Ian’s two letters speak for themselves. He wrote the second letter after receiving a different explanation for his symptoms which helped him to understand them. He is now back at work and largely symptom free.

Dr …..
Consultant Neurologist
Dept for Clinical Neurosciences Western General Hospital Crewe Road
Edinburgh
EH4 2XU

Dear Dr ……,

08 September 2008

I thought I would drop you a quick letter to give you an update on my progress since I last saw you. I know you take an active interest in medical conditions similar to what I experienced and, as I have no need to see you again regarding my condition, I thought you might like to know how I’ve progressed. There is every chance that you may want to share this letter with future patients who struggle to come to terms with their symptoms.

I am largely free of the health anxiety attacks that troubled me for much of 2007. Looking back on the previous 18 months it’s now easy to see just how much I didn’t help myself – although I’m still not sure how much I could do about it(?). I understand fully that my condition was made much worse by my worrying.

I still suffer with the chronic daily headache every day although this is largely manageable. The symptoms have progressed to one of a light pressure sensation rather than ‘pain’. I also understand that this is caused by muscle contraction and I can exaggerate the sensation by ‘clenching’ the muscles around my jaw, head and neck.

I am still taking citalopram (20mg) and this continues to help prevent the anxiety attacks. I have felt myself have the onset of a ‘panic attack’ with what I describe as the physiological symptoms (sweating, tingling rush all over and occasional dizziness) but I have been able to prevent them by talking myself out of them and using your technique of distraction. Fortunately these happen less than once per month now and the trigger seems to be a sudden involuntary squeezing or clenching of the muscles at the back and side of my head, leading to blurred vision which, all together, still unnerves me.

I still don’t really know how all this started, or what caused the initial extreme dizziness. I know that worrying about what was wrong contributed to the severity of the symptoms. Despite seeing two neurology consultants before yourself, and getting assurances that there was nothing organically wrong, the appointments didn’t help to ease my anxiety. I believe this was because of a lack of a good explanation for why I felt the way I did. Both consultants told me what was not wrong with me but did not offer a good explanation of what was wrong. Because of my worrying and anxiety I

made several visits to several GPs, often through the Out of Hours service, searching for an answer and explanation when symptoms became severe. With hindsight, I now see how unhelpful this was and the various doctors speculating as to what may or may not be causing the symptoms was to my detriment despite them all meaning well.

I do not believe it is a coincidence that I improved progressively after the two appointments with yourself where you were able to talk me through your experience and give an explanation as to what was going on. This, coupled with the excellent support I have received from my own GP, to reinforce the message and provide ongoing help, have been the main reasons behind my recovery.

I have not had a day off work with illness in 2008 (against a backdrop of having nearly 8 months off in 2007!). I have recently started aerobic exercise at the gym twice a week which is the first in over 18 months, and I am due to become a father for the first time in just over a month. The difference you and my own GP have made to my life has been significant.

I still feel as if I’m getting better. The progress has been very slow – certainly compared to how quickly I became ill – but it is progress nevertheless and I can do things now, such as visiting the gym, which I couldn’t have done just a few months ago. I believe that I will make a complete recovery in time.

Thank you again for your time and assistance. Yours sincerely,