S6E19 - Time to Hit the Road?

So you survived your brain injury. You’ve completed both in-patient and out-patient rehabilitation and are ready to get on with your life. In other words, it is time to start getting your independence back, dust off those car keys and hit the road with your favorite tunes playing in the background. But then reality hits: how do I do that and what are the liability concerns? Brandon Higgs of  H & T Driver Rehabilitation Specialist LLC walks us through the process of how to get back on the road safely. Join us as he eloquently discusses how to align your Doctor, the Texas Medical Advisory Board, and the Texas Department of Public Safety to not only get you back driving but also how to protect yourself from any liability risks in the event an accident occurs.  

Guest Social Media info - https://www.facebook.com/htdriverrehab/
https://www.instagram.com/htdriverrehab/#

Transcript

Brandon: 0:00

And just so you know, the Association for Driver Rehab Specialists is called ADED, and it's a, it's a, it is a national, uh, well, it's a worldwide. Uh, association. We have people from Australia, Canada, all the, all kinds of countries. And so we're focused on driver rehab and adaptive driving.

Bernard: 0:31

Opinions shared by the guests of the show are their own and do not necessarily represent the views of the hosts bindwaves or the Brain Injury Network. This podcast is for informational purposes only, and it's not a substitute for professional medical advice, the diagnosis or treatment. Always seek the advice of a healthcare provider with any questions you may have regarding a medical condition.

Speaker 2: 0:55

Thank you.

Brittany: 0:58

Hi, I'm Brittany and I'm a brain injury survivor and member of BIND.

Carrie: 1:02

And hi, I'm Carrie, a stroke survivor and a member of BIND as well. And today we are welcoming back Brandon Higgs. And Brandon is the owner of H T Driver Rehabilitation Specialist LLC, which is a driver rehabilitation program that focuses on the road for back on getting back on the road for neurologically impaired population of North Texas. So welcome back, Brandon.

Brandon: 1:26

Thank you. Thanks for having me.

Carrie: 1:27

Yeah, it's, it's been a little over a year, I think. So, um, just to get started, I thought we'd just go back and start a little bit with the basics. And so if someone's looking to get back to driving after a brain injury, where would they start?

Brandon: 1:41

Well, I think they would start with their physician, ask the doctor if they think the doc, the physician, feels like it's appropriate for them to consider returning the driving, and then go from there. Um.

Carrie: 1:55

Okay. Yeah, that,

Brandon: 1:56

that can step. Yeah, just go from there.

Carrie: 1:58

Okay. So again, that was kind of my next, like who evaluates when they're ready to drive and do you need doctor approval? So,

Brandon: 2:04

so it depends, uh, here in Texas we have the Medical Advisory Board and they advise the Department of Public Safety, which is the DPS office, is where you get your driver's license. And so it is, it's a relationship between the Medical Advisory Board and the Department of Public Safety. If you have a brain injury, nobody's gonna knock on your door from the state and say, Hey, you need to take a driving test. Uh, most of the time the physicians are not gonna recommend that either because they're just not, that's not something they focus on. However, if you do some research, uh, you'll find that the medical advisory board does have some language on it. When it's, uh, concerning driving and, uh, brain injury and so it, you have to read that document, uh, or you can call somebody like me and help you kind of interpret the rules. It is a gray area. A hundred percent.

Carrie: 2:55

No, I know. We, but yeah, we, when we had you a year ago, we, we did a lot of different topics on this and technically you don't have to tell the state. I mean, we brought, but I mean, right. Like when you go in to renew your license, that's when it asks you have you had. A brain injury and we tell people whether,'cause if you call DPS and say, I've had a brain injury or stroke, they're gonna be like, oh no, you don't need to come back in. That's right. We tell everyone, go back in.

Brandon: 3:21

Right. And it's to cover yourself from a liability standpoint. Right. So if you're safe, you know, I would, I would definitely go in because eventually, like you said, when you renew, they're gonna ask you specifically, do you have a medical situation that could impact your driving ability? And you know, I, I think, yeah, go ahead and say, Hey, I wanna take the road test. Uh, and you can do that. And when you go online at DPS,

Carrie: 3:44

right, and I mean, I'm in my brain, I'm thinking, do all that go to you, get re-certified and if. The medical, I don't think the medical advisory board's really gonna get involved unless you're maybe driving unsafe and things start to happen,

Brandon: 3:59

right? Well, they can. So, you know, like I said, once again, going back to kind of that gray area, when you go to DPS, it's sub, it's subjective. So the person working behind the counter, if they see you walking with a limp, uh, or you have some kind of, you know, uh, aphasia that's impacting your speech, they can recommend a road test there. They can recommend you, uh, be evaluated by the medical advisory board there. Uh, and if you are reported to the medical advisory Board, you'll get a packet in the mail and you'll have to fill it out and your physician will have to fill it out and mail it back or fax it back to the medical advisory board. Then they still may recommend you take a road test. So I like to just be preemptive and just go ahead and get the doctor involved. Pull him in right away and come see somebody like me, a certified driver rehab specialist. Go through the whole evaluation, do some training if you need it, and then get re-certified, so to speak at DPS. That way you're already ahead of everything and you know that a third party has looked at your driving and said, Hey, yeah, you're safe. Or maybe there's some adaptive equipment that could help you out. Um, and then if you do get recommended down the road to the medical advisory board, you already got the doctor on your team. You already got the CDRS on your team, and they can help you navigate the next steps. So it's, you know, that's the best way to do it. The medical advisory board, they do have specific language. If you have a significant, uh, deficit, like you do have hemiplegia and you, you know, you're walking with, you know, you got some flexor synergy tone in your arms, or you have a vision, a hemianopsia or, or slower processing speed. Now they do recommend you'd retake the test at, at DPS. It's a recommendation. If you get pulled over by, um, you know, um, a Texas State Ranger, they're not gonna know. But if you're getting a wreck and hurt somebody or kill somebody, right, then that's when you can run into a problem.

Carrie: 5:55

Right. I mean, yeah, I know. I retested. So, um, but yeah,

Brandon: 6:01

and just so you know, the Association for Driver Rehab Specialists is called ADED, and it's a, it's a, it is a national, uh, well, it's a worldwide. Uh, association. We have people from Australia, Canada, all the, all kinds of countries. And so we're focused on driver rehab and adaptive driving. Um, we have a Texas chapter and I'm the president. Okay. I'm the president, and right now as we speak, I'm talking to the supervisor in the North Texas area for DPS, and we're gonna get on a phone call and try to standardize everything. I don't know if that's gonna happen, but I want us to talk, you know, I, I want to have a, uh, the medical advisory board, they're revising their, their documents too, to where it's just, it, it's, it's more black and white. It's more streamlined and there's not such a much of a gray area. The system we have now is not bad, honestly. You know, you have a brain injury, you retake, you road test, you prove you're safe, and you go on about your business.

Brittany: 7:02

Okay. Yeah. So, um, with you talking to the board, um, what more procedures would, would you put in place or like to recommend?

Brandon: 7:12

Yeah, I would just, well, I would like for, for instance, if you come see somebody like me, um, this is me personally. If you come see A-C-D-R-S now that's somebody that's done it for multiple years. They've, they've taken a national certified test. They gotta, uh, participate in continuing education. It's a practitioner in the field, you know, if they say you're safe, I would like that rec that document to to withstand and the medical advisor board actually look at those documents and then there's nothing after that.'cause right now, in the current process, you can come see somebody like me. You can, I can recommend you retake the road test. You can retake the road test, pass the road test, and then you still get recommended to the medical advisory

Carrie: 7:57

report. Right. Okay. I'm gonna back you up real quick. CDRS certified driving rehabilitation specialist.

Brandon: 8:02

Yes, ma'am.

Carrie: 8:03

Okay, so now you got me thinking even since last time we talked, um, some. Rehab facilities, some therapy places have their own driving. I mean that's right. It's, so it's a, is it an either or or is it a Both. Like you can go through driving with your, if you're at a, let's say, Pate, Pate, and I don't know for sure, disclaimer, I don't know for sure that Pate has their own driving service. They do. Um, but. Is it a, I go through Pate don't need to come see you, or I go through Pate,

Brandon: 8:36

but

Carrie: 8:36

maybe I still wanna come see you, or it

Brandon: 8:38

depends. I know the guys at Pate. I know Christine Nelson. Christine Nelson, uh, she's like over the program. Yeah. I

Carrie: 8:44

think we actually interviewed our team now that you said her name. Yeah. She's

Brandon: 8:46

awesome. Yeah. Good friend of mine. Um, and then there's um, there was another guy there and then there's a younger guy that's taken over. They got a, they got an awesome driving rehab program. They, they were at conference, we were just at conference up in Columbus. So yeah. If they have the time, uh, to see absolutely, uh, you, you know, go through them. Absolutely. The, the only problem with some of those hospital based programs, they might not have all the equipment, the adaptive equipment. So it's just, yeah. If you see somebody's a, a, a driving rehab professional, A DRP or ACDRS, yeah, you're on the right track there.

Brittany: 9:21

Mm-hmm.

Brandon: 9:22

And, and if you have any questions about where to find these people ADED, it's ADED. aded.net, the association for driver Rehab Specialists, you can seek these people out.

Brittany: 9:35

Okay. So, um, you just mentioned adaptive equipment. So since we spoke last, are there any new adaptive equipment for driving since, you know,

Brandon: 9:46

um, the, so we just got back from our annual conference up in Columbus, Ohio, and, um. The manufacturers of the equipment, they're, they're getting better. They're innovating, you know, the equipment it costs more than ever. It, it really does. Uh, but it's, it's, the electronic components are, uh, I'm sorry, the acceleration is all electronic now. Uh, there. They're tapping into the vehicle computers and everything's seamless. It's, it's almost like factory. You know, we call it OEM. It all seems OEM now. So if you do get adaptive equipment put on your vehicle, it'll look like it, it looks like it's meant to be there. The companies are a lot more, uh, commutative now if you have a issue with it, you know? Um, so I don't know if there's any new pieces of equipment out per se. Uh, there are new pieces of equipment out. Um, actually there's a cool piece from a company called Vicki. And if you're in a power chair, uh, and you're driving from your power chair, they do got a nice stabilizer bracket that's hooked up to the back of the chair and the B pillar. So there are things like that.

Carrie: 10:57

Okay.

Brandon: 10:58

Um, yeah,

Carrie: 10:59

so I guess then that kind of brings me like one of our next questions. So new or not new, what are maybe the most common adaptations that people that you see, that people need? I mean, like we, we talked about, you know, Brittany and I both have our issues. I mean, I am. Mine is all on left side, so I can drive easily with the right side because mm-hmm. Cars are meant, I mean, sorry, left handed people cars are kind of more, they're geared more to the right handed people. Right. Unless it's a stick and we know, I mean, like I said, I've been, and I saw that's the designation on my licenses. I'm automatic only,

Brittany: 11:33

right? Because

Carrie: 11:34

obviously my left leg cannot push in a clutch, right? I can't push in a clutch and shift a gear and hold a steering wheel, all with my right hand. It's not gonna happen.

Brandon: 11:43

Right. And that was smart of the DPS worker to put that on your license. Mm-hmm. Um, that's another part, going back before I answer that question about DPS, excuse me, sorry. Another thing about DPS, we'd like to get'em all on the same page regarding restrictions. Um, but as far as the most common when it, uh, brain injury, of course there's a lot of, uh, we call it hemiplegia, where one side of your body is partially paralyzed for whatever reason. In that scenario, it might be a left foot accelerator, what we call'em, spinner knobs, or like a smart spinner knob with the turn signals in the spinner knob because for whatever reason, you wanna keep your hand on that steering mm-hmm. On that device. So we see a lot of those. And of course, hand controls, I mean, hand controls are the, are the most common, um, device.

Carrie: 12:29

Do y'all still, um, I don't know the exact wording. But be able to change the pedals for someone that maybe their right foot is what's paralyzed. I know I had a friend that his. How whatever they did, they covered the gas pedal Right. And moved the pedals over, added a pedal. It's a left,

Brandon: 12:47

left foot accelerator. Okay. Yeah. So the, your, your accelerator is on the left side and then, and you still use the, the factory brake pedal, but now you got a left foot accelerator.

Carrie: 12:57

Okay.

Brandon: 12:58

And it is all electronic now, so that'll be there. And then say your spouse or the mechanic needs to drive the vehicle. They just don't turn that pedal on. Okay. And that pedal's dead.

Carrie: 13:07

Yeah.'cause that's, I always wondered how he did it.'cause in my mind it was covered, but now it's not. It, it

Brandon: 13:12

might, in the old days, it was when it was mechanical. But, um, the, the mobility dealerships, they don't really like installing mechanical left foot accelerators. They, some of'em still do, uh, but were really trying to get away from that and just go all electronic.

Brittany: 13:27

Okay. Yep. Um, are there any more, um. Adaptations or modifications that can made for someone that has Hemi.

Brandon: 13:37

Yeah, yeah, absolutely. So, so it could range from, like I said, a lot of times we do that left foot accelerator that solves a problem of the partially paralyzed foot, the right foot, so that that solves that. Now how do you steer? We got some kind of steering orthotic now. How do you get to the secondary? It's your turn signal. So you might need help, you know, with a drop down turn signal extension, or if you're paralyzed on the left side, you might need a crossover turn signal extension. Mm-hmm. So you're not reaching through the steering wheel, getting there. I don't know. Your, your left arm looks pretty good. Yeah, I mean, no, I can't

Carrie: 14:12

use my left arm, but I've seen those, but. You don't use it? No. Because look how tall I am? Yeah. Yeah. Do you know where it would go?

Brandon: 14:20

Right. Right. And there's, there's pros and cons, but

Carrie: 14:23

I, I don't have any problem. I mean, it's just right in reaching, do the steering wheel. Mm-hmm.

Brandon: 14:26

Yeah. Well just pay attention to it. Some people do for whatever reason. Yeah. Uh, but yeah, sometimes we'll do the crossover or the smart, uh, steering. I've seen those and I, that

Carrie: 14:37

might be something later if I ever start up, but like the car I have now, it's easy. I don't have issues. Right. And

Brandon: 14:42

every vehicle's different. Every person's different. So those are, those are the most common for that? Um, yeah. Mm-hmm.

Carrie: 14:51

Okay. Now this is a question that, that our members have asked, um, which is a good question whether you're brain injured or not, but how do you help manage someone that has anxiety? A, about just driving in general, or especially as a survivor, that anxiety of returning to driving, because I do have.

Brandon: 15:12

The,

Carrie: 15:13

the issues now.

Brandon: 15:14

Medical marijuana? No, I'm joking. No. Uh,

Carrie: 15:17

I don't think you're supposed to take that and drive.

Brandon: 15:19

No, you're absolutely, no, you're not. You're not supposed to take that and drive. And that was a big topic at our conference, like, it's like drinking and driving. No, it anxiety is everybody's problem, brain injured or not. It's the, the young person with autism, it's the 40-year-old with the spinal cord injury. It's the 80-year-old with dementia. Everybody I see. They're nervous, especially when you're seeing somebody like me for you driving. And you know, I, me personally, I, I like to say, let's focus on the present. You need to stay in the present, you know, and then I got a whole strategy the way I do things. But sometimes they need to go back to their doctor and say, Hey, do I need to get in therapy or do I need to get on a medication to help just for right now? Mm-hmm. You know, I'm not. You know, I'm not, I'm not pushing medication, but

Carrie: 16:09

Right. But

Brandon: 16:09

we do get to a point where it's like, look, you're not making progress because of your anxiety. So, but me personally, stay in the moment. Don't worry about anything but what we're doing right now, you know? And because that's where anxiety comes from. You're worried about what happened or what's going to happen, so

Brittany: 16:27

Yeah.

Brandon: 16:28

But it's not like a light switch. No. You know, I can't stop being nervous come. Right. It's just So that's. I'll say one thing. There's a guy, his name's Chad Stroman. He's outta Houston, Texas. He's been doing it for like 30 years, maybe longer. And he went and got his, uh, doctorate degree in OT. And he was speaking at our conference and he said, um, he specialized in anxiety for his doctoral program because it it is, and, and when he said that, I mean, I, I, I, I totally agree. Everybody's nervous and it is a barrier. It is a huge barrier because you can't focus on what you're doing. You know, and if you already have a little bit slower processing speed or you know, you can't divide your attention or multitask like you used to, anxiety plummets those, that those functions even more.

Carrie: 17:19

Yeah, I can do that. Um, I'm gonna take a quick little break and remind our listeners to go ahead and click that like button. Click that share button, click that notify button, click all the buttons that have a thumbs up. And, um, we will get back. Let me look and see where we were. I don't wanna put the me or you, Brittany.

Brittany: 17:36

Um, she'll,

Carrie: 17:39

um, so I know we, we've talked about this a lot too, um, and. It's not necessarily always brain injury related again, but we see it more brain injury, seizures. I mean, again, that's another one of those that I know, and I think if you get a, if you have a seizure, you're a neurologist, or your doctor, they tell you you can't drive for six months. Now again, no one's reporting that anywhere. It's just a, I mean, if you drive within that timeframe, then yes. It will be documented then, and you'll know if you get in an accident within that time, so it mm-hmm. But it's still kinda a honor system from the way I understand it. Mm-hmm. But, or is there any other things you can tell people about with seizures, like returning back to driving and,

Brandon: 18:22

yeah, once again, it goes back to the liability, uh, aspect. If your doctor tells you not to drive and you drive and you hit somebody and you, you could be sued, you know, bad, you know, so, so that's. That's a risk you gotta take. What I would do if I was returning and driving, I would have the doctor sign something. Well, let's say you came to my program and you've had a seizure with, I need to know you've been seizure free for 90 days.

Brittany: 18:47

Okay.

Brandon: 18:47

And the doctor, there is a form called a DL SE 1 77. It's a DPS form, DL 1 77, and it's medical information request. You take that into your physician, have him sign that and. You know, might, you might, he might even indicate that it's controlled by medication. That's fine. And you could come back to driving sooner if they sign off on that. Also, if you're still having seizures, but it's controlled by medication, well, not, you're still having seizures, but uh, you know, you're epileptic for whatever reason. Mm-hmm. You really should have a special restriction on your driver's license. I can't remember the restriction off the top of my head. I think it's like a b something. No, it's not a B, it's something. Um, but it indicates you cannot drive transportation vehicles. No taxi cabs, no ambulances and no school buses.

Carrie: 19:40

Right. But you can drive your personal car. You can drive your personal

Brandon: 19:43

car. Right. We're talking about liability.

Carrie: 19:46

Right. And I think that's a big thing is, I mean, you know, a lot of what we talk about is survivors to other survivors is. CYA, you know?

Brandon: 19:57

Absolutely. And when you're young and you're not, you're like, whatever, da da, da. But they happen. I mean, I, I hear those stories sitting on this side of the table, you know? Yes. So just cover yourself and do it the right way.

Brittany: 20:08

Yeah. So,

Brandon: 20:09

and if you have, if you have questions about how to do it the right way, call somebody like me. If I can't help you, I'll give you the information.

Carrie: 20:17

Right. You

Brittany: 20:17

know,

Brandon: 20:17

so,

Brittany: 20:18

so questions about doing it right way, um, why we already know it a why,'cause liability, but when do you have to disclose a brain injury to get re-certified?

Brandon: 20:28

Uh, well, I mean, like we talked about earlier, when you go to renew, they have that question on the, on the page two, you know, and then at that point it's like, hey. You know, do I reveal this or not? You know? And, and that's up to you. I mean, I just think from a liability standpoint, why not just put all your cards on the table, right? And if the medical advisor board wants to send you documentation, you just take it up to your doctor, Hey, sign this. We'll, we will play that game until I'm totally cleared. Well,

Carrie: 20:58

and I guess that's a good thing to mention just because you mark on the form. That, yes, I've had a brain injury doesn't automatically mean you don't get to drive. It just means there may be additional steps that need be taken.

Brandon: 21:09

That's right. And remember the Medical advisor board is a group of physicians, and most of them, from my experience, they're a little bit older. They've been doing it a long time. You know, they're reviewing these cases and they're not out to get you. They're just out to make sure, you know, we've considered everything from medical standpoint. And then they're gonna review it and maybe ask you to take a road test or get something signed by your doctor, and then that's it. You know, your, your license could be, even if your license gets medically suspended and then revoked, you could get it reinstated, you know, uh, you might have to, you know, get some additional information from your physician, so, right.

Carrie: 21:48

Um. So, um, we talked more about the physical limitations, but what are some of the other common limitations that you see for people like cognitively or vision? I know we've talked about in the past and in my brain, I was just thinking like, how, well maybe if you've got the cognitive and or a fa, I mean I can see it both ways, but like GPSs, are those a hindrance or a helper?

Brandon: 22:18

It depends. It depends upon the person. You know, it depends on are those verbal cues gonna be helpful? Are they distracting? You know, are you looking down at your screen? Is that distracting? You know, it's just something we gotta test out in the field. Okay. And that's why it's good and, and come to somebody like me, spend a little bit of money. But you get, you get real life tools you're gonna use for the rest of your life. So from a cognitive standpoint, you gotta have enough processing speed. You know, we test processing speed, we do a clinical evaluation. And if it's significantly impaired, I mean, that might prevent you from driving, you know? And then visually we know a common one is the hemianopsia, right? The loss of the vision field at in, you know, and, and if you have a, a loss of vision, uh, peripheral vision, that can become a big problem because use your peripheral vision almost more than you use your central vision when you're driving.

Carrie: 23:09

Right. Well, I know. Yeah.'cause I know in the very beginning I had le left neglect and I still have it to an extent, but that was. I mean, I didn't know about you, but you know, this was 14 years ago. Mm-hmm. When my stroke was 16, I waited several years till I felt better. You know, I just hired the local student driving people to Right. So that I knew I had someone that had that as much as I hated it at 16, I wanted it at 39, 40. You know, I wanted the guy with the brake, so if I was about to run into the curb on the left hand side, he could stop the car.

Brandon: 23:40

And like you said, if, if there's a school that would do that and you get the right person, great. But it's just, you kinda, you never know what you're gonna get. Well true. You know, but it was,

Carrie: 23:49

it was a better option than my dad at the time, so,

Brandon: 23:52

yeah. And that's the problem. Most people, their family, they can't, their family member, they can't be helpful'cause they're the family member's more nervous than the actual driver.

Carrie: 24:00

Oh yeah. I mean, I didn't want my, um, I didn't want my dad and helping me at 16. Oh yeah. Okay. Didn't, definitely didn't want him helping me as a grownup. So

Brittany: 24:09

how do you help the, um, family members, um, cope or. You get on the side of the person that wants to return to driving

Brandon: 24:18

medical marijuana? No, I'm joking. No, no. Um, you know, it just depends if, if they're open, you know, we just say, Hey look, we'll take it one session at a time. You know, you know, it just all depends on the family. You know, hopefully the family member, they're on board and they understand that, you know, Johnny has some deficits that he has to overcome and it's gonna be a process. You know, if he gets done quick, great. But if we need to do, you know, multiple sessions over a couple months. You know, you just have to understand that. So, and we, we do homework sometimes we per we, and we want the family member to be bought into that, you know, and help with the

Carrie: 24:59

homework. That makes sense. So, um, what, maybe just to kind of wrap this up here, what advice would you give to survivors or even caregivers of survivors for someone wanting to return back to work? You know, I mean, not work, sorry. Driving.

Brandon: 25:13

Yeah. I would say, you know, um. Talk to your doctor first to see if it's appropriate, and then look up a driver rehab specialist in your area. If you're here in Texas, I would contact Texas Workforce Solutions, voc Rehab, if you need some assistance of getting back into the workforce, and they can help pay for our services. But you know, just like I said, talk to the doctor first to see if you're even in kind of in that ballpark. And if you are, you know, reach out to a driver rehab specialist near you.

Carrie: 25:44

Okay. That's great. Well, Brandon, thank you for joining us again. We always like having you here. And next time we're have to bring, you'll bring a car and let us go do wheelies in the parking lot. Yeah, let's do it. Let's do it. I'm just kidding, but, or donuts. Yeah. And thank you. Thank you to everyone for listening, so we appreciate you taking the time outta your day. You can find our new episodes on all your favorite platforms. Until next time.

Rick: 26:07

We hope you've enjoyed listening to bindwaves and continue to support Brain Injury Network in our nonprofit mission, we support brain injury survivors as they reconnect into life, the community, and the workplace. And we couldn't do that without great listeners like you. We appreciate each and every one of you. Please remember to click the like button, the share button, and the subscribe button on YouTube. And follow us on Instagram@bindwaves and Brain Injury Network on Facebook. You can email us at bindwaves@thebind.org or go to our website bindwaves.org or call us at(972) 769-2463. Please continue watching. Until next time.