Waiting for a Hurricane

We already have soup warming in the crockpot.  There's a plethora of baked goods I made from assorted pumpkins and such.  The trees look crazy outside.  I would normally be at work, seeing one of my favorite patients.  But I'm not.  I'm home on the couch, waiting for the hurricane.

Which hurricane?  Sandy.  We have been warned that this is no Irene.  They have evacuated a great deal of people in NYC and in NJ.  Locally, the folks living near the river in Piermont and Stony Point have also been advised to go to higher ground.  It's kind of scary.  As my friend Deborah says, I'm a "weather weenie".  So here I sit, hoping the large tree in our front yard stays right where it belongs.

I was thinking about how our dog, Bella Shmatta and our rabbit, Latke Lapin have no idea what's about to go down.  I guess ignorance is bliss but it also makes me think about  how much we don't see coming--and how little control we have over the future.

I am thinking of my patients now.  Several have a diagnosis of aphasia, which is a terrible neurological condition (often the result of a stroke)  that affects communication.  Some of my patients can only speak a few words.  Some cannot speak at all.  Aphasia often stops people from sharing their ideas, their hopes, dreams--even asking for what they need.

I try everything in the book with my patients--and then some.  One of my patients, who I'll call Bea, has asked me to write a book about some of the techniques that we've come up with together.  Sometimes Bea and I break words up visually with color and she is then able to read and pronounce them.  Sometimes we  do mass repetitions of unstressed syllables in words and tiny little words like "a", "the" "it", etc.  After 12 years, Bea can use them again with a fair amount of fluency.  At times, when I find a patient can string words together, I create "scripts" that are relevant to their everyday lives and they can then take part in conversations.  One of my patients is a priest and we came up with a way he can continue to respond to people during confession.  Finally, for my patients who have progressive aphasia (which only gets worse with time) I program speech machines or apps on iPads so that they can retrieve family names and biographical information.

These people are all intelligent--some are positively brilliant.  But a hurricane came and took away their most precious means of conveying that brilliance--their ability to communicate.

We never know what may come our way.  I hope to maintain an "attitude of gratitude" for each day I have my family, my health and the ability to communicate with friends like you.

In the meanwhile, there is hope.  One of my patients who was only able to say her dear husband's name after a year and a half of trying, spoke to me on the phone about the hurricane yesterday.  We had a delightful conversation, much of it without my help--and she ended it by saying the most beautiful words I've ever heard: "I love you".

So, come on Sandy.  I'll be glad to see the back of you.  There's life after you--and hope--everywhere.

Cold Feet, Warm Heart

As the days grow chillier I am reminded of a favorite folksy quote--the one with the cold tootsies and the cozy corazon.

If you are a caregiver; that is, if someone you know is suffering from a cognitive, language, swallowing or speech disorder, please get some help yourself.  Your warm heart can use a little down time.  It's not easy to take care of yourself, a family maybe, a job and someone suffering with a disability.  It can make you grumpy and sad.  Maybe the help will come in the form of a friend who can give you a couple of hours or days to yourself.  Maybe it's going to come in the shape of somebody who you can speak with.  Perhaps it's not possible to completely get away.  Some other ways that people rejuvenate are walks or books or just  getting a couple of extra Zzzzzs.

My point is, your warm heart can get pretty frosty when overwhelmed.  I've seen people (who mean so well) actually hurt someone with a disability by demanding too much too soon.  The flip side of this is to give up on the hope of any improvement at all.  People who have communication disorders are not immune to other people's attitudes.  Sometimes being a cheerleader, however tough that may seem, is just what the doctor ordered.

Remember that several neurotransmitters, or chemicals that go from neural cell to neural cell, increase with positive responses; that is, praise, hugs, exercise...sometimes a little reward, like something delicious, can do that, too.  Then you both win.  The patient is motivated to work harder, which is what you both want.  The converse is also true.  Yelling; "You know that! I just told you that!" can reduce someone's ability to remember/speak/think in a flash.  So, as much as you'd like to let it rip, it's in nobody's best interest.  Then you have guilt to add to your miseries--and you're too exhausted to deal with that one.

So, do a bit of acting if you have to--try to keep it light and positive--as much as you possibly can.  And when you feel unable to do that, try to get some kind of change of scene or a willing ear.

I send you warm thoughts...to match your warm and caring heart.  And I honor your commitment and bravery with all of mine.

Almost Apple Pickin' Time!

Fall.  We put aside the sunscreen and the beach blanket and get back to work.  Farewell to the sea and the smores, lightning bugs and sugar snap peas on the vine.  Sigh!   I have to be truthful about this, though; the autumn is my favorite time of year.  Maybe it's something about the things that usually come to mind about the season--you know the stuff--cornucopias, maple leaves and the like--but I think it goes a bit farther down the gene pool for me.  It seems to me that my Russian heritage (everybody on my mother's side hails from Kursk or thereabouts) may be the root of my attraction.  As Pushkin so eloquently wrote:

The flowers of autumn days

Are sweeter than the first of plains

For they awaken an impression,

That's strong, although it may be sad

Just as the pain of separation

Is stronger than the sweet of date

The combination of coolness and color, early twilight and the brittleness of dying trees makes me very happy, somehow!  It also makes me think of something else that occurs while we are gearing up for school or work, whatever your particular brand of harvest happens to be.  And that, dear reader, is... ALLERGIES!  Yes, along with the poetry of the season comes the kleenexes and the sore throats.  Sorry to leap from Aleksandr to Allegra but the deal is that your voice can take a beating!  So here are some ideas to help you keep your pipes in tip-top condition:(1)  More water (or liquids with no caffeine); (2) Lemon (not an old wives tale--this cuts mucous well-- just be sure your stomach can tolerate the acidity; (3) Steamy Showers (stay in there a bit longer, sing a little September Song while you're at it); (4) Saline (for stuffy noses); (5) Nix on the Loud Throat Clearing (you are killin' those cords when you do that); and (6) No Blood-Curdling screams on Halloween (need I remind you that you will sound like Don Corleone shortly thereafter?).

So happy apple pickin' and enjoy the freshness of the season.  Take good care of your voice this season so you can BOO with the best of 'em!!   

Losing Your Voice?

When was the last time you "wha-hooed" at a terrific rock concert?  How about cheered your favorites in a great baseball game?  Did your kid just win a blue ribbon and you are an extremely supportive (and vocal) parent?  How loudly did you scream at the last scary horror flick?

You may be an enthusiastic soul--that's a GOOD thing.  When you wake up the next morning and you sound like Rachel Ray or Harvey Fierstein--that's NOT SO HOT.  Having a throaty, raspy, breathy vocal quality is not stylish or sexy.  It means that your vocal cords are either very dry, inflamed or even damaged due to hemmorhage.  If you do enough screeching you could sustain damage that translates into nodules (also called "nodes"), polyps and/or bleeding from the trauma of even A SINGLE YELL.  Consistent vocal abuse may necessitate surgery.  If you are hoarse, see a speech pathologist who knows about voice.  Lots of us don't.  Here's my website for referrals if you are not in my neck of the woods: http://www.speechpathologyworks.com.  Come in for a visit if you're local, but whatever you do, if it persists, DON'T DO NOTHING.  The voice you save may be your own.

So, think twice when you yell loudly.  Practice your whistle, or better yet, buy one.  Clap like the god of thunder.  Jump up and down.  Wave a banner.  Just don't engage in vocal abuse.  It hurts.  And if you are so happy (angry/scared/freaked out/thrilled) that you can't help but let out a war whoop, baby your voice for a while.  Drink a lot of water.  Stand in a steamy shower for 5 minutes.  PROTECT YOUR VOICE.  There, I said it.  Sorry about the shouting....

Poodle in Ptown

We are having a terrific time at a place called Four Gables in Provincetown, Cape Cod, Mass.  The poodle has shown remarkable self control when a bunny rabbit skipped by her in the garden yesterday.

I was thinking about how important taking vacations are--we hadn't been away in a long time.  Supposedly, changing your perspective and taking in new experiences results in new patterns of neuron synapses--in other words, more activity in the brain.  As you take on a new activity or see a new place (even a new restaurant!) neuronal activity increases.  If there is sufficient stimulation, the neuronal firing becomes "hard wiring" and literally makes your brain grow!

That's good news for anybody--particularly if you are over 30.

So don't feel guilty taking a little down time.  It's an exercise regime for the brain and those new sights and scenes are working overtime while you (sigh) sit back and look at the shoreline!

Help for Swallowing, Voice and Speech in Rockland County--Where Is It?

I continually hear the same scenario from my patients.  These are adults, primarily--although I do have one 7-year old with a stuttering problem.  They tell me; "Why couldn't we find you earlier?" or "I couldn't find a speech pathologist anywhere in the County who was available" I hear frequently.

There are millions of Americans who suffer from problems with voice or swallowing.  Additionally, many adults with acquired neurological impairments such as Parkinson's Disease or stroke have real need of immediate and consistent help in remediating speech and language deficits.

So where are the speech pathologists?  Well, one answer is in the hospitals.  I worked in hospital settings for many years.  The problem is that  there is such a demand for these services that many outpatient clinics are overbooked, with waiting lists that go on for weeks or months!  When someone has just had a stroke, he or she requires IMMEDIATE and TIMELY intervention.  Yes, one can improve for the rest of one's life, but it is VITAL that someone start as soon as possible.  If a voice disorder is put off too long, the resulting abuse concomitant with putting that first visit off can cause structural damage that may require surgery or may eventually be PERMANENT.

If you are suffering from a voice, communication or, even more of a concern, a swallowing problem, you just can't afford to put off getting help.  Because hospitals are so overbooked, some people look for therapists in other locations.  Sometimes they find them.  Sometimes they don't.

I get referrals from doctors in my area, but I am just getting known, as most of the MDs that I've worked with associate me with hospitals that I've worked for in the past, so I'm trying to get the word out.

If you need help, call 845 608 1080 or visit my website for information http://www.speechpathologyworks.com and I'll be happy to try and help.  It's what I do.

So, I began this blog to get the word out.  I simply need to let people know they have a choice.

Don't wait, no matter what you decide.  The "use it or lose it" motto applies here.  Don't put off getting help for yourself--or for someone you love.