Appeal to Tribunal - Long term illness.

Sigh - okay, so yet again I am having to appeal after my MR. A couple of questions have come up after chatting with a fellow PIP claiming friend.
If you have been ill for a long time [in my case 27 years] and been claiming DLA and then PIP full rate (twice awarded after Tribunal), does mentioning this in your written submission for the Tribunal help or not?
and
If your illness/disabilities are long term and you do not attend specialists/specialist clinics at hospital, does this count against you?
Surely they can't expect you to clutter up the NHS by attending when all that can be done is to self manage your condition with the occasional help of a Physio and GP (for any adjustments of medication)?
I hope I've explained my issue correctly, my head is bursting with it all. Time for a cuppa and a break I think. TIA.

Thank you, I was unsure if I was just overreacting, I worry about annoying the panel.
I have a massive medical record, but only up to about 2010, with the help of my GP and local Physio we have done the best we can to manage meds etc.
I will mention the previous claims etc in my submission and keep my fingers crossed.