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Narcolepsy And Dui


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#1 Sleepy Sleepy

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Posted 18 May 2010 - 05:21 PM

I have had severe Narcolepsy for at least 10 years. I take Ritalin LA 40 mg in the morning, and am allowed three 5 mg Ritalin pills during the day. The three 5's are called 'tailored medication.'

Sometimes I only need two 5's to get me through the day, some days I need all 3. Am also prescribed Valium 10 mg at bedtime to help me sleep.

I hate taking the medication and force myself to take it. A family member (also diagnosed with N), raved about some freaky vitamins that helped her with her Narcolepsy. She sends me these things and I try it for a month. Did it work? No.

Hate driving at night and know better, but I went to the store late one night. I was speeding and a cop stops me. He thought I was intoxicated. I was too afraid to tell him that I had Narcolepsy because he was really mean. I refused the roadside tests and was charged with DUI.

I had been seeing a LPN as a fairly new patient in a doctor's office. I saw her about 3 times and she filled my medicine with no problems at all. After the DUI horror, I decided I needed to get my butt in there and get my medicine.

She had seen my picture in a crime section because they put all the DUI people in the newspaper. I was completely refused ALL of my medicine and she said she no longer would treat me for Narcolepsy and slight insomnia. She said flat-out that she was refusing me treatment because I had been accused of DUI.

I was in complete shock when she denied my refills. I have not been convicted and am fighting the DUI charge based on Narcolepsy. I have never been denied my medication at all. Ever, until that fateful day.

Does anyone think it's ethical of a LPN to refuse to refill meds or treat a Narcoleptic based on a DUI charge? All of this is completely horrible, and I am now left untreated until I can find a new doctor or LPN that will treat me.

I suspect that she has passed my name on to some other doctors in town (I live in a very small town). I have Medicaid, and every doctor I call says they won't treat me (she's an LPN for 3 other doctors in town). This is one of the worst things I have ever been through.


#2 Ironmind

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Posted 18 May 2010 - 07:42 PM

Maybe it's a law in the state you're in that even a DUI charge means your prescription is halted? Or maybe you need to travel to the nearest bigger town?
Small town people have small minds, I have lived in one my whole life. They think it's all in your head.
Even if I am officially diagnosed I would be hesitant to tell anyone.

I am guessing the "influence" is the Ritalin? If you have a prescription I would bet they can't do anything unless it is proven you were taking more than prescribed.

#3 kiragrace

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Posted 18 May 2010 - 09:17 PM

I can't imagine that it would be legal if you have narcolepsy and can prove it.

One has nothing to do with the other.

It's like denying a cancer patient chemotherapy because of a DUI.

Who were you seeing before the LPN? Do you have medical records "proving" your narcolepsy? ie. PSG/MSLT, gene test, etc?

Maybe she is being cautious because you are a new patient. But I think its unethical for her to refuse your meds if you can prove your narcolepsy and especially if the picture in the paper is only about being pulled over and charged and it has not gone to court yet.

What ever happened to innocent until proven guilty?

Seriously, I really don't think she is allowed to do this.

#4 kiragrace

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Posted 18 May 2010 - 09:22 PM

Oh, and I've also been pulled over and asked by an officer if I had been drinking because I was slurring my words.and I was not drinking and he did not administer a DUI test, but he did talk me up for a long time, probably to make sure. Unfortunately, this happens.

But again, this is just not right and I wonder if you could go "over" her - like to her boss....I think it may be unethical and she has no right to do this........

Can you go to someone higher than an LPN? And are you saying LPN as in licensed practical nurse? I didn't even think an LPN was allowed to prescribe medications/fill out prescriptions? I know the 2 states I have lived in you can't write out prescriptions as an LPN. you have to be a doctor, or a physician's assistant.

Please follow up on this for yourself and for others......and best of luck.

#5 vidar

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Posted 18 May 2010 - 11:10 PM

First off, in most states you are SOL for having refused the road side test.

Not much you can do about that, though I wish you the best of luck on the first account.

Second, that LNP at the least is committing patient abandonment and in WI would likely face some sort of sanction, fine or be placed on probation for it. If harm came to you, as it was willful abandonment, she could lose her license. I would recommend that you first speak to her again, but make it very clear that 1) you have not been convicted of any crime 2) She has a legal and ethical obligation to continue to treat you regardless 3) By discontinuing treating you she has endangered your health. Period. 4) Explain to you you will endeavor to find a new physician but unless she allows you reasonable time to do so before discontinuing your treatment, you will file a complain with the state licensing board. Depending on the geographical area, reasonable is at least 3 months.

Then, because I am a vindictive pr*** at times, after I found a new doctor I would then go ahead and file a complaint anyways.

NB: Stimulants are not like high dose narcotics in that if you mix them with alcohol or other substances you have a decent chance of killing yourself. And in those cases, patients sign a "pain contract" which specifies ahead of time appropriate expectations and behavior.

And Kiragrace, I think he meant licences nurse practitioner, not licensed practical nurse. Most have masters, but increasingly they are "Doctors" of nursing (but not eh PhD variant as they didn't need to do a thesis and on average have 10,000 hours less clinical experience then a family medicine doctor fresh out of residency...). LNPs can write Rxs in some cases in some states...

#6 Tracer

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Posted 19 May 2010 - 12:37 AM

Like Vidar said refusing the roadside test was not your best choice here. In NC you can lose your license for a year for that alone and the police officer can and will use that as evidence against you in court. They will also have to testify as to your mannerisms on the scene and driving. You are probably in for a long, hard ride with this. Why did you refuse the roadside test? If you don't mind me asking. You don't have to answer.
As far as being refused prescriptions...I don't much about that to even comment.
If this LPN has told other doctors to not treat you that sounds like a HIPPA violation to me. Maybe not, but I would follow up with that and find out exactly what was said. Keep good notes if you talk to other doctors and denied treatment.
Good luck with this. I'm sure this is very stressful for you. I would go somewhere, maybe out of that city/county for another doctor.

#7 Horizontal Hold

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Posted 20 May 2010 - 12:33 AM

Many doctors, especially small-town docs, overly fear coming under the scrutiny of their states and the DEA. Scripts for Ritalin and other stimulants are monitored because of their abuse potential and the possibility of diversion (giving or selling meds to others). In the mid 2000s narcolepsy patients on high doses of stimulants (which are sometimes necessary) were being accused of "drug seeking" or being addicted to their stimulants. So, given that your photo and name were published in the local paper, I think the doctors who have refused to treat you have a leg to stand on in refusing to treat you and a plausible defense against a HIPAA challenge. It wouldn't be the first time the truth was skirted.

I agree with others that it would be worth seeking out a sleep Doctor in the nearest big city. Valium is not a commonly prescribed for narcolepsy. Sedating drugs can last much longer in PWN. It would be good to have your treatment re-evaluated. Was your nurse practitioner willing to prescribe Xyrem? Can a NP even prescribe Xyrem? Maybe she was more comfortable with Valium even though it's not the equivalent of Xyrem. You would probably qualify to get Xyrem free under the Patient Assistance Program and it could work much better than your current treatment.

Why you refused the drug test? Was it just a bad decision or was your judgment impaired because you had already taken the Valium when you decided to go to the store so late? Sedatives can have side effects like sleepwalking, automatic behavior and REM behavior disorder, and PWN seem to be more prone to them. Even if you can argue against the DUI it would be fair for a judge to ask how you're going to avoid a repeat of this night. If medication prevents you from making responsible decisions either the medication needs to be changed or you need to take other measures while you're judgment is intact, like leaving your car keys with a family member or neighbor for the night.

Good luck!

#8 KatNapper77

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Posted 29 May 2010 - 03:41 AM

I'VE EXPERIENCED SOMETHING SIMILAR...WHERE I LIVE THE NEWSPAPER REPORTS DAILY ANY AND ALL ARRESTS. WHETHER OR NOT A PERSON IS EVER CONVICTED IS APPARANTLY NOT NEWS WORTHY. THE INNOCENT UNTIL PROVEN GUILTY CONCEPT IS NON-EXSISTANT HERE IN THIS SMALL TOWN WHERE EVERYONE READS THE PAPER.

I WAS ARRESTED FOR GETTING INTO A VERBAL ARGUMENT WITH SOMEONE AND CHARGED WITH DOMESTIC VIOLENCE AND DISORDERLY CONDUCT. WHILE THIS SITUATION HAD NO BEARING ON MY MEDICAL ISSUES REGARDING NARCOLEPSY, THE PC I WAS SEEING AT THAT TIME FELT THE NEED TO COMMENT ON IT IN HER NOTES (SHE NEVER BROUGHT IT UP TO ME) WHEN I ARRIVED AT MY APPOINTMENT WITH HER THAT SAME WEEK.

WHEN I APPLIED FOR DISBILITY AND WAS DENIED, I REQUESTED ALL OF THE INFORMATION THAT WAS SUBMITTED ONLY TO FIND THESE NOTES SHE HAD WRITTEN ABOUT MY ARREST. AFTER THAT DATE, COMMENTS ABOUT THE MEDS I WAS PRESCRIBED (RITALIN AND XYREM) WERE NOTED AS ADDICTIONS. THIS WAS ALL INCLUDED IN MY PERMANAT MEDICAL FILE MAKING MY OUT TO BE A DRUG RIDDLED, VIOLENT CRIMINAL.

I CHANGED DR.'S AND IN MY ATTEMPTS TO SEEK OBJECTIVE CARE FOR MY N, I PURPOSLY SIGNED FORMS TO PREVENT SHARING OF MY MEDICAL RECORDS, AS PER HIPPA PRIVACY LAWS. STIGMAS WERE ALREADY IN PLACE AS MY DR.'S CONTINUED TO CC INFORMATION ABOUT EACH VISIT, TEST, MEDS, ETC., TO EACH OTHER...IRRELEVANT AND DAMAGING COMMENTARY INCLUDED.

GETTING DECENT CARE FOR N IS A CHALLANGE IN GENERAL. DR.'S ARE SUPPOSED TO BE FOR THE BENEFIT OF A PERSONS HEALTH, RIGHT? SO MUCH RIDES ON THE ACCURACY OF ONE'S MEDICAL RECORDS AND WHEN SOME DEFAMATORY ASSUMPTIONS GET INCLUDED, FORGET ANY SYMPATHY OR UNBIASED HELP IN THE FUTURE.

I CAN'T STRESS ENOUGH, GET COPIES OF YOUR RECORDS ON A FREQUENT BASIS. NOT ONLY TO KEEP YOURSELF INFORMED, BUT ALSO TO SEE WHAT THE WORLD KNOWS ABOUT YOU, OR THINKS THEY KNOW. IN THIS ELECTRONIC AGE SOMETHING ON YOUR SHARED MEDICAL RECORDS MAY BE KEEPING YOU FROM RECEIVING APPROPRIATE HELP.




#9 drago

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Posted 30 May 2010 - 09:37 AM

Hate driving at night and know better, but I went to the store late one night. I was speeding and a cop stops me. He thought I was intoxicated. I was too afraid to tell him that I had Narcolepsy because he was really mean. I refused the roadside tests and was charged with DUI.


What road side tests did he ask you to do? Breathalizer?

Also, you're not obligated to tell someone that you have narcolepsy. If he pulled you over for speeding, and he thought you might be intoxicated, you don't have to list all medical conditions he could be assuming as "drunkeness." For example, my mom does not have to tell them she has Type II Diabetes and could have low blood sugar.

Depending on the road side test, and depending on the lawyer you get, you might be fine. A person with a neurological disorder who is put under severe pressure (ie a cop being agitated/mean/assuming they are drunk) can show worse symptoms (I know that when I am stressed out, I feel much more physically tired) than they had been experiencing before that. The courts will focus on what instigated the cop to ask you to do a road side test. Slurred speech? Jitteryness? Nervousness? If he had little visual evidence, it could be seen as an illegal search & seizure. (He needs cause to search your vehicle, and needs cause to make you take a test, too.)

So, my best advice: Get a lawyer who knows what's going on, and especially one who has worked with people who have disabilities/disorders that are "invisible", if at all possible.

I had been seeing a LPN as a fairly new patient in a doctor's office. I saw her about 3 times and she filled my medicine with no problems at all. After the DUI horror, I decided I needed to get my butt in there and get my medicine.

She had seen my picture in a crime section because they put all the DUI people in the newspaper. I was completely refused ALL of my medicine and she said she no longer would treat me for Narcolepsy and slight insomnia. She said flat-out that she was refusing me treatment because I had been accused of DUI.


Well, firstly, I think it is unethical of a newspaper to print a section based on people's ARRESTS, because many people are arrested by accident, or wrongfully, and the charges are dropped before they even go to trial! So I would think part of the unethical bit goes to the newspaper. (Unless you mean they had a police report section with all reports... but this sounds like it's a special DUI section.)

As far as I am aware, a doctor can refuse treatment for a patient for a number of reasons. Can a doctor or LPN treat a patient for a few months than stop treatment because of an accusation or an arrest? As far as I am aware, that would be considered unethical. Not to mention the fact that she specifically told you it was because you were accused of a crime, but you haven't been tried yet. Not to mention the fact that she has dropped you, with no medical redirect, despite the fact that you have a persistent medical need -- narcolepsy -- that must be treated. I believe that alone is unethical, most doctors who refuse treatment to patients provide referrals.

I suspect that she has passed my name on to some other doctors in town (I live in a very small town). I have Medicaid, and every doctor I call says they won't treat me (she's an LPN for 3 other doctors in town). This is one of the worst things I have ever been through.


Well, if you're uncomfortable (or unsure) about a lawsuit, there is always the other avenue: media. You might not be interested in it, but bad press generally makes people reconsider their prejudices... esp. if you are found innocent or have a reduced charge on the DUI. You could, hypothetically, go to a local reporter/newspaper with this story -- proof that places with limited resources need additional laws to prevent patients with chronic medical needs from being left untreated because of people's prejudices or assumptions... :-\ Unfortunately, I'm not sure how else to deal with something like this...


I wish you the best of luck,
drago

#10 Sleepy Sleepy

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Posted 22 June 2010 - 05:07 PM

Like Vidar said refusing the roadside test was not your best choice here. In NC you can lose your license for a year for that alone and the police officer can and will use that as evidence against you in court. They will also have to testify as to your mannerisms on the scene and driving. You are probably in for a long, hard ride with this. Why did you refuse the roadside test? If you don't mind me asking. You don't have to answer.
As far as being refused prescriptions...I don't much about that to even comment.
If this LPN has told other doctors to not treat you that sounds like a HIPPA violation to me. Maybe not, but I would follow up with that and find out exactly what was said. Keep good notes if you talk to other doctors and denied treatment.
Good luck with this. I'm sure this is very stressful for you. I would go somewhere, maybe out of that city/county for another doctor.


Sorry it has taken me so long to reply. I refused the field sobriety tests because a friend of mine (who is an attorney) told me that anyone who is stopped by police as a suspected DUI will fail the tests. In the state I reside in, you aren't required by law to take them and there is no penalty for that. In some states it might be required by law. He did tell me that he could not force me to take any field sobriety tests and I didn't have to. He said he wanted me to take them to see if I was alright to even drive at all that night. I also know that these tests are filmed with their in-car dash cameras and used as evidence against you in court. I will note that I was extremely polite, and very nervous.

I didn't reply sooner because my attorney told me not to talk about it anywhere until my case was done and over with.

I think that in all states you are required to submit to any chemical test a law enforcement officer asks you to take. It is usually a blood, breath or urine test, and the officer can choose which one to ask you to submit to. Nine times out of ten; they want a blood draw. Some states suspend your license right then and there if you say no. In some states, the suspension comes only after a judgment of conviction.

The day I went to that nurse practitioner that treated me like trash - I came home and called my attorney and told him what had happened. I asked him for advice, and it so happened that he knew her supervising doctor on a personal level. He told me that he felt I should make an appointment with the doctor and explain how I was treated, and how she refused to refill my medication based on my legal troubles.

Reluctantly, I did go see the doctor. I told him what had happened on that visit and told him that she had written my prescriptions three times before with absolutely no problems. He pretty much defended her and said that she "Had problems with writing prescriptions for Ritalin since it was a scheduled drug." I tried to keep my cool and told him that the problem started when she found out that I had been accused of DUI. He said that she was "moody" and that's just how she was. I was furious inside!

So, I discuss my medical history and tell the doctor that I have a ton of records that prove I have narcolepsy and I had signed three medical release forms so they could get all the proof they needed to treat me. That office had four months to get these faxed. The doctor sees that the records were never requested and he had nothing in my file in reference to narcolepsy! I told him to call my neurologist/sleep medicine specialist (I had called them before the visit and they told me they would fax whatever the new doctor needed to treat me).

I explain that I have to be treated by a regular physician and I can not see a specialist on a monthly basis. I also explain how the neurologist does not accept the insurance I have or I would have just went back to him for a referral to someone that has experience with narcolepsy.

I knew that when he defended the nurse practitioner's behavior; I was in for a medication battle. He looks at my current meds and says, "I think you are on way too much medication. What I am going to do is give you the Ritalin LA 40 to take in the morning. I will not write you the 5 mg Ritalin to take 3 times during the rest of the day. I am replacing your Valium with Ambien, because Valium is addictive. I also think you need to see a psychiatrist and have a whole new sleep study conducted."

My heart sunk inside because I know that when a doctor messes with my medication for N, it totally screws my daily routine up. I had a system and medication plan that was working. I thought, "Oh here we go again." At the end of the visit, he said he would get all of my medical files and we would discuss it in a month.

A month later, I tell him that I would like my meds to be the way they were before. I had been sleeping from noon to about 10 at night and it was not working out. He went on about the sleep study and harped on me having a psychiatric evaluation and cited that he had no experience with narcolepsy and felt that he could not properly treat me. I did get the Ritalin LA 40's and Ambien 10's. I vowed then and there I was not going back and it was time to move on.

I was able to get the neurologist/sleep doctor that diagnosed me to call me at home. He said the following: "You have narcolepsy. There is no cure. It never gets better but can be controlled with medication. I don't feel that you need a whole new set of sleep studies. I don't understand why they seem to be wanting a second diagnosis, or why they want you to see a psychiatrist. I would treat you but I know you can't pay out-of-pocket for a visit. I am sorry this is happening to you."

He did refer me to a doctor who seems to be willing to treat me and accepts my insurance. I won't know how that goes until mid-July.

However, I did report the nurse practitioner to the state board. Her credentials were - A.P.N., -C. The state found that she acted unethically in refusal to treat me because of her personal beliefs. She was fined $500.00 and has a mark on her record. This all went down last week.

Oddly enough, this afternoon I got a phone call from a receptionist of a psychiatrist. The lady said that my doctor was requesting me to make an appointment for a psychiatric evaluation at the request of my physician. I told my physician that I wasn't interested in that on my last and final visit and he knew that I was going to find a new doctor.

Then my memory kicks in when I hear the name of the psychiatrist. In 2002, I applied for disability. Social Security had me go to this office for a full psych evaluation. After the evaluation, the psychiatrist said I was completely sane and not depressed. That same week in 2002, the psychiatrist was the one to refer me to the neurologist/sleep medicine doctor where I was diagnosed with... you guessed it...Narcolepsy! I told the lady to check their medical archives and refused the appointment.

I am beginning to think that the physicians around here are the people that need to be on medication, lol!







#11 sleepyinmichigan

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Posted 25 June 2012 - 06:29 PM

It is beyond the LPN's scope of practice to prescribed medications in any state. You need to go around her and talk with the doc's.

#12 Enginerd

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Posted 26 June 2012 - 02:11 AM


However, I did report the nurse practitioner to the state board. Her credentials were - A.P.N., -C. The state found that she acted unethically in refusal to treat me because of her personal beliefs. She was fined $500.00 and has a mark on her record. This all went down last week.


Good for you! This is why I NEVER trust nurse practitioners. A lot of them have a God complex. She had no right in refusing to write prescriptions for you based on her beliefs that if you got a DUI (that MUST have been "real") then you're probably abusing pills, too.

Just like you're allowed to refuse a roadside test. I just figured what would happen in an instance like that is you would've been escorted to the station (since a cop wouldn't want someone they felt was inebriated to continue driving) to determine your blood-alcohol level via urine or a blood draw.

Not that this is likely to happen again, but what did your lawyer advise you to say should history repeat itself? I wonder because there could be an occasional night where I might be driving home but my medication is wearing off. I don't think I'd ever come across as reckless or drunk, but if I am pulled over and appear exceedingly tired, what is the best way to handle the situation, knowing that I don't have great balance in the first place, much less while I'm tired? I guess agreeing to be breathalyzed would be the way to go.......... :unsure: