{"text":"' preblem: Tiredness and exhaustion \nDEPARTMENT OF RESPIRATORY MEDICINE \nConsultant Physicians \n~ Dr Gavin Boyd 4218 \n. Ext.4239 Dr Robert Milroy . 4217, \nFax number 041.557.0468 \nRC.EM.Kilsythecl 1 \n3rd November 1993 \u2018 - - . \n{(Dictated 1st November 1993) \u2019 \u2018 \n_ Dr D. Dick, \nThe Health Centre, ' \nKILSYTH, \u2019 \nGlasgow G65 OHY - - \u2019 \nDear Dr Dick, \nAGNES CLELLAND, dob 8.9.55, Unit No. 338654 \n39 Rennie Road, KILSYTH, G65 \ni \nThank you for referring this lady to Dr Milroy's clinic. I saw her \n1togeth\u00e9r with Dr Milroy on the 1st November 199%4 055 you know she dates her \nproblems back to July of this year when she had watSH she thought was the flu. \nThis consisted of headaches, aching in her legs, \" catarrhal symptoms and \nfeeling tired. You prescribed some antibiotics but these failed to lead to \nany improvement in her symptoms. She has noticed the fatigue in that she now \ngets very tired after walking upstairs- and making the beds. She has also \nnoticed this .is particularly bad after she has got the children off to school \nin the morning and finds that she thas to rest herself after this period. \nThere is no tendency for her symptoms to get worse towards the end of the day. \nThere is no'diplopia,'loss of voice or difficulty with swallowing or eating. \nShe has no constant aches and occasionally describes some vague muscular aches \nin her right.arm and right forearm and left leg. She feels generally that she \nhas lost some of the strength in her limbs and can no longer .do things that \n. she could do before without needing to rest. \nshe describes poor sleep for the last 3 months. Sometime\u00e9 when she is lying \ndown flat she feels as though she is not breathing right, and she cannot find \ncomfort in any particular position. She snores also. Her , husband has \ncommented on this but he also is a deep sleeper. He \u2018has not noticed any \nepisodes of apnoea. She has suffered with intermittent episodes of headaches \nfor the last few months. 1In the last 2 weeks these have been a particular \nproblem occurring in the frontal area. These are not associated with visual \nauras. . ~ \nThere are no respiratory symptoms of note and in particular no cough, wheeze \nor breathlessness. Her husband kept budgies and parrots up to one year ago \nafter having had them for a period of 18 months. He was forced to get rid of \nthem due to an illness precipitated by exposure to the budgies. She also had \ncontact with the birds. She is a married lady. She has never -smoked. She \nhas performed factory work in the past but has not worked for 5 years. 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