Cardiac complications, not elsewhere classified,Atrial fibrillation,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Tracheostomy status,Personal history of tobacco use,Personal history of malignant neoplasm of larynx
Mal neo upper lobe lung,Surg compl-heart,Atrial fibrillation,DMII wo cmp nt st uncntr,Hypertension NOS,Tracheostomy status,History of tobacco use,Hx-laryngeal malignancy
Admission Date:  [**2136-6-12**]              Discharge Date:   [**2136-6-19**]

Date of Birth:  [**2062-5-27**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 4679**]
Chief Complaint:
Left upper lobe lung cancer.


Major Surgical or Invasive Procedure:
[**2136-6-12**]:
1. Left thoracotomy.
2. Partial decortication of lung.
3. Left upper lobectomy.
4. Mediastinal lymphadenectomy.
5. Flexible bronchoscopy.
6. En bloc resection of pericardium.


History of Present Illness:
The patient is a 74-year-old male with a previously treated head
and neck cancer now with an enlarging nodule in the left upper
lobe.  Biopsy was
consistent with non-small-cell lung cancer.  The tumor was very
close to the inferior pulmonary vein, lower lobe bronchus, and
lower lobe PA and, given this location, we recommended an open
approach.

Past Medical History:
DM
HTN
T3 N0 M0 glottic squamous cell carcinoma s/p chemoradiation
therapy
spiculated nodule in the left upper lobe

PSH:
tracheostomy on [**2134-11-3**]
a PEG tube placed on [**2134-11-17**].


Social History:
He quit smoking three years ago after 150-pack-year history of
smoking.  He used to be a teacher in [**Country 5881**] and he came back
himself at the time of consultation.


Family History:
His father was taken to Siberia when the patient was a young
child and he does not know any details of his death or medical
history.  His mother died at age 85; perhaps from some sort of
cancer.  He has two sisters who are both living, age 75 and 76,
who are reasonably healthy.  He has three sons, age 48, 44, and
32.


Physical Exam:
VS: T: 98.2  HR: 70's SR  BP: 120/52  Sats: 97% RA
General: 74 year-old male ambulating in halls in no apparent
distress
HEENT: normocephalic, mucus membranes moist
Neck: supple no lymphadenopathy
Card: RRR normal S1, S2 no murmur
Resp: clear breath sounds throughout
GI: benign
Extr: warm no edema
Incision: left thoracotomy site clean dry intact no erythema.
Lower back with 2 cm x 2 cm area of erythema
Neuro: awake,alert oriented.

Pertinent Results:
Admission labs:
140	106	21	glu 156	
3.9	24	0.6	
Ca: 8.2 Mg: 1.6 P: 3.9

8.8 > 31.8 < 210

PT: 14.3  	PTT: 26.1  	INR: 1.2

Brief Hospital Course:
Mr [**Known lastname 84573**] was admitted to the Thoracic Surgery service
immediately following his open left upper lobectomy for a hilar
mass. Please see Dr[**Name (NI) 5067**] operative report for further details.
Of note, estimated blood loss was 500cc and he was transfused
one unit of packed red blood cells. After a brief uneventful
stay in the PACU, he was transferred to the ICU intubated, with
epidural in place and two chest tubes on suction. POD1 in the
ICU he was extubated and continued to remain stable. On POD2 he
was transferred to the floor without issue. He did well the
first night on the floor, but on the morning of POD3 he went
into atrial fibrillation and became hypotensive to SBP in the
low 80's. He was transferred back to the ICU and begun on an
amiodarone drip. He was again transfused 1 unit PRBC while
cardioversion was considered. Cardiology was consulted and
cardioversion was not performed as his blood pressure improved.
He remained in atrial fibrillation most of the day but converted
to sinus rhythm by the evening of POD 3. At this point his
apical chest tube was noted to be draining very little fluid and
did not show an air [**Last Name (LF) 3564**], [**First Name3 (LF) **] that tube was removed. The
following day he was noted to have increased oxygen demand and
chest pain. CT chest revealed a large air/fluid collection in
his left hemi-thorax. A pigtail pleural catheter was placed in
the apex which drained 400cc of serosanguinous (Hct 13) fluid in
the first 24 hours and a significant amount of air. By the
following morning his oxygen requirements were back to baseline
and he remained in sinus rhythm. He was transitioned to oral
amiodarone and returned back to the floor. His epidural and
foley were removed and he was able to void spontaneously by POD
5. His remaining chest tubes were clamped on POD 6 and follow-up
CXR showed no re-accumulation of air or blood.
By the time of discharge on POD7, he was tolerating regular
diet, had his chest tubes removed, voiding spontaneously and
ambulating independently. He was provided discharge instructions
and told to follow-up with Dr [**First Name (STitle) **] as scheduled.

Medications on Admission:
Metformin 500'', Omeprazole 20''

Discharge Medications:
1. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated [**First Name (STitle) **]:
One (1) Adhesive Patch, Medicated Topical 12 Hours on/12 Hours
off: cut in half and place on either side of chest incision.
Disp:*30 Adhesive Patch, Medicated(s)* Refills:*2*
2. oxycodone-acetaminophen 5-325 mg/5 mL Solution [**First Name (STitle) **]: [**5-22**] mL
PO every 4-6 hours as needed for pain.
Disp:*400 mL* Refills:*0*
3. metformin 500 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO BID (2 times a
day).
4. tamsulosin 0.4 mg Capsule, Ext Release 24 hr [**Month/Year (2) **]: One (1)
Capsule, Ext Release 24 hr PO HS (at bedtime).
5. senna 8.6 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO BID (2 times a
day) as needed for constipation.
6. amiodarone 200 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO once a day.
Disp:*30 Tablet(s)* Refills:*2*
7. lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1)
Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily).
Disp:*30 Tablet,Rapid Dissolve, DR(s)* Refills:*2*
8. polyethylene glycol 3350 17 gram Powder in Packet [**Last Name (STitle) **]: One
(1) packet PO once a day.
Disp:*30 packet* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
[**Company 1519**]

Discharge Diagnosis:
Left upper lobe lung cancer
Diabetes Mellitus T2
Hypertension
T3 N0 M0 glottic squamous cell carcinoma s/p chemoradiation
therapy


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
Call Dr.[**Name (NI) 5067**] office [**Telephone/Fax (1) 2348**] if you experience:
-Fevers > 101 or chills
-Increased shortness of breath, cough or chest pain
-Left chest incision develops drainage or increased redness
-Chest tube site removed dressing and cover with a bandaid until
healed

Pain:
-Acetaminophen 650 mg every 8 hours as needed for pain
-Roxicet [**5-22**] mL every 4-6 hours for pain
-Lidoderm patch cut in [**1-15**] on either side of chest
incision.
(DO NOT PUT ON INCISION)

Activity
-Shower daily. Wash incision with mild soap & water, rinse, pat
dry
-No tub bathing, swimming or hot tubs until incision healed
-No lifting greater than 10 pounds until seen
-No driving while taking narcotics

Followup Instructions:
Follow-up with Dr. [**First Name (STitle) **] [**0-0-**] Date/Time:[**2136-6-28**] 10:00 on
the [**Hospital Ward Name 516**] [**Hospital Ward Name 23**] Clinical Center [**Location (un) 24**]
Chest X-Ray 4th Radiology 30 minutes before your appointment
{'Malignant neoplasm of upper lobe, bronchus or lung,Cardiac complications, not elsewhere classified,Atrial fibrillation,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Tracheostomy status,Personal history of tobacco use,Personal history of malignant neoplasm of larynx'}


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 upper lobe lung cancer.

PRESENT ILLNESS: The patient is a 74-year-old male with a previously treated head
and neck cancer now with an enlarging nodule in the left upper
lobe.  Biopsy was
consistent with non-small-cell lung cancer.  The tumor was very
close to the inferior pulmonary vein, lower lobe bronchus, and
lower lobe PA and, given this location, we recommended an open
approach.

MEDICAL HISTORY: DM
HTN
T3 N0 M0 glottic squamous cell carcinoma s/p chemoradiation
therapy
spiculated nodule in the left upper lobe

MEDICATION ON ADMISSION: Metformin 500'', Omeprazole 20''

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: VS: T: 98.2  HR: 70's SR  BP: 120/52  Sats: 97% RA
General: 74 year-old male ambulating in halls in no apparent
distress
HEENT: normocephalic, mucus membranes moist
Neck: supple no lymphadenopathy
Card: RRR normal S1, S2 no murmur
Resp: clear breath sounds throughout
GI: benign
Extr: warm no edema
Incision: left thoracotomy site clean dry intact no erythema.
Lower back with 2 cm x 2 cm area of erythema
Neuro: awake,alert oriented.

FAMILY HISTORY: His father was taken to Siberia when the patient was a young
child and he does not know any details of his death or medical
history.  His mother died at age 85; perhaps from some sort of
cancer.  He has two sisters who are both living, age 75 and 76,
who are reasonably healthy.  He has three sons, age 48, 44, and
32.

SOCIAL HISTORY: He quit smoking three years ago after 150-pack-year history of
smoking.  He used to be a teacher in [**Country 5881**] and he came back
himself at the time of consultation. 

### Response:
{'Malignant neoplasm of upper lobe, bronchus or lung,Cardiac complications, not elsewhere classified,Atrial fibrillation,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Tracheostomy status,Personal history of tobacco use,Personal history of malignant neoplasm of larynx'}
