Doctors sometimes write the most unhelpful comments - Headway

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Doctors sometimes write the most unhelpful comments

sospan profile image
13 Replies

One of my symptoms is that I don't seem to need sleep but sometimes during the day I shut down for 5 to 10 minutes. All that happens is when I sit down at lunch time, mid afternoon or early evening, I switch off for about 10 minutes. I don't feel tired or yawn it is just like someone pressed the off button and I am gone. I was given a sleep monitor to wear overnight to check for sleep apnoea. The tests showed I didn't have it.

However, my discharge letter from my "sleep" doctor had a final sentence that said

“I remind you not to drive if you have any excessive sleepiness for any reason”.

Which might sound simple enough advice, but now it is in my medical records, could have a significant bearing should I have an accident.

When I contacted my insurance company, they were very concerned by the statement and asked does the doctor mean I can or can't drive ? My prospective son-law whom works as an accident claims solicitor agreed that finding something like in a persons medical notes would comply undermine any defence - how would you define excessive sleepiness as opposed to sleepiness? - you shouldn't drive with either and the killer quote "for any reason" - just had a big meal? you have just been to work or shopping ? coming back from a walk?

What seems like a friendly piece of advice is now going to take a lot of effort to undo trying to get further statements to confirm if I can drive.

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sospan profile image
sospan
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13 Replies
Kirk5w7 profile image
Kirk5w7

They have to cover themselves at all times too, a difficult one for you but probably truthful. If you were involved in an accident with me I'd be having your medical record scrutinised believe me X Janet

sospan profile image
sospan in reply to Kirk5w7

Thats the problem though.

Like most of us I have seen many neurologists, neuro psychologists, psychologists, GPs etc. Even re-taken my driving test. Whilst each one has asked if i can drive, not one has given any indication that I shouldn't drive or even take extra care.

However, this one comment could hold so so much sway

StrawberryCream profile image
StrawberryCream in reply to sospan

My understanding is that it is up to the DVLA to assess whether you are fit to drive and you should be declaring any medical conditions to them. The DVLA then send relevant forms for you to complete and on receipt they seek information from your specialists, GP etc. It is your responsibility to do that and if you don't you will invalidate your insurance and be braking the law. It is the DVLA doctors who assess fitness to drive. Only sometimes when a patient has for example dementia will a GP advise that you are not to drive and should surrender your licence to the DVLA. Mostly the Drs will just remind you you should be notifying the DVLA. If you go on to the DVLA website there is a very long list of conditions that should be notified. It does not always mean you are stopped from driving but your fitness to continue has to be considered by them. If there is concerns of deterioration of condition or ability a medical review licence will be issued rather than a full licence. If you are concerned about your safety to drive when you are sleep deprived then you are expected to recognise that and not drive. It is not just yourself you put at risk but everyone else - road user or pedestrian! Do you want someone's death on your conscience because saying 'the Drs didn't tell me not to drive' will not exonerate you in a court of law as your son-in-law to be no doubt has told you. I doubt you will get it removed from your medical notes because it is reasonable advice and as Janet says it covers there back to prove they had the conversation with you should you be responsible for an accident with serious injury to others or cause a death. Wasn't there a bin driver in the past year who injured and killed many people because he hadn't declared his medical history which then caused him to black out or collapse and plow his vehicle into everyone ahead.

MXman profile image
MXman

Hi Sospan,

Have a chat with your Doctor and ask him/her to be more specific on his /her statement and closing words. Worth a try. N

sospan profile image
sospan in reply to MXman

I know, its the pain, hassle and time to chase it up. The medical service down here works incredible slow - it took me 10 months to get an appointment, 2 months to get the test and a further 2 months for the doctor to tell me the results of the tests. Since he signed me off I would be lucky to get a response in another 2 months if at all.

MXman profile image
MXman

My God thats awfully slow. Is it not worth putting it in motion though?.N

sospan profile image
sospan in reply to MXman

I will have to do it to satisfy the insurance company and for any future queries. It will get resolved but I know its going to take a long time and a lot of frustration just for a simple comment

It is possibly worth considering contacting the specialist driving assessors directly and arrange a re-assessment yourself, we did this for me, and it short circuited the process to an extent, you have to pay up front for the assessment, in my case after we had booked and paid for the assessment, the DVLA made a referral for the assessment so we were able to keep the date we had booked privately but the DVLA reimbursed cost.

I agree it is very frustrating when you are confident in yourself that you will be safe to drive, we live in a fairly rural part of Wales and the public transport is close to none existent (about every 2 hours for a bus), but it gave me and my wife confidence that I would be safe on the road.

I'm fairly certain that we used mobility-centres.org.uk/ to find a relevent centre (these are the centres used by the DVLA).

Just been on the Wales part of the website (wmdas.co.uk/) and the assessment is currently £93.

We first used them after we were in a car accident and my wife's arm was badly injured and she needed a driving re-assessment and it was recommended that she could continue to drive but would need to have an automatic vehicle. Because we knew of the service, we made contact directly with them after I had had a SAH to get me re-assessed, whilst waiting for DVLA to decide what they wanted to do. I was eventually given my licence back with no limitations (apart for losing the D1 provision for driving minibuses), initially for 12 months, and subsequently until I'm 70.

sospan profile image
sospan in reply to

Thanks but already been reassessed and passed fit to drive by Rookwood. All the other specialists I have seen never had a any concerns

Kavib profile image
Kavib

I really think you should try and get a second opinion from another doctor.

I'm unable to drive after my SAH and even though I think I can now I get very tired as if my battery has ran out . So it is dangerous...

Please see my Video Blog on recovery and what has helped me:

youtu.be/7V5ESdgSnrU

Lydgate profile image
Lydgate

I submitted my licence and the DVLA wrote to the neurosurgeon and my GP but not to my Occupatinal Therapist who knew me and my ABI better than anyone. When I was OK'd to drive by the DVLA I was so relieved. On my first unaccompanied journey I got lost on a familiar route. My OT told me to leave it a few months. I did and benefitted from it.

That sentence is very frustrating but if it was written about me it is still true. I changed jobs earlier this year and the extra concentration levels needed for a new job meant I was tired more often and I did sometimes have to pull over, even on short journeys, and have a nap. I had to leave that job.

There are times when I ask my wife to drive (probably once in the last 4-5 months) rather than me when we're out as a family. So I am following that instruction even though it wasn't written about me.

SAMBS profile image
SAMBS

Hi sospan, read all the replies,so no comment about driving yet, but its the times you say you sleep, eat or not, that got me thinking in terms of my experiences here.

A) My husband, no BI, does the same as you in day & sometimes early evening. I have a bizarre sleep pattern, but was always a night owl anyway.

My dad and grandparents liked a kip after lunch, but they were much older. Not sure how old you are.

B) I totally lost my appetite after BI, never feel hunger pangs, enzymes missing from my stomach perhaps and/or neurotransmitters not transmitting, So no regular meal times, eating when I remember I should but It's also after eating I feel drowsy, unless I get cracking with doing something, but sitting down, whether on computer or watching TV, yes I get drowsy.

C) Try this theory on for size!

'Babies' get fed - they fall asleep soon after finishing.

Toddlers get put to bed after their lunch, they sleep for a couple of hours or so.

Elderly people (grandparents) sleep after midday meal, still go to bed early at night after dinner/tea. Remember Sunday and Christmas lunches, who sits down and has a nap, older ones while younger ones clear and wash up!

so, why don't I get hungry, don't sleep regularly - but did realise this year that when I do eat more or better, it seems to triggers my snooze mechanism, no I haven't researched this and don't intend to, not at present anyway!

After BI have neurotransmitters been Kickstarted or stopped . Before mine, if I had not eaten for too long, I used to get lightheaded and knew I needed to eat something with sugar or carbohydrate in it. Sugar absorbs more quickly, Carbs are slower absorbing and longer lasting Both stopped the lightheadedness but did not make me feel sleepy,

So perhaps food, even just a cuppa and biscuit mid afternoon, because of your BI triggers your sleep mechanism, whatever its called!

One thing I have learnt purely from the Thyroid Uk Community, is that correct nourishment, vitamins, minerals, etc., without od'ing on them are essential for the endocrine system to work better and properly. This could be why I think the meds from the doctor were accumulating in my liver causing more and worse neural symptoms. I wasn't eating properly then. It's only recently I've taken info on board better and acted on it.

The 2 may be connected or may not! If they are that's not a good reason to stop you driving if you find a logical reason you can act on.

I know I'm not capable of driving again in the foreseeable future. 3-4 months after my car accident which also came 9 months after BI, both in France, I paid for and took 3x1hr assessment lessons in a dual control driving school car, and my brain couldn't process quickly enough information on the road signs, the Highway Code ones. I was driving a LH drive car for 1st time in my life after more than 30 yrs of a RHD one, and 6 yrs of driving Here on RHS. I would love to drive again, but feel,I would be a danger to me and other drivers, which is why I won't again, things improve for me.

If you find a connection between food and sleep triggers, print it off and send copy to your Sleep Doctor, if you think it's relevant, in your case, ask him to remove his warning. Any meds you are on will carry drowsiness warnings also. Do you take one at lunchtime?

Good luck and best wishes, hope you get to drive again soon Shirley x xx

sospan profile image
sospan in reply to SAMBS

So pleased to see you back on the board and hope things have resolved.

The switching off thing is really bizarre. I don't fall asleep in the traditional way, yawning, eyes get heavy or drowsy - i just sit in a chair and suddenly my head drops and I am out. When I was waiting to see a cardio doctor I was sat in the waiting room and switched off right in front of the nurse, as she said to the doctor - I was looking at him and then suddenly his head dropped and he was out. Never happens when I am standing up, sitting down doing something like peeling veg but can power down holding a cup of tea, pointing a remote at the TV etc. The odd bit is that I never feel tired, never feel the urge to sleep

But one of the things I am so glad about your post is that you mentioned the Thyroid function and hadn't considered that as a source of some of my symptoms - when I fell I came to on my knees with my chin pressing on my chest bone. Being Welsh not exactly blessed with a swan like neck :-) ]

So have been wondering for a while if I have damaged the carotid vessel or something else and when I sit down and relax something gets compressed/restricted making me shut down. Which would explain why my forehead feels icy cold when I come to.

Thanks given me another avenue to explore

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