Speech therapy is a term that encompasses many different types of therapy including voice and swallowing therapy. There are many reasons why your doctor may want you to consider voice therapy. You could have a lesion or nodules on your vocal cords that could be reduced with therapy. You could have a quiet voice from a diagnosis like Parkinson Disease. Your voice could be strained or hoarse from your job. Sometimes people are sent to voice therapy because they are having asthma-like symptoms or choking sensations in their throat where they feel like they can’t breathe. This can be diagnosed as vocal cord dysfunction.

What is voice therapy going to do for me?
Voice therapy has many different approaches but the first part usually involves learning about your voice and how you should be treating it. A speech therapist will teach you exercises to make your voice feel and sound better. Voice therapy can help with hoarseness, and/or a quiet or strained voice. It can be used to strengthen and/or reduce tension in the throat. You will learn stretches and breathing exercises that will help you maximize your voice to its full potential.

Can’t they just give me the exercises for home?
Voice therapy is highly individualized as each person presents with a different diagnosis. It is difficult to say how long or what type of voice therapy you will have to adhere to without doing a thorough voice evaluation. The duration of speech therapy is usually dependent upon the origin of the hoarseness and the severity of the problem. Upon completion of your evaluation, your speech-language pathologist will talk to you about the issues you are having with your voice and discuss with you the frequency and duration of your therapy. The therapist needs to make sure you are performing the exercises correctly or you could exacerbate the problem.

Is it expensive?
Most insurances cover voice therapy. We believe in improving your voice and allowing you to recover and heal your voice versus costly alternatives such as surgery or taking time off work because you cannot talk. Some patients must pay high copays or deductibles for therapy, but voice therapy IS a covered service.

If you are having trouble with your voice, ask your doctor to send you to a speech-language pathologist or check out the rest of our website and give us a call. Vegas Voice Institute is always here to assist with your healthcare needs.

Electrolarynx

by Vincent M. DelGiudice, MSCCC-SLP
Speech-Language Pathologist

Choosing the best option for your communication after a total laryngectomy depends on several factors. Most people can use the electrolarynx while other options may be more limited.
The electrolarynx is a relatively simple device to use. The upkeep with the device is easy and only requires battery changing. An electrolarynx is a good option for someone who isn’t eligible for other types of devices. This device is easy to learn and you can communicate as soon as you start using it.
The device takes the place of your voice box. It vibrates the throat and when you mouth words, you will hear what you are saying in a slightly robotic voice. It will take some time to learn to space out words and certain sounds to maximize intelligibility. There is a short learning curve to using this device accurately. This device is a cylinder shape. It looks similar to a thick glue stick and would have to be carried in your purse or pocket wherever you went.
My grandfather uses this device and when I asked him why he chose this device, his answer was, “there were no other options. This was the only option for me.” As that may be true, he may not have been given other options, so it is important to ask before your surgery about all of the options for communication. You want to make an informed decision on how you want to communicate and there is no reason why you shouldn’t test out an electrolarynx before your surgery, as anyone can use it with or without a larynx.

You Have A Hole In Your Throat, What’s Next?

by Vincent M. DelGiudice, MSCCC-SLP
Speech-Language Pathologist

Total laryngectomy is a procedure used to save a person’s life when a doctor feels that throat cancer may spread. Disrupting someone’s natural airway and voice is not something we typically take lightly in this field, but it is something that is done. After this procedure is performed, it’s time to deal with the problems in front of us and decide how to compensate and improve the quality of the life saved.
After this surgery, you are left with a few choices to regain your “voice” or ability to communicate back. The first type is the electrolarynx. This is a device that is used to vibrate the oral and pharyngeal cavity and act as the vocal cords. It is small and can fit in your pocket. It’s a cylindrical device and you hold it to your neck. They can be expensive, so try not to get in the pool with it. You might laugh at this, but you will become so accustomed to using this device it, will be part of you.
Another for regaining your voice is called esophageal speech. This is essentially burping your speech. You remember when there was the kid in grammar school that could burp the ABC’s. This is the type of voice that you can attempt after losing your vocal cords. Some people have a great quality voice with this speech while others find it is too much work or they may not like the sound.
Lastly, you can get a tracheoesophageal puncture (TEP). This is a device that is set up during the initial surgery or during another minor surgery a few weeks following the total laryngectomy. It is a device in your stoma that when held forces air through the esophagus (food pipe) instead of the no longer existent larynx (top of the windpipe). It vibrates the top of the esophagus and creates the vibrations needed for speech. There are now also devices that are hands free so that you don’t have to reach up and hold your stoma. There are also plenty of different variations of prostheses that can be used to make you more comfortable. Discuss this with your doctor or speech pathologist to see what would work best for you.
Again all of these options are up to you. Think about it carefully and ask around. Ask your doctor and your speech pathologist to discuss ALL options with you. It is better to make a well-informed decision rather than to choose what someone else prefers. Choosing between these options can be difficult for some people. Fortunately, there’s no reason you can’t try all of them. You can practice esophageal speech and try the electrolarynx before you even have surgery to know if either of those would be good options for you. Stay tuned for the next few blogs where I will discuss these three options in more detail.