Aa
driver's license, the saga continues, need your feedback
I was re-reading my last neuro report today and something jumped out at me that I missed the first time around. In describing my overall functioning, my neuro included the following statement: “She still has diplopia, though this has been significantly improving. She has in fact returned back to driving and feels relatively confident with this.”
It is the words “relatively confident” that concern me. I know for sure I did say that I feel “very safe” driving, so I’m not sure why he had the impression I am only relatively confident.
The reason this concerns me is with respect to my driver’s license. Some of you may recall that I renewed my license in June, after avoiding driving for many months due to severe double vision. I allowed my license to expire on my birthday since my I was not comfortable driving due my double vision, and wasn’t going out in public with an eye patch. I planned to renew it when things improved.
By June my vision improved to the point where I was comfortable driving. My GP and ophthalmologist had no concerns. I called 4 different licensing agents plus the dept of transportation and the MS Society and no one could give me a straight answer on whether or not I was legally required to report my dx, even though it currently was in no way hindering my ability to drive safely.
I went to renew my license, and declared my new MS dx to the DMV agent, to be on the safe side. When I did so, I provided my medical report from my ophthalmologist, the agent made a phone call, and told me that my license was renewed no problem, my only condition was I now must renew my license annually with a medical report, rather than every five years with no medical. Fine.
Three months later, I get a letter from the DMV stating the following: “This letter is written in follow-up to your disclosure to an Alberta registry Agent on June 28, 2008 that you suffer from MS. Before any further consideration may be given for approval for your Operator’s License, it is necessary that you have the enclosed Special Medical report completed by your regular attending. The medical report must document the stability of your multiple sclerosis and how it affects your ability to safely operate a motor vehicle.”
Ummm, what????
SO….....I get my GP to complete the “Special Medical Report” (even though all the various agents I called previously said there were no additional forms to do!), reiterating my ability to drive safely, and sent it in a few weeks ago. I am awaiting a reply.
In the meantime, I notice the “relatively confident” comment in my neuro’s report and it concerns me more than it otherwise would, in light of this license issue. Normally I would wait till my next appt to request a correction, but I don’t see him for several months. With past minor errors I have pointed out, he simply comments on the correction in the next report, rather than changing the original.
So this license thing is up in the air I’m wondering if I ought to contact my neuro’s office pre-emptively and request an correction to the report. It may seem to them I am making a mountain out of a molehill, and perhaps I am. Although to me there is a big difference between "feel very safe" and "feel relatively confident."
What would you do?
It is the words “relatively confident” that concern me. I know for sure I did say that I feel “very safe” driving, so I’m not sure why he had the impression I am only relatively confident.
The reason this concerns me is with respect to my driver’s license. Some of you may recall that I renewed my license in June, after avoiding driving for many months due to severe double vision. I allowed my license to expire on my birthday since my I was not comfortable driving due my double vision, and wasn’t going out in public with an eye patch. I planned to renew it when things improved.
By June my vision improved to the point where I was comfortable driving. My GP and ophthalmologist had no concerns. I called 4 different licensing agents plus the dept of transportation and the MS Society and no one could give me a straight answer on whether or not I was legally required to report my dx, even though it currently was in no way hindering my ability to drive safely.
I went to renew my license, and declared my new MS dx to the DMV agent, to be on the safe side. When I did so, I provided my medical report from my ophthalmologist, the agent made a phone call, and told me that my license was renewed no problem, my only condition was I now must renew my license annually with a medical report, rather than every five years with no medical. Fine.
Three months later, I get a letter from the DMV stating the following: “This letter is written in follow-up to your disclosure to an Alberta registry Agent on June 28, 2008 that you suffer from MS. Before any further consideration may be given for approval for your Operator’s License, it is necessary that you have the enclosed Special Medical report completed by your regular attending. The medical report must document the stability of your multiple sclerosis and how it affects your ability to safely operate a motor vehicle.”
Ummm, what????
SO….....I get my GP to complete the “Special Medical Report” (even though all the various agents I called previously said there were no additional forms to do!), reiterating my ability to drive safely, and sent it in a few weeks ago. I am awaiting a reply.
In the meantime, I notice the “relatively confident” comment in my neuro’s report and it concerns me more than it otherwise would, in light of this license issue. Normally I would wait till my next appt to request a correction, but I don’t see him for several months. With past minor errors I have pointed out, he simply comments on the correction in the next report, rather than changing the original.
So this license thing is up in the air I’m wondering if I ought to contact my neuro’s office pre-emptively and request an correction to the report. It may seem to them I am making a mountain out of a molehill, and perhaps I am. Although to me there is a big difference between "feel very safe" and "feel relatively confident."
What would you do?
Portland OR is full of yahoos, too! I read the other day about two of them racing in separate vehicles on a busy freeway, going something like 135mph, cutting in and out of traffic.
We have a lot of migrant farm workers that drink to relax and then don't drive real well.
We get a lot of stories like that man being killed. Often the speeders are also drinking, so they usually aren't badly hurt because the alcohol relaxes their bodies. We have a lot of bicyclists that get hit, as well as some pedestrians. I wish we had the funds for more enforcement of driving laws!
I avoid driving during rush hour, or in rainstorms, as there always seems to be accidents, whether fender-benders or fatalities.
You be careful out there! I will, too.
Kathy
We have a lot of migrant farm workers that drink to relax and then don't drive real well.
We get a lot of stories like that man being killed. Often the speeders are also drinking, so they usually aren't badly hurt because the alcohol relaxes their bodies. We have a lot of bicyclists that get hit, as well as some pedestrians. I wish we had the funds for more enforcement of driving laws!
I avoid driving during rush hour, or in rainstorms, as there always seems to be accidents, whether fender-benders or fatalities.
You be careful out there! I will, too.
Kathy
You situation re: your chart is just another example of mistakes that are easily made, esp when we are being transferred from one doc to another. It is great that you were proactive to have the correction made promptly. That is why I think it's so important that we get copies of our records in a timely way, so we can review them and have any inaccuracies corrected.
When my record was transferred from the on-call neuro to my MS specialist, it said that I previously had VEP done and it was negative. I have never had any evoked potentials, I have no idea where they got that. Also, although not as big of an issue, but it also said that I had travelled to Ireland in Oct 2007, when I had actually been there in Oct 2006, a year before I had any disabling symptoms or was dx'ed . In Oct 2007, I was having a major MS attack and was being seen by the on-call neuro. So how could I possibly be in Ireland and also in hospital in Edmonton at the same time? The report was actually written by the resident on behalf of the on-call neuro and obviously neither one picked up on these errors. I pointed it out to my MS Specialist and he commented on the correction in his first report on me.
What you said about driving and cell phones and head sets reminded me of something I learned at an international safety conference a few years ago. The presenter said that talking on a cell phone using a head set while driving was only marginally safer than with a handset. The reason is exactly what you said, that your attention is on something other than the road. Someone asked how it was any less safe than having a conversation with someone in the passenger seat. The difference is that with another person in the car, you have another set of eyes (unless they are visually impaired I guess, I just thought of that) on the road.
The policy at the company I work for is no talking on handsets or headsets while using company cell phone and/or company vehicle. There are several provinces in Canada where it is now illegal to talk on a cell phone (handset). I suppose it would be very difficult to outlaw headsets; those Blue Tooth devices are so small they could easily go unnoticed.
I feel frustrated like you do about other drivers who shouldn't be on the road, while those of us who happen to have medical conditions but are safe to drive, are scrutinzed more closely. I live in a remote and heavily industrial city, a large portion of the population is here just for the work and are transient, thousands live in company work camps. The average age here is young, age 30 or so. So this place attracts lots of young males, "yahoos" as I like we call them (not all of them of course, that would be stereotyping, lol!) driving half tonne souped up trucks. The driving here is the worst I've seen anywhere, including cities like Toronto and Vancouver. Running red lights and stop signs, ignoring yield signs, getting cut off, and speeding (like 180kms in 100 zone!) is commonplace here, and every time I see it happen, it's a young guy in a half tonne truck! So it irks me to no end that I'm now subject to the scrutiny, assumptions and misconceptions of the DMV. Shoulda listened to my ophtha and kept my yap shut!!
BTW, a 50-something year old man was killed here the other day driving home from work, as a result of two teenaged girls speeding, losing control of the stolen truck they were driving and crossing a median, and striking the innocent drivers. The teenagers survived.
When my record was transferred from the on-call neuro to my MS specialist, it said that I previously had VEP done and it was negative. I have never had any evoked potentials, I have no idea where they got that. Also, although not as big of an issue, but it also said that I had travelled to Ireland in Oct 2007, when I had actually been there in Oct 2006, a year before I had any disabling symptoms or was dx'ed . In Oct 2007, I was having a major MS attack and was being seen by the on-call neuro. So how could I possibly be in Ireland and also in hospital in Edmonton at the same time? The report was actually written by the resident on behalf of the on-call neuro and obviously neither one picked up on these errors. I pointed it out to my MS Specialist and he commented on the correction in his first report on me.
What you said about driving and cell phones and head sets reminded me of something I learned at an international safety conference a few years ago. The presenter said that talking on a cell phone using a head set while driving was only marginally safer than with a handset. The reason is exactly what you said, that your attention is on something other than the road. Someone asked how it was any less safe than having a conversation with someone in the passenger seat. The difference is that with another person in the car, you have another set of eyes (unless they are visually impaired I guess, I just thought of that) on the road.
The policy at the company I work for is no talking on handsets or headsets while using company cell phone and/or company vehicle. There are several provinces in Canada where it is now illegal to talk on a cell phone (handset). I suppose it would be very difficult to outlaw headsets; those Blue Tooth devices are so small they could easily go unnoticed.
I feel frustrated like you do about other drivers who shouldn't be on the road, while those of us who happen to have medical conditions but are safe to drive, are scrutinzed more closely. I live in a remote and heavily industrial city, a large portion of the population is here just for the work and are transient, thousands live in company work camps. The average age here is young, age 30 or so. So this place attracts lots of young males, "yahoos" as I like we call them (not all of them of course, that would be stereotyping, lol!) driving half tonne souped up trucks. The driving here is the worst I've seen anywhere, including cities like Toronto and Vancouver. Running red lights and stop signs, ignoring yield signs, getting cut off, and speeding (like 180kms in 100 zone!) is commonplace here, and every time I see it happen, it's a young guy in a half tonne truck! So it irks me to no end that I'm now subject to the scrutiny, assumptions and misconceptions of the DMV. Shoulda listened to my ophtha and kept my yap shut!!
BTW, a 50-something year old man was killed here the other day driving home from work, as a result of two teenaged girls speeding, losing control of the stolen truck they were driving and crossing a median, and striking the innocent drivers. The teenagers survived.
Hi,
I know this is frustrating but what I would do is just ask your neurolosgist for a letter or ask him to fill out the medical form. Although he documented that in your last chart note-thingsd change and it should not be a problem. I work for three doctors and I am frequently asked to write letters or sign forms. It is not generally a problem-unless the doctor specifically felt you were impaired. In general though it is usually per the report of the patient as only we are aware of our symptoms.
I know this is frustrating but what I would do is just ask your neurolosgist for a letter or ask him to fill out the medical form. Although he documented that in your last chart note-thingsd change and it should not be a problem. I work for three doctors and I am frequently asked to write letters or sign forms. It is not generally a problem-unless the doctor specifically felt you were impaired. In general though it is usually per the report of the patient as only we are aware of our symptoms.
I'm glad you're being so vigilant with your driving. I always try to do that on the occasions that I need to drive, and I don't even have a diagnosis. Even so, I've found that twice, while using my cell phone (with a headset) I've missed my exit off the freeway and had to hang up and work my way back on surface streets.
I've come to the conclusion that my cell phone should not be used while driving (duh!), as it takes away from the extra vigilance I need to use to feel safe. Some of our states are making it mandatory to wear a headset, but I think it is still distracting to be talking on the phone while driving. It's one of the reasons I need to be extra vigilant; there are a lot of people talking on their phones, thinking about getting where they're going as fast as possible, so I've always been a defensive driver.
I know of an older man, with dementia, complications from a kidney transplant, etc. He has a whole team of doctors, and not a one of them has reported him as unfit to drive. I saw him, several years ago, run a red light across 6 lanes of traffic. I know that it took him 3-4 minutes at a doctor's appointment to get his name and address 50% correct. He recently passed the test for older drivers, and got his license renewed. Apparently it is simply a vision test, where they read letters.
I think everyone should pay very close attention when they drive, as there are doctors that are more concerned with how a person would feel if they weren't allowed to drive when seriously impaired than following the letter of the law.
I'm sory to vent on your post, but this situation has me very frustrated. A diagnosis can put people in a special reporting system, even when they are doing well, while others that are seriously impaired can drive with a whole team of doctors knowing that they should not. I better not get started on how many drunk drivers continue to drive after being arrested several times....
BTW, I'm pretty finicky when I read my chart notes, too. I try to bite my tongue and say nothing, but when I first saw my current neurologist, she wrote in her chart notes that my last neurologist was someone that I had never even heard of before. I had sent her the chart notes from the three visits with that former neuro, so I didn't wait. I sent her an e-mail and let her know about the mistake in her notes, and my concern that she hadn't received the chart notes that I had faxed to her.
I got a fairly quick response apologizing, thanking me for pointing out the error, and reassuring me that the chart notes were indeed in my file. Made me feel better.
wishing you wellness,
Kathy
I've come to the conclusion that my cell phone should not be used while driving (duh!), as it takes away from the extra vigilance I need to use to feel safe. Some of our states are making it mandatory to wear a headset, but I think it is still distracting to be talking on the phone while driving. It's one of the reasons I need to be extra vigilant; there are a lot of people talking on their phones, thinking about getting where they're going as fast as possible, so I've always been a defensive driver.
I know of an older man, with dementia, complications from a kidney transplant, etc. He has a whole team of doctors, and not a one of them has reported him as unfit to drive. I saw him, several years ago, run a red light across 6 lanes of traffic. I know that it took him 3-4 minutes at a doctor's appointment to get his name and address 50% correct. He recently passed the test for older drivers, and got his license renewed. Apparently it is simply a vision test, where they read letters.
I think everyone should pay very close attention when they drive, as there are doctors that are more concerned with how a person would feel if they weren't allowed to drive when seriously impaired than following the letter of the law.
I'm sory to vent on your post, but this situation has me very frustrated. A diagnosis can put people in a special reporting system, even when they are doing well, while others that are seriously impaired can drive with a whole team of doctors knowing that they should not. I better not get started on how many drunk drivers continue to drive after being arrested several times....
BTW, I'm pretty finicky when I read my chart notes, too. I try to bite my tongue and say nothing, but when I first saw my current neurologist, she wrote in her chart notes that my last neurologist was someone that I had never even heard of before. I had sent her the chart notes from the three visits with that former neuro, so I didn't wait. I sent her an e-mail and let her know about the mistake in her notes, and my concern that she hadn't received the chart notes that I had faxed to her.
I got a fairly quick response apologizing, thanking me for pointing out the error, and reassuring me that the chart notes were indeed in my file. Made me feel better.
wishing you wellness,
Kathy
Thank you for your input. I am thinking I'll sit on this for now, and will bring it up at my next regular appt with my neuro. If I'm feeling as good or better about driving at that time, I'll make sure he writes that I am "very confident" driving, in the next report. I know I tend to be nitpicky about documentation. When I was trained as a social worker, I was trained to document what clients and other parties would say in quotes, and not to put words in their mouths. This was important since so many of our files went to court. Of course I would have impressions and opinions based on what clinets said and did. So I needed state when it was an impression, to make sure it's clear that it's not stated as fact. So if my neuro had said "My impression is that she feels relatively confident" I would be less uptight about this. Yes, I am nitpicky!! Drives people around me crazy, I'm sure.
I will also ask my neuro to state his opinion in his next report that there is no medical reason why I should be restricted from driving, assuming that remains to be true. He said as much at my last appt; I would like this documented, so that it's clear in writing that my GP, ophtha and he are on the same page. Now that I think of it, when I see my neuro-ophtha again in a few months, I will ask him to document this as well. All five of the docs I've seen since July (incl. Boston doc) all know I'm driving and none are concerned, in fact they all stated how well I'm functioning and good for me to be back at work, driving, travelling, etc.
My ophtha did caution me about the hassles I might encounter if I disclosed. As I called around trying to understand my legal obligation, I was ANNOYED that no one - DMV head office, licensing agents, MS Society - would give me a straight answer. I did get the sense that the vagueness was due to covering their butts. So I erred further to the side of caution than was probably necessary.
I am encouraged though by what my boss told me this week. Her husband had brain surgery a few years ago, for what I'm not exactly sure. He had months of slow recovery and could not drive for a long time. Once he was well enough to drive, his license was renewed with the same condition as mine: annual renewal supported by medical evidence. He did this for a copule years, then wrote the DMV directly, detailing his history, how well he is doing, and requesting that the annual renewal condition be lifted. This was supported by his doctor. Lo and behold, DMV agreed and lifted the condition.
Whatever he had wrong was probably seen as a one time acute condition, as opposed to the chronic lifelong condition of MS. However, should I be lucky enough that my symptoms stabilize for a longer period, hopefully aided by my Copaxone treatment, I will definitely try the same approach with DMV. It wouldn't hurt to try.
In the meantime, I will wait to hear back from them and hope that the additional info my GP provided is sufficient for now. Given my birthday is in 2 months (renewal date of license), I will be VERY annoyed if I have to provide yet another medical report again in such a short time. That would be 3 medicals in less than six months. Surely they are not that illogical, then again it IS the DMV! lol
Rena, you are right that it's costly, $100 for a report from my GP, of course they can't bill Ablerta Health for the service so I don't blame her. At least she is very prompt, she had my last report ready to pick up the next day. My ophtha didn't charge me anything for his report, I wish the ophtha report was sufficient but they want one from the GP, even though they pretty much said the same thing.
Quix, I hear what you're saying about MS and reaction times, and I don't think you're being antagonistic for making the point. We do need to keep in mind that this is out there. It's unfortunate that we are lumped together like that, when we all know how different we all are in terms of symptoms and disease course. Personally, I know I am driving more safely than before. I am being extra cautious. I no longer speed, which I'll admit I used to do a lot. Not like crazy fast, but 10 - 20 kms over the limit when I felt it was safe to do so. Now, I'm always within the limit. I feel I'm extra vigilant and aware of what's going on around me, and am driving defensively. For me, for now at least, my MS has made me more safety conscious and less inclined to take risks.
I will also ask my neuro to state his opinion in his next report that there is no medical reason why I should be restricted from driving, assuming that remains to be true. He said as much at my last appt; I would like this documented, so that it's clear in writing that my GP, ophtha and he are on the same page. Now that I think of it, when I see my neuro-ophtha again in a few months, I will ask him to document this as well. All five of the docs I've seen since July (incl. Boston doc) all know I'm driving and none are concerned, in fact they all stated how well I'm functioning and good for me to be back at work, driving, travelling, etc.
My ophtha did caution me about the hassles I might encounter if I disclosed. As I called around trying to understand my legal obligation, I was ANNOYED that no one - DMV head office, licensing agents, MS Society - would give me a straight answer. I did get the sense that the vagueness was due to covering their butts. So I erred further to the side of caution than was probably necessary.
I am encouraged though by what my boss told me this week. Her husband had brain surgery a few years ago, for what I'm not exactly sure. He had months of slow recovery and could not drive for a long time. Once he was well enough to drive, his license was renewed with the same condition as mine: annual renewal supported by medical evidence. He did this for a copule years, then wrote the DMV directly, detailing his history, how well he is doing, and requesting that the annual renewal condition be lifted. This was supported by his doctor. Lo and behold, DMV agreed and lifted the condition.
Whatever he had wrong was probably seen as a one time acute condition, as opposed to the chronic lifelong condition of MS. However, should I be lucky enough that my symptoms stabilize for a longer period, hopefully aided by my Copaxone treatment, I will definitely try the same approach with DMV. It wouldn't hurt to try.
In the meantime, I will wait to hear back from them and hope that the additional info my GP provided is sufficient for now. Given my birthday is in 2 months (renewal date of license), I will be VERY annoyed if I have to provide yet another medical report again in such a short time. That would be 3 medicals in less than six months. Surely they are not that illogical, then again it IS the DMV! lol
Rena, you are right that it's costly, $100 for a report from my GP, of course they can't bill Ablerta Health for the service so I don't blame her. At least she is very prompt, she had my last report ready to pick up the next day. My ophtha didn't charge me anything for his report, I wish the ophtha report was sufficient but they want one from the GP, even though they pretty much said the same thing.
Quix, I hear what you're saying about MS and reaction times, and I don't think you're being antagonistic for making the point. We do need to keep in mind that this is out there. It's unfortunate that we are lumped together like that, when we all know how different we all are in terms of symptoms and disease course. Personally, I know I am driving more safely than before. I am being extra cautious. I no longer speed, which I'll admit I used to do a lot. Not like crazy fast, but 10 - 20 kms over the limit when I felt it was safe to do so. Now, I'm always within the limit. I feel I'm extra vigilant and aware of what's going on around me, and am driving defensively. For me, for now at least, my MS has made me more safety conscious and less inclined to take risks.
by the way...It was mentioned to DMV that I have MS when I went to get my disabled parking tag but nothing was said about it otherwise...I myself cringe at the thought of having to have a dr. fill out a form for DMV every year...it is costly and a royal pain in the backside when you have a gp like mine that takes her sweet time in filling out forms.
Rena
Rena
Hey girl...I am only going by my past experiences but when I was diagnosed as having seizures I was told to not drive until I was seizure free for 6 months and on my honor I didn't drive for that period of time. The doctor told me that here in Canada once you tell them that you have a disability as such that it is a royal pain to obtain your license from then on so they said they only let the DMV know if they are certain that the patient will try to drive despite the warnings. However, in your position I would be worried about the neuro's statement coming out in the event of a MVA and due to this statement you could be found at fault. Personally, I would speak to the neuro about this and let him know why you are concerned and I don't see any reason for him to change his comment to avoid any question should an MVA occur.
Just wanted to put in my two cents and I hope I have helped a little!
Lots of Hugs
Rena
Just wanted to put in my two cents and I hope I have helped a little!
Lots of Hugs
Rena
Since being diagnosed almost 13 years ago, I have never told the Division of Motor Vehicles that I have MS. My first Neuro told me that if he has a patient that would be hindered enough to drive unsafely, that this is the only time he gets involved with DMV. He said in the U.S. that it is not necessary for me to tell DMV unless he told me it was unsafe for me to drive with my current symptoms. It's also his duty in the U.S. to notify DMV if I shouldn't be driving due to my condition.
So, to this date, I have never told DMV that I have MS. I hope and pray that I know WHEN I should not be driving, just as you did on your own.
I hope you get this straightened out. I see no reason, why you should be restricted from driving.
All the best dearheart,
Heather
So, to this date, I have never told DMV that I have MS. I hope and pray that I know WHEN I should not be driving, just as you did on your own.
I hope you get this straightened out. I see no reason, why you should be restricted from driving.
All the best dearheart,
Heather
I'm not sure I would ask for a clarification of the neuro's report. The use of the "relatively" confident may have taken into consideration other things that you said, your facial expressions while saying it and the amount of confidence he heard.
I have to add to all of this that several studies have shown a decrease in reaction times of MS patients in general. Some have shown "impaired driving." I'm not trying to be antagonistic, but we should all be aware that these studies are out there. As a group we are worse drivers, because of this and it is documented in the literature. If we were to be in a accident, our defense would be compromised by this information.
What you should do depends on how strongly you feel he misquoted you and that he will merely add an addendum to the original report. Actually this is the recommended procedure.
Good luck with this.
Quix
I have to add to all of this that several studies have shown a decrease in reaction times of MS patients in general. Some have shown "impaired driving." I'm not trying to be antagonistic, but we should all be aware that these studies are out there. As a group we are worse drivers, because of this and it is documented in the literature. If we were to be in a accident, our defense would be compromised by this information.
What you should do depends on how strongly you feel he misquoted you and that he will merely add an addendum to the original report. Actually this is the recommended procedure.
Good luck with this.
Quix
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