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Posted by: Tammy Caudell ® 11/06/2002, 22:15:53 Author Profile Mail author |
Hi Everyone! I am a speech language pathologist and currently working with my first spasmodic dysphonia patient. I would like to hear from all of you what you have found most useful (specific therapy techniques, ideas, suggestions, etc) as well as what you found not helpful about speech therapy. I want to make therapy as productive as possible for my patient and feel your insight will be invaluable. Thanks! |
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Posted by: Linda spain ® 11/06/2002, 22:31:23 Author Profile Mail author |
Tammy: You don't say what type of SD your patient has. I have AB. I spent months with a speech therapist and it was worth every second. I was, for practical purposes, without functional voice. Now, while my voice isn't pretty and it isn't easy to phonate or control breathing for good phrasing, I'm back to work (CEO of a technology company) and even occasionally (with the help of special amplification equipment) giving speeches! The most important things for your patient are never to give up and never to lose his or her sense of humor. Also, patience is essential. It took me quite a while to develop alternative speaking techniques, even with determination and unrelenting practice. To write about the specifics would take a long time. I'd be happy to talk with you and/or put you in contact with the therapist who helped me. Your personal support of your patient also is important. He/she is so fortunate to have you willing to take your time to consult with others of us who have been down this road. Best regards,
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Posted by: Tammy Caudell ® 11/07/2002, 17:01:53 Author Profile Mail author |
Linda, Thank you so much for your response. As for what type of SD my patient has I am not sure. All the dr order said that he brought to me was "probable spasmodic dysphonia speech therapy for relaxation". I asked him if his dr had told him if it was abductor or adductor and he said his dr didn't say. So, as you can see I don't have much to go on and have to wonder about the dr since the word spasmodic was spelled incorrectly on the therapy order! I really feel he needs to see a physician who specializes more in SD, but he refuses to see anyone else. I would certainly be interested in talking with the therapist (and you Linda) that helped you so much. I always value and love learning from other therapists. To start I am gathering as much information as possible (general info, treatment options, resources, etc) and creating a binder on SD for my patient. I thought that was a good place to start. I have really used several of the resources in some of the past postings in the archives. Those have been so helpful. I am also starting with creating a more relaxed breathing pattern and increasing breath support with him. I appreciate all the input from each of you. You are my best guidance! |
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Posted by: mark porter ® 11/07/2002, 18:51:57 Author Profile Mail author |
At last, a speech therapist who is interested in comparing notes with other therapists who have tried to treat SD. BRAVO! My hats off to you. I have had the adductor type since 1994, and have been to several speech terapists and voice teachers. None of them have helped at all except for Dr. Morton Cooper. I did a week of intensive therapy (8 hours a day) with him and showed great improvement at the end of the week. The problew was that I could not retain the improvement - even with daily exercise. Mark Porter |
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Posted by: Tammy Caudell ® 11/07/2002, 21:56:55 Author Profile Mail author |
Thanks Mark! I am curious if you talked to Dr. Cooper as to why you could not retain any of your improvement? Do you feel it was simply due to the progressive nature of the SD itself? Or the fact that you may have been unable to practice as intensively at home as you did in therapy? Do you think Dr. Cooper would mind if I contacted him for suggestions? I think my patient also has the adductor type based on the characteristics he exhibits which are the pitch breaks, hoarseness, and loss of phonation. However, this is simply my observation as his physician did not send me a specific diagnosis. I had hoped my patient would be able to join this wonderful forum, but they do not have a computer in their home. Sorry for all the questions, but just really trying to learn from those of you who have experienced this first hand. |
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Posted by: gavin hadley ® 11/11/2002, 11:49:44 Author Profile Mail author |
Hey Tammy... welcome to the SD BB. Dr. Cooper's first suggestion would probably be to send him money. I talked to him once but it quickly turned to a conversation centered around either coming to CA for intense therapy at a megabuck price level or buying his tapes. He doesn't believe that SD is a neurological disorder but rather bad voice habits that have to be unlearned. The day I finally learned that it IS something I can't control was very freeing. Let us all know how you make out with your research. gavin |
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Posted by: mcporter ® 11/13/2002, 18:42:27 Author Profile Mail author |
Tommy: I don't believe my SD was getting worse. I just could't do voice exercises all day long. I would think it would be hepful for you to contact Dr. Cooper. He has a web site. Would love to find out whats working for you in treating your patient. Mark Porter
--modified by Moderator-DB at Wed, Nov 13, 2002, 18:53:03 Modified by at Wed, Nov 13, 2002, 18:53:04 |
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Posted by: Dwight Cruikshank ® 11/11/2002, 22:43:47 Author Profile Mail author |
Morton Cooper is rude, greedy person. And the techniques he uses are nothing special. There out there for anybody to use. The Lessac method is one of the best. The voice therapy set out by Arthur Lessac. Kristin Linklater's book is helpful, too. Carl Stough has done some remarkable research on breathing and has techniques that can help SD. People talk about getting the voice in "the mask" or the nasal resonance. That's off base. REal resonance comes from directing the voice on the hard palate. If you make an yeeeeeeeeeeeee sound with your lips slightly rounded you'll feel the vibrations on the roof of your mouth behind your teeth. |
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Posted by: MICHEAL PAULSON ® 11/08/2002, 01:48:03 Author Profile Mail author |
Hi Tammy, I have been away from the board for a while and do not know if you have posted other messages but wanted to pass on a little information.Go to www.dysphonia.org and listen to the sound samples of AB and AD they have there.It will give you excellent examples of how both conditions sound.Also check out their materials page for books and videos about SD.There is a lot of good information there.Last but not least go to a meta search engine like www.dogpile.com and type spasmodic dysphonia into your search.There are a lot of good information sites I have found and some very interesting posts out there in cyber space.Please feel free to e-mail me privately about any further questions,I do not check in as often as I should and private e-mail will be faster. |
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Posted by: Tammy Caudell ® 11/08/2002, 16:40:02 Author Profile Mail author |
Mike, Thanks for your suggestions. Ordering videos, brochures, and books was actually the first thing I did for my client. I have also started a binder for him which he brings to and from therapy to organize all the information I have compiled so far and to continue to add new information as we progress through therapy. Since he does not have a computer I have been printing several of the posts to add to his binder of information. So, to let you all know the information you share here is so very helpful and appreciated! Tammy Caudell
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Posted by: john s. beeman ® 11/11/2002, 12:22:36 Author Profile Mail author |
The one thing speech therapy did that was helpful was working on breath control. When Botox worked, the techniques I learned in therapy helped me "extend" the duration of my injections. John AD/SD/SLAD - NO VOICE
--modified by john s. beeman at Mon, Nov 11, 2002, 14:37:45 |
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Posted by: fancynancy ® 11/11/2002, 13:26:06 Author Profile Mail author |
John, are you an AD or AB type? Since I'm AB, I'm wondering if breath control is possible to learn, as this type has a hard time controlling breathiness while speaking. --fn-- |
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Posted by: john s. beeman ® 11/11/2002, 14:39:23 Author Profile Mail author |
Sorry - I was an "AD/SD". I had Dr. Berke's SLAD surgery - I now sound more like an AB/SD - what little sound I do make. I updated my earlier message - good point. John |
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Posted by: gavin hadley ® 11/12/2002, 06:49:57 Author Profile Mail author |
Fancynancy.. Linda Spain is a new poster here. She has AB and I talked with her on the phone last week. She uses an amplifier but is able to talk with few breaks. Linda reprogrammed her speech mechanics through therapy which, as most here know, is no mean feat. Linda, you might want to expand on this. gavin hadley |
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Posted by: Linda Spain ® 11/12/2002, 17:29:14 Author Profile Mail author |
Hi, this is the "Linda" Gavin referred to. I have AB, quite severely, and I learned breath control. So, to answer your question directly, yes, it is possible. It takes practice and patience, but actually is easier than learning the pitch part of what I do, which I call alternative phonation or my engineered voice. At the outset, I often had trouble with more than a few syllables per breath (sometimes I could say only one syllable and some sounds just didn't work at all or took forever to get out), and I also was constantly "running out of air". Now, my phrasing is good. Part of it is breath control, and part of it is what I call "budgeting" - knowing how much air you have and how much air it takes to make various sounds so you can pause at logical points of your verbalizing to inhale. Sounds complex, but, over time, this gets to be second nature. It is important to note that learning to achieve pitch also helps with phrasing because sounds can be made more efficiently, i.e. you don't waste so much air. When you mention breathiness, I think more of the pitch part; I think of breath control as the "running out of air" part. I hope this information is helpful. I apologige to you, fancynancy, and all other readers for this being so rambling. I'm in a hurry but thought a timely reply might be more helpful than an elegant one. Linda
--modified by Linda Spain at Tue, Nov 12, 2002, 18:09:46 --modified by Linda Spain at Tue, Nov 12, 2002, 18:15:28 |
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Posted by: Kim ® 11/11/2002, 15:34:42 Author Profile Mail author |
I didn't even get that. About the only useful thing I got from it (in terms of SD) was that SOMETIMES the relaxation stuff would reduce the SEVERITY of a spasm ...but only if I had warning it was coming on; when I had no warning it didn't do any good at all. Any of the techniques that were supposed to make speech more fluid nad easier only made things worse, and often resulted in my complete inablity to use speech at all. Of course, speaking on demand has never been something I've been able to do very well (likely some apraxic elements involved) so focusing on it was a very bad idea!!!! |
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Posted by: Larry Blair ® 11/11/2002, 14:25:39 Author Profile Mail author |
Hi Tammy, Here's to you... I mentioned this BB to my GP at first since he had only seen one other case of SD in his profession. Thought he would be able to acquire alot of knowledge here. I also mentioned it to my own Speech Pathologist. Don't know if they have taken advantage of all the information here or not. I think it is great that you are dedicated enough to find out what you can about SD. This is the place!! I read Dr. Coopers book "Voice Suicide" after my ENT gave it to me as a second option to Botox injections. I also spoke to him personally, and he gave me some phone numbers of some of his previous patients. One in particular I spoke to, said he came to L.A., where Dr. Coopers office is. He said he ended up staying here in L.A. in a motel room for 2 weeks, at 8 hrs. a day. He said it was alot of work and money and that you have to really be motivated, as he was. I spoke to him, and his voice sounded very good over the phone. He owns his own company I believe, and this was his motivation to get his voice back. The voice problem was starting to cause problems with his business. I beleive his name was Brian Fox. I beleive I still have his E-mail address here somewhere. He was kind of interested in my case and wether I was going to see Dr. Cooper. Like I said there is alot of money involved. Dr. Cooper let's you know that right up front. Some insurance companies will cover a portion, but not many. You know, I just gave that book to my Speech Pathologist on my last visit, since it was given to me. She seemed interested also, in his procedure. I am sure you can get all your questions answered here on the BB. Lot's of great and willing people here to help out. Larry
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Posted by: Tammy Caudell ® 11/11/2002, 15:42:49 Author Profile Mail author |
Larry, Thanks for all your information. I will be certain to order Dr. Cooper's book for my patient. I have ordered a host of books, videos, and brochures for him. I would love to see him be able to see Dr. Cooper, however, it would be financially impossible. I live and work in a poverty stricken region which is actually one of the lowest in our nation and unfortunately my client is among that majority. He even has difficulty getting to doctors appointments in larger cities due to lack of transportation and the inability to drive as a result of failing eyesight secondary to a stroke. To be honest, I will be his only resource outside his scheduled doctor's visits which is why I am trying so hard to provide him with all the information and highest quality care possible. I have the advantage of having grown up in the very small rural town where I live and work, therefore, know all the people. So, we already have a very trusted and respected relationship built with one another which has proved to be invaluable. You all have been such an important resource for me. I can't thank each of you enough for taking your time to respond to my posts and send emails with additional helpful information. I am forever greatful! |
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