Back behind the wheel: After stroke, Huntley man relearns how to drive to regain independence lost

Dan Davis didn’t seem like a candidate for a stroke. The 46-year-old Huntley man didn’t smoke and rarely drank alcohol.

But nearly a year ago, on June 28, Davis was getting ready for work when he suddenly collapsed. His wife, who has a medical background, called 911 but already realized what it was – a stroke.

Through much of that morning and his 27-day hospital stay, Davis retained his cognitive abilities. What the stroke took from David, now 47, was strength on his right side. What it threatened to take away from him was his independence. Could the working father of two sons continue to drive when his right foot could no longer work the gas and brakes in his car?

“I was dependent on my wife to take me places. Even getting down the stairs ... I had to quickly assess how I lived my life and think more carefully about it than I did before,” Davis said. “Every move I make, I have to assess if it is feasible to do it.”

Assessing if Davis would be able to get behind the wheel of a car again is Karyn Silvestri’s job. The occupational therapist at Northwestern Medicine exclusively works with people – both teens and adults with acquired or congenital disabilities – to determine if they can drive and help them learn to drive with adapted vehicles. Some have had a traumatic brain injury or, like Davis, a stroke.

Silvestri is one of just a handful of occupational therapists in Illinois who is also a licensed driving instructor, she said. She has clients come from Indiana and Wisconsin.

“There are not enough to serve the clientele that really needs driving rehabilitation services,” Silvestri said.

Her role is twofold, Silvestri said. First, she evaluates clients to determine if they can safely drive. Then, she works with them to ensure they can pass the state’s driver examination, often with a vehicle adapted for them.

Much of the behind-the-wheel training happens in parking lots at Northwestern Woodstock Hospital or Marianjoy Hospital in Wheaton. They don’t use simulators, but real vehicles the drivers will be using that better represent what being behind the wheel feels like, Silvestri said.

These days, a majority of his driving is going to Marianjoy for his rehab appointments, Davis said. Getting behind the wheel with Silvestri to practice was “like being a 16-year-old again, learning how to do this.”

His car is adapted with a knob on the left side of the steering wheel – his stronger hand – allowing him to steer. Instead of using his right foot for the brake and gas pedals, Davis now uses his left foot. It helps, Davis said, that he had 30 years of driving experience.

“How to turn – that doesn’t go away. The muscle memory resides in me,” he said. “But the nerves ... it was like being a 16-year-old. The stakes are high and you don’t want to fail those tests.”

After practicing with Silvestri and re-memorizing the rules of the road, Davis aced his driving test. He’s had his license back, with a C restriction requiring a mechanical aid or adaptive devices, for three months. He has driven about 3,000 miles since then, running errands and getting back to a little normalcy.

He has to think about where he is going, too – not how to get there, but what will be required of him when he gets there.

“Keep in mind the independence you gain [by driving], but you also have to be conscious of what you have to face where you are going,” Davis said. Those obstacles might be getting from a parking garage to his destination.

“Stepping onto a curb – I have to think about it. If I have to carry something heavy, I have to plan it out more than I did a few months ago,” he said.

Davis is hoping for a surgery in the near future for a device that will help his nervous system operate his right side again, but insurance would not approve it. As a right-handed person, not having control over that side of his body has made everything from writing to reading a book a lot harder, Davis said.

“Even eating dinner. I am good at left-handed eating, but for things like cutting my meat ... I am figuring it out,” he said.

Those fine motor skills are not as necessary for driving as things like reaction speed, visual processing and concentration, Silvestri said. But there are few things harder than telling an adult they are taking the car keys away for good.

“What if I came up to you today and said, ‘I am taking the keys away from you. You are not OK to drive again’?” Silvestri said. “It is a blow to take away that independent status.”

Working with adults to ensure they can keep driving, and retain independence, can help keep people healthier as they are continuing to socialize, too.

There are options if a license is taken away, including dial-a-ride and app-based services, she said.

“But different communities have different levels of resources. In certain areas, yes, but there are not enough in other areas,” she said.

“The important part is, can we preserve skills so they don’t have to rely on other sources that are not as available?” Silvestri said.