Driving and MS

Before I was diagnosed with MS, I developed a fear of driving. I would get very nervous even before I got behind the wheel. As I inched along in my car at speeds well below the speed limit, it would take all my resolve not to slam on the brakes if a car 200 feet ahead of me changed lanes. My biggest horror was a traffic circle I would have to get through on the route from my home to almost anywhere. By the time I reached my destination, I would be shaking and drenched with sweat. When I spoke to my doctor about it, he told me to practice more, which was the last thing that I wanted to do.
 
Shortly after that, strange sensations in my legs led to my diagnosis of MS. My neurologist agreed that my anxiety about driving was most likely related to cognitive effects of MS and told me not to drive if it made me uncomfortable. Except for rare trips to a nearby grocery store, I did not drive again for almost 8 years.
 
While it is well-established that many visual, sensory, motor and cognitive symptoms that are part of MS can interfere with safe driving, there are no established guidelines as to who is fit to drive. As long as a person can pass a road test, they are declared “roadworthy” and sent off with a driver’s license.
 
I was not surprised to hear in an interesting presentation at ECTRIMS 2013 that drivers with MS are over three times more likely to be in a car accident  than the general population.
 
In studies conducted on a driving simulator, it was shown that, compared to people without MS, people with MS tend to:
  • Drive faster
  • Have a much higher variation of speed under constant conditions
  • Move around the lane much more
  • Poorly prioritize tasks, meaning they cannot focus on driving if they are trying to do more than one thing or are distracted 
In many cases, people with MS self-regulate their driving. Research has shown that people with “mild” MS drive about as much as people without MS, about 2.7 trips per day. In comparison, people with “moderate” MS (EDSS 3.5-6.0) only drive an average of 1.5 trips per day and rely much more on public transportation or other people to drive them.
 
In the presentation that I attended, Hannes Devos presented an intervention that he and his research team at Georgia Regents University have studied to help people with MS “learn” to drive again.
 
Dr. Devos had 36 people with MS participate in a 5-week training program, where they spent an hour each week in a driving simulator. The program focused on six critical driving skills, tailored for the individual participants:
  • Lane positioning
  • Brake reaction time
  • Passing other cars
  • Road sign recognition
  • Hazard perception (figuring out if it was safe to pass an accident or obstacle)
  • Anticipation (assessing what a car parked on the side of the road might do) 
After participation in the program, 5 of the 7 people who had “failed” the initial assessment were deemed fit to drive again and all showed improvement. Dr. Devos reported that his group is working on a larger study of the intervention, so that it may be available more broadly to people with MS in the future.
 
Although it was a tremendous burden on my husband and others when I stopped driving, I am certain that I kept myself and my family safer with this decision, as well as other people on the road. Today I feel much more comfortable and am driving again on a limited basis. I do not drive on highways or on unfamiliar routes, and before I start the car, I remind myself to focus on driving and only driving, putting away my phone or any other potential distractions. On days when I feel at all “fuzzy-headed” or nervous about driving, I simply don’t do it, relying on the good will of others (and taxis) to get me to where I want to go.
 
I urge all of you to take a hard look at your driving and decide whether having a backup transport plan in place might be a good idea.

 
**If you’re unsure about your driving abilities, you may want to look into a Certified Driving Rehabilitation Specialist. They can assess your physical and cognitive abilities, and recommend adaptions to your car that will help keep you driving. Visit the Association for Driving Rehabilitation Specialists. Occupational Therapists can also help assess how much symptoms are affecting your driving.**
Tags Research, Symptoms      2 Appreciate this
Julie

Julie Stachowiak, PhD

Julie is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award in the Health Category. She is an epidemiologist who is also a person living with MS, Julie has an in-depth understanding about current research and scientific developments around MS. She also has first-hand knowledge of the frustrations and anxiety surrounding the disease, as she had MS for at least 15 years before receiving a diagnosis in 2003 and has had several relapses since her diagnosis.