CS..You just reminded me of a recent decision Ive made..Im looking for a new truck, a Ford Ranger or something small..I got online and found a special at a local dealer..A 2003 Ford Ranger, with 42,000 miles..$8999.00..So I figured after I talk them down a bit, and with a trade in maybe I could own the thing for $7500.00 or so with affordable payments..The next morning the thought hit me..Hmmm..Wonder if it is a standard or an automatic?

Figures it turns out to be a standard 5 speed transmission with overdrive..

I can still drive one now..but what about a year or two from now?.. ..Damn!!

I forgot to mention in my previous post about telling the motor registry and insurers of your P.D.
You might be in hot water if for instance you're in an accident that's not your fault, the other party and or police see a tremor that is worsened by the stress of you just seeing your life flash before your eyes and they query the unrecorded shaking.
While you feel the need to justify the shaking to Parkinsons, they may either (perhaps) think you're not telling the truth and looking guilty or record the fact that now suddenly you do have P.D. and have had for some time and why wasn't it recorded in your licence records and then why don't the insurers of your car know.
Confessing might be wise, sure it's a nuisance but the letter from your Dr and or the driving test they make you do periodically is done for a reason.
Cheers,
Lee

Lee, your comment about whether to tell the truth or not...

I wear a MedicAlert bracelet. Mostly because I am diabetic, but I also have PD engraved on it. While I have to be realistic, having read the hospital horror stories, I would hope that having this and the fact that anyone can call the 1-800 number to verify I have doctors listed in the MedicAlert system and all of my medications...hummm...is that a good thing or a bad thing.

I suppose this could work for me and against me if I ever have an accident, which I hope not to do...ever!

Hi Carolyn,
Not too sure about rules in your neck of the woods for insurance and drivers license.
Here if you don't have (in our case P.D.) recorded with the motor registry you're taking a big risk of losing your license.
I get a letter sent annually from the motor registry and my Dr answers the questions asked and signs that.
As for the insurance company it wouldn't take much for them to use our P.D. as an excuse not to pay up after an accident if they didn't have it on record.
Cheers,
Lee

Lee, I am already about checking this out this morning. I have a close friend who is a VP with a national insurance company, so I posed the question to her. Will let you know the reply later today.

Thanks for the heads up.

The reason I wear the bracelet is that I have traveled along for a very long time. Here in the north, I travel to and from Corning NY, four hours each way...Baltimore, two hours each way...etc. Especially with insulin dependent diabetes, I felt uncomfortable driving along if I was to have a roadside issue or and accident.

Now I may have to fear the government and the insurance company as well...

...if it is truly unsafe for one to drive, is that grounds for filing disability with the SSA? I am self employed in a rural area and am still able to drive most of the time. But because i have no employer to tell me to turn in my keys, that's going to be a judgement call on my part. It would be easier to make if starving wasn't part of the equation.

reverett...

See New Thread --Social Security Disabiltiy...Driving, etc.

While I am still not on meds after 4 years, I can remember telling my wife 3 years ago that I would not be able to continue driving the kids to dance etc. for much longer due to increase in tremor when driving.

Weelll, her car - an Odyssey with a power seat changed driving from a worsening chore to almost as much fun as it used to be.

I found that with the seat cushion tilted up a great deal and moved forward from where I would ever have used it before there was a lot better support for the leg and driving was no longer a tremor inducing task.

take care ,,, ken

Whilst acknowledging that having Parkinson`s certainly affects to varying degrees,our driving skills,I think it is important to bear in mind that as my heading says...the problem ain`t all ours.With more traffic on the road ,an increase of "healthy" yet discourteous drivers,speed freaks and the like,my guess is that driving is daunting for many folk regardless of them having PD or not.
Personally,my lack of stamina prevents me from driving long distance,and as many of you point out in your replies,we are more than capable ourselves in deciding when we give up.And typical of PD, we can be great one day and totally useless the next.Recently I drove my car two minutes up the road to the local village hall[not lazy...I had a mountain of stuff to deliver] but when youth group had finished,I was incapable of driving back,so had to leave my car and walk home.To me,driving these days is not a pleasure.No longer in England can you take a leisurely drive out on a Sunday,as with the advent of Sunday shopping,the Lords day as they say is darn near as busy as the rest of the week.
The post that sticks with me and leaves a sad impression is the one where the old guys keys were "confiscated" by his family.For two pins,I`d like to hand him the keys of my convertible,put the roof down and say "DRIVE YOUNG MAN....DRIVE!"

Ah...rebellion is sweet.
x

Doesn't matter what part of the world you live in, this applies to anyone who drives.

Between the comments that Dr. Shulman made to me just 10 days ago, and what I have read in the replies above and the contents below, I should consider distance and type of traffic before my next out of town drive, and insist my daughter take me places like Baltimore, which is 90 minutes away and in traffic that can be quite intense. This consideration also impacts my ability to see my younger daughter who live 199 miles/4 hours north of me...hummm.

I was curious if studies had been done about our driving capabilities. When I searched, the first two were from Univ of South Florida, Tampa, FL, USA, and the USA National Highway Traffic Safety Administration.

Not sure if it is a good thing or a bad thing that I no longer see Dr. Z or Dr. Hauser at USF, Tampa...since it seems they are keeping an eagle eye on their patients. She was one of my initial MD docs…yikes!! And, Dr. Hauser is the one that dxd me in 1994…yikes again!!

Can you find yourself in the St. Petersburg Time article??

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Journal of Neurology Neurosurgery and Psychiatry 2005;76:176-180
PAPER: Quantitative assessment of driving performance in Parkinson’s disease

http://jnnp.bmj.com/cgi/content/full/76/2/176

Excerpt:
Results: The drivers with PD were rated as significantly less safe (p<0.05) than controls, and more than half of the drivers with PD would not have passed a state based driving test.

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Neurology Review
Tuesday, April 04, 2006 11:26:00 AM

(This online page expires in mid-December, so I have reproduced it in whole so that it is not lost.)

http://www.neurologyreviews.com/jun0...0_driving.html

UNSAFE BEHIND THE WHEEL?
DRIVING SAFETY IN PATIENTSWITH PARKINSON'S DISEASE

SAN DIEGO—The ability of patients with Parkinson's disease to drive may be overestimated by both the patients and their neurologist, according to Theresa A. Zesiewicz, MD. "Patients with advancing disease may need evaluation by a driving instructor or a driving simulator to assess their safety to drive," she said at the 52nd Annual Meeting of the American Academy of Neurology.

Dr. Zesiewicz, Robert Hauser, MD, and colleagues evaluated the driving ability of 39 patients with Parkinson's disease (mean age, 65.6) and 25 controls (mean age, 64.9). The participants underwent a Mini-Mental State Exam, Trailmaking B Test, and a self-report questionnaire about their driving history. Additionally, participants with Parkinson's disease underwent "on" Unified Parkinson's Disease Rating Scale (UPDRS) evaluation and Hoehn and Yahr staging immediately before testing. The average Hoehn and Yahr score for Parkinson's disease patients was 2.10. The researchers measured the participants' driving ability by the number of "day" and "night" collisions registered by the driving simulator. Dr. Zesiewicz is Assistant Director of the Parkinson's Disease and Movement Disorders Clinic at the University of South Florida, Tampa.

A GREATER RISK OF COLLISION

Parkinson's disease patients had more simulator collisions than controls had, the researchers found. The difference (mean, 1.25 versus 0.2) was statistically significant, said Dr. Zesiewicz. No significant correlation was found between number of accidents and nighttime driving or sleepiness. She added that most accidents occurred at the first intersection of the driving test.

Data also indicated that patients with more severe Parkinson's disease were more likely to be involved in simulator collisions. Risk of collision was significantly associated with Trailmaking B time to completion score (r = .477), UPDRS motor score, (r = .487), and Hoehn and Yahr score (r = .507). Twenty percent of Hoehn and Yahr stage 1 participants, 56% of stage 2 participants, 90% of stage 3 participants, and 100% of stage 4 participants were involved in at least one collision. Dr. Zesiewicz noted that neither dyskinesia nor tremor was associated with risk of collision. The study did not control for medication, nor did it indicate a correlation between side of involvement and side of accident.

OBJECTIVE OPINION MOST ACCURATE

Some Parkinson's disease patients had already restricted their own driving: 18% had stopped altogether, and 26% had decreased their driving. Among Parkinson's disease patients who had restricted their driving, 20% cited concentration difficulties and 30% cited stiffness as the primary reason for the restriction. Although some patients with Parkinson's disease had restricted their own driving, there was no correlation between self-report of driving ability and simulator collisions. This indicates that patients may not be able to adequately evaluate their own driving, she said, and neurologists may be overestimating the patients' driving ability. "We are following the subjects in this study to determine how well driving simulator results predict accidents in [Parkinson's disease] patients," concluded Dr. Zesiewicz.

EVALUATION VIA MANY METHODS

A previously published study by researchers at the Merikoski Research and Rehabilitation Centre, Oulu, Finland, also indicated that neither patients with Parkinson's disease nor their neurologists could accurately evaluate their standard of driving. During the study, 20 patients with Parkinson's disease and 20 controls were evaluated by a neurologist, a psychologist, a vocational rehabilitation counselor, and a driving instructor, using a 10-point scale. As Dr. Zesiewicz and colleagues also found, the patients with Parkinson's disease performed worse than controls on the driving test; however, the Finnish study did not indicate that severity of disease correlated with test score.

While driving ability is greatly decreased in patients with Parkinson's disease, the evaluation of patients' driving ability is difficult to accurately assess without psychological and psychomotor tests. Patients and physicians should seek additional professional assistance in determining a patient's driving competence, Dr. Zesiewicz concluded.

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St. Petersburg Times
12/10/2002

http://www.sptimes.com/2002/12/10/St...son_s_ca.shtml

Study: Parkinson's can impair driving
The lead author of the USF study says patients' ability should be monitored as the disease progresses.

By WES ALLISON, Times Staff Writer
© St. Petersburg Times, published December 10, 2002

TAMPA -- A new study by researchers in Tampa found that Parkinson's patients are much more likely to be involved in car accidents, especially as the disease progresses.

In an article published today in the journal Neurology, the study recommends establishing guidelines for when patients should surrender their licenses, a notion gaining popularity among some advocates and researchers, but one most states have not addressed.

"We shouldn't be afraid to say that we need to monitor a patient's driving ability when they advance in disease," said Dr. Theresa A. Zesiewicz, associate professor of neurology at the University of South Florida and the study's lead author.

"We're not talking about restricting patients on a global scale," she said. "What we're talking about is there needs to be dialogue, that physicians need to be aware that there is a potential problem. ... And as (patients) advance in disease, their driving ability ... needs to be carefully monitored."

About 4-million Americans have Parkinson's disease, including about 55,000 in Florida. Although the study focused on Parkinson's, experts say it raises issues germane to a variety of diseases affecting mind and body.

All states have special licensing requirements for people who suffer seizures, as from epilepsy, but most don't address progressive neurological diseases such as Alzheimer's or Parkinson's.

Whether people keep driving is usually left to them. Their family or doctor may influence them, but Dr. Abraham Lieberman, medical director of the National Parkinson's Foundation, said it's often hard to tell if someone should be driving.
Lieberman recommends people with Parkinson's -- or any neurologic disease -- go to a driver's license office, explain their condition and ask for a road test. They should retake the test periodically, he added.

"This study is an important study because it raises the issues, particularly in a state like Florida where you have a large number of elderly people and a lot of people with Parkinson's disease," said Lieberman, a neurology professor at the University of Miami.

"When you first get the disease, you're doing okay. But three or four years into the disease you're doing terribly, and there's no provision for someone to say 'Okay, you've had Parkinson's, come and see me."'

The USF researchers enrolled 39 volunteers with Parkinson's and 25 without any neurologic disease. Both groups had a median age of about 65. After practicing for about 15 minutes, they were tested on a driving simulator.
The test counted only the accidents that the computer considered fatal. Although Zesiewicz said she expected the Parkinson's patients to crash more, she was shocked by the magnitude:

Among those with the earliest stage of Parkinson's -- Stage 1 on a 5-stage scale -- 20 percent were involved in an accident, versus just a fraction of study participants without the disease.

56 percent of Stage 2 patients crashed.

And 90 percent of Stage 3 Parkinson's patients crashed.

All of the Stage 4 patients crashed, and Stage 5 patients generally are considered unable to drive.

Only a few of the non-Parkinson's patients crashed.

Zesiewicz, assistant director of the Parkinson's Disease and Movement Disorders Clinic at USF, said the problems stemmed from both mental and physical declines. Parkinson's causes cognitive lapses in about one-third of patients, and frequently causes tremors, stiffness or slowness of movement.

Janet Reno, former U.S. attorney general and Florida's best-known Parkinson's patient, drove her red truck more than 30,000 miles during her unsuccessful campaign for governor this year.

Both of her arms shake noticeably, but Reno says she has always asked friends and family to tell her if she becomes wobbly behind the wheel.

"All of us, whether it's because of Parkinson's or something else, have got to take steps to ensure that they're competent to drive," said Reno, who has Stage 2 Parkinson's. "I think all of driving relies on one's good judgment."
Neurology is one of the nation's most respected medical journals, and today's publication will likely aid Zesiewicz's efforts to win more funding for further study.

But some aspects of the findings are bound to be disputed. Some researchers question the accuracy of driving simulators, and suggest people drive better on the road, when they know it counts.

Increasing restrictions on older drivers also has traditionally been met with resistance in Florida, where little public transportation is available.

But Dr. Janan Smither, associate professor of psychology at the University of Central Florida and head of the research subcommittee of the Florida At-risk Driver Council, said focusing on specific diseases and driving, rather than age, may ease the resistance.

In Florida, anyone can anonymously report an unfit driver to the Department of Highway Safety and Motor Vehicles, and the state can require drivers to submit a medical report or undergo an examination.

Otherwise, Floridians may renew their license three times -- up to 18 years -- via phone, mail or the Internet, without passing so much as an eye exam. Some states, such as Illinios, require drivers over 70 or 75 to pass a road test when they renew licenses, but most have few restrictions.

What's lacking, experts say, is a quick and reliable test that seniors can take at a community center or doctor's office to see if they need additional testing.

Disease stages

Progressive stages of Parkinson's disease, based on the Hoen and Yahr scale. Drugs often help patients stay at Stage 2 or Stage 3. Few reach Stage 5.

Stage 1: Tremors or rigidity affecting one side of the body.
Stage 2: Tremors or rigidity affecting both sides of the body.
Stage 3: Stage 2, plus postural instability, or awkwardness of gait.
Stage 4: Stage 3, plus need for routine assistance.
Stage 5: Must use wheelchair.

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National Highway Traffic Safety Administration
Driving when you have Parkinson's Disease
http://www.nhtsa.dot.gov/people/inju...Web/index.html

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