Thursday, September 9, 2010

What A Day

This morning started like any other; I got up, ran through the routine of getting cleaned up and ready for work. Lunch was packed and I was ready to go, until...

My wife awoke with the same migraine headache, which had been crippling her for the last few days. She was nauseated and feeling quite miserable. It was time to go to the doctor's office, no "ifs", "ands", or "buts". After running through the [new] morning routine of getting the children put together and off to school, my wife and I headed in to the clinic for her scheduled appointment.

She was given a prescription (which took seemingly forever to fill] and we were sent on our way. Had I been able to drive her home, the doctor indicated that they would have given her injections to stop the pain. However, since I could not legally drive, she had to wait for her prescription to be called in for the oral medication. I was kicking myself about that situation- if only I could drive, "things would be better!" She had to endure another couple hours of pain, waiting for her medication to apply and I ended up making the long walk to pick up the kids from school.

After getting home and helping my wife settle in for some sleep, I received a phone call from the low vision doctor I'd previously seen at Casey Eye Institute/OHSU. He was calling me back, to let me know that he had contacted a person who is relatively elevated in position at the Department of Motor Vehicles and intended to share my story and medical charts and field tests with him.

This conversation was prompted by a discussion I had with the good doctor about a year ago regarding the ability to drive; although my visual acuity (20/60) now could exceed the basic requirements for driving (20/70) in Oregon, the gap in my visual field didn't meet the state requirements. Although with the way my peripheral vision actually maps out, I can pass a DMV visual field test (I did so back in 1992), even though my contiguous field is somewhat broken, and below their stated requirement. They simply don't test on a gradient at the DMV, and it's for this reason I was able to pass in my youth. It may be a technicality and moral issue that separates me from an Oregon driver's license today. If I had no values, I'd have gone back and tested by now... I was even told by a professional that I could always move to another state with lower visual field requirements...

At any rate, the main reason for the Warren/OHSU/DMV conversation stream was to see if there's any way the Motor Vehicles medical examiner could allow for me to demonstrate my ability to safely pilot a car. This is potentially a litmus test as to whether or not I'll be allowed to drive again. It's not a guarantee, and they may flat out tell me "no", but I hope and pray that I'll be given this opportunity to prove myself- and pass with flying colors!

The aim is to try and formulate a program which dovetails into the existing Oregon Bioptic Driving Program. In this program, individuals which have a fairly complete field of vision, but a visual acuity of between 20/80 and 20/200 are fitted with a special telescopic lens on their glasses. This looking glass highly magnifies road signs at a distance and allows for restricted, daytime driving.

We're talking people who can perhaps read no further than the "big E" on an eye chart, here. These are the people who can enroll into a rehabilitation program, log many, many hours of driving with a specialized instructor and then endure annual scrutiny and "re-certification" in order to retain their driving privileges. It's grueling for certain, but the program exists for people who meet these criteria.

There is no equivalent program for people like me, who posses greater visual acuity, but lesser field of view than perhaps many of the Bioptic Drivers. With the same framework of customized, accommodating rehabilitation, followed by many man-hours behind the wheel with a specialized instructor, I believe that I can drive safely in Oregon. I'm not asking for the impossible, just a daytime restricted license to assist my wife in picking up milk from the grocery store.

Whether people are afflicted with retinal conditions like I am (Retinopathy of Prematurity), or Diabetic Retinopathy and forms of Macular Degeneration, all of which can affect your visual acuity or field of view, I would like to help create a sense of hope. Thousands of people who either cannot drive, or can no longer drive due to compromised ocular conditions. The disease or condition may have different names and prognoses, but the net outcome is generally classified as "low vision".

If the world sees in "High Definition", people with low vision see in "Standard Definition". I would love to pioneer a driving program for people with stable, but low vision like mine. Perhaps one day, people with age-old, or newly-acquired low vision can establish or continue their driving independence with the aid of such a training program. Advances in optical and networking technology may also push the envelope of visual and spatial augmentation, offering a "virtual co-pilot" to the driver.

TODAY: A person attains a standard driver's license when they're 16. They maintain that status until they're 60. At 61, a retinal disease is diagnosed. Visual field and acuity are affected, but the overall condition is only moderately progressive. Under normal circumstances, that 61 year old can either forfeit their independence, or will have their keys taken away by family. Or, they may simply stop driving out of a fear-based mentality. Some may continue to drive, but in our example, this person now depends on family and friends for transportation.

TOMORROW: Imagine if that same person whom at 61 is diagnosed with a progressive retinal condition, is notified of and automatically enrolled in a rehabilitation course, which is suited for their specific needs- not just limited to a select group of people? Now, this person is informed of their personal limitations, is specifically trained in how to accommodate them (scanning the horizon, checking mirrors more frequently, etc), is effectively restricted to their highest level of personal capacity (daytime driving), logs many hours of behind-the-wheel training and is re-certified as "safe" on an annual basis? This senior would likely yield more confidence behind the wheel and would retain their independence for perhaps years longer. What's more, if the screening process indicates the need to cease driving, it would be detected far earlier than traditional methods. The low-vision habits and accommodations learned could also prove useful in life, post-license.

Thank You, Jesus for this divinely-timed phone call today! All for your glory!

Good Night

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