My letter I wrote for my GP's to place in my file, as it appears not much is being written there

Patient : Louise Clarke                                                                                

To who it may concern,

I am writing this letter in order to address the concern I have after my telephone conversation I had with Dr********** last Monday 17/11/14.

I have suffered with physical complaints for many years, mostly pertaining to my back, but in the last year I also have had great difficulties regarding my knees.

Last week I was in need of a repeat sick cert, in order to receive the appropriate benefits, therefore I called the surgery and asked a Dr called to arrange one. Dr *********** called me and told me she was not happy to write one for me. Not wishing to debate the matter I said ok. but then she went on to state that she had read through my notes and that there was nothing to suggest I was unfit for work.
I therefore went on to explain to her that I had previously been having Dr ^^^^^^^^^^  write my sick certs, and she had continued to write that my problem was with my knees, although I had not been mentioning my knees but explaining how my back was too weak for me to sit to write and that I was an Author so needed to sit to write.
I also asked did it not say in my notes that I had collapsed a few weeks back and waiting over a day for a GP to call, who then told me to got to A&E.
I added it was not the issue with my knees that prevented me from working, and yes the swelling had gone down but the muscles have remained weak.

She then remarked that i did not have a diagnosis. To which I informed her I was currently waiting to attend an appointment with Neuro, and that this was as a result of me seeing a physiotherapist at the MCAT team, and asked was that referral report not in my file either.

I said I was not a doctor but do know that my symptoms are fitting what is found with Cerebral Palsy and that it may not be CP I have but I hope the Neuro specialist will be able to diagnose the cause of my problems, as the physiotherapist in his report notes that he does not think it is caused by bones.

Dr ********  asked when was my Neuro Appt for, to which I informed her 18/12/14. She said that she would give me a sick cert until then and wrote one to end on the 17/12/14.

My concerns are that it seems my files are absent of the issues I have been stating to the GP's each time I make contact and thus this misunderstanding has occurred, plus my files will not contain a clear picture of my health, thus I feel a need to outline my current health difficulties and the resulting problems.

My disabilities

My first issue is with my spine, I have suffered from weakness in my spine since 1997 but also on occasion before had difficulties, dating back to childhood.

In 1998 I had a discectomy L5/S1 which prior to having I was unable to walk for 9 months, in which time I suffered from extreme sciatic pain where the disc was pushing into the nerve. I was offered surgery but refused and hoped to cure myself without needing the operation, I received a lumber injection that had no effect. So I was wrapped in plaster caste , my whole torso and sent home with crutches, I was unable to sit throughout that time so was transported around on a stretcher, receiveing various forms of physio and also I used Chinese medicine and other alternative treatments. Throughout the time I was on maximum doses of pain killers. i eventually accepted I needed surgery and agreed to have. 

The surgery was successful, thus I returned to work, offering training and counselling but my back remained weak, the muscles on random occasions would just give way, and my torso became like jelly, with no strength to hold me up. The occurrance of this increased over time, but also I have become more aware of when my muscles are weakening so now manage to avoid total collapse occurring so often; although sometimes like with the recent collapse I had no prior warning; I stood up to go out and collapsed back down again.
At those times I can not lift my body even onto to zimma frame and once I do manage to get onto, can't move it as it requires I hold myself up as i lift the frame up off the floor which I lack the strength/stability to do; it's like my body becomes paralysed from above my waist, So maneuvering is extremely difficult. Also when this total collapse occurs my ability to pass urine also stops. This has resulted in the past in my stomach swelling up very large and then projectile vomiting occurring. Always when I collapse i start to feel a tightening around my waist to. I find the best I can do is try to relax and gradually the problem goes,this takes about a week on average for me to be able to stand without a zimma frame, but also this can be for limited time.

My current problem is with my spine, the lumber area is weak and as the day progresses it becomes increasingly weaker, the muscles front and back seem to struggle to hold me up, like the strength depleats from them; so I am unable to sit for long.
With walking the distance i can walk varies, from not far at all like only around my home, and maybe in need of zimma frame, for support, to walking quite a distance, but after walking for X amount of time my knees become stiff the muscles become weaker around my knees and start to lock up, and also the lumber area struggles like without strength and my lower spine becomes sore,and my hips become more and more flexed, resulting sometimes in me having great difficulty getting home, needing to rest by leaning over walls as I struggle to stand up.
Climbing steps or walking on an incline is extremely hard, and also I walk very slow, and if I try to walk faster its like the mechanism involve does not function properly and the rhythems in waking go wrong and my legs buckle, and just wont do as required, it feels like I'm walking like a robot. and I need to concentrate my mind to move my limbs. 

Also sometime my spacial awareness is out and so  I trip/miss step or knock things with my feet in shops say.

My difficulties seem to be with my muscle tension either too tight like in my hips, knees and eye; causing double vision. or too loose so no/little lumber strength or in my ankle my foot buckles sometimes under me.
Once home from walking my back weakened it can be very hard to sit in a chair even with pillows for support I slide down the chair. Plus after walking my calf muscles tighten up along with my thighs, and hips and so sitting becomes uncomfortable. I also have pain in my ankles of stiffness after walking.

Resting causes muscle stiffness so I try to move around regularly, but tiredness weakens my muscles further so it is  a constantly varied situation for me. It is like i only have so much I can do in a day, which also varies, but if I rest well I can achieve more. Also it is noticeable that my muscle recovery time is far too long, in that normal rest time is not sufficient to ever fully recover. Also when I get tired my body starts to vibrate and shake, and jolts involuntary. It is like my body is suffering from exhaustion even though I am not doing things that would over exert an average person of my age.

I also will add here that I am currently under an eye specialist for my double vision, where the muscles in my left eye become too tight, diagnosed as thyroid eye disease. He did request that i have blood tests and be referred to an endocrinologist to determine the cause of my sweating I have and also the nervous twitches and jerks, and anything other to understand my eye condition, but the practice decided against referring me to the Endocrinologist. I am soon to visit the eye specialist again with the results, (8/11/14).

The above outline I hope helps you to understand why I ask for sick certs, as my condition results in normal activities taking far to long to achieve, hence just getting ready for the day can take hours as it requires i rest often sometimes, and coupled with this doing basic home chores like washing up, which strains my back as standing still is far more difficult than moving, in fact moving helps me lots but tires me too. All a balancing act that is unpredictable so planning ahead is somewhat hit or miss.

I feel i have covered my complaints pretty much here in this letter, and it is my hope that with this being placed in my file a better understanding can be reached by anyone concerned with my case.

I thank you for you time in reading this and hope future communication is improved by it.

Yours Sincerely

Louise Clarke (DOB )

The Dr called, (a different  one than normally calls, the one who said the swelling in my knees was fat)

She started by saying..she is not happy to sign me off............I said Ok, ( a bit perplexed)

she then added, she has been reading through my notes and there is nothing to suggest I am unfit for work.
I responded with the facts...saying

'The other Dr keeps writing about my knees on my Med Cert, but I don't say anything about my knees. The swelling has gone down and they are not strong. but I can work with bad knees it's my back; I can't sit up for long, I write, I am an author but because my back is weak I can't.

'I colapsed a few weeks back and waited over a day for a Dr to call, who then said go to A&E.
don't know if it says it in my file.

She said there's no diagnosis.

I told her 'I found the symptoms fit with CP- maynot be, maybe something else, I'm not a doctor. My symptoms fit with cerebral palsy, and I want to know what is case and why. I am awaiting my appointment with Neuro'


She asked when was the appointment for


I told her the 18 Dec, I added that in my file there should be a report done by the physiotherapist from the MCAT team, he asked for the appointment to be made to Nuero and said it was not my bones. So he asked you to refer me to Neuro.
(She sounded like she found it.)

She said 'ok, but laying down all day is not good for your back, and did they give you back exercises.

I said yes and do them when I can. But first I had physio for where my knees were swollen, and now they have gone down, but still they are not strong. And my back is weak in lumba area and sore in lower area. And that also my calf muscles at the back hurt after walking and my ankles hurt too.

So I don't sit for long and I need to in order to write.
(forgot to add I have double vision when reading/writing)


She said ok she would sign for one month, until my neuro appointment.