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, ma'am. Can you confirm your age for me, please?
Patient: Good morning, I'm sixty five years old, doctor.
Doctor: How are you recovering from your operation?
Patient: I'm doing okay. Can you remind me what operation I had?
Doctor: Um, we did a left upper lobectomy for your stage I A non small cell lung cancer.
Patient: Thank you, doctor.
Doctor: Absolutely, do you have the results of your pelvic C T?
Patient: Yes, I have the report right here.
Doctor: Thank you, so this shows an enlarging simple cyst of the left kidney.
Patient: What can we do about this?
Doctor: Well, that's why we did the barium swallow, which showed a small hiatal hernia with minimal reflux.
Patient: Oh, yeah, I remember that.
Doctor: So, I have your x rays from November twenty third two thousand nine here, we did an A P and lateral view, and they're normal.
Patient: Oh, well that's good too.
Doctor: Are you having any pain with swallowing food?
Patient: Yes, I get some chest pain, but I'd say it's pretty mild. Look at my calf, doctor, it's much bigger than the right one.
Doctor: Chest pain is probably due to tertiary contractions with some delayed emptying. Is it tender?
Patient: No, there's no real tenderness.
Doctor: How long has this calf been enlarged?
Patient: Um, it's been several months at this point.
Doctor: Have you ever had D V T?
Patient: Yes, um, in nineteen seventy five, and in nineteen eighty five.
Doctor: Are you having any abnormal weight loss?
Patient: No, everything is normal there, and I'm eating normally.
Doctor: What about any cold or flu symptoms? Any fever or chills?
Patient: No, that's all fine too.
Doctor: Any new aches or pains?
Patient: No, all my muscles feel pretty good.
Doctor: Have you had a cough, or coughed up any blood.
Patient: That's a negative, doctor.
Doctor: What about shortness of breath while at rest or difficulty breathing with exercise?
Patient: No, that's normal too. I'm breathing just fine.

assistant: The patient is a 65-year-old female who underwent left upper lobectomy for stage IA non-small cell lung cancer. She returns for a routine surveillance visit. She has undergone since her last visit an abdominopelvic CT, which shows an enlarging simple cyst of the left kidney. She underwent barium swallow, which demonstrates a small sliding hiatal hernia with minimal reflux. She has a minimal delayed emptying secondary tertiary contractions. PA and lateral chest x-ray from the 11/23/09 was also reviewed, which demonstrates no lesions or infiltrates. Review of systems, the patient continues to have periodic odynophagia and mid thoracic dysphagia. This most likely is secondary to tertiary contractions with some delayed emptying. She has also had increased size of the left calf without tenderness, which has not resolved over the past several months. She has had a previous DVT in 1975 and 1985. She denies weight loss, anorexia, fevers, chills, headaches, new aches or pains, cough, hemoptysis, shortness of breath at rest, or dyspnea on exertion.