 |
 |
Hi . i received this from another list source. I know we do not have MS, however, neuro illnesses do affect ur brain. Control?? Yep. I just want the card. Screw the driving. Gas is too expensive, the HHA can drive,senior center van can drive, or public door to door transportation. Medicine ?? The drug stores will deliver. Cost?? Some small towns have people who drive right by ur home who will be glad to drop off ur monthly meds. Wait timefor the alternative transportation?? Giving up ??or Accepting?? DRIVING- do not wait til u get into an accident and maybe kill someone's kid or family member because of loosing another independent part of life. Noone likes to give up a driver license and accept not driving. It is very restricting. However, once u get a system in, then it isn't too bad. With gas 2-2.50 a gallon and have a 10 mpg van, the senior van and public transportation is looking real good. I can depend on the seniors more than the ones under 65. They are generally retired, less stressed out, and show up when they say they will. Places to call 1.Try Dept. on Aging- They also cater to the disabled population not just 'seniors'. Generally have an 800 phone number or email. 2.local senior center- Talk to the social worker at the town hall or the senior center. Considerations- a.Explain ur illness restrictions to him/her such as; Needs of getting to a doctor appt and meds not working properly all the time. Also, when the meds are not working properly driving a vehicle is lifethreatening to others. Saying u have PD doesn't cut it. b.UR family - If u are single or just have a spouse to rely on , definitely need alternative transportation. Door to door public transportation are excellent, but the paper work takes up to 3 months to appeal and prove that u can't walk to the regular bus or train stop and stand out in the heat or cold. c.Cancel penalties?? If u cancel , do u get dropped from the service? d.Wait time? Most say there will be a 20 mins time before and/or after ur schedule time. Ask other people who they ride with. e.Prority appts.? Generally dialysis patients get priority, then work, doc's/ hospital appts., grocery shopping, banking, hair appts, malls. f. Do u have to pay for the assistant/caregiver when riding?? generally no. When applying for door to door service from ur local public transit or senior center- 1. Doctor has to fill out the forms. 2. wheelchair is needed to take the lift for safety reasons and liability. 3. appeal ? Usually they will turn u down for door to door service. Appeal then and have a social worker help u. 4. Volunteers on the appeal committee usually. retirees, other disabled people, ect. nancy Driving and MS: On the Road by Martha Jablow Americans have loved to drive ever since Henry Ford's first Model T rolled off the assembly line nearly 100 years ago. The automobile means independence to come and go at will to visit family and friends, to get to work, to shop, to take vacations, to be out in the community. That freedom can be threatened by several of the symptoms that accompany multiple sclerosis: vision problems, fatigue, muscle stiffness, slowed reaction time, and limited mobility that simply makes it difficult to get in and out of the driver's seat. These symptoms raise tough questions. Can I still drive safely or am I taking chances? Will I have to give up driving? There are different levels or demands of driving, notes Dr. John DeLuca, director of Neuroscience Research at Kessler Medical Rehabilitation and Education Corporation in West Orange, New Jersey. It is not a yes-or-no thing: either you can or cannot drive. Instead, there are ways to continue driving safely but within limits, such as not driving at night and avoiding high-density highways or times when you are likely to be tired, or bothered by extreme heat. In addition to changing driving patterns, many people with MS continue to drive by using adaptations that involve physical equipment or vehicle modifications. (See Adaptive Devices.) Visual changes Nothing is as critical to safe driving as good eyesight. But vision problems in MS may be subtle. According to Dr. Laura Balcer, a neuro-opthalmologist and assistant professor in the Department of Neurology at the University of Pennsylvania School of Medicine, a person with MS may have 20-20 vision on the black-on-white vision charts but still have episodes of optic neuritis when vision is blurry, eye movement is painful, or colors seem washed out. MS can affect the pathways or circuits in the brain that direct eye movement, Dr. Balcer said. The myelin (the fatty material that insulates nerve fibers) in the brain or brain stem is affected by MS, so the pathways for colors, contrast, or shades of gray are affected. MS also can affect the optic nerves, which are the main highway, if you will, from the eyes to the brain. This may mean it's harder to perceive contrasts. That's why night driving is often difficult. Plus there's glare. People may need a prescription for eyeglasses that are best for night driving. Double vision is another MS symptom that occurs from time to time. Sometimes the double vision goes away if you cover one eye, Dr. Balcer said. âSome people use a patch over one eye when double vision occurs in episodes, particularly when they âre tired. And some people experience episodes when objects seem to jump around particularly when looking to the side or down. Dr. Balcer notes that medications for thisgabapentin and baclofencan dampen the bouncing of the eye. Peripheral vision (the far right and left edges of the full field of vision) also can be affected by MS. Doctors rarely advise people to stop driving if only their peripheral vision is impaired because drivers can learn to compensate by turning their heads as they move to another traffic lane or turn a corner. But if something is coming in quickly from the side, a driver with poor peripheral vision may not see it in time to react safely. Dr. Balcer advises people with MS to drive only if they are comfortable and their vision is deemed adequate by their doctor. Use your judgment about when and where you drive and at what speeds. Dr. Balcer is currently conducting research to improve ways of measuring vision in people with MS. Good measures will hopefully lead to better therapies and strategies for vision problems in MS, she said. Physical changes Most commonly, the first concerns are weakness in an arm or leg that may affect steering or pushing the foot pedals, said Dr. Maria Schultheis, a research fellow at Kessler Institute. Some people with MS find it difficult to push the brake or gas pedals because they lack extensor tone (the degree of tension in the muscles that serve to extend any part of the body), or they have trouble bending their knees enough to move the foot quickly from one pedal to the other. Others have a sensory loss in their feet, so their foot may slip off the pedal. (See Adaptive Devices for suggestions about ways special equipment may help.) Fatigue clearly affects driving. A lot of people decide not to drive when they âre feeling fatigued or when, as many say, they're having a bad day. They simply choose not to go out, Dr. Schultheis said. She suggests planning ahead. Look at the coming week, and spread out chores, errands, and appointments so you don't get fatigued by driving all over town on one or two days. Heat may also affect driving. I get overheated, my vision goes blotto, said John Babbo, who was diagnosed with MS in 1977. For other people, heat triggers fatigue. If your MS is heat-sensitive and it gets hot outside or you've just taken a hot bath or shower, symptoms may flare, explained Dr. Balcer, don't drive soon after getting overheated. Always take a cold drink or ice along with you to stay cool. And turn on the air conditioning. Cognitive changes Driving requires processing many pieces of information simultaneously. Imagine you are approaching a major intersection where several traffic signs indicate different routes. You are in the left lane when you realize you must get into the right lane in order to take the road you want. Your brain is processing many things at once. Your eyes are on the road ahead; you're watching other vehicles; you're steering; you're braking or accelerating; you're making a decision about which road to take; and you're turning on your signal. Add to this several distractions: The car radio is on; your children are chattering in the back seat; a new traffic sign appears up ahead. You must scan this whole environment, making appropriate decisions. This involves processing lots of information all at once. A person with MS may find that it takes longer to absorb, digest, and sort out the important information in order to make quick decisions. Response time has two aspects, Dr. DeLuca pointed out: the physical part (how long it physically takes to turn the steering wheel and swerve away from an oncoming car) and the cognitive part (how effectively a person can process high-speed incoming information). Processing speed is separate from visual acuity. It's important to distinguish between a visual and cognitive problem, as they call for different treatments.â Memory loss may also affect driving. We hear a lot of I get lost. This might be poor memory or it might be visual perception because people don't recognize where they are, particularly when going someplace for the first time,Dr. DeLuca said. He recommends a neuropsychological evaluation to determine the degree of cognitive problems. The evaluation shows that there are significant problems, one might also want to have a comprehensive driving evaluation. Unfortunately, there are only a handful of such programs around the country. He suggests locating one through a major rehab institution or hospital. The nearest Society office will have information about any major centers nearby as well as referrals to occupational therapists and other rehab professionals in your area. Support from professionals and family members A lot of people practice their own restraints, without doctors knowledge or input, Dr. DeLuca said.People with MS may limit or stop driving because they know their abilities aren't what they were, even though their doctors say it's okay for them to drive. A lot of that goes on. Other people may be reluctant to mention their driving problems to their doctors because they think they'll lose this privilege. Dr. DeLuca urges people with MS to take charge of the situation for themselves. The risk of losing one's driver's license is much bigger if problems are not faced and treated. To consider the safety issues and keep your license talk to professionals, he said. Family members need to know that both the cognitive and the physical changes of MS can affect driving. They need to listen to the person with MS who is probably saying two things at once: I'm having some problems driving, and I don't want to lose my license; I'm fine. Safe driving may be a real possibility once problems are identified and dealt with. Dr. Schultheis thinks it takes teamwork. âDemands vary from one family to another, but together, family, friends, doctors, and other specialists can often find solutions that allow the person with MS disabilities to continue driving safely within limits or with adaptations. For additional information ABLEDATA Rehabilitation Study Explores Effects of MS on Driving Ability (research Bulletin) Martha Jablowâs last contribution to InsideMS was a feature on memory and problem solving in the Spring 2000 issue. ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn