Patient 5

Patient 5

Dear Mr Rejali,
I’m not sure if you remember me but I was one of your patients at XXXX Hospital  just over a year ago. During that period you diagnosed me with a combination of Chronic Subjective Dizziness and Mal de Debarquement (MdDS). My treatment consisted , after an initial assessment, of the use of one of your optokinetic videos in conjunction with visual reality goggles and mobile phone. You also advised me to have a course of Venlafaxine via my GP.
My reasons for sending you an email therefore are to give you , hopefully, some valuable and welcome feedback after following both of the mentioned treatments!.. It is with real pleasure to tell you that they have both succeeded in helping me enormously to getting back to some kind of normality. I no longer rock or sway and feel much stronger in both body and mind. Obviously time too may have played a part in my improvement but equally I am convinced that the treatments you prescribed have been significant in my overall improvement. I can’t say that physically I am exactly as I used to be but I am getting there. I feel that my comments will be of use to you when dealing with other patients in the future that might suffer in the same or similar way that I have and could offer hope to them. I understand that someone may have already been in contact with you from the MdDS online support group as a doctor who has treated a person with this condition. I was asked for your details last year and thought you wouldn’t mind giving some general advice on the matter. Hopefully, now I have been in touch with some feedback,this should give you a further insight when discussing MdDS with other patients. Utilising the means used in my case could even lead to another persons recovery when all else appears to have failed. The Optokinetic approach has now been adopted in Sheffield in a more sophisticated way and sadly has to be paid for privately. This technique has already been used in New York at Mount Sinai Hospital and has had a certain degree of success.
Naturally,having the daily treatment in only one place is not the most practical or economic route for most people,so perhaps the methods you prescribed seem to me a good way, albeit not exactly the same, in giving people like me a chance. It certainly worked in my case, although like a lot of things it takes time and can have a delayed action, so patience is key.
Well Mr Rejali, it is only left for me to say thankyou so much for helping me.You certainly seem to have a good rapport with patients and I felt confident in your hands.
I hope my comments are of use to you and thanks again, as it has changed my life for the better.
Kind Regards,
Yours sincerely,

Thank you for replying to my email and indeed so swiftly!
In answer to your questions, firstly I have only ever done one 3 week daily sessions of Optokinetic treatment building up the time gradually. This I did while still under your care a year ago, which I am sure you will recall. At the time I reported back to you with notes that I had kept and that you took a copy of , which you must have  hopefully kept somewhere At our final consultation I said that I felt some improvement had been achieved in the reduction of my swaying feeling. A course of Venlafaxine was then suggested by you,which I was subsequently  prescribed by my GP on a very low but steadily increasing dosage over a period of about 2 months to 150 mg daily (75mg am and 75mg pm). In April 2016 I continued to take this dosage and am still taking it with a further review at the end of May 2017. My GP has indicated that at that point I could begin a weaning off process but that is yet to be discussed. Fortunately, throughout this period I have been unaware of any real side effects. However my GP has been reluctant to up the dosage to avoid any side effects coming into play. I feel the Venlafaxine must have helped me but the optokinetic  treatment must have also played it’s part, perhaps on a delayed basis. As I understand from my research into MdDs it appears it is often the case that any recovery is not necessarily instant. However, apart from the 3 weeks Optokinetic Treatment and taking Venlafaxine  for over a year, I have not  repeated this treatment,
undertaken any other treatment or taken any other drugs. Regarding using my case for the purposes of writing in a  journal I am quite happy to allow this as it is of scientific importance and should you need to question me further in the future I would only be too pleased to reply.
Furthermore, I also agree to you using my story to put on your website if you think it will be to your advantage.
On a final note, as you say, knowledge, strength and determination are vital and can help to make you stay focused but needless to say it isn’t always that simple and we are not all alike. However, I think that  the improvement in my mood certainly helped
 and perhaps in my case, the fact that I was determined to find a way of improving my health in any way that I could, including seeing someone as yourself, was indeed a positive contributory factor.
Thanking  you for your continued interest,
Kind regards,
Yours sincerely,