1340 E. Pebble Road #115
Las Vegas, Nevada 89123

phone | 702.558.9900
fax | 702.558.9920

What is Vocal Hygiene?

Do you have good vocal hygiene? Its probably not something that many people think about except for singers, performers, and speech-language pathologists. But just like a singer relies on her voice, you rely on yours every day. Whether you’re talking to family, your coworkers, or when you’re calling up the pizzeria to get a pizza on Friday night, you need your voice just as much as anyone else. Everyone should care about vocal hygiene. Here some ways you can make sure to keep your voice clean and healthy.

Hydration

Water. Water. Water. Water is the key to vocal hygiene. If your vocal cords are dry and your mucous is thick, you’re going to be straining all day. Keep your vocal cords moist by keeping your body hydrated. How much is enough water? The US National Academies of Sciences, Engineering, and medicine say women should have 2.7 liters and men should 3.7 liters. Of course, if you are exercising or live in a dry place, like Las Vegas, you have to increase those numbers. A good goal is to take your body weight and divide that number in half and then drink that amount of water per day.

Warming up

There are plenty of exercises to warm your voice up. Humming is a great way to start. Labial trills are another warmup to try. Think about the “raspberries” you give a baby. Now, just turn your voice on and make buzzing sounds trilling your lips. There are so many warmup exercises you can learn on YouTube. If you are having voice difficulties, it would be great to see a Speech Pathologist so you can see how to improve your voice quality!

Sleep

Our vocal cords, just like every other muscle in our body. They need a break at night when we sleep. So, that means we need to get good sleep. Yes, of course we should try to get our 8 hours and such but there are other important factors during our sleep. The main factor having to do with what we eat before we sleep. Acid reflux during sleep is a problem that runs rampant in the United States but most people don’t even know its happening to them. It’s important to remember that gravity helps keep our food down in our stomach. When we lay down its possible for some low levels of acid to travel back up our food pipe (esophagus) to our throat (larynx/pharynx). Although acid is fine in the stomach, it can damage our vocal cords. We must remember to space eating and sleep by 3 hours, so that your stomach isn’t digesting food when we lay down at night. You may notice you wake up in the morning with mucous in your throat. This could be a sign that you are having some level of acid reflux.

Vocal Hygiene

It is important that everyone have good vocal hygiene, not just professional voice users. Poor vocal hygiene and voice misuse can lead to dysphonia, or hoarseness, in anyone. If you do feel like your having hoarseness, it would be a great idea for you to see a speech pathologist especially someone who specializes in voice. Ask your ENT for a referral to a speech pathologist and if you’re in Las Vegas, ask for a referral to Vegas Voice Institute.

Better Speech and Hearing Month 2022

This month, Vegas Voice Institute celebrates Better Speech and Hearing Month. Each May, Better Speech and Hearing Month allows Speech Pathologists to raise awareness about communication disorders and the role Speech Language Pathologists have in treatment. Whether it be communication or eating, speech pathologists help those who can no longer take those two simple tasks for granted.

Speech therapy comes in all shapes and sizes. Speech Therapy can be provided for those with strokes, dementia, Parkinson Disease, and others. In speech, you might see us helping people learn how to use language again, improve their speech, or improve their memory and cognition.

Vegas Voice Institute also has speech pathologists who specialize in working with patients who have swallowing and voice disorders. Helping people relearn how to eat and swallow is a life-altering therapy that allows patients to join the dining table with their family again.

We don’t realize how much of our day is spent at a table where we eat or at events like weddings or family parties. We work with patients who have recently had pneumonia or breathing problems causing problems such as aspiration pneumonia or choking when eating in speech therapy. We also work with patients after radiation who have had cancer of the head and neck. These patients often are unable to use their muscles to eat and have a tube in their stomach for nutrition. Our NMES Vital Stim treatments and dysphagia treatments help restore their function so they can eat and drink again. Providing speech therapy to allow patients to rejoin the family dinner is challenging and rewarding work.

Voice therapy includes working with professional voice users, singers, or people who just have a hoarse voice. You don’t have to be a famous singer or tv analyst for the Vegas Golden Knights or the Las Vegas Raiders to need voice therapy. Having a hoarse voice isn’t “typical” and we can usually help with reducing hoarseness in your voice.

Many of our patients have difficulty controlling their breath when exercising or cough often requiring speech therapy to increase their voice and breath control which is called vocal cord dysfunction. We also help patients who are experiencing voice weakness after COVID-19 when they have trouble projecting their voice or getting air in when speaking.

Speech language pathologists work in many different settings including acute hospitals, inpatient rehab, schools, and nursing homes. There are also outpatient rehab centers, like Vegas Voice Institute, where patients come for treatment. Speech therapy can now be provided through a combination of telehealth and in-person therapy for most areas.

If you or someone you know needs speech therapy, you can ask your doctor for a recommendation for a local speech language pathologist. Payment for speech therapy services can be covered by private insurances like Aetna, Blue Cross, P3, Medicare, and others or can be paid out-of-pocket.

Better Speech and Hearing Month isn’t about celebrating speech pathologists even though our team of speech-language pathologists are fabulous, highly trained, and effective in their jobs. It’s about raising awareness about how quality of life can be improved through speech therapy. Everyone deserves to be able to communicate effectively and eat safely.

Traumatic Brain Injury and First Responders

Improving Interactions with People with Traumatic Brain Injuries

By Vincent M. DelGiudice, M.S.CCC-SLP
Speech-Language Pathologist
Vegas Voice Institute

Traumatic Brain Injury (TBI) is when a person has a physical injury to their head or neck resulting in a disruption of normal function. This can be caused by a blow to the head, penetrating injuries, assault or motor vehicle accidents. The injury to the head may affect cognition, attention, memory, a person’s movements, and their emotions. With these deficits, any high stress situation can escalate quickly. So, it is important to understand what the signs of a TBI are and how to best interact with a person to decrease the chance of escalating the situation.

Being aware of these signs or symptoms is an important first step to interacting with someone with a TBI. TBI survivors sometimes have difficulty with controlling emotions and/or overreacting. Identifying these signs or knowing that someone had a TBI can be the difference between a safe interaction and a crisis. These tools can help de-escalate situations to make it safer for the first responders and law enforcement.

Communication is key when encountering anyone who may have poor short-term recall. Try to include family in the conversation when obtaining details or information as they can help fill in gaps if memory is an issue. Try to give the person breaks if they are looking fatigued from trying to remember information. Try to avoid patronizing or asking them to “calm down.” Suggest using deep breaths to help them calm down if they are becoming frustrated or aggravated. Allow more time than usual for the person to respond. Processing time for information can be slower and they may need more time to think about the question.

If you or someone you know has recently suffered from a traumatic brain injury and you think they may need help, we, at Vegas Voice Institute, are here to help. Speech/Language Pathology can be a way for you to improve some cognitive and processing deficits as well as learn how to cope with new deficits. Vegas Voice Institute can work with you and your family to help develop strategies specific to the problems you or a loved one may have. Don’t hesitate to call to find out how speech pathology can help you.

Your Neighborhood Speech Pathologists!

By Vincent M. DelGiudice, M.S.CCC-SLP

Speech-Language Pathologist

Here at Vegas Voice Institute, our team of Speech Pathologists has been serving the Greater Las Vegas area since 2003. As speech pathologists we serve a variety of patients. As the name of our business suggests, we treat and educate those in the community who have been affected with voice disorders. But that is not where we stop. Our team of speech pathologists is trained to treat disorders that affect your swallowing, speech, ability to communicate with others, and memory.

At our clinic, we are equipped to perform most of our assessments right in the office. If you are having difficulty with swallowing, we can provide a dysphagia (difficulty swallowing) assessment right here in our office. When a patient comes to us with a voice disorder, we are able to perform a Stroboscopy right in our office as well. A Stroboscopy is an assessment of your vocal cords. Your vocal cords move so fast that we need a strobe light to slow down the movement of your vocal cords to assess what is causing your voice disorder.

Vegas Voice Institute treats all kinds of voice disorders including hoarseness, vocal nodules, muscle tension, quiet or weak voices and vocal cord dysfunction. But we don’t just treat singers with voice disorders. We treat all professional voice users, including teachers, preachers, real estate agents, attorneys, coaches and more recently, all professionals who have begun working remotely. But professional voice users aren’t the only people who have difficulty with their voice. As you get older, it is possible that your vocal cords and voice may weaken and people can have difficulty hearing you. At Vegas Voice Institute we feel it is of the utmost importance to used research-based therapeutic approaches. This means that the therapy has been researched over and over again before we try it out on you. For example, if you have a weak voice, we may use the Lee Silverman Voice Treatment or PhoRTE voice treatment because they are some of the most well researched types of therapy available. That means we know it works.

Vegas Voice Institute can provide you with therapy and exercises to help you improve your ability to communicate whether you are singing on the Las Vegas Strip or you just want to be able to hear your husband from across the room. Feel free to click on the Services tab to discover the therapeutic approaches we use for voice therapy.

Unfortunately, your voice isn’t the only thing that can cause problems with communication. There are a LOT of reasons you may have difficulty with communication. Have you had as stroke? Do you know someone who has suffered from a stroke? At Vegas Voice Institute we treat neurological disorders with different therapeutic approaches to improve language, memory, processing, and speech. These disorders can be caused by a stroke, or other diseases such as dementia, aphasia, brain injuries, and brain tumors.

Although there are certain deficits that may be progressive or permanent, our team is always willing to work with patients and family to find the best ways for you to communicate.

Vegas Voice Institute proudly serves the community of Las Vegas. We appreciate all of our patients, as we feel it is a privilege to have been treating patients here since 2003.

Aphasia: Finding Communication Opportunities during COVID-19

By Kyle Traux, M.S.CCC-SLP, Speech-Language Pathologist

A common problem for people with aphasia and their caregivers is how to find opportunities to safely practice communication during the time of COVID-19. In normal times, getting this would be relatively effortless: one would have the option of moving freely around one’s environment engaging others at will or joining social groups. For those less outgoing or not quite ready to strike up conversations with strangers or even place an order at a restaurant, there are groups one can join made up of individuals who share similar experiences with language loss and rehabilitation. But with so many of these avenues temporarily blocked because of restrictions on social gathering, what can one do?

We at Vegas Voice Institute would like to help you find some options for increasing communication and language opportunities:

  • Chat on the phone or on-line- Communication with friends and family often allows for a less stressful and/or overwhelming experience as these tend to be people who are familiar with your difficulties with communication and can help support the conversation. Schedule recurring phone ‘dates’ with friends and family and use scripts or talking points to aid the conversation.
  • Practice with Apps- A variety of apps are tailor made for aphasia and offer a wide variety of skills to target. These apps are designed with the person with aphasia in mind and are thus user friendly. Check in with your Speech-Language Pathologist (SLP) for advice on selecting apps to supplement speech therapy.
  • Join virtual groups- A few aphasia groups have moved online due to social restrictions. While it may not be the ideal way to satisfy our social needs, it may just be the best option we have for now. Check out Aphasia Recovery Connection on Facebook.
  • Write, Read and Listen- Pick up a pen and write a letter, keep a journal or practice writing something from memory, such as the Pledge of Allegiance. Try listening: Tune in to an audio book or browse the seemingly infinite library of podcasts.
  • Dust off a favorite book: If your favorite author now appears too complex, pick up a magazine or even a book targeted toward younger readers. You may find support in aphasia friendly material. Check out this news site: http://talkpathnews.aphasia.com/
  • Ask your SLP for some home practice- If motivation is a problem, request that your SLP give you some home practice. Your SLP will be able to provide tasks that are specific to your area(s) of need.

Though current conditions prevent us from seizing the most optimal rehabilitative opportunities, we don’t have to remain silent. Be creative and take opportunities like welcoming a new neighbor from a safe distance, ordering at the drive thru window or asking the stocker at the grocery store when they expect more toilet paper. Your recovery is not yours to face alone, but it will likely require some initiative. So try something new.

If you or your loved one doesn’t currently have a Speech Language Pathologist to work with, contact us at Vegas Voice Institute and we can guide you through the steps needed to get the support that you need to begin or resume your rehabilitation.

Speech Therapy and Covid-19

This year has been a crazy ride for all of us. Whether you work full-time, or you are retired, whether you work in healthcare or the service industry, we have all been experiencing changes in our life because of Covid-19. Unfortunately, we must learn to adapt to this new world we are living in.

At Vegas Voice Institute, we have been doing our best to provide a safe, sanitized, and clean environment for our patients to be seen in the office. Our team sanitizes each room after a patient was seen to ensure the patient and the staff is entering a clean sanitized treatment or procedure room. Our staff wears a mask, our rooms are outfitted with UV filters and we provide plenty of space for patients to socially distance. We also offer Telepractice sessions for most types of treatments when patients would prefer not to come into the office. Telepractice means that we offer therapy via video chat instead of having to come to the office. We want our patients to feel as safe as they do in their own homes.

There are some exams and treatments that we do need to see you in the office. For example, if we are going to evaluate your swallow to make sure that you are eating and drinking safely, we need to see you in the office so that we can be absolutely sure your swallow is safe. But for certain treatments, such as voice therapy or cognitive therapy, we can provide patients with the ability to be seen from home via Telepractice or video chat. If you are thinking about sending your patients to us or if you are a patient and prefer to stay home, we would be more than happy to set up your appointments to be seen from home.

Vegas Voice Institute has been doing therapy sessions for patients by utilizing Telepractice for years before Covid-19 first began. We are not new to Telepractice, so the transition has been going smoothly. Fortunately, we have a great team who can provide you with support if technology is not your strong suit. Of course, we would prefer to see our patients face-to-face, but we want to continue providing service for the people of the Greater Las Vegas Area and this virus is not going to stop us.

Now, Vincent DelGiudice M.S. CCC-SLP is returning to our team, and he will be solely providing therapy via Telepractice. You can check out his bio at this link.

If you have more questions about the precautions, we are taking here at Vegas Voice Institute, feel free to call us anytime. We can also provide you with more information on our ability to do Telepractice with you or your patients. Whether you or your patients are located too far from the office or you feel you or your patients are still not feeling safe because of the Coronavirus, we would be happy to discuss options to provide therapy to you in the safest way possible.

Better Speech and Hearing Month

The month of May is Better Speech and Hearing Month. This is a month that speech pathologists have dedicated to spreading information and enlightening communities about people who struggle with speech disorders. It is about advocating for those who can’t advocate for themselves; teaching about speech disorders that otherwise may never be known about or understood. 

Speech pathologists serve a large variety of disorders. We won’t go into depth of all of the speech disorders, but let’s talk about one cause for speech disorders that is often misunderstood; strokes.
A stroke, otherwise known as a Cerebrovascular Accident (CVA), is a loss of blood flow to the brain, whether it be a blockage or a rupture in an artery. The lack of oxygen causes brain tissue to die. A stroke can cause aphasia, dysarthria, memory loss, and even swallowing problems.

Aphasia is the loss of language following a stroke or some other neurological event. It can cause the person to have difficulty finding words or the person may be able to speak, but what they are saying may not always make sense. The part of the brain that understands and uses language is often affected after a stroke. This means that people often keep their intelligence but are unable to express it. 

Dysarthria is muscle weakness in the speech muscles. Speech can sound slurred or spastic when someone suffers from dysarthria. His/her volume may be much lower or uncontrolled, or the voice may sound hoarse or strained. The speech does not reflect the person’s intelligence. 

Swallowing problems from a stroke occur in more than 50% of survivors but luckily it usually resolves within 7-10 days. After that, 11-13% of patients continue to suffer from dysphagia (swallowing problems). Swallowing problems can make it difficult to chew and/or swallow your food. It can cause you to choke or cough on food or water. Swallowing problems can lead to aspiration pneumonia, which can make you a frequent visitor to the hospital. 

Finally, memory loss occurs in stroke patients but more often in older patients. Symptoms can include confusion, wandering or getting lost in familiar places, difficulty following directions, and/or trouble with money. When we know someone has had a stroke, keep an eye out for these symptoms, to ensure his/her safety.
If your family member or loved one, or even a friend suffers from any of these symptoms, tell them about speech therapy. In speech therapy we can help improve work on and improve these symptoms. Speech therapy and rehabilitation has been shown to improve memory loss as well as the ability to communicate and speak. If you have swallowing problems, tell your doctor that you are coughing and/or choking while eating or that food gets caught in your throat. 

If you have any questions about speech therapy, please feel free to call or email Vegas Voice Institute at 702-558-9900 or email: vegasvoice@lvcoxmail.com.

Speech Therapy Help After Having a Stroke

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

Speech Therapy Talks About Strokes

When someone in our family has a stroke, it can be a very difficult event. Of course, we want to make sure our family member is going to be okay, but sometimes it can be difficult to communicate with medical professionals. Listening to doctors, nurses, & other members of the medical team can be like listening to a different language.

In speech therapy, patient education is usually the first step, because by the time you get to us, you probably have plenty of questions. We are going to break down some of the terms you may hear discussed when you or a loved one has a stroke. Let’s start with a simple one.

CVA: A CVA or Cerebrovascular Accident is another word for a stroke. You can either have an Ischemic Stroke or Hemorrhagic Stroke. Ischemic means blockage and Hemorrhagic means a brain bleed.

In speech therapy, we work with the following impairments:

Dysphagia: Difficulty or inability to swallow. This can result in aspiration (food or liquid going down the wrong pipe) which can cause pneumonia.

Dysarthria: This is when speech sounds slurred due to muscle weakness or muscle incoordination.

Apraxia: This is a neurological disorder that results in a person’s inability to perform physical movements, whether it is speaking or moving one’s arms and legs. The person wants to perform the task but motor planning is impaired. In other words, the brain knows what it wants done, it just doesn’t know how to do it.

Aphasia: The loss of one’s language resulting in difficulty communicating. A person can have difficulty with speaking or understanding others. This usually results from damage to the left side of the brain.

Some other terms that you may run into outside of speech therapy are the following:

Hemiplegia: Total or partial paralysis of the body

Hemiparesis: Weakness on one side of the body

Quadriplegia: Total or partial paralysis of all of the limbs.

TPA: Tissue Plasminogen Activator, or TPA, is a drug used to break up clots in an artery. The drug will dissolve the clot to restore blood flow to the brain. This drug is only used if there is a clot, not if there is a hemorrhage.

TIA: Transient Ischemic Attack, or TIA, is when blood flow to a certain part of the brain is cut off for a short period of time, usually less than 15 minutes. A TIA is a warning sign that something is wrong, and it should be taken as seriously as a stroke.

Thrombus: This a blood clot that forms in a blood vessel in the brain.

Lability: When a person has emotional responses that do not coincide with the current situation.

Hyperlipidemia:  High Cholesterol

Hypertension: High blood pressure.

Endarterectomy: Surgical removal of plaque from an artery.

Stenting: Placing a small mesh tube in an artery during an angioplasty.

LTAC: Long term acute care.

Skilled Nursing Facility:  A facility that offers long-term care and rehabilitation with therapy such as physical, occupational and speech therapy.

The most important thing to know is what to do if we think a loved one or anyone is having a stroke. We use the acronym act FAST. FAST is an easy way to recognize the most common symptoms of a stroke.

Face: Ask the person to smile. Does one side of the face droop?

Arms: Ask the person to raise both arms. Does one arm drift downward?

Speech: Ask the person to repeat a simple phrase. Does their speech sound slurred or strange?

Time: If you observe any of these symptoms call 9-1-1 immediately. Acting quickly is important. Note the time when you began observing these symptoms.

If you or a loved one had a stroke, and communication or speech is a problem. Contact Vegas Voice Institute for speech therapy at 702-558-9900 so we may assist.

We provide speech therapy for patients having difficulty communicating or understanding others. Let us help you regain your communication.

Communicating is Hard!

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

Does someone you know have Aphasia? This isn’t a word we hear often. People usually only learn about Aphasia when it directly affects them or a family member. You may have met someone with aphasia and didn’t really understand what was wrong, but knew something wasn’t quite right. Here is a breakdown of what aphasia is and how we deal with it in speech therapy.

Aphasia most often occurs when someone suffers from a stroke, but it can occur when there is any type of brain damage such as a brain injury. A person with aphasia may have trouble understanding, speaking, reading, or writing. Aphasia DOES NOT cause a loss of intelligence or ability to think.
People with aphasia may describe it as knowing what they want to say but unable to form the words. It is similar to when you have a word on the tip of your tongue but can’t quite think of it. When someone is newly diagnosed with aphasia, it is important that they go to speech therapy to try and regain as much language as they can. The longer someone waits to go to therapy it decreases the chances of making progress.
If we break apart language into a couple different parts we can look at different symptoms of aphasia. Here are some of the symptoms we may look for in speech therapy.

Expressive Language (or talking)

  • They can’t think of words.
  • They use made up words.
  • They have difficulty forming sentences; maybe using single words is easier.
  • They may use the wrong word in a sentence. It may be a related word, like mixing up “river” and “ocean” or it could be unrelated such as replacing “chair” with “milk”

Receptive Language (or understanding)

  • This is when there is difficulty understanding what others may say whether it be because they are talking to fast or because it is too noisy.
  • A person who has difficulty understanding may have difficulty correcting their own sentences because they don’t hear or feel like what they are saying is wrong.

Reading and Writing

  • Any difficulty reading whether it is with books, a form to fill out at the doctor’s office, or a grocery list.
  • Difficulty with spelling or writing words in the correct order.
  • Difficulty with using math for basic activities such as paying a bills or adding and subtracting.

In speech therapy, we treat all these impairments. We use communication-based and impairment-based strategies. Communication-based therapy focuses on the “now.” We look at ways to help communication now, so that our patient can communicate basic needs. Impairment-based therapy focuses on repairing the impairments that a patient may be suffering from. This include programs such as melodic intonation therapy.

There are certain strategies you should employ when conversing with someone with aphasia. It isn’t always easy to communicate with someone suffering from aphasia but there are ways that it can improve just by using some simple strategies.

Tips for communicating when someone suffers from Aphasia

  1. Get the person’s attention before you start speaking.
  2. Give them context or tell them the topic of what you will be discussing.
  3. Speak slowly and be direct. Don’t speak loudly or yell, they can hear you just fine.
  4. Maintain the topic that you are discussing. If you change topics, be sure to let your communication partner know.
  5. Use visuals if necessary to help explain.
  6. It may help to write things down if they are not having difficulty reading.
  7. Try to ask questions that have “yes” or “no” answers.
  8. Don’t finish their sentences, allow the person time so that they can express what they want to tell you.
  9. Let the person make mistakes and let them try to fix them on his/her own. Wait until they ask for help before jumping in.

Aphasia is frustrating for everyone involved! Although humans are able to communicate, we all know that we aren’t always the best communicators. Work hard at being patient with someone who is having difficulty with communicating. It takes hard work to make sure that everyone’s wants and needs are being addressed. Look up a speech therapy office like ours at Vegas Voice Institute, to help you and your spouse, family member, or friend improve their ability to communicate with others!

Why is my doctor sending me to speech therapy for my voice?

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.