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: Okay I am looking at you for multiple issues today. One of the biggest being swelling on your left leg. Can you tell me more about that?
Patient: Yes sure. I got this swelling for almost three years now, and it has been worse for the past two to three months. Sometimes it gets better in the morning when I get up, but then throughout the day it begins to swell again. Lately it is staying bigger, and it feel uncomfortable with it being so large. The right leg also swells, but not nearly like the left leg.
Doctor: How old are you, miss?
Patient: I am forty four. My biggest problem is this pain in my left shoulder. I feel as if this low back pain is due to a poor mattress.
Doctor: Did you hurt your shoulder?
Patient: No, I don't remember hurting shoulder, but gradually I am losing some mobility. It is hard for me to get my hands behind my back or behind my head. I am losing strength in the left shoulder gradually for the last year.
Doctor: Ok let's look at your labs.
Patient: So far white counts are high. In April two thousand five Doctor X Y Z was asked to look at my high white count, but she thought it wasn't a problem and asked me to come for follow up.
Doctor: Any other complaints?
Patient: I have a lot of frequency with urination, and I get up to pee at night at least two to three times. Also, I have gained weight, I think about twelve pounds since March. Right now, I am two eighty four pounds.
Doctor: Okay. So, I can see that your blood pressure is staying stable. You do take Atenolol twelve point five M G per day and Lasix as needed.
Patient: Yes, that's correct. It makes me pee so much. I do not take it.
Doctor: How about chest pain or shortness of breath?
Patient: No chest pain, but I am gradually feeling short of breath.
Doctor: What work you do?
Patient: I work for the city of Wichita as bus dispatcher. My work demands sitting a lot, and just really does not move around much. But towards the end of the day my leg swells up.
Doctor: Okay that's okay.
Patient: I need cholesterol check right?
Doctor: Yes, you do, but all the other labs are normal.

assistant: The patient is a 44-year-old white female who is here today with multiple problems. The biggest concern she has today is her that left leg has been swollen. It is swollen for three years to some extent, but worse for the past two to three months. It gets better in the morning when she is up, but then through the day it begins to swell again. Lately it is staying bigger and she somewhat uncomfortable with it being so large. The right leg also swells, but not nearly like the left leg. The other problem she had was she has had pain in her shoulder and back. These occurred about a year ago, but the pain in her left shoulder is of most concern to her. She feels like the low back pain is just a result of a poor mattress. She does not remember hurting her shoulder, but she said gradually she has lost some mobility. It is hard time to get her hands behind her back or behind her head. She has lost strength in the left shoulder. As far as the blood count goes, she had an elevated white count. In April of 2005, Dr. XYZ had asked Dr. XYZ to see her because of the persistent leukocytosis; however, Dr. XYZ felt that this was not a problem for the patient and asked her to just return here for follow up. She also complains of a lot of frequency with urination and nocturia times two to three. She has gained weight; she thinks about 12 pounds since March. She now weighs 284. Fortunately, her blood pressure is staying stable. She takes atenolol 12.5 mg per day and takes Lasix on a p.r.n. basis, but does not like to take it because it causes her to urinate so much. She denies chest pain, but she does feel like she is becoming gradually more short of breath. She works for the city of Wichita as bus dispatcher, so she does sit a lot, and just really does not move around much. Towards the end of the day her leg was really swollen. I reviewed her lab work. Other than the blood count her lab work has been pretty normal, but she does need to have a cholesterol check.