Internet Laryngectomee Support
January 2000

Happy New Year 2000!

Laryngectomee Becomes Mayor

    Dr. Chuck Howe, veterinarian and laryngectomee, has now become His Honor, the Mayor of Woodward, Iowa!  He begins his duties on the first day of the new year and millennium after winning election this past November over a write-in challenge by a former mayor.

     Dr. Howe continues to work part time with a poultry company as well as maintaining a limited veterinary practice.  Also active in his local Masonic Lodge and church where he teaches Sunday school, he even occasionally fills in with a sermon when his minister is out of town.

    Dr. Howe credits his successful recovery to a number of people including his wife, Martha, whom he had only married six months prior to his surgery.  She “stood by me, encouraged me, cajoled me, scolded me and otherwise kept me on the straight and narrow...but most of all she just kept loving me.”

    He also credits a fellow laryngectomee, Derald Morse, who visited him before and after the surgery and provided encouragement.  Chuck reflects what many larys feel when he says he would like to “return the favor by encouraging a new laryngectomee some day.” 

    Chuck currently uses the Servox, although he expects to eventually speak with the TEP prosthesis now that his post operation radiation is finished. 

    He has a decidedly positive outlook on life and said, “life goes on despite what happens, and while the loss of a voice is momentarily traumatic for about an hour or so, I can think of a lot worse things that can happen.”  He even insisted on doing several surgeries a few days after coming home from the hospital despite still having a feeding tube attached, saying that he “just needed to prove that I could still do these things.”

    As was the case for many of us, all is not completely rosy since he continues to have to contend with fistula problems, using a laryngectomy tube to deal with some shrinkage of his stoma (stenosis), and the usual post surgical problems with mucous and coughing.  But he continues to be upbeat saying, “I hope I'm a better person for all of this, and if I ever find time I'm going to worry about some of these little things.  Meantime, Lord willing and with Martha's encouragement, I'll keep going and going.”  He said that he “knew lots of people before, but they all know old Doc Howe and his Servox now!” 

    Congratulations Mr. Mayor! Your victory is yours, but is also a victory for all laryngectomees since you have shown once again what most of us already knew, that we can do anything.  Today, Woodward, Iowa; tomorrow, the world!

IAL Treasurer Jack Keilsohn Resigns

Jack Keilsohn of Potomac, Maryland recently resigned as Treasurer of the International Association of Laryngectomees.  His successor will be chosen at the IAL convention in August in Nashville.  Until then, Vice President Jack Henslee will fulfill the duties of Treasurer.  The IAL will now use a new address for IAL correspondence purposes (PO Box 2664, Newport News, VA 23609-0664; Tel: (757) 888 0324; Fax: (757) 888 0965, Email: ial@larynxlink.com).  IAL President George Ackerman of Manitoba, Canada praised Jack Keilsohn for the great job he had done as treasurer, and accepted his resignation with regret.

Another Use for "The Gizmo"

    "The gizmo" is described by SLP Zilpha Bosone in a chapter in the classic book by Ed Lauder, "Self-Help for the Laryngectomee".  This chapter is also reproduced in the Hints section on our website, and describes how to make and use the device.  Read it at "A Simple Device for Smelling and Nose Blowing after Laryngectomy" http://www.webwhispers.org/pages/library/smeller.htm 

    In addition to using it for blowing your nose and temporarily restoring the sense of smell, you can use it as a "visual aid" to demonstrate the invisible water vapor which is lost from our stomas as we exhale.  When the larynx is removed the connection from the lungs to the mouth and nose is severed.  Without that connection, we have lost the humidifying capabilities of the original pathway since the air now goes directly into and out of the lungs via the stoma. 

    Except in cold climates during the winter when you can "see your breath," the water vapor we breathe out is invisible, and we are usually not aware of it.  The "gizmo" can help any laryngectomee to understand this loss by actually seeing it.  While the device as described in the article uses about a foot of clear vinyl tubing, a longer tube will make an even more dramatic demonstration. 

    To use it, hold the base of the nipple against your stoma and breath normally in and out.  As you exhale, water vapor will condense on the inside of the tube as fog and visible water droplets.  As you inhale, the tube becomes clear again as the water is converted back to vapor and returns to your lungs.  Helping to preserve the humidity in your lungs is one of the major functions your mouth and nose performed before the laryngectomy. The fact that we lose all of this humidity helps new and "experienced" laryngectomees understand why we must take action to conserve the moisture in our lungs, and supplement it by using humidifiers and dampening our stoma covers.

    If you visit new laryngectomees, attend support group meetings, or give talks to small groups, they will all benefit from an understanding of the usually invisible moisture we lose each time we exhale through our stomas.  This demonstration will encourage all of us to do whatever we must to maintain a healthy humidity in our lungs.

Acid Reflux and Laryngectomees

    Laryngectomees are more likely to develop problems with GERD.  GERD sounds like the nickname of someone’s great aunt Gertrude, but the initials actually stand for Gastro-Esophageal Reflux Disease.  This is the current medical and popular name heard in television advertisements on “heartburn,” excessive acidity, or stomach acid which gets out of the stomach and causes problems.  In addition to giving us discomfort in the stomach, the acid can reflux or back up into the esophagus, which may lead to serious problems.  Many laryngectomees have GERD prior to their surgery, and are more likely to have problems with it afterwards.  Another risk factor for GERD is age, and laryngectomees are primarily older individuals.

    The normal esophagus has sphincter muscles at the top and bottom which permit food to go down, but normally keep acid or food from coming back up.  As we grow older, the lower sphincter muscle can become weaker and allow stomach acid to back up into the esophagus.  An additional problem is that the laryngectomy operation compromises the upper sphincter, or it may even have been effectively removed depending on the type of surgery you had. 

    Symptoms of GERD include that familiar burning sensation in the stomach (or even chest, which can sometimes be mistaken for heart problems), an acid taste in the mouth, accelerated tooth decay, asthma attacks (particularly at night), cough, sore throat, hoarseness, regurgitation of a small amount of incompletely digested food or drink, and similar problems. 

     Virtually everyone has had heartburn at some point in time, and occasional reflux is not a problem.  In most cases, an over-the-counter antacid such as Tums, Mylanta, Maalox; or other medications such as Tagamet, Pepcid, Zantac, etc. takes care of this temporary problem.  But according to a recent article in the New York Times, it is a more serious problem for about 15 million Americans who have a chronic problem with GERD.  In many cases it cannot be prevented but must be aggressively treated for the rest of the person’s life.  And, according to recent medical research reported in The New England Journal of Medicine and from Sweden, the risk of developing cancer of the esophagus increases significantly for those who are chronic sufferers and who go untreated or ineffectively treated.  According to the Times article and ABC "20-20" program, esophageal cancer is the most rapidly increasing form of cancer in the U.S., and is a form of cancer which has a low cure rate.  If not caught in the early stages esophageal cancer has only a 5% survival rate.

    There are three approaches to dealing with GERD.  One of the most important is prevention.  Ideas for preventing acid reflux are in the list of ideas from the American College of Gastroenterology “What We Can Do About Acid Reflux.”  For those who suffer from chronic GERD, your medical doctor may prescribe a medication such as Prilosec or Prevacid which works by blocking the formation of stomach acids.  Other medications may be prescribed to protect the lining of the esophagus or to speed up the time it takes the stomach to empty.  A final alternative is surgery, and there are several procedures which have been developed for GERD-caused damage to the esophagus.  But as with so many things, prevention is the best approach to keep a problem from developing in the first place rather than try and repair the damage once it is done.  
(Basic information from April 27, 1999 New York Times; December 10, 1999 ABC "20-20" program; and the April, 1999 "Cal Voice" newsletter).

A Hint from the U.K.

    If you are sometimes not understood when you speak over the phone you might try a hint from the United Kingdom to use the NATO alphabet in spelling out your name or other words with which your listener is having a problem.  You might want to make a copy of it and put it near your phone.

(From the December, 1998 CLAN)

An Invitation to Two-Way Communication

    The following was given to students on the first day of class by their teacher, a laryngectomee : 

A Lary Limerick from Down Under

    Wendy Mottram, editor of the Australian NSW Newsletter, was visiting Britain and was inspired to write the following which we found on the UK website:

There once was a man from Frome
   Whose mother-in-law made him groan
   He became a laryngectomee
   And was so pleased that he
   Could get out of answering the phone.

Welcome New Members

    We welcome new WebWhispers members who joined
us in December :

Gilbert Bujold
Lorraine, Quebec, Canada
Bob Cass 
Newport, VT
Tom Coyle
Gaithersburg, MD
Eugene Eyre
Boise, ID
Thomas Hainze
Farmers Branch, TX
John Hoggatt
Pearl, MS
Mary Ell Izzo - SLP
Poughkeepsie, NY 
Doyle Jennings
Houston, TX
Tony Joynes - Caregiver
Cheadle, Staffordshire, England
Vera Karger - SLP
New Canaan, CT
Jonas Karling - SLP
Stockholm, Sweden
Carl Kilmer
Plantation, FL
Bonnie Pastor - SLP
Tamarac. FL
Nita Palochkoo
Deming, NM
George & Darcey Remetich
Montrose, PA
John Ray
Brooklyn Park, MD
Ron Stepan
Vancouver, B.C., Canada
Lisa Strawn
Littleton, CO
William Thomas
Seat Pleasant, MD
Jim Upton
Tahlequah, OK
Frank Watkins
Greenfield, WI