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Losing My Driver's License: The Battle Continues

August 14, 2013

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So ... When I last left this story of an Angeleno trying to fight the system and get my driver's license reinstated or at the very least have my DMV hearing to examine the issues in my case, I was moderately hopeful and pretty stubborn. Today, as the middle of August 2013 approaches, I know I've lost some of my spunk and a lot of pep in my step. Fighting the system wears you out. Or at least it does me.

I first started with my HIV specialist, Dr. Moe, who had a great idea in referring me to a clinical driving assessment program offered through the occupational health program at Cedars Sinai Medical Center. I had to pay out of pocket for the assessment because no insurance companies or Medicare covers such an assessment. Minibattle #1, they win -- but as I succumbed to the testing and the fee, my aunt and uncle donated the funds and my appointment was set. In actuality, I was pumped to have my assessment. Surely I thought, when the nurse on the phone explained they would be simulating areas that pertain to safe driving such as reaction time, ability to see, process, dexterity, physical movement, all items that are necessary for safe driving, I can do this! At the end of the exam, they would give me an on the spot answer to take back to my doctor that said one of a few choices like: no areas of concern found; or she needs a behind the wheels assessment; or she needs remedial training, reevaluate in 6 months; or she is not a candidate for independent driving. I was VERY optimistic because I felt confident that all of those things as they related to driving I could pass. There would not be a vehicle the nurse said but something would be simulated using a computer. Easy peasy ... BOY was I wrong!!!!!!

The tests given to me I would describe more as neuropsych testing. They were difficult, tedious and in my mind had nothing to do with driving. There was one simulated test with me behind the wheel accelerating and braking. The rest were pen and paper tests or computer tests, all like I had inpatient at the hospital or in my formal neurological testing for cognitive delays back in 2005. Needless to say the tester found vision-perception difficulties, attention difficulty with divided attention and processing speed difficulty. She explained that all the research showed that delays or difficulties in those areas correlated to a high crash experience or ratio so with one quick decision, she found me unsafe to drive at this time and recommended a behind the wheels assessment with remedial training to determine further driving safety. I was devastated.

Being the fighter that I am however, I took a deep breath and dove right into figuring out the piece on the behind the wheels assessment. In order to get that piece done I needed a special drivers permit. In order to get the permit -- AHHHHH -- you guessed it if you are following along closely ... I needed the medical form filled out by my doctors saying I was safe to drive!!! SIGH ... I'm sure that people in my neighborhood could hear me banging my head against the wall and wondered what was so wrong in that tiny little house down the block!!!

Once again, I begged my doctors for help. My psychiatrist whom I've grown very fond of just couldn't override the rest of the team. My HIV specialist explained she could lose her license if she signed off and then something happened to me or God forbid someone else while I was behind the wheel. My neurologist presented a similar story. However the neurologist did offer a new plan: get the following things done and let's see where you are and what diagnostic info we get back and maybe I will be able to fill out that medical form to let you get the special driver's permit so you can get the behind the wheels assessment and remedial training. Her wish list included an MRI, a lumbar puncture (spinal tap) and a compete battery of neuro-psychological testing. Phew!! I was off and running to get my tests complete!!

MRI -- I nearly panicked and gave myself a heart attack. This was my second one and it was no easier than the first. They really should find a way to make those things more patient friendly. They are a monstrosity truly! Happiness though ... my MRI was normal. White matter changes seem to have disappeared. Good news for me. Battle #2 -- I win!

Lumbar Puncture -- Done in my HIV doctor's office -- not particularly pleasant but I survived. I pictured myself in some type of jungle warfare, with access to a hospital limited and all medical care done in tents and on the field. I knew I was in great hands but to keep my anxiety under control it helps to visualize a scenario where I knew that the minimalist surroundings were normal and applicable to my care. They were doing the test to see if HIV could be measured in my spinal fluid as well as identifying some other specific proteins. Happiness is ... my Spinal Tap was normal ... apparently my CSF is looking really good! Battle #3 -- I win!!

Now I am on top of the world, I just know that I am going to get my medical evaluation to get my special permit, behind the wheels testing and ultimately signed off to drive. I just feel that once the doctors finish all my testing I will be able to go into my hearing calm and collected and that the judge in my case will see that I am fit to drive and that with some minimal restrictions the DMV can lift my suspension confidently.

Last to get scheduled was my neuropsych testing. There were several glitches along the way in getting this battery of tests scheduled. Unfortunately for me that meant I had to wait nearly five months to get the testing done. A lot can happen in five months. I had a major psychiatric turn of events in those five months where I got into a crisis. It took my psychiatrist, my husband and I that entire time to get on top of it and get my anti-depression and anti-anxiety medication straightened out. Both drugs ended up being titrated up to double their original dosing. As I write this I am now completely stable and so thankful to my doctor for listening to me and helping me through my very rough patch without a psych hospitalization.

My neuropsych testing was finally scheduled right toward the end of that psych crisis where I thought I was good but in hindsight I probably was still a little bit in crisis and we hadn't yet found the exact combination of drugs and drug dosages to help me. I think now looking back that maybe I should have rescheduled the testing but I didn't because I wanted to get it over with because I had waited so long for it to be done. Anyway, the testing revealed many deficits in my cognitive abilities. They found some that have stayed the same since 2005 and 2012 (dates of my last testing), a lot that have gotten worse and a few that have actually improved.

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