HEADLINES
Pat Sanders, Editor
Kirklin Clinic Head & Neck Cancer Support Group, Birmingham, AL
distributed by American Cancer Society
January, 2001

HYPERBARIC OXYGEN THERAPY

Let’s talk about hyperbaric oxygen therapy.  Hyperbaric oxygen therapy or HBO is the breathing of 100% oxygen at greater than atmospheric pressure.  The normal oxygen content of the air around us is 21% so this represents a dramatic increase in the amount of inspired oxygen.  The result of increasing the amount and the pressure of the oxygen is that it greatly increases the amount of oxygen in the blood and in the tissues of the body.  This produces and encourages the formation of new blood vessels which in turn aids in wound healing. And that is the very reason that folks need HBO in the first place.  They have injuries or wounds that display poor healing.

HBO was originally used to treat decompression sickness, known as the bends, in divers. Other uses include treating carbon monoxide poisoning, large burns, and gas gangrene. However, the principal use today is in the setting of poor wound healing.  This is particularly applicable in the cases of patients who were treated with radiation therapy as this is widely known to impair wound healing.  Osteoradionecrosis is a problem that develops when a mandible (lower jaw) becomes injured, gets infected, and ends up actually dying after treatment with radiation.  HBO is a very useful adjunct to surgery in this setting as it can greatly aid in the healing process.

HBO, despite its utility, is expensive, very time consuming, requires special expertise and is only given in a very few centers around the country.  These things tend to limit its widespread use and also limit what insurance companies are willing to pay.  But in the face of a non-healing wound,  HBO is a very useful addition to the treatment regimen. 

Happy Holidays and God bless us all!!!

Glenn E. Peters, M.D. , F.A.C.S.
Director, Division of Otolaryngology - Head and Neck Surgery
University of Alabama at Birmingham
Birmingham, Alabama, USA

JOB TALK –Laryngectomees in Sales

HARRIET – HOW DOES IT WORK?

I am in sales - I own an advertising agency - and often make full presentations requiring continuous speech and handling of materials.  I use an EL (TEP has not been an option up to this time because of other difficulties) and have been a laryngectomee over four years. Currently I use the Tru-Tone by Griffin Labs - it is lightweight and smaller than most ELs - more comfortable for a woman and for situations calling for hours of speaking.  I also find that it offers a bit of inflection and tone, has little reverb and can be used with a mike when I address large audiences (I am also Executive Director of the Regional Advertising Association). 

I try from jump street to make my clients and audience aware of the situation, introduce them to my voice and let them know I am not shy...I will repeat if necessary and I don't offend easily.  I have had to excuse myself in the middle of presentations to leave the area and clear my throat.  I just tell the truth.  I have had to be temporarily speechless when I am showing materials or need to write. I tell clients to enjoy the silence, it isn't something I allow very much....in other words, make them feel at ease by being at ease. 

Some days the whole thing is a pain in the butt but some days things in general are a pain in the butt.  They were that way before I was a lary and they will always be.  I do a bunch of phone work and get people that think I am a robot, they laugh, they hang up, they are rude but I just call back, explain the situation, keep it up till I have their attention and then get on with it!

You must prove over and over that you can do a job...take it one day at a time.  Respect your abilities and respect will come back ten times over.

 Harriet Thurston,  Cincinnati, OH    paperharri@aol.com

HERB: A FRIEND QUESTIONS GOING BACK TO SALES WORK

I speak with a Servox, but used a Cooper Rand for the first two weeks after surgery and found that in most instances the Servox is a much better device for clear, easy to understand speech. Those who have TEP’s with the Servox as a backup, or alternative method of speaking, have the best of both worlds. If you wake up and know you are having a “bad TEP day,” you could opt for using the Servox.  You can take it to work with you and switch during the day if you find yourself tiring or struggling to be heard over background noise.

In order to get adept with any method of speech, you have to practice. Whichever method of speech we choose or desire to use after our surgery, the most important thing is that we are able to be both heard and understood.

I remember and was very happy for you when you applied, interviewed, and were hired for this position you now hold.  You were elated and shared it with us on WebWhispers. You impressed them enough with your qualifications, experience, courage, confidence and personality to be offered the position over the other candidates.  My guess is that had you been using a Servox when you were going through the interviewing process, sounding clear and understandable, while saying the exact same things with the same expressions and confidence, you would have still been hired.  They didn’t hire you for the way you sounded—they hired you because you were the best, most qualified person to fill the position and meet their needs.  But it was what you could do for them that was the largest part of their decision making process.

It may be necessary to use a different method of speech sometimes.  Prepare them to accept you as you are and all the while do a great job for them and keep smiling!  If you are doing a fine job for them, they will be understanding of your situation. They knew you were a laryngectomee when you were hired.  If something is bothering you, try not to let it show.  You are a professional!  You have the job and you earned it. Interviewing is the hardest part as a laryngectomee -- to win the position, to be selected over all the other candidates. Make them know they made the right decision when they hired you.

I went back to work selling new, custom-built $500,000 to $800,000 townhomes in suburban Washington, DC about 4 and a half months after my surgery.  They had just signed my assistant to a contract to replace me.  She had been there all that time I was healing and hadn’t sold anything.  I had never spoken to them on the phone because I wasn’t very clear with the oral adapter and didn’t want to turn them off.  I used to e-mail and fax to them, but wouldn’t speak to them.  When I was able to shed the oral adapter, I made an appointment via e-mail for an in-person meeting with them.  I tried to sell them on the fact that I was as good as I ever was.  THEY didn’t think so because of my voice, but I had the self confidence, and eventually led them to my way of thinking when I mentioned the legal complications that could and would occur for them when I related this situation to my attorney.  I followed that with a look straight into the CEO’s eyes with the question: “Can you understand what I am saying?” When he answered yes, I explained that the prospects for these elegant townhomes would be able to understand me too!  With that they gave me a chance to prove myself again.  Twelve months later I had sold as many of their custom townhomes as I had in the 18 months prior to my surgery.  They were happy.  I was happy because I had been successful in winning back my job, building my self confidence, and also filling my pockets with those nice large commissions.  I KNEW I could still do what I did before my surgery!  I just sounded different. I had to win back my old job and you went out and got a new job.  I really think what you did was harder.  I knew I could do my job—I was motivated and determined. 

I had to adjust to life as a lary on the job and to the suits and ties everyday.  I had to adjust to the sudden “mucous attacks” that would startle everyone, (including me at first) while I was making a presentation to prospects.  I was embarrassed some in the beginning when these instances would occur, but as I got used to what was happening with me, I adapted and, sometimes, depending on what I was like that day, I’d forewarn customers of the possibility of a strange cough. Other times I wouldn’t say anything and just concentrate on why we were both there in the first place.

Herb Simon,   Silver Spring, MD      H457@aol.com

Letter to a Laryngectomee-to-be

I am so sorry that you will have to have your larynx removed.   But there are some very important messages I received as a laryngectomee-to-be and afterwards, and I would like to pass them along to you.

1.      It may look like it right now to you, but “this is not the end of the world.”  This particular type of cancer has an exceptionally high cure rate.   The odds are overwhelming that you will survive.   The word “cancer” still has the power to scare us all, but know it is no longer a death sentence, especially for this cancer.

2.      Not only can one survive the loss of a larynx, you can actually “thrive.”  By this I mean that you can regain almost all that you lost when you lose your larynx.   Fully recovered laryngectomees often say they are 90% (or even more) the same as before the operation.   It is typical that you may be focusing on the 10% loss in the beginning and lose sight of the 90%, but that will change with time.

3.   You will speak again, although the method or methods you will use may not be known right now.   I work full time as a teacher and I know other laryngectomees who are salesmen, ministers, or others who have to talk for a living.   I hope that your hospital is one which works on speech rehabilitation right away such as with an oral adapter on an artificial electronic larynx.   But whether it begins in the hospital or not, speech rehabilitation is something you will focus on once the physical healing is well underway.

4.   If you work full time and can do so, retain your rights to eventually return to your job.   The people you deal with at work or otherwise will almost certainly know nothing about this cancer.   They may think it is fatal, or know nothing about how someone can speak without a larynx.   So do not let anyone define you as “handicapped,”(including yourself), much less as someone whose usefulness is now at an end because they won’t be around much longer.   But do not be surprised by peoples’ ignorance, and try not to allow their lack of knowledge to affect your image of yourself.

5.   You are not the first person to go through this, and you are not alone.  

I hope that you have already been visited by a laryngectomee.   This is vitally important.   If there is a local support club, join it and attend when you are able to do so.   Get the telephone numbers of several recovered laryngectomees you can call when you have questions.   No one understands better what you are facing better than someone who has gone through it.

6.   Healing from this takes time.   The healing time is not measured in days or even weeks, but months.   Sorry, but that is the way it is.   But do know you will feel SO much better down the road...”back to your old self.”  There are adjustments you have to make to life as a laryngectomee, but you can make them.

7.   If you own a computer, join the WebWhispers group.   It is an Internet-based laryngectomee support group.   You can get all kinds of information here and answers to your specific questions.   We understand, and we care.

Warm regards,
David Blevins, Editor
New Voices, WebWhispers Journal, IAL News