Parkinson

Bloody Parkinsons: THE VOICE

What follows is mostly true and mostly based on personal experience. If this Blog is anything it is probably ‘Parkinson’s for people who haven’t got it’ or are recently diagnosed with it.

Parkinson’s has some major symptoms to do with inhibited movement, but it also has what could be termed as relatively minor symptoms such as problems of voice and swallowing.

So one of the many ways in which Parkinson’s Disease can get you down is by removing your normal voice and replacing it with another, much inferior one. In my case the new voice is an occasionally weak and reedy one. And then there is an occasional deep and oddly gravelly version that can take over from time to time too.

I mentioned this odd modulation to my GP whose practice had flagged up the existence of physiotherapeutic help (ie physiotherapists, speech and language therapists, occupational therapists based at the big hospitals) .

So I met all three types and thought that the most relevant was the speech therapist who might be able to do something about food bits getting stuck in my throat, gagging on my toothbrush, or the reedy – weedy – needy speech. Or even the gravelly – wavelly kind of voice that appeared now and then.

Up to now the only awareness I had of speech therapy was from ‘The King’s Speech’ or from my wife’s cousin’s daughter who is a speech therapist.

FOODY BITS

I began with a videofluoroscopy after complaining of a sensation of food sticking in my throat. Also of choking when brushing my teeth. Basically tests showed my swallowing was fine and dandy; various liquids, sandwich bits, a muesli bar were photographed going down with little trouble. No further action was required. Apparently I presented with a functional swallow, and some instances of reduced hyo-laryngeal excursion. Nothing to worry about!

Thought I could outfight my toothbrush and get on with it. Which just left the weak voice….

SINGING AAAAAAAGHHHHHH!

It was recommended that I try LSVT (Lee Silverman Voice Treatment), an intensive Speech and Language Therapy which has a strong evidence base to support improvement and maintenance of voice and swallow function in people with PD.

People with PD, or other progressive neurological diseases, can be resistant to speech treatment. Almost 90% of these people suffer with voice and speech disorders of some kind, but only 3-4% receives speech treatment; even when reduced ability to communicate is considered to be one of the most difficult aspects of PD.

Limitations of communication include, for example:

· Hypophonia: reduced loudness

· Monotone: reduced pitch variation

· Breathy and hoarse voice

· Imprecise articulation

· Lessened facial expression

So PD sufferers are less likely than others to participate in conversations. In the pub this is exacerbated by the tendency of most old curmudgeons to dominate the conversation by simply talking louder.

The Speech Therapist was fantastic, articulate (as you’d probably expect!), well organised, professional, friendly and patient. And LSVT LOUD as the treatment is known, having been tested for over 20 years, has led among Parkinson’s sufferers to improved loudness, intonation and voice quality, with improvements noted for two years. LSVT LOUD has also been effective in improving disordered articulation, diminished facial expression and impaired swallowing.

We began each one hour session in a quiet room with 15 repetitions of a loud middle range aaaaaah note, held in my case for a slowly increasing time of up to around 20 seconds, followed up with 15 rising aaaaaah-eeeeeeehs (High!) and 15 falling aaaaaah- oooooos (Low!), followed by 5 readings of 10 simple sentences, followed by debate of a series of questions and answers, and other readings, all the time measuring the voice: eg duration of aaaaaaaah noise, volume and so on.

Lots of sips of water required!

Over the course of two weeks of these intensive sessions I was also encouraged to undertake one or two revision sessions of 10 to 15 minutes per day. And after the course a daily revision session, often in my case in the car. Also do quizzes, crossword, number and word puzzles. Thus keeping the remaining brain cells as alert as possible.

So far so good.

But the dog hates it and howls like a banshee. But for all I know she’s joining in.

PETE BRADLEY’S HYMN BOOK

On the subject of singing…

At school we had to back our books in brown paper, holding them up in turn to prove it, which often meant lads backed only one book of each size and held it up to represent all fat books, all thin books or all large format books. Pete Bradley had backed even less than the rest of the class and was holding up his hymn book each time, for fat, thin and large format, relying on being in the back row to provide camouflage.

It got round to Songs of Praise, the fat Hymn Book, and our form teacher shouted for all 33 of us to hold up our carefully backed copies. Thirty two hands and books were held up and Ticker Robinson (initials TKR), form master, said ‘Bradley, where’s your Hymn Book?’ to which young Bradley said ‘it’s all right sir, I know all the words’.

And in spite of being a 69 year old heathen, so do I….

SHEFFIELD UNITED MAY BE RUBBISH, BUT….

Relatives from the Deeney and Wood family of Sheffield, staunch Blades, have presented me with a football signed by the team. See below. And after a poor run, they won on Sunday! Obviously cheered on by my new strong voice.

Also took me for a couple of delicious pints of Pedigree to a fabulous pub called the Barrel at Bretton in Derbyshire, plus a pint before the match of Kelham Island’s Easy Rider at the Sheaf View. Clint Eastwood may be the greatest cowboy actor of all time, but I bet he’s never had a pint of Pale Rider.


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