whispers on the web - october 2007 - - throat

09/30/2007 12:56 PMWhispers on the Web - October 2007

of 22http://webwhispers.org/news/oct2007.asp

October 2007

Count the Numbers on the First Anniversary

In just a few more days, we will reach the first anniversary of the opening of our new website. We signed up, fromthe start, with Google Analytics, which runs more stats on web sites that we can possible use or understand. Theyhave traced our progress from the beginning. Here are some facts and figures from our first year with this new website that I think you will enjoy.

80,618 is the number of visitors to the site in this first year, averaging 203 per day.

Of these, 50,556 were new visitors. 30,062 were returning visitors.

One of the biggest days was 401 visitors on November 1st, 2006 and that was the morning when our founder,Dutch Helms died.



The first day of each month is a peak time because we announce the newsletter, Whispers on the Web, as beingon site and ready to read.

The top browsers in your visits were, Internet Explorer, Firefox, Safari, several Mozilla types, followed by Opera.Operating system was overwhelmingly Windows 75,057, Macintosh 5,181 and 304 Linux users.

65,606 of the visits are from the USA; 4,142 Canada; 3,479 United Kingdom; 1,148 Australia; 482 India; 348Philippines; 296 Germany; 263 Pakistan: 257 Turkey; 240 Netherlands; 224 Israel; 204 Ireland. There are anotherdozen countries that fall into the100-200 visits bracket. All in all, we have been visited by people from 147 differentcountries. You might find it interesting that we had 23 visits from Russia, 14 from Iraq, and 63 from China.

Since the US has a huge number of visits, where are you out there?Over 5,000 CAOver 4,000 NYOver 3,000 TX, FLOver 2,000 GA, PA, ILOver 1,000 OH, MI, MA, NJ, VA, AL, WA, NC, IN, MO, OK, MN, WIEvery state has visitors and there are only a few under 100.

How did you get to the site?19,358 came directly to webwhispers addresses.1,837 through a link from the Delphi Forum878 through a link from the IAL Site357 through a link from Laryngectomylife.com279 through a link from F-L-A

Those who searched for a word or phrase and found us:30,862 came to us through google.5.698 through Yahoo4.967 through MSN1,683 through AOL295 through wikipedia255 through canmedica

In searching, something near 4,000 found us by using the word "webwhispers" in one word, two words, .org addedand other variations of our name.

"Laryngectomee/laryngectomy" was next with other words like surgery or support groups added into the search.

Funny one is Soft Foods which takes the searcher directly to our "crock pot" section. These are likely people whonever heard of a laryngectomy but needed to find soft foods for other conditions. We are happy to share.

As we count our numbers, we count our blessings for being able to be together in this superb support group.

Enjoy,Pat W SandersWebWhispers President



VoicePoints [© 2007 Lisa Proper]Coordinated by Lisa Proper, MS-CCC-SLP, BC-NCD-A, BRS-S ( [email protected] )

The successful rehabilitative management of the near-total laryngectomy is composed of many individualsincluding the surgeon, nursing personnel, American Cancer Society personnel, hospital dischargepersonnel, speech pathology, and others. The intention of Part II of this article is to provide a detailedguideline for the treatment of the near-total laryngectomy by speech pathology. It is recommended thatupon the establishment of one's own protocol, one should thoroughly discuss the entire treatment protocolwith each surgeon who will be performing the near-total laryngectomy procedure as individual surgeonsmay prefer variations in the suggested protocol. The primary information in the following protocol for speech pathology intervention in the care of the near-total laryngectomy patient was originally developed by Proper and Pearson in 1987, in order to establish aconsistent level of care for each near-total laryngectomy patient. Further development of the protocol wascompleted with the assistance of Robert L. Keith, M.S., CCC, Speech Pathologist, who has since retiredfrom Mayo Clinic -Rochester. Mr. Keith made highly valuable suggestions to the establishment of thisprotocol. For specific information regarding the Near-total laryngectomy procedure. please refer to Part I, publishedlast month in VoicePoints

The Near-Total Laryngectomy And The Role Of The Speech-Language PathologistPart II: What's an SLP to do?Lisa M. Proper The role of speech pathology in the treatment of the near-total laryngectomee commences pre-operatively with aneducational consultation for the patient and his or her family. During this consultative session, the speechpathologist will be discussing the near-total laryngectomy procedure, but may also need to discuss other surgicalprocedures such as the total laryngectomy and/or a supraglottic laryngectomy. The inclusion of several types ofsurgical procedure within the information provided to the patient pre-operatively is due to the surgical selectioncriteria that cannot be determined until the actual surgery. The surgeon will be able to provide the speechpathologist with the possible surgical outcomes for each patient. The speech pathology pre-operative consultationenvironment should provide ample opportunity for the patient and family to ask questions and should follow thesame guidelines for any pre-operative laryngectomy consultation. In addition to the pre-operative speech pathologyconsultation session, there may also be a need to arrange either a personal or telephone pre-operative interviewfor the patient with a well-rehabilitated near-total laryngectomee. A post-operative laryngectomee hospital visitationmay also be arranged at this time. At our facility, the patient also meets with a nurse for further education at thepre-operative stage.

The patient may also be asked if they would like the Speech Pathologist to visit with the family during the patient'sactual surgery to provide the pre-operative education information for any family members who may not be presentduring this consultation session. This is particularly important for the patient who attended the pre-operativeconsultation session on his/her own. This practice of visiting the family during the time of surgery, even if noeducation is provided, is very well received and appreciated by both the patient and family of all laryngectomy typesurgeries.

Post-operative speech pathology treatment is initiated approximately three days after surgery. However, a briefsocial visit from speech pathology the day after surgery is also encouraged. The initial treatment encounter is anadditional educational session in which the information provided to the patient and family is specific only to thenear-total laryngectomy procedure and rehabilitation. This is in contrast to the multiple procedure discussion that



occurred pre-operatively. A post-operative hospital visit from a laryngectomee, preferably trained by the AmericanCancer Society, should also be arranged, if it has not been previously completed. It is preferable that the trainedlaryngectomee visitor is a near-total laryngectomee; however, this is not always possible, so it is acceptable if thevisitor uses tracheo-esophageal fistula speech. If visitation is made by an individual who utilizes tracheo-esophageal fistula speech, brief patient education should occur regarding the variations of the arriving visitor'stracheal-esophageal fistulization voice and rehabilitation aspects versus the patient's near-total laryngectomyvoice. (The visitor should also be trained in the variations.) A video or voice recording of a proficient near-totallaryngectomee speaker should be utilized to demonstrate the possible differences between his/her voice versusthose of the laryngectomee visitor. This initial treatment session should also incorporate an assessment of thepatient's oral mechanism and voiceless consonant articulation as well as introducing the patient to an artificiallaryngeal device. This device is to be utilized for verbal communication until the speaking fistula can be utilized forconversational voice. Thereafter, the artificial laryngeal device may be utilized as a permanent back-upcommunication system. Instructions for the use of the artificial larynx with the near total laryngectomee do notdiffer from that of a total laryngectomee.

Initial treatment with the voice shunt should occur between 5 and 7 days post-operatively. Speech pathologyshould always obtain direct surgeon approval prior to initiation of this stage of treatment. This session isaccomplished with the tracheostomy tube removed and the stoma perimeter cleaned. Speech pathologists nottrained or comfortable with tracheostomy tube removal may want to coordinate this session during a tracheostomacare session or patient education session performed by nursing. However, all speech pathologists working withlaryngectomy patients of all types are encouraged to be trained and comfortable with all aspects of tracheostomacare.

The initial voicing trial will be with speech pathology occlusion of the open stoma. The patient is instructed toinhale, the speech pathologist then gently occludes the stoma with a complete seal of a gloved finger to the stomaand the patient exhales through an open mouth in attempt to achieve initial voicing. At this time, the stoma isgenerally not healed and will most likely contain sutures around its perimeter; therefore, use of gauze coveredfingers during stoma occlusion may be necessary to establish a complete seal. The force of exhalation used bythe patient during these initial post-operative sessions should not be excessive.

Voice may or may not be achieved as it varies with different patients. Voicing may be achieved during this initialsession or not for several weeks. Specific techniques for achieving voice may include easy onset production ofvowels or serial automatic speech tasks, such as counting, listing days of the week, etc.

When employing this technique, it may be necessary to ask the patient to "whisper" to avoid excessive pulmonaryor muscular effort. Additionally, the patient may need to be encouraged to continue "counting" even if sound is notachieved on the first few syllables or words, as sound often occurs more easily after several syllables or wordshave been mouthed. This technique of occluding the stoma during exhalation is highly beneficial in achieving voicefor the first time. Should no voice be achieved, speech pathology may employ a brief one-time voicing trial withmoderately excessive force in an attempt to achieve initial voicing; however, excessive force should not be utilizedduring continued trials during the initial post-operative week. The use of excessive force may reduce optimalhealing of surgical tissue and therefore must not be initially used on a continual basis.

Independent of voice achievement, the patient should be trained in the occlusion of the stoma and attempts atvoice trials. The speech pathologist should assist the patient in choosing the best single finger or thumb for stomaocclusion, which is preferably on the non-dominant hand. The speech pathologist should not only take into accountstoma occlusion but the placement of the entire arm, which needs to be in a relaxed position. Once the patient iscomfortable with stoma occlusion, the tracheostomy tube is replaced. The time the tracheostomy tube remainsremoved should be kept to a minimum in this initial treatment session to allow easy reinsertion of the tracheostomytube. In rare cases, voicing may have been easily achieved on all trials with minimal to no patient effort. In such acase, the speech pathologist may want to attempt voicing trials with the tracheostomy tube in place. If successfulupon speech pathology occlusion, then patient instruction may occur. Should the patient be successful producingvoice without increased effort with the tracheostomy tube in place as well, surgeon approval should occur withregards to the amount the patient may use the voice shunt.



regards to the amount the patient may use the voice shunt.

Most patients however, do not achieve such effortless voice during the initial treatment sessions; therefore theyshould be educated with regards to self -practice. The patient is then instructed to attempt voicing via direct stomaocclusion 5-10 times upon all occurrences of complete tracheostomy tube removal (usually two times daily). Oncevoicing has been achieved at any level, the patient should be educated to the fact that the quality, intonation, pitchand loudness will continue to improve over several months of conversational voice use.

Should voicing not be acceptable at the time of hospital discharge, speech pathology sessions should be arrangedto occur at the same interval as surgeon visits for treatment of voice shunt utilization. The patient should beinstructed to increase the number of voicing trials during post-operative weeks 3 and 4 as considerable stomahealing should be occurring which will allow for the tracheostomy tube to be left out for increasing periods of time.If no voice has been achieved by post-operative week four, an additional speech pathology visit is extremelyimportant. Speech pathology intervention needed at this point should explore the variations in patient exhalationeffort.

To this point, the patient has only been trained in the use of relaxed or moderately increased exhalatory effort,which is generally sufficient for achieving voice. However, a minimum number of patients will need to utilizeincreased exhalatory effort to open the shunt and achieve voicing for the first time. This increased exhalatory effortis used only to achieve initial voicing and should not be maintained with actual voice use. If voice has not beenachieved with a satisfactory quality, there may be a complication with the shunt. A discussion regarding thecomplications of the near-total laryngectomy voice shunt occurred in Part I of this article.

Most all patients should be able to achieve some form of shunt voicing generally around six weeks followingsurgery. However, communication may not yet be accessible due to stoma healing and tracheostomy tube use.Therefore, it may be possible and necessary to fit the patient with a flexible tracheostoma vent with a customizedfenestration, which would allow for more effective stoma occlusion or valving and increased voice production.

Speech pathology intervention that is necessary following voice establishment is generally minimal. However, itmay be necessary to continue to reinforce optimal stoma occlusion abilities and focus attention to the treatment ofthe patient's articulation, rate and various aspects of voicing (Keith, & Thomas, 1994). As mentioned, appropriatestoma occlusion and voicing achievement includes obtaining and maintaining a complete finger/thumb to stomaseal with the non-dominant hand. Additionally, the patient should be instructed in appropriate respiratory andvoicing coordination (or "valving" as referred to by Keith, 1994) to optimize voicing fluency while not producingunwanted extraneous sounds that may occur from inappropriate stoma occlusion.

In the event the patient is unable to achieve an adequate stoma seal due to anatomical differences, then speechpathology will want to pursue the various avenues of treatment in this area as well. In addition to valving, treatmentfor appropriate speaking rate may also be necessary at this point in time. Many patients will speak too fast, eitherout of pre-operative habit or in attempt to produce more words to decrease frequency of stoma occlusion. Otherpatients may speak slowly or in a staccato-type manner to compensate for their new voice. Therapy for improvedarticulation should incorporate enhancement of general articulatory precision as well as voiced/voiceless consonantproduction.

Areas commonly overlooked in the rehabilitation process of the near-total laryngectomee are the use of atracheostoma valve that would allow for hands-free communication and the use of a heat-moisture exchangesystem for the stoma. The voice of the near-total laryngectomee is probably more susceptible to the effects ofreduced humidification than are other laryngectomy voices. This is because the fistula or the air passage is madeof natural tissue versus that of silicone in the tracheo-esophageal prosthesis patient. Therefore, the speechpathologist needs to know the surgeon's tracheostoma care regime and remind the patient of the need forcontinued appropriate tracheostoma care as prescribed by his/her surgeon, which will assure the patient ofcontinued voice.



continued voice.

Overall and continued hydration is paramount for shunt functioning. A frequent complication experienced by longterm near-total laryngectomees is reduced voicing abilities caused by insufficient humidification as they "forget" theneed for continued diligence in this area. Since this is so important to the functioning of voice in this population, itis the job of the speech pathologist to educate the patient in this area. I frequently answer the question of "Howlong" do I have to use tracheal saline installations? With "Until you grow a nose" (at your stoma obviously).Intervention in the use of a hands-free valve as well as a heat-moisture exchange system does not differ from thetraditional methods speech pathology incorporates with tracheo-esophageal prosthesis users.In summary, the near-total laryngectomy procedure provides an alternate surgical option for the treatment oflaryngeal carcinoma while providing improved voice with reduced patient care and effort for voice achievement.Speech pathology intervention techniques vary in the establishment of voicing and the procedure demands more ofthe speech pathologist with regards to their knowledge and abilities with tracheostoma care. However, the generalrole of the speech pathologist in the treatment of the near-total laryngectomee patient varies little from the rolespeech pathology plays in the treatment of the total laryngectomee patient.

REFERENCESKeith, R. & Thomas, J. (1994). Near-total laryngectomy and voice shunt. In E. Trudeau, M. (1987). Acousticalcharacteristics of speech following Pearson.sLauder & J. Lauder (Eds.) Self Help for the Laryngectomee (pp. 103 -106). subtotal laryngectomy: A case study.Folia Phoniat.. 39, 178-182.San Antonio, TX: Lauder Enterprises. Woods, R. & Pearson, B. (1980). Alaryngeal speech and development of anPearson, B. (1981). Subtotal Laryngectomy. Laryngoscope. 91. 1904-1912. internal tracheopharyngeal fistula.Otolaryngol Head Neck Surg., 88, 64-73Pearson, B., Keith. R. & Woods, R. (1983f Near-Total Laryngectomy...as an alternative to total Laryngectomy.Pamphlet, Mayo Foundation, Rochester, MN.Pearson, B. & Woods, R. (1980). Hartman, D.: Extended hemi-Laryngectomy for T3 glottic carcinoma withpreservation of speech and swallowing. ---Laryngoscope. 90. 1950-1961.Proper, L. & Pearson, B. (1987). St. LI/ke's Hospital Speech Pathology Protocol for the Treatment of the Near-Total Laryngectomee. Unpublished Speech Pathology Policy and Procedural Manual. St. Luke's Hospital.Jacksonville, FL.



The Other Side of the Looking GlassDebi Austin "Oh The Places You'll Go" was written by Dr Seuss, the world's greatest doctor. When he was diagnosed withthroat cancer he wrote, "You're Only Old Once, a book for obsolete children." Ted Gisel, Dr Seuss, died August1991 of throat cancer. I sent my office home that day. Little did I know 14 months later I would need these booksmore than ever.

We often talk about the people we have become, after surgery. Some have an easier time adjusting than othersand no one knows for sure why this is. Some will say the support groups and our caregivers have a great deal ofeffect on how we view the world at this point. I am sure that is true. And I have found that the ability to understandrelationships is another beneficial tool in our progression.

Earlier this year I was forced/bullied into taking a relationship class because a research project that I did, wasconsidered cold and impersonal, even though no one argued with the findings. I have no doubt that it was exactlyas they said but it was research, not soul searching. However, the class gave me insight into another major part ofmy life - being a laryngectomee. It was not "just" a surgery, a continuing disability, or even a major lifestylechange. Ummm, now comes the soul searching.

I was pushed down the rabbit hole and came out on the other side of the looking glass! A very large part of mybeing was destroyed. I was mentally and physically scarred, and disfigured. This was no emotional roller coaster; Ihad been derailed. All of my life. I heard, "When something bad happens, pick up the pieces and move on." Whatdo you do when someone takes some of your pieces away? How do you put your life back together when youdon't know who you are anymore? My voice was not all that was missing but how do you explain that to someonethat has never been through this? How do you explain anything for that matter?

Did you ever have a pretend friend when you were a kid? The one you blamed whenever you got caught in thecookie jar or picking mom's flowers? There were times I considered my laryngectomy part as my evil twin, my splitpersonality so to speak. That was not me; it was some stranger that I simply could not get rid of, lock the door on,or just come to terms with. This sounded too much like my first marriage. Then realization set in. This is not an eviltwin that I need to contend with, this is a relationship that I need to work at. Hard work! I have to make this be theanswer for me because any other option is unthinkable. It was not living with the common cold that I had tocontend with. I had a shadow relationship I had to make work in order to maintain a quality of life. This is thehardest relationship I have ever maintained. I once compared it to having a "high maintenance" boyfriend with nofringe benefits. What has happened to me does not define who I am. I am who I am because I have learned fromwhat has happened to me. At least I try very hard to make this true.

My support group was awesome. We talked about everything that we went through. I listened to ladies talk aboutissues I didn't realize were "my" issues until I would wake up in the middle of the night thinking, DUH... that is whatthis is. I would make notes and give them to my doctor. At one time, shortly after surgery, I got to the point I couldbarely walk up the stairs to my apartment. The doctors couldn't find anything wrong with me. I said something toElizabeth Finchem about this because I was thinking that the cancer was somewhere else. Elizabeth told me tohave my thyroid checked. Bingo! My surgeon had left clean lines, the radiation was not aimed close enough to thethyroid (they thought) but no one considered this until I brought it up. After hurdling that obstacle, life looked somuch better. The next challenge came with finding someone that knew there was a difference between nonfunctioning and mal functioning. Seemed pretty clear to me, not always true in the medical field, they have otherissues to consider also, the big picture so to speak.

I became a Motivational Speaker by accident. I was perfectly happy sitting home playing with my art work andgrowling at the world from time to time. Being an old hippie I was used to people making snap judgments aboutthings they knew absolutely nothing about and voicing those opinions when they thought no one would challenge



things they knew absolutely nothing about and voicing those opinions when they thought no one would challengethem. I wasn't quiet about being judged then and I am certainly not quiet now.Here is a list of some of the comments that set my broom in high gear and motivated me to speak out and screamwhen necessary:

1) I could not learn esophageal speech because of my weight! Elizabeth fell in the floor laughing at this one. Blessher. I have been a public speaker with esophageal speech for 13 years. And, yes, I sound very human, thank youvery much. But I had an SLP tell me I was doing it wrong. I asked him to show me how to do it right. Ended thatconversation. He may have been in training, thinking it would help. I did not snap and bite, only growl a little.

2) Laryngectomees can't laugh! Do these people really think they removed our sense of humor when they removedthe larynx? I don't think I ever met a laryngectomee that didn't laugh after the shock wore off. Many of us laughout loud as often as possible, it is very good medicine and it catches on!

3) No one will want to be around a laryngectomee! Why not, do we have cooties? In my case my warped sense ofhumor and grating personality might have something more to do with avoiding me than the surgery itself. I met mybest friend and partner after my surgery. We seem to set limitations and expectations far more extreme than othersset for us.

4) People will only see the mistakes you made, not who you are. This is the easiest lie we buy into. My experiencehas been that people view us and many like us as survivors of a silent war. We are a basic comment on thehuman spirit, the fight for survival and the importance of our very being. We inspire people starting their ownadventure with medical/health issues. We help people examine who they are, where they are and what they aredoing. We help them to fast forward with their view of personal wants and needs. And we can accomplish all thisby simply walking into a room. Ain't we cool?

5) Kids will never listen to someone that made all these mistakes! DUH... Do you think they listen to people thatnever made a mistake? They want the truth and they want it from someone that has, "been there, done that." Theydo not want to be judged, they want to hear the truth about how you got here. They don't want to hear "don't".They want to know about choices and how to see positive approaches for themselves.

I specialized in "at risk" youth because I always heard that if you make a mistake it stays with you all your life.This is only true if you are surrounded by narrow, empty, people. Many things in life cannot be changed, but youare in total control of the person you are and how you want to see the world. One of my inspirations is a lady thatcame to the same support group where I was a member for many years. Margie has had a feeding tube many ofthese 14 years, she has had many surgeries and disappointments. This is a lady that has had to fight every day tohave a quality of life. She is a survivor! She is a positive comment on swimming through the devastation. This is awoman that had to make a relationship with evil to have a good life and raise an wonderful family. You get tochoose how you make this relationship work for you.

Live out loud! Dance, choose adventure. Always be aware of a life fully lived. When you surround yourself withpeople who expect little of you, you will live up to their expectations. When you surround yourself with people whoexpect more of you, you will exceed their expectations.



At a Loss For Words

The title says it all… and for those of you who know me, THAT doesn't happen very often! I am reminded of myDad's comment when we met, for the first time, the woman who would soon be my brother's wife. The dinner wentwell...we all knew he was besotted and we were thrilled. I had gotten my Servox, only a few months earlier, andmy family was commenting on how well they and their friends could understand me. I must have said somethingalong the lines of, "It takes some getting used to… yada yada yada…" And Dad interrupted, with a laugh, "Well, itsure hasn't slowed her down any! She's never at a loss for words."

But this month, I have had an awful time coming up with the words for a column. This is my fourth attempt and thecarcasses of the previous attempts are just plain pitiful. Either mawkishly sentimental or repetitiously banal or inone spectacular case, both; they were all self-indulgent. Were it not for the stern specter of Pat looming incyberspace as the deadline for my column came and went, you would not be reading even this. As I resolved toforce myself to write something, anything, my muse awoke. Write about that, she whispered. Write about thosetimes when you have nothing to say.

I thought about the title of this column, Between Friends, and remembered that sometimes friends just listen.Friends don't always have to offer advice when you are troubled or share a story when you are feeling alone.Friends don't always have a funny story to cheer you up or some constructive criticism when you need a talking to.Friends DO do all those things, at one time or another, or they wouldn't be friends, but sometimes friends don't DOanything at all except just be there for you. Sometimes friends are the silent, supportive presence as we pick ourway through the Sturm und Drang of our daily lives.

It occurs to me that WebWhispers is like that. We often read a post on the list that goes something like this, "Idon't write in very often, but I read it all and you have been such a wonderful source of information and support…"We have members who write in when they have bad news or are discouraged and sometimes the best we canoffer them is our silent support. They will hear from just a small percent of our nearly 2000 members, but theyknow we are all out there, somewhere, rooting for them. It means a lot.

So it is with this newsletter. Each month we have good solid advice and information. We have stories to share tomake you laugh and sometimes shake your head at the folly in the world. We try to be a good friend, to challengeand support you, to encourage you as you try to make the most out of life. And sometimes, when we run out ofwords, we just listen and hope you understand that even when we have nothing to say, we are always here foryou. Because that's what friends are for.



you. Because that's what friends are for.

Donna

CHECKING THE WAKE

Practically Speaking usually addresses matters that concern the everyday stuff of our lives as laryngectomees. Itoccurs to me that we also have our moments when we want to celebrate our "benchmarks". We highlight in somespecial way the months and years that roll on for those of us who manage to survive and thrive.

October 2, 1978 is an important date for me. I was 42 then. Like all laryngectomees, I remember the day my lifechanged forever. Depending on how well rehabilitated we become, we may, in time, no longer focus on our newvoices or all the other issues of stoma care, or the ability to taste and smell. Then comes the anniversary date andwe remember all of it. I relate the details of my surgeries, radiation, and speech therapy memories to delivering mysix children. Once you're past the pain and difficulties of adjustment, there is life and joy all around to experience.

How do you celebrate the gift of life on your benchmarks and anniversaries? As a boat owner I was taught tocheck the wake left behind by the propeller churning the water as you move forward.

How straight is it? Or are you swerving and wandering around aimlessly? I like that metaphor. As I look back tocheck the "wake" of my activities, I note a clear pattern.

To mark my 5th Anniversary as a total laryngectomee, I started a year before. I was elected to a three year termon the IAL Board of Directors, and began planning a statewide conference to be held in Kalamazoo, Michigan. Itwas a personal imperative to share all the wonderful knowledge given by the professionals who reached out tohelp through all of my stages of rehabilitation. The title of the conference was, "The Team Approach to TotalRehabilitation for Laryngectomees". We began with the basics from an ENT, and had a faculty that included JimShanks and Frances Stack as guest speakers. The ACS, Western Michigan University, and Bronson MethodistHospital helped every step of the way from funding, printing/postage, and meeting space. That was October, 1983.



Five years later I had divorced and moved to Los Angeles, CA. There was a large club of laryngectomees there,and I became an active member. A situation I found hilarious came up as word got around that I taught alaryngealspeech. The Club matriarch did not allow electro larynx to be used at the meetings...not allowed to even enter theroom. Those who had ELs were turned away at the door and told, "There is this 'girl' who will teach you how touse that thing...here is her number." I started to teach the new laryngectomees to use the ELs, but also ended upteaching every one of them to use esophageal speech.

You may wonder how the above story relates to my history of past personal celebrations. It is my belief that weneed to recognize what one person can do to facilitate change. Whether it is greeting one person, or an entireclass, all we need to do is say "Yes" and show up.

My first meeting with the California Association of Laryngectomees (CAL) was in 1983 when I was invited to SanDiego to do a Larkel [swimming] demonstration at their Annual Meeting. By 1985 I was living in California andattended other CAL meetings as a Delegate for my local Club. Much to my surprise in 1988 I was asked to serveas CAL President, and was elected to a 2 yr term.

That was the beginning of plans for what I perceived as a "triple header" for the 1990 CAL meeting in Marina delRey, CA. Again, it was important to me that the West Coast laryngectomees and SLPs had a mini sample of whatthe IAL Voice Institute offered. I hoped those who attended would see the opportunity, and register for the realdeal in the future. Funds were raised so we could invite Shirley Salmon, Jim Shanks and Eric Blom as our faculty,and cover their expenses. It was a turning point for CAL. Attendance went from 35 to 100 for a 3 day conferenceinstead of a one day event. Yes, it was a big risk to take, but it was a great party. Is that such a bad thing?

As the anniversaries rolled on I almost forgot about my benchmark date. Imagine? I recall one CAL meeting whenit suddenly hit me that it was my 20th Anniversary. Wow! How could I have forgotten that biggie? Time really doesbegin to fly when you are busy! I had been elected CAL President again for 1998-2000, and had another party toplan. This time it was CAL hosting the IAL in Reno in 1999.

As anniversaries go the 25th is called the "Silver Anniversary". Mine happened in 2003. Once again, I started theyear before by planning the Atlanta IAL meeting while serving as the IAL President. I understand it was a greatmeeting, but unfortunately I was too ill to travel to that one. It was a sad time for me. As my health improved I wasable to help CAL, and my local Club (Orange County Lost Chord Club, in Santa Ana, CA), prepare to host theAnaheim IAL meeting in 2004.

On October 2, 2007 I will have completed 29 years post op. Here I am, back on the IAL Board of Directors, tocontinue the work that began so long ago. As I begin to celebrate my 30th year as a laryngectomee I will bepacking my bags, and loading the car to attend another conference. The Queen Mary Conference, hosted by theOrange County Lost Chord Club, promises to be a great party onboard a very nostalgic ship for a few days withold and new friends, our vendors, and of course...Jim Shanks.

Now let's see, for my 40th I'd like to....?



MeditationBy Lanny Keithley

Throughout this year, my articles have focused on freeing up the mind to limit the negative aspects of your life andincrease the positive ones. They have offered suggestions in dealing with difficult areas of life and making the bestuse of your available resources. This month's article will address the tool to help make your mind function betterand more clearly in any and all situations - Meditation.

In my experience, few topics have had more negative and misleading information distributed about it thanMeditation. Most folks don't know what it is except that it is a bad thing. Most of this ignorance comes from it beingviewed as mystical, religious, and foreign in nature. They might link it to the crazy, long haired, bare footed, androbed Hari Krishna people that lived in airports chanting and begging for money, decades ago. Or, they mightenvision some cult, or remember the old Transcendental Meditation stuff that was so popular with the Beatles andall the folks on the "A List" back then. All of these things are from an era that many people would like to forget.

In my church a few weeks ago, my Pastor was talking about a friend of his, that was known to the congregation,and mentioned that back then he was into Meditation. The crowd made this "o that's too bad" sort of groan, whichimpressed me. The subject has been out of the news for many years, but folks still have this negative attitudeabout it - whatever it is...

So, I am writing this month's article about Meditation to provide a realistic understanding about what it is and whatvalues it can offer to everybody. It has been one of the most valuable tools in my life and can also be in yours,with very little work involved to learn or practice.

To start, we must understand what Meditation really is - and what it is not. It is one of the most simple self helptools that exists. I can completely define it in one sentence, are you ready for it? Meditation is focusing the mindon one, and only one, thing. There, that wasn't so bad was it?

There are no social, political, organizational or religious parts to it at all. It doesn't require any tools or props to do itand it can be done without any formal lessons or training, though there is a lot of information available out therethat can be used to provide an overall understanding. There are also training classes available for learning "How"to meditate, but regardless of the path you take, it really comes down to one thing - stopping and focusing all thethoughts that are usually going on in your mind.

It is something that is done only by one's self, and cannot involve anyone else, by definition. Anybody can do it thathas the ability to think and it will provide wonderful benefits to any and all that practice it. It doesn't take years of



has the ability to think and it will provide wonderful benefits to any and all that practice it. It doesn't take years ofpractice before you gain the real benefits of doing it, as so many other activities do. You realize tangible benefitseach and every time you do it - even from the first time. Do I have your attention now?

First, let me explain the benefits and values you get from practicing Meditation. In many of my previous articles, Ihave mentioned or eluded to the concept and value of mental 'free time' - time that you are not feeling itnecessary to think or be concerned about many other things than the one thing you are currently doing. In today'stime and lifestyle, most folks are constantly worrying or thinking about many different things all the time. This istiring, frustrating, and ends up causing problems - both physical and mental in nature. And, the insidious part of allthis thinking and concern is that it is almost entirely negative in its results, while detracting from the one thing thatyou are actually doing at that given moment.

The most dramatic illustration of this concept would be something like text messaging while driving. Most peoplewould agree that is not good. But, those same people, while not really doing the texting, will allow themselves tobe thinking about it and a few other tasks that might need to be done. These "extra" thoughts detract from yourconcentration on the real task at hand, that being driving your vehicle, in this example, and can have the seriousconsequences to you and others around you.

Meditation is the tool to train and teach your mind to focus on the one thing at hand, and not continually getinvolved and consumed in all the things that your mind feels might need consideration for the future. It's verysimple to do and the benefits are immediate, so let's get into how it works.

You need to be in a quiet place with minimal distractions. This will make it easier to concentrate. Then, you needto select one thing to focus on. This can be anything that you can visualize, but not something that you wouldanalyze in thought. You wouldn't want to pick something that had many facets or features that you might end uppondering on individually. This is to keep your focus on a single thing/concept and not think or change your mentalimage of it. Some classic objects include a candle flame or a single thing of nature. When, you select a real objectto focus on, this is called 'with Seed' in the meditation world, the seed being the object you selected. There is alsomeditation 'without Seed'. This is focusing on nothing, or no specific object. You can focus on the red light you seewhen you close your eyelids, for example - which is what I usually use. Anything will do as long as it is somethingyou can focus on, without producing thoughts.

No matter how you choose to do it, the technique, effort and result is the same - to keep all your concentrationfocused on the object you have selected. As you are focused on the object, you will find your thoughts wanderingoff onto other things. When this happens, just mentally say 'no', and refocus on your object. It will happen overand over again at first, and can be frustrating, but keep at it and you will be rewarded. It is said that the mind islike an impatient child that doesn't like to be told what to do, and must be dealt with accordingly. When the childdrifts away, you must sit them back down and re-focus them on the task at hand. Soon, the child will learn to obey.The mind is no different than the child, as it is use to having its own way.

After some time, which can vary from moments to many minutes, depending upon your mind's level of acceptanceand your evolving ability to focus, you will enter a very calm and peaceful state of relaxation. This is the State ofMeditation and what this is all about. This 'place' is very enjoyable and desirable, as you will see once there. Stayin this state as long as you can. The longer you stay in this state, the better and more relaxed you will feel.

After you have enjoyed this state for whatever length of time you can spend, it is wonderful to use this heightenedstate of awareness to work on specific things you might desire. It is a very creative place and you have much moreof your mental capabilities available to you then. If you are a religious person, it is a good time for spiritual work.

When you do stop your meditative state and continue on with your normal activities, which you just do by pickingup with what you want to do - there is no trance or anything like that at all. For something so maligned in oursociety, there is no downside to Meditation. It is something you can do almost anywhere, anytime, and for any



society, there is no downside to Meditation. It is something you can do almost anywhere, anytime, and for anylength of time. It can be used to bring you mentally back to a focused state, when you are out and about dealingwith the craziness of today's high speed world.

The feeling of peaceful calm relaxation in this state of heightened awareness will stay with you a little while at firstand will continue to grow in length over time. You will be more competent in anything you do and will have yourmind focused on doing the task you are working on. You will feel better in all aspects of your existence.

In An English Country Garden…with Rosalie Macrae

I had an unexpected nightmare experience this week at a famous local plant nursery. The owner is not anightmare, I must stress. She is an elegant woman in her eighties, called Beth Chatto, who floats around the worlddissecting soils in all conditions. Sometimes she can be sighted here in her own place, beheading shrubs whichdare to trespass and try to strangle the opposition. She has coach loads of visitors with prized gardens backhome. They want to grow strawberries in the Sahara, flowering jasmine in Alaska. Beth understands thesemysteries, or will phone a sheikh pal who does... or an inuit. I digress, but I'll put her website at the end and youcan read about her. No she doesn't do commissions! Not even a cutting.

As I was saying - the nightmare... It had started off so nicely. A promising September day and the bare patchesdug up by the dog were looking really bereft. Nay, naff. They needed a beauty injection. Next-door's Virginiacreeper, which I had artfully trailed and pegged down along the earth, was cheating. Not that next door Mirandawas worrying, as she has a new baby called Rudolph, who, she said over the wall, is not a reindeer but has a rednose. I would get her a plant too.

Over at the Chatto place I found some great big shrubs. Triffids, with poison in their tentacles for dogs, to forget-them-not. They cost a lot, and before deciding if they were worth it, I asked a mildly technical question of one ofthe Miss World look-alike gardeners. Zut! It turned out that she was Swedish and couldn't understand the Servoxvery well. Fair enough. A woman with a vicar in tow, who had been listening in, nodded nicely, crooked a finger,and I was surrounded by a throng of parishioners, who were with her, hyped up by their tea and scones into achorale of feel-goodness. You could just about make out their Christian faces bobbing behind the green stuff theyhad bought. They were on a trip from the church gardening club somewhere in the shires, and they wanted tohelp. The vicar's lady shouted at me that one of their gels (sic.) was a speech therapist. She would find her.



help. The vicar's lady shouted at me that one of their gels (sic.) was a speech therapist. She would find her.

"DOROTHY!" she boomed. "COME HERE. YOU ARE NEEDED." The Swedish gardener stopped working, trowelin mid scoop. The vicar waved at some imaginary Harvey and wandered off as fast as gravitas would let him. Ithought longingly of the dog holes and wished myself in one. A sweet old dolly who didn't look like a Dorothy, butit was she, pounded out of a greenhouse and the situation was explained. She took over, and held my free handin a tight clutch speaking to me v-e-r-y-s-l-o-w-l-y and clearly. I told her politely that I wasn't deaf. The Servoxwas as clear as it had ever been but she went on mouthing that she had been on a course and UNDERSTOODmy frustration. The foreman gardener turned up, saw me, remembered,-- we larys are always remembered!-- gavea wink and wandered off to tend his horrid hostas. He did not want to get involved.

All I had wanted to know was if they preferred sun or shade. Wet or dry. Did they have good spread? The answerwould have been in the catalogue anyway. I didn't feel it was important enough to mime being a ray of sunshine ora shower of rain or a spreading chestnut tree.

I am making light of it. Larys always do. We have to, and develop thicker skins than I would have believedpossible as a sensitive teenager. But it upset me nevertheless, being beamed at benevolently. I had this suddenfeeling of hysteria bordering on hyper-ventilating, looked at my watch, said I would be late, and did a White Rabbit.

I bought some humbler plants on the way home, and tea roses for Miranda, (they don't sell things like tea roseschez Chatto), at one of the big nationwide conglomerates I usually avoid. At the checkout the Irish girl shook herhead at the wilting purple hydrangea, said I wasn't paying the full price for that, touched my Servox withadmiration and thought it 'great the way yon things worked', and banged on a half-price sticker.

I felt the day had been just about worth it.

Ah, the website. http://www.bethchatto.co.ukEnchanting place. Usually!

Stroke, Part II

As I lay on the ER gurney receiving the experimental drug, the hospital staff, just to be safe, proceeded to put in atotal of four IV ports. One to draw blood, one as a back up to that function, one to administer drugs and one toback up that function. I didn't care and didn't really feel them inserted. I counted tiles in the ceiling, noticed that at



back up that function. I didn't care and didn't really feel them inserted. I counted tiles in the ceiling, noticed that atleast a few needed repair (hmm, will have to tell someone later).

After the experimental drug was finished, they took me for an MRI. Now, I was afraid. I was away from my safespace that held Frank, the doctor, and his assistant Karen. It was cold and I trembled uncontrollably. A wonderfulperson noticed it and covered me with those fantastic blankets that they keep in a warning oven. But the tremblingdid not stop. It was more than being cold; it was nerves and panic.

I had let go of my defenses earlier, now I had to face what was happening and let go of my denial. I had to behonest with myself, and eventually with the doctors, about all of the warning signs I ignored because I was toosmart, too smug, too busy, and too afraid to face the possibilities.

For seven years Frank and I had worried about a recurrence of laryngeal or related cancer. The first two yearswere the worse. Then we became more reasonable as the activities of daily life resumed, albeit modified. So I hadMRIs and PET scans and regularly scheduled checkups instead of being obsessed with the possibility of cancer.Still, every ear ache, every sore throat, every neck pain was first thought of as a source of cancer. But we hadagreed to wait a week before we acted on anything and, of course, all aches and pains disappeared since theywere normal results of getting old, overdoing it, and a host of the results of other daily life experiences.

So one of the lessons to be shared is to not focus on our cancer to the extent that we ignore other healthconditions. Let's face it, we are all getting older and are susceptible to a variety of other chronic and acute healthconditions. Our lives should not revolve around cancer, either emotionally or to the exclusion of general healthcare issues.

As I went through the MRI, being the good recovering Catholic that I am, I did an examination of conscience. Manyof you may remember that exercise. And then you have to tell the priest/doctor and finally say, “I am heartily sorryfor all my sins.” So I knew when I returned to the ER I would have to give a full history.

There were several times over the past year when I felt “spacey” and my ears would ring. I would have difficultyseeing and walking in a straight line. Not a good thing to have happen when you are at work. But I learned tocompensate. Honest translation, hide what was going on. No warning of these episodes which also includeddifficulty writing. I couldn't read what I had written when these things were going on. Of course I didn't tell anyonebecause the episodes didn't last that long and I didn't think it was anything more than stress and being tired. I wasworking 50-60 hours a week so that was my excuse for everything.

One day I was watering hanging plants outside and lost my balance, ripping up my arm and falling. I told Frank Itripped over a patio stone, which again was not true. And since it only happened once, I put it down to the heat.Then one day I was leaning over cleaning the tub and blacked out. When I came to, I could not get out of the tub.I had a very large goose egg on my head. Now our household is strange, I can't talk very loudly and Frank can'thear very well. So here I was upside down in the tub, unable to get up, and so I started to bang my shoe on thewall. It took forever for Frank to figure out I wasn't around although our dog, Annie, would run from the bathroom tothe kitchen repeatedly When Frank helped me out, I got a scolding but I never told him I blacked out, just that Ileaned over too far.

The headaches would start in the morning before I left for work. I would take 'over the counter' allergy meds andaspirin before I left and Tylenol all day at work. When my stomach could not tolerate the aspirin and other selfmedications, I made an appointment with my PCP. However I was not honest with him either except to tell himabout falling into the bathtub. He checked my cholesterol, almost perfect. Blood pressure was high. He changedmy medications and told us to monitor my blood pressure 3 times a day and record it. (if you decide to do thisusing a monitor from the drug store, take it into your doctor and have them check to make sure it is accurate.Save the receipt and don't hesitate to return it for another one if it does not check out with your doctorsequipment).



equipment).

We started taking my blood pressure at home at least twice a day and it was all over the map. I in my classicmode of denial, said to myself, that is the culprit. We will get that under control and all will be well. Except I reallydidn't believe it.

So those were all my sins that I confessed to Dr. Nash when I got back to the ER. Or at least I tried. I had to lookin those piercing eyes and confess again through my tears. He just looked at me and said, “We know. The MRIshows a multitude of TIAs (Transient Ischemic Attacks) which you knew you were having. Is there anyone moredifficult than a nurse?” I choose not to answer that last question.

More medications were given, more blood was drawn, and more tears were shed. Poor Frank was not clear onexactly what was going on but he knew it was not good. Once again, he took my hand, while Dr. Nash took myother hand and Karen helped push the gurney. We were off to Neuro Science ICU.

There are not words to express the kindness and professionalism of the staff in that unit. They were gentle, noicedthat I was crying so I got more pats than I give my beloved Annie. And assurances that were constant. Even whenthey asked me to lift my arm and leg, which I couldn't do, they would smile and say that tomorrow would be better.

There was more machinery in the room than in a car shop diagnosing a car problem! Unfortunately there was alsoa bed pan that I did NOT want to use. I didn't care that the left side of my body was not working, no bedpan! Theblack nurse aide who was ample in size and looked like she could flip me like a pancake, put her hands on herhips and said, “Girl, I have 20 minutes until my shift ends. And I won't be spending it picking you up off the floorand then filling out forms. Who you think you are? Superwoman? Well you ain't! Now lift your skinny butt so I canput this thing under you..” Guess what I did.......

Thanks to her, I gave up what little control, I thought I had, to the staff and followed all directions to the best of myability. It was intense because they could not figure out where the clot came from. I had very few risk factors.Tests, tests, and more tests. And additional tests because I was part of the investigative study. I should have beenglowing in the dark.

We had a few speed bumps. They worried about me aspirating. Dr. Nash said, laughing, “trust me, she will notaspirate!” Still the staff was afraid of my stoma and equipment. Frank brought in our book with the diagrams. Theycalled the hospital speech therapist, who had never changed or cleaned a TEP. But with the help of the booklet,and remembering her training, was able to give an inservice to the staff.

I don't remember much of the next few days. Except for one thing, there must have been a special on cannedgreen beans that the hospital bought. I had green beans for every lunch and dinner while I was there. And I atethe little buggers. However you will not find them on my plate now that I am home.

My thinking was not clear and at times. I had trouble with words. I couldn't remember maybe one word in asentence I wanted to say. More frustrating than not being able to talk is not being able to say what you mean.Everyone was so patient with me. They would wait for me to think of it and even suggested words. And when Ifinally got it, hugs all around.

One day Dr. Nash came in and said we can't afford to keep you here waiting for another stroke because that is avery high probability. We are transferring you to another hospital that specializes in rehab. It is a real hospital,affiliated with this one and we will be there checking on you.

I was terrified! And he knew it. So he said that we would skip the ambulance ride and Frank could take me, IVsand all. But! He said, no stopping at home because he knew I would not leave.



and all. But! He said, no stopping at home because he knew I would not leave.

So with many kisses and hugs and best wishes all around, I was off to my next adventure but not before westopped for take out from a great deli. (don't tell anyone!) I only ate half of a half but boy it was good! And it didnot have green beans.

On to the next adventure, intensive therapy.Vicki

What is a TIA or transient ischemic attack?

A TIA is a "warning stroke" or "mini-stroke" that produces stroke-like symptoms but no lasting damage.

Recognizing and treating TIAs can reduce your risk of a major stroke.

Most strokes aren't preceded by TIAs. However, of the people who've had one or more TIAs, more than a third willlater have a stroke. In fact, a person who's had one or more TIAs is more likely to have a stroke than someone ofthe same age and sex who hasn't.

TIAs are important in predicting if a stroke will occur rather than when one will happen. They can occur days,weeks or even months before a major stroke. In about half the cases, the stroke occurs within one year of the TIA.

What causes a transient ischemic attack?

TIAs occur when a blood clot temporarily clogs an artery, and part of the brain doesn't get the blood it needs. Thesymptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes. The average isabout a minute. Unlike stroke, when a TIA is over, there's no injury to the brain.

What are the symptoms of a TIA?

It's very important to recognize the warning signs of a TIA or stroke. The usual TIA symptoms are the same asthose of stroke, only temporary:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the bodySudden confusion, trouble speaking or understandingSudden trouble seeing in one or both eyesSudden trouble walking, dizziness, loss of balance or coordinationSudden, severe headache with no known cause

The short duration of these symptoms and lack of permanent brain injury is the main difference between TIA andstroke. TIAs are extremely important predictors of stroke. Don't ignore them! If symptoms appear, CALL 9-1-1 TOGET MEDICAL HELP IMMEDIATELY. A doctor should determine if a TIA or stroke has occurred, or if it's anothermedical problem with similar symptoms. Some examples are seizure, fainting, migraine headache, or generalmedical or cardiac condition. Prompt medical or surgical attention to these symptoms could prevent a fatal ordisabling stroke from occurring.

For stroke information, call the American Stroke Association at 1-888-4-STROKE.

Related AHA and ASA publications:Heart and Stroke FactsWarning Signs of Stroke (Quick and Easy Reading) (also in Spanish)

Learn To Recognize A Stroke

Stroke is a medical emergency. Know these warning signs of stroke and teach them to others. Every secondcounts:Sudden numbness or weakness of the face, arm or leg, especially on one side of the body



Sudden confusion, trouble speaking or understandingSudden trouble seeing in one or both eyesSudden trouble walking, dizziness, loss of balance or coordinationSudden, severe headache with no known causeCall 9-1-1 immediately if you experience symptoms!Time lost is brain lost!

From American Stroke Association, a division of the American Heart AssociationWeb site is:http://www.strokeassociation.org/presenter.jhtml?identifier=1200037

My Brother - Fuzzy Buck, a whisper on the web......

Eighteen months ago, we sat in a waiting room, not knowing if my Brother would make it through surgery, let alonespeak again. There seemed to be a chill in the air and watching him across the room broke my heart. We satacross the room so his wife, Emily, and Daughters, Kim and Kerry, could be with him those last few preciousmoments before his voice was gone forever. Who knew what his last spoken words would be and how he wouldhandle this. He seemed to be his jovial self and motioned us over. He told us he loved us (Jill, my sister, andSusan, our sister in law, and me). Those precious words were the last ones he spoke out loud to us and we willtreasure them forever.

After the surgery we tried lip reading and he would write down his thoughts on a little chalk board and he triedmaking motions to us. Some we got and some we did not. The frustration of it all was he knew what he wassaying and we did not. He tried speaking but it was not coming out. Then later before leaving the hospital aftermany days in there, he got a little robotic mouth piece that he could speak through. We could understand it partlybut he tried to talk so fast and we still had to adjust to the sound of it. There were times he would just shake hishead at us and try again. He kept practicing and Emily kept working with him on sounds. One day while cleaningthe house the phone rang and it was Fuzzy....our Fuzzy on the phone wanting to speak to our Mother. He told herhe loved her and that was the most precious sound she had heard in a couple of months from him.

It is true he has always been his best/worst critic. Even growing up he took his own advice! He is his own bestsounding board and has always relied on what he thought. We were raised to be our own persons and to think forourselves. He struggles with new ideas, thoughts, and even trying new things to speak. He has come such a longway that now we are able to sit and listen to his stories as he tells them without having to say what, what....what



way that now we are able to sit and listen to his stories as he tells them without having to say what, what....whatdid you say?

We are so thankful for each day we have with him and we too, look at life differently. What a blessing your supportgroup has been for him and we appreciate all of you and what you all do for each other. God bless you all andcontinue the good work!Carolyn McHone

New Idea!! Last month we had several surprises -- one of which was the inclusion of some terrific snapshots of real lary life --from fishing in Michigan to meeting old friends in Bali -- we have also, in the past, included marathons in Irelandand solstices in Scotland -- all of which leaves us hungry for more. We now have the capabilities of including yourdigital photos as part of our monthly newsletter. This is a opportunity for us, as cyberspace friends, to put a face toa name. Send us YOUR photos of your life -- this may be the one time you can indulge your need to be a star.Did your wife catch you mowing the lawn in those godawful shorts with a ratty bandana wrapped around yourneck? God love you -- we want that shot -- some newbie is going to be mighty encouraged by the possibility ofmowing his own lawn someday soon. Or for those grandparents who just can’t resist bragging about their “kids”--how about a picture of you all snuggled up as you read to them while you occlude -- or the one I hope to somedaysubmit, as I read Harry Potter using my EL. You get the idea. For this month…to get you started we have asampling from the 2007 WW Cruise.

Web Whispers Wonder Woman in a rare photo ofher masquerading as a mere mortal

Girls just want to have fun

Please send your photos to [email protected] subject PS PIC



Welcome To Our New Members:

I would like to welcome all new laryngectomees, caregivers, vendors, and professionals to WebWhispers! There ismuch information to be gained from our website, especially our Library, and from discussions held by our memberson the email lists. Needless to say, we also hope you will revisit our newsletters.

Pat Sanders, WW President

We welcome the 33 new members who joined us during September 2007:

Angela AlredCartersville, GA

Majella BestOshawa, Ontario, CAN

Donna M. Bivins (Caregiver)Farmington Hills, MI

J.J. BlumDallas, GA

Griffith Boyster (Vendor Member)Temecula, CA

Karen Chiasson (Caregiver)Metairie, LA

Edward EvartsScranton, PA

John GoodFlanders, NJ

Pippa Harris (Caregiver)Grovelands, Kidlington, Oxford, UK

Linda J. Hartley (Caregiver)Covington, IN

Hamid Hassan - (Caregiver)Kotri, Sindh, Pakistan

Jennifer Hill (SLP)Brisbane, QLD, AUS

Donald Hugh HoganDanville, AL

Helen Hogan (Caregiver)Danville, AL

JoAnn HoseaDelhi, LA

Kenneth G. HvamHackettstown, NJ

David L. JonesVandalia, MI

Gilbert T. JonesClarks Mills, PA

Margaret Charmaigne KazeeOcala, FL

Joan Koch (Caregiver)Crystal Lake, IL

Mick OldhamMason, OH

Wendell PettitGansevoort, NY

Mandy Pietropaolo (Vendor)Coatesville, PA

Kathy Rigley-Rowell (SLP)Clawson, MI

Vikki Slaybaugh (Caregiver)Gettysburg, PA

Elizabeth Snewin (Caregiver)Townsville, Queensland, AUS

Walter SnewinTownsville, Queensland, AUS

Douglas StaniforthSheffield, South Yorkshire, England

Cas Stevens - (Caregiver)Charlton City, MA

Steve TinklerNottinghamshire, UK

Kenneth D. Vanderslice (Caregiver)Arvada, CO

Shirley Wilson (ReturningMember)Ada, OK

James K. WithersKeokuk, IA



WebWhispers is an Internet based support group. Please check our home page for information about theWebWhispers group, our email lists, membership, or officers.For newsletter questions, comments or contributions, please write to [email protected] Managing Editor - Pat Wertz Sanders Editor - Donna McGary

Disclaimer: The information offered via WebWhispers is not intended as a substitute for professional medical help oradvice but is to be used only as an aid in understanding current medical knowledge. A physician shouldalways be consulted for any health problem or medical condition. The statements, comments, and/oropinions expressed in the articles in Whispers on the Web are those of the authors only and are not to beconstrued as those of the WebWhispers management, its general membership, or this newsletter's editorialstaff.

As a charitable organization, as described in IRS § 501(c)(3), the WebWhispers Nu-Voice Clubis eligible to receive tax-deductible contributions in accordance with IRS § 170.

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