Kirklin Clinic Head & Neck Cancer Support Group,  Birmingham, AL

distributed by American Cancer Society

Pat Sanders, Editor

March 2003


Getting your life back, a slice at a time                                   by Bill Snowden 

When my good friend Pat asked me write about the Barton-Mayo Button and the use of the Hands Free valve I was delighted to do so.  Being able to speak with the button and the valve is such a big plus and affects your life as a lary in a number of ways.  So back to the beginning. 

In the late 90's I, like so many of us, experienced voice and sinus problems.  My doctor reviewed by records and determined I had classic allergies and I must have gone virtually the gambit of antibiotics.  One ENT even did a biopsy and the results were negative for cancer.  Enter Dr Glenn Peters and Nancy Lewis at the Kirklin Clinic. Nancy figured it out and I’m sure Dr Peters did it under a minute.  Like most of us, I knew nothing about throat cancer or what the surgery entailed or all the other ramifications, but once I knew I had this disease,  I wanted it cut out, the sooner the better.  I got lucky and didn’t require radiation or chemo, and more importantly had the benefit of Web Whispers and the Kirklin Support Group and the accumulated information in Headlines.  After the hospital stay of nine days, and on the feeding tube 24 days, I begin with the oral adapter on the Servox, quickly went off the adapter and shortly thereafter, in January 2001, had the TEP done by Dr Peters. 

I wanted to achieve Hands Free speech.  I begin with the housings that are glued on, mostly using the ATOS flexiderm oval ones.  I tried the discs and the attachable housings but found the one piece type the best for me.  After a number of months I could usually get from 4 to 6 hours before blowing a seal.   The trick was being able to remove the valve before coughing.  Workable, but time consuming, and for extended speech, it just doesn’t give you much confidence.  Also, the speech quality varied.  Some days, it was excellent and others it appeared to be slurred.  It seems many also have problems with the glue irritating the skin so I was still open to other ideas.

About a year ago, I begin to hear about the Barton-Mayo Button.  Although it has been around awhile, I had not met anyone, in any of the groups I attend regularly, who was using it.  It was an article in the IAL News that got me really interested.  Since I get most of my supply needs at the VA (Ramona Fawcett at the
Birmingham VA is outstanding in her support of larys and has never failed to meet any request I have ever made) that was stop “one”.  B-M Buttons come in a number of sizes, the sizes indicating both the length and diameter of the part that is inserted in the stoma.  (I eventually ended up as a size 10 short)  Fitting is very important and is not easily determined except by trial and error.  A fenestration hole is usually required in order to get air to the prosthesis and I have found that the 97 cent punch from Wal Mart works best and leaves no rough edges.  The B-M Button is inserted easily by folding and coating with a little water soluble KY jelly (The manufacturer recommends Olive Oil, but I personally do not believe that is a good idea).  Once seated, the button should be comfortable, but tight.  If it slides or pistons, irritation of the stoma most likely will occur.  With the Hands Free device inserted in the button, speech become fairly normal and. to be honest, most people just think I have a bad cold or just harsh speech, but it does not appear that anyone has trouble understanding me.  I still try to remove the device if I cough, but if I can’t get it out in time, the worst is that the humidifilter gets clogged with mucus or the membrane on the device gets stuck.  I have learned that I can usually poke my finger nail on the top and pop the membrane back into the Hands Free.  If it still stuck, the device has to be popped off and the filter changed or thrown away (the device will work without it for speech) , but no seal is broken if the button is still seated correctly.  Some wear the button 24/7, some just for a few hours at a time. I usually wear it 6-10 hours a day if I’m planning on doing any real talking.  A word of caution, I have found it best to remove the button gently as possible to avoid nicking or cutting the lip of the stoma.  With practice, I rarely do that anymore.  All together, it takes maybe a minute to install the Button and maybe a few seconds to take it out.  What do I achieve.

I have the confidence to go virtually anywhere I want.  I have more volume in voice than I did before (possibly more than I had before surgery).  I can give a Sunday School class talk or lecture before audiences (I find that with a microphone, it comes out pretty good). In other words, it gave me a slice of my life back.  Remember as you add the slices, you sure enough get a loaf.                          


 Bill Snowden:  SNOWDEN989@aol.com




Fifth in a series of articles about self-massage and stretching.


In previous self-massage and stretching sessions we utilized hands, fingers, a towel and a tennis ball as tools.  In this session, foot and hand reflexology, also called reflex zone therapy, we will use fingers, thumbs (shorter fingernails are a plus!),  a pencil eraser, and the curved end of a teaspoon as our tools.  Did you ever imagine you had the recipe for a good massage right in your house?


Reflexology works on an ancient eastern theory that the body, divided into zones, can be treated to maintain balance in its organ, muscular and nervous systems by stimulating the coordinated areas on the feet and hands that refer to the different systems.  The hands and feet, as well as each of the large toes are divided into these particular zones.  Each hand and foot is divided into five zones, as is each of the large toes.  I am not sure for our particular needs that it is necessary to know what organ systems or body parts are in each zone.  We will do an overall treatment, with the hope that by stimulating the entire body through the zones, that your body will know how to disperse the energy from the treatment.  Reflexology can be done any time, for any length of time, as long as the treatment feels good. 


When treating the right hand or foot, the right side of the body is treated.  The same goes for the left side.  The zones in the feet run vertically, from toe tip toward the back of the heel, and eventually terminate at the ankle joint.  The zones in the hand run from finger tips to the heel of the hand, with the line-up of the fingers dividing the hands into five zones. 


When doing these treatments, be sure to use pressure that is comfortable for you, noting spots that are tender.  You may want to go back to them for additional treatment.   If you are curious, you can look on the reflexology charts to see what the tender spots coordinate with in your body.  There are many web sites where you can find more information.


You will be sitting somewhere comfortable for this session.  You will need to be able to access the bottoms of your feet as much as possible, so sitting on a bed, sofa, or chair is okay, as is the floor.  Make sure you have adequate support for your back.  As always, it is important to warm up your hands before doing any type of massage.  Here is a great exercise.  Clap your hands three times.  Rub your palms together briskly, noting the warmth from the friction.  Use your left hand to briskly rub the back of your right hand, taking time and care to rub in between the fingers, giving the webbing a little extra attention. Roll each finger and thumb, squeezing each as it is rolled.  Rub your wrist and forearm, around to the elbow.  Shake out your left hand that just did all the work, allowing it time to relax, then repeat on the other side, with the right hand rubbing the left.  When you are finished, give both of your hands a good shake, then your entire arms. 


You can enhance your massage by varying the intensity of your grip, or increasing or decreasing the rhythm and/or pressure of your movements.  Using a delicate strength will allow you to work longer with your hands.  Do not rely simply on the muscular strength of your hands.  Rather see them as dexterous, flexible and resourceful tools.  When using the pencil eraser or spoon, use a gentle grip that won’t tire your hands.


The first sequence is the “get to know your foot “ part of the reflexology session.  In your seated position, you need to gain access to the bottom of your foot.  So, that may mean crossing the left leg over the right at the knee, or if you are on the bed or floor, simply turning your bent left leg outward to access the sole of the left foot.  First, grasp your left foot with both hands and give it a good one minute, all-over squeeze. 


The next sequence is rhythm and pressure.   Holding the top of your foot with your fingers, wrapping your thumbs around to the sole of your foot, press the sole of your foot with your thumbs, using a mild pressure in the following sequence, dividing the foot into five sections toe to heel.   Start at the big toe joint at the foot, under the big toe, pressing down, thumb width by thumb width,  through the arch to the heel.  Alternate  thumbs as needed, making sure not to put too much pressure on the thumb joints.  (You can actually get a rhythm going when you become more experienced.)  Then go under the next toe and work your way to the back of the heel and repeat until the little toe and outside edge of your foot has been treated.  It is not necessary to cover every millimeter of your foot.  Next is the pressure sequence.  Treat each of your toes, beginning with the big toe, by pressing the underside of each toe, from the toenail, over the top,  to the joint at the foot, covering the entire surface area of the bottom of the toe.   When finished, give each toe a nice, firm squeeze.  Turn your attention to your ankle joints, pressing around the ankle bones in a circle.  Push your finger in the spaces between your toes and stretch your toes to the sides, the grasp each and stretch back and forth.  Rub your left foot all over, clap your hands three times and give your hands a good shake out.


Rest if you need to, and then repeat the two sequences on the other foot.


Remember that I mentioned a pencil eraser and a spoon?  These are alternate/additional tools for pressure.  If you have trouble doing the treatment with your thumbs, try using the eraser end of a pencil, or the curved end of a spoon.  You can also do a light treatment with your thumbs, then an additional, deeper second treatment with your tools.  Make sure that there is adequate support under your foot, and that you don’t press so hard as to cause damage.


The hand treatment is the same as the foot treatment, except it is all done with the hand against a firm surface.  Since you can only utilize one hand to do a treatment on the other, this is a perfect time to try your tools.  Give your entire left hand a firm squeeze with your right hand. Support your hand on your lap.  Press the area from the finger joint at the hand, thumb first, all the way to the wrist, dividing the hand into five sections, just as you did your foot. When treating your fingers, only use your opposite hand and not the tools.  Be sure to really rub and squeeze the webbed area between your fingers, which is so full of sensation.  Use your right hand to separate the fingers of the left, passively stretching and bending the fingers back and forth.  Clap your hands three times, give them a shake, and repeat on the right hand.


Many experts in the field of reflexology believe (through experience with treatments) that treatment on the feet is much more effective than on the hands.  Perhaps that is because we are constantly bearing weight through our feet, and that our hands, used throughout the day in a non-weight bearing manner, tend to get treatments vicariously. 


My belief is simple.  Touch is touch.   More is better.  It is all essential.


Have a healthful and happy experience with touch and feel free to email me with any questions about the sessions we have covered in this series so far, or about your special needs regarding touch therapy.


Shari Aizenman, Atlanta, GA




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