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: When was your injury, sir?
Patient: Um, if I recall, it was on November twentieth two thousand eight.
Doctor: What do you do for a living, sir?
Patient: I work at the Purdy Correctional Facility, doctor.
Doctor: How did you get hurt?
Patient: Well, an inmate broke some of the overhead sprinklers, and I slipped on all the water and I landed on the back of my head, and then onto my back.
Doctor: Which side took most of the hit?
Patient: It was mostly on my left side.
Doctor: How were you after the fall?
Patient: Well, I was pretty stunned, mostly. I didn't want to come in, but my employers asked me to just to be sure.
Doctor: Who has evaluated you to date?
Patient: Um, I went to Gig Harbor Urgent Care, and then they sent me to Tacoma General Hospital. At Tacoma they said I have a whiplash and concussion.
Doctor: What did they do at the hospital?
Patient: Um, they did a C T scan, and they found a dark spot on my brain.
Doctor: What did they recommend about the spot?
Patient: They said I should have another M R I and they diagnosed an, um, recurrent acoustic neuroma.
Doctor: So, you've had this before? How did they know you had it?
Patient: I used to see a chiropractor, and they suggested that I get a scan and that's how they found it before.
Doctor: When was this?
Patient: Um, it was in October of two thousand five.
Doctor: Did you have surgery on this?
Patient: Yes, I'm recovering now.
Doctor: Are they still considering radiation?
Patient: Yes, it's under consideration but there's no final decision yet.
Doctor: Okay, what does the chiropractor do for you?
Patient: You know, the usual, adjustments and massages, stuff like that.
Doctor: Has there been any improvement?
Patient: Overall, my spine pain has improved a lot.
Doctor: That's good. Okay, so after your fall, what other treatments did you have?
Patient: I went to Prompt Care in Bremerton, and saw Doctor X Y Z. She's an osteopathic doctor.
Doctor: How did she treat you?
Patient: She ordered an M R I of my neck, I have the report right here.
Doctor: Okay, this shows some mild disc bulge at C four C five. Did she let you go back to work?
Patient: Yes, she released me back to full duty. I was doing fine after the neurosurgical treatment.
Doctor: Do you have any other treatment planned?
Patient: Some radiation.
Doctor: What else has she treated you for?
Patient: Oh, you know, just general aches and pains on my back and neck. I have been seeing her since two thousand and two.

assistant: This patient was injured on November 20, 2008. He works at the Purdy Correctional Facility and an inmate had broken some overhead sprinklers, the floor was thus covered with water and the patient slipped landing on the back of his head, then on his back. The patient said he primarily landed on the left side. After the accident he states that he was generally stun and someone at the institute advised him to be evaluated. He went to a Gig Harbor urgent care facility and they sent him on to Tacoma General Hospital. At the Tacoma General, he indicates that a whiplash and a concussion were diagnosed and it was advised that he have a CT scan. The patient describes that he had a brain CT and a dark spot was found. It was recommended that he have a followup MRI and this was done locally and showed a recurrent acoustic neuroma. Before, when the patient initially had developed an acoustic neuroma, the chiropractor had seen the patient and suggested that he have a scan and this was how his original acoustic neuroma was diagnosed back in October 2005. The patient has been receiving adjustments by the chiropractor since and he also has had a few massage treatments. Overall his spine complaints have improved substantially. After the fall, he also saw at Prompt Care in the general Bremerton area, XYZ, an Osteopathic Physician and she examined him and released him full duty and also got an orthopedic consult from XYZ. She ordered an MRI of his neck. Cervically this showed that he had a mild disc bulge at C4-C5, but this actually was the same test that diagnosed a recurrent acoustic neuroma and the patient now is just recovering from neurosurgical treatment for this recurrent acoustic neuroma and some radiation is planned. Since 2002 the patient has been seeing the chiropractor, XYZ for general aches and pain and this has included some treatments on his back and neck.