HeadLines

Kirklin Clinic Head & Neck Cancer Group,  Birmingham, AL

distributed by American Cancer Society

Pat Sanders, Editor

November 2005

 

Drinking & Driving?  You, Too, Can Be Tested!

 

By Michael Dreisbach

 

 

            Very seldom do we, as laryngectomees, go back to engaging in behaviors that are detrimental to our health. I would venture to say that 99.9% of us have laid down the cigarettes, cigars, or any type of tobacco product. Some of us, myself included, liked to partake of the “spirits” from time to time. When you combine the above and throw in, as I did, abuse of my vocal cords by teaching, being employed by 911 for over 13 years, speaking on the radio for 12 hours at a time, acid reflux, bad diet, volunteering with the fire department as a fireman and NOT wearing an air pack when I should have, it combines most of the makings of getting larynx cancer. These factors all played a role in my developing cancer of the larynx.

 

            This being said, where did I go from here? After getting over the initial shock and going through the radiation and chemo, I thought I would have it beat. Then it raised it's ugly head and I was confronted with the dreaded operation where I lost not only my voice, but a major portion of my identity/personality. When you’re on the radio, even though it’s a small selective audience, you become known for your voice.

 

            Following my laryngectomy, I was out visiting some friends at the Garner Police Department. Garner is a suburb of Raleigh, NC, where Glinda and I live. I know most everyone on the department from my days as a 911 dispatcher. They wanted to know what I was doing and I told them, "Nothing."  I also told them that I wasn’t overly thrilled at doing nothing and inquired it they had anything that I could do, perhaps as a volunteer.  That was the wrong question to ask.

 

            I soon became the unofficial administrative assistant to the "investigation" staff. They sent me back to school to again become certified as a Department of Criminal Information operator through the NC State Bureau of Investigation. They had me running all sorts of inquiries on the state's system once I was certified again. I was entering all pawn shop transactions, daily reports, etc. I was their errand runner to the magistrate’s office to pick up warrants, to the courthouse, and other police departments to retrieve records on cases they felt were connected. My volunteering soon turned into a 35-40 hour work week and earned me their Outstanding Volunteer Award for 2002. Cheap labor to say the least.

 

            It was during one of these trips to the magistrate’s office that I stopped in to visit my friend at the Raleigh/ Wake County-City County Bureau of Investigations. Again, I knew most of the staff there as we, 911, had dispatched for this agency as well. I was given the grand tour of their recently renovated processing area which included one large room whose sole purpose was conducting Intoxilyzer Examinations. I inquired as to what the job requirements for an ID Technician were. I also inquired if there were any openings and they said I should keep my eye on the county web site, which I did. I felt that I had the qualifications to become an ID Tech so I applied. I was interviewed and accepted a position in May of 2003.

 

            My position requires me to interview prisoners and enter their information into the county-wide data base, take their fingerprints, and verify their identity by comparing the prints they give us with those that are on file. I also give suspected impaired drivers Intoxilyzer examinations to determine their Blood Alcohol Content.

 

            Even though I use an artificial larynx, a Cooper-Rand, as my primary method of voicing, I have encountered only a handful of people who absolutely refuse to listen and understand.

 

            Performing Intoxilyzer examinations is rather interesting. I was required to attend a week long school to learn not only about the instrument but also the laws surrounding the "driving while impaired" statues. We were also required to drink and take the examination. I didn't partake of this opportunity as, at that time, I had not developed my little gizmo which would allow me to take the exam. At the end of the week long class, I had to pass a state required test to become a certified Intoxilyzer operator. I kept thinking that when I go to court and testify in these cases, some defense lawyer is going to question me on how I, as a laryngectomee, can give this exam yet not be able to take the exam myself.

 

            One of the things that has me using an electrolarynx as my primary method of voicing is a large stoma and a small thumb. I found it difficult to occlude my stoma and get a good seal. I also had problems with housings in that I kept blowing the seals, which made utilizing my TEP more difficult. One of the things I had tried was a baby bottle nipple. This worked well but was awkward to say the least. I then thought that if I use the baby bottle nipple for the Intoxilyzer exam, sticking a catheter in the nipple end and attaching one of the mouth pieces we use at the other end of the catheter, I might be able to take the exam. Well after some failed attempts to get all the plumbing right, I was finally successful.

 

            Another ID Tech and I tried it out one night when things were slow. I attached the mouthpiece into the tube of the Intoxilyzer just like I would if I was giving the examination to a suspected impaired driver. I then took a deep breath, occluded my stoma with the nipple and “blew” into my contraption for about 5-7 seconds. This is the same period of time required of those with normal plumbing. I took the exam twice, the same as required of “normal” folks. I obtained the desired results. I was able to take the examination and pass.

 

            When I am called upon to testify in court about giving the examination, I can truthfully say that I can also take the test. In North Carolina if one refuses to take the examination, they automatically lose their license for 30 days plus a 12 month revocation by the Division of Motor Vehicles. This is a total of 13 months without the chance of obtaining limited driving privileges.

 

            Some of the people refuse to take the examination for medical reasons. Some say they have asthma, they smoke, or have dentures, to name a few. Should this be the case, I again inform them of their 13 month suspension and if they refuse, it is logged as a willful refusal. Normally this type of case doesn’t make it court. If it does and their lawyer attempts to provide that they were unable to blow for the required length of time because of their medical condition, it quickly becomes evident to everyone present, judge, lawyers, jury, etc, that if I, as a laryngectomee, can take the exam and I do not “blow” through normal methods, then their client should be able to blow as well. Most of the time it gets no further that the District Attorney inquiring if I can take the examination. My response of “yes, I can, and here is my own test ticket.” is enough evidence that the defense gives up without much of a fight.

 

            Occasionally one of the arrestees will state that they are unable to understand me. Some have even called me “robo-cop” (sorry, Scott, I know that is your nickname), or say that I sound like Peter Frampton. Some state they can understand me and then half way through reading them their Intoxilyzer Rights they say they can’t.  They also try to use this as a defense when cases come to court. I had one lawyer state, and I found this amusing, is “What we have here is a failure to communicate.”  So far none of the judges, DA’s, or for that matter most defense attorneys, have or make an issue out of me utilizing a Cooper Rand to communicate.

 

            Another benefit of my utilizing a Cooper Rand is that it gives me a tool to actually demonstrate what it is I want the arrestee to do when taking the exam. The mouthpiece, which the Intoxilyzer uses, is about the same diameter of the “straw” for the Cooper Rand. I just hold up the mouth piece and the straw and state that I want them to wrap their lips around the mouthpiece like this. I then demonstrate how they should place their lips on the mouthpiece by placing mine on my end of the Cooper Rand’s straw. The Cooper Rand also provides a great sound effect device when I have to explain that the instrument will make a tone or noise when one is taking the examination properly. I give them a 5 second buzz of the Cooper Rand and there can be no question as to whether or not an adequate demonstration was provided.

 

Being a laryngectomee has required me to re-evaluate many things in my life. It has also made me make numerous adjustments as to what I can and cannot do or must now do differently. I have been fortunate enough to find a position with an organization that does not view me as having a disability. This is a far cry from my last employer (prior to my operation) who, in the process of merging two organizations, eliminated my position since they didn't want their training manager giving the appearance of being disabled. Morally it's wrong but legally it can be done.

 

Should you decided to visit our fair state, don't drink and drive. You may end up with me as your intoxilyzer examiner and I know just how to give a laryngectomee a test!

 

 

Listen To Me

 

by Donna McGary

 

 

We are probably all familiar with the saying “Talking to hear the sound of his own voice”.  It is not a compliment.  Talking is not a solitary exercise…it what we humans do to communicate…chiefly with others but not always.  Talking to oneself can be a useful means of sorting out our own complicated thoughts and emotions.

 

I suspect the reason it can be so helpful is because we respect ourselves and we are actually listening to what we are saying and thoughtfully responding.   Regardless of whether one talks to another or oneself, implicit in the act is that someone is listening, which is why the above dismissive critique is so withering - the “talker” is not only oblivious to his audience, but blatantly disregarding them.  Effective and meaningful communication requires two separate and equally active participants. It is not enough that “I” have something I want to say, there must be someone who is willing and able to listen.  If I think what I have to say is important, it is my responsibility to say it in a way you can hear.

 

For those of us who have lost our natural voice and have developed alternative methods of talking, engaging our listener can be as problematic as learning our new voice.  I have a dear friend who says that in the beginning when she was just learning to talk again, her favorite phrase was “Look at me”.  What she was really saying was “Listen to me” because our new way of talking requires a new way of hearing if it is to become truly communicative.

 

I touched on this phenomenon briefly in my last WebWhispers column.  My first experiences with other people who sound like me were disconcerting.  A bit of history may be order.  When I first had my trach, I could talk by occluding since I still had limited use of both my airway and vocal cords.  I met Libby Fitzgerald at a get-together for people with adenoid cystic carcinoma. Up until then I had never met anyone with that cancer or anyone who sounded like me.  It was comforting and encouraging and I will always be grateful for the hospitality she and her husband showed me that weekend.  I left thinking that if this was indeed to be my fate, I would be fine.  I had no idea at the time the struggle which lay ahead.  By the next time I saw Libby and John, I no longer sounded like Libby or anyone else I knew and I could not understand the first person I met who did sound like me!  By then I was using an electrolarynx, my vocal cords and airway permanently damaged by radiation scarring and swelling. 

 

I went on the Panama Canal WW cruise with my mother and we met Len Librizzi along with other fellow cruisers the night before we left.  I could NOT understand him and God forgive me, Lenny, I remember thinking “I don’t sound like that!”  Lenny and my mom & I became fast friends during that cruise and I quickly learned to understand him…all the while thinking I didn’t sound like him!  Ah, the sweet hypnotic appeal of denial.

 

That comforting cocoon of denial was rudely rent in Boston.  I sounded exactly like Lenny and about 200 other EL users!  Do you remember the first time you heard your own voice on a tape recorder - perhaps as a child?  We all have the same reaction.  I sound like THAT?  Even if all our friends say, yes indeed, that sounds just like you, we don’t quite believe it and most of us are not happy.  That was me in Boston.  I realized quite suddenly just how much effort was required by our listeners to not only hear us but to understand and listen in a meaningful way.

 

First off, just hearing us can be problematic.  My friend said, “Look at me” for a very good reason.  Whether we have a TEP or use ES or an EL, none of us can compete with loud background noise.  We can’t answer from the next room and we can’t talk over someone else.  On the plus side, I don’t interrupt nearly as often as I used to!  People have to want to listen to us and even if they do, they can’t always hear us.  I had to learn to slow down my talking in order for my EL speech to be understandable.  That means the listener must also slow down.  Most of the time, I don’t hear the EL buzz anymore - I hear my voice in my head the same way I heard my old voice - but it no more resembles my true voice today than it did then.

 

There are distinctive peripheral noises associated with alternative voice methods and all of them can be distracting to the uninitiated - even if you exhibit them yourself.  I suspect that I am not alone in hearing my old voice in my head.  Several months ago there was an interesting discussion on The WW list about remembering our “old voice”.  A number of  members said they had saved  recordings of that voice and took pleasure in listening to them in much the same way we enjoy looking at photos of our younger, perhaps thinner and more hirsute, selves!  The discussion was surprisingly emotional with some members deeply regretting they had no record of that old voice.  I am one of them…I would love to have a copy of one of those old tapes I hated back then. 

 

At the IAL conference, it was suggested that the voice we use in our dreams indicates how well we have adjusted to and accepted our situation - that if we use our old voice we have not quite come to terms with it.  I respectfully disagree.  I have many dreams where I can talk “normally” - sometimes very funny ones where I can’t talk but I can sing or where I can talk if I occlude to “jump start” my voice.  I always know, in the dream, that this is a breakthrough discovery and I also think I know it isn’t real, but I savor the experience like a bittersweet reunion with a favorite old lover.  Like going through those old photo albums, it is both comforting and cathartic.  

 

As sweetly sentimental as that may be, it is not the real lesson.  If I want you to listen to me, I must find a way to talk to you.  Having a conversation used to be as easy and natural as breathing - something else which is no longer easy and natural.  We have learned to breathe again and so we can and must learn to talk and listen again.

 

 

            Do you have a digital servox?  Then, don’t miss page 6!

 

 

HOW TO SET THE INDIVIDUAL BUTTONS

ON A SERVOX DIGITAL

by Randy Lempster  

 

  1. Unscrew the bottom of the Servox and remove the battery.
  2. Slide off the cover – hold onto the top of the unit.
  3. Replace the battery and the end cap.
  4. Looking at the electronic circuit board you will see 2 very small switches – these are called DIP switches.
  5. To set the level of the upper button of the Servox, slide the 2nd (right hand) switch to the down position and leave the 1st in the up position.
  6. To increase the frequency of the sound, press the upper button as many times as necessary to get the right tone. To lower the frequency, press the lower button.
  7. When you have the desired levels for the upper button, reverse the order of the DIP switches – 1st down & 2nd up. Then repeat Step 6 for the lower button.
  8. You will have to adjust these levels quite a bit as each push of the buttons only increases/decreases the frequency by 1 hertz.
  9. Once you are satisfied, set both DIP switches to the down position,  remove the end cap & battery and replace the cover – then replace the battery and end cap.
  10.  You will probably find that the tones will change when the cover is replaced so you may want to replace the cover from time to time to see what things sound like.

 

 

Kirklin Clinic Head & Neck Support Group Meetings

No meetings until further notice

In the interim, we suggest that you join WebWhispers if you have an email address. We are also invited to attend an All Cancers group with a luncheon every third Tuesday.  Call or email Pat Sanders if interested.  ,   205-980-8416; pat@choralmusic.com  HeadLines Newsletter

                                                                                                                                                                                                               

 

 

For cancer information call 800.ACS.2345 or visit our Web site at www.cancer.org

American Cancer Society in Birmingham:   nprice@cancer.org