system: You are a clinical documentation assistant. Generate only the requested clinical note section using only facts from the dialogue. Do not invent information. If the section is not supported by the dialogue, return N/A.

user: Section: GENHX

Dialogue:
Doctor: Good morning, sir. Can you confirm your age for me, please?
Patient: Good morning, doctor. I'm fifty nine years old.
Doctor: Great, and which hand is your dominant hand?
Patient: Um, I use my right hand for everything.
Doctor: Great, thank you. So, what seems to be the problem today?
Patient: I have had this weird feeling in both of my legs for about three weeks now.
Doctor: Have you been treated for this so far?
Patient: Um, I went to the E R about a week ago.
Doctor: What did they tell you there?
Patient: They said I had progressive sensory and motor deficits in both legs.
Doctor: Can you describe your symptoms for me, please?
Patient: Um, I have numbness, like here starting at my trunk, and then over the last month or so, it moved into my legs.
Doctor: I'm going to apply some pressure right here at the nipple line, can you feel that?
Patient: No, I'm numb from there down.
Doctor: Have you had any weakness in your legs?
Patient: Yeah, I have for the last week or so.
Doctor: Is it getting worse?
Patient: Yes, it is.
Doctor: When did you start using the cane?
Patient: Um, about five days ago, now.
Doctor: Why did you begin using it?
Patient: I'm having trouble walking and going up and down stairs.
Doctor: Are you able to stand without it?
Patient: No, I'm not.
Doctor: Have you had any loss of bowel or bladder control?
Patient: No, thankfully not, but at the same time I haven't had a bowel movement in about three days.
Doctor: When was the last time you urinated?
Patient: It was about twenty four hours ago.
Doctor: In addition to the numbness, how else would you describe your leg symptoms?
Patient: Um, I'd say it feels cold, at least I've felt that for the last day or so.
Doctor: Do you have any back or neck pain?
Patient: No, nothing there.
Doctor: Do you have any shortness of breath?
Patient: Well, I've had it chronically for a while now, but I think it's getting worse.
Doctor: Have you had any lightheadedness or feelings of faint?
Patient: Um, yeah, when I try to stand up.
Doctor: How long have you had that feeling?
Patient: I've had it for about two days now.

assistant: This 59 y/o RHM was seen and released from an ER 1 week prior to this presentation for a 3 week history of progressive sensory and motor deficits in both lower extremities. He reported numbness beginning about his trunk and slowly progressing to involve his lower extremities over a 4 week period. On presentation, he felt numb from the nipple line down. In addition, he began experiencing progressive weakness in his lower extremities for the past week. He started using a cane 5 days before being seen and had been having difficulty walking and traversing stairs. He claimed he could not stand. He denied loss of bowel or bladder control. However, he had not had a bowel movement in 3 days and he had not urinated 24 hours. His lower extremities had been feeling cold for a day. He denied any associated back or neck pain. He has chronic shortness of breath, but felt it had become worse. He had also been experiencing lightheadedness upon standing more readily than usual for 2 days prior to presentation.