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: The next patient we have is Miss Dey, we have been regularly following up with her for her hydrocephalus since two thousand and two.
Guest_clinician: Oh, okay.
Doctor: She also had anterior cervical corpectomy, we removed her front part of the vertebra followed by fusion from C three to C five in March two thousand and seven.
Guest_clinician: Oh wow!
Doctor: Yeah. We last saw her in March two thousand and eight at that time she was experiencing some head fullness and ringing in the ears, however we decided to leave her shunt setting at one point zero.
Guest_clinician: Okay, then you asked her to follow up doctor X Y Z regarding her cervical spine M R I.
Doctor: Yes exactly! Let's go see her. Hello Miss Dey, how are you? This is my colleague doctor Jen, and she will be accompanying me today if that is okay with you?
Patient: Of course, Hello doctors.
Guest_clinician: Hi Miss Dey.
Doctor: So, tell me what is going on?
Patient: Well, last week I had some urine issue, like had to pee frequently. I had few episodes of urgency.
Doctor: Okay and how do you feel this week?
Patient: This week it's much better I am not feeling like how I was feeling last week.
Doctor: Okay good.
Patient: I feel no urgency or inconsistency and I am able to empty my bladder completely.
Doctor: That's good.
Patient: However, I do leak some pee when I cough. I wear pads daily.
Doctor: And did you notice any changes regarding your bladder, do you think it is better than before or worse since the last time I saw you?
Patient: I don't think it changed much, it feels almost the same.
Doctor: Okay. Let's talk about your memory, any problem there, are you able to remember stuff and think about stuff?
Patient: Yes, all good there, no issues.
Doctor: Any headache?
Patient: Nope!
Doctor: Any changes in your walk or balance?
Patient: Yes, I feel both have worsened. I am able to walk on uneven surface most of the time. But I feel I have become very slow.
Doctor: And are you able to climb up and down the stairs?
Patient: Yes.
Doctor: Are you able to climb in and out of the car normally without any fuss?
Patient: Yes.
Doctor: Are you using cane at this point of time?
Patient: No, no cane.
Doctor: Okay good. Anything else you want to tell me?
Patient: Ah yes, in the beginning of May, I got a spell of severe cough and because of continuous coughing I think I developed pain in my hip which travels down to my legs.
Doctor: Oh okay, do you feel any tingling or numbness.
Patient: Yes! I feel constant tingling sensation and a feeling that something is pinching my never. Sometimes it's just so painful.
Doctor: Okay.
Patient: Often I feel like my legs have become like elastic. I feel this tingling sensation is the reason my walking has become slower.
Doctor: Doctor Jen did you take the notes of what she said?
Guest_clinician: I did.
Doctor: Okay great, anything else Miss Dey?
Patient: No, I think I told you everything.
Doctor: Alright you take care. I will see you next time.
Patient: Bye!
Doctor: Bye.
Guest_clinician: Take care Miss Dey, Bye!

assistant: She has been followed for her hydrocephalus since 2002. She also had an anterior cervical corpectomy and fusion from C3 though C5 in March 2007. She was last seen by us in clinic in March 2008 and she was experiencing little bit of head fullness and ringing in the ears at that time; however, we decided to leave her shunt setting at 1.0. We wanted her to followup with Dr. XYZ regarding the MRI of the cervical spine. Today, she tells me that with respect to her bladder last week she had some episodes of urinary frequency, however, this week she is not experiencing the same type of episodes. She reports no urgency, incontinence, and feels that she completely empties her bladder when she goes. She does experience some leakage with coughing. She wears the pad on a daily basis. She does not think that her bladder has changed much since we saw her last. With respect to her thinking and memory, she reports no problems at this time. She reports no headaches at this time. With respect to her walking and balance, she says that it feels worse. In the beginning of May, she had a coughing spell and at that time she developed buttock pain, which travels down the legs. She states that her leg often feel like elastic and she experiences a tingling radiculopathy. She says that this tingling is constant and at times painful. She feels that she is walking slower for this reason. She does not use the cane at this time. Most of the time, she is able to walk over uneven surfaces. She is able to walk up and down stairs and has no trouble getting in and out of a car.