Vancouver!

    Vancouver, British Columbia, Canada, is a very beautiful city.  Surrounded by mountains, including snow capped ones, as well as located on the water, it makes virtually every list of the most beautiful and livable cities in Canada and the world.  Flowers seemed to be everywhere. 

    The 51st IAL Annual Meeting and 42nd Voice Institute met in Vancouver from July 9-14th.  Congratulations to Elizabeth Finchem, Chair of the IAL Annual Meeting Committee, and Murray Allan, member of the Committee and local club host, for their work in putting together an excellent conference. 

     For those who attended, the first impressions of Vancouver were provided by the very beautiful airport and the very charming lady bus driver who took many of us from the airport to the hotel.

    Attendance was under 300 for all participants, probably due to the distance and cost of airfare, post-9/11 travel concerns, meeting outside the U.S. with passport and currency exchange issues, etc.  The Wednesday night Meet and Greet reception was again sponsored by Jim Lauder and InHealth.  It featured giant roasts of beef along with an incredible amount and variety of fruits, veggies, and other delectables and drinkables.

    The Canadian flavor of the convention was evident in the Opening Ceremonies which featured a bagpiper and two Royal Canadian Mounted Police officers carrying the Canadian and American flags.  Both national anthems were sung.  The Keynote Address was given by cancer survivor Judy Caldwell of the Canadian Breast Cancer Foundations.  She described and showed slides of a fascinating program in Canada for breast cancer survivors which involves their participation in a festive national sport, "dragon boat" racing.  The speech was inspirational and applicable to all cancer survivors.

    Dr. Joseph Sniezek then gave an overview of larynx cancer and treatments, Dr. Peter Stevenson-Moore talked on dental issues, and Dr. John Wu spoke on hypothyroidism.  Participants were reminded that laryngectomees are 20 times more likely than the general public to develop hypothyroidism.  Later in the day Dr. Eric Blom provided an overview on TEP speech, and the traditional Sing-A-Long rounded out the evening.

    The Friday program began with a session by Jim Lauder, Lenny Komar from Siemens, and Tom Lennox on troubleshooting and making simple repairs to ALs.  Jim and Lenny are, at present, the only authorized service providers for the new Digital Servox as well as the older model Inton in North America.  This session was followed by a fascinating presentation by Dr. Corina van As of the Netherlands on restoring the ability of larys to smell (see separate article below).   

    At the swimming pool the Larkel was demonstrated, and Elizabeth Finchem, Pat Sanders and others demonstrated how they swim by covering their stomas.  A session on CPR for larys began the afternoon sessions, and Dorothy and Tom Lennox gave a presentation on choosing and using the right voice amplifier, George Ackerman hosted a session on "Laryngectomees Around the World" with representatives from more than a half dozen countries, and Dr. Jim Shanks gave a presentation on traditional esophageal speech.  The WebWhispers reception and dinner rounded out the evening (see separate article below).

    On Saturday morning WebWhispers webmaster and founder Dutch Helms conducted a session with Pat Sanders on "Web Surfing Hints for Laryngectomees."  IAL Board members Bob Mehrman and Wayne Baker gave a presentation on Tobacco Education, Dr. Shirley Salmon described the proper training of hospital visitors, and there was a panel discussion on the "Dynamics of a Thriving Club" where representatives of some of the strongest laryngectomee support clubs shared ideas.  This topic will be a major one in the September issue of the IAL News.  The IAL Delegates met to conduct business, the Annual Fun Show was held in the late afternoon, and the Meeting concluded at the annual Banquet and Dance.  The banquet food was great, and many danced to the jazz and old favorites played by the band.

    Of particular interest to many AL users was the all new digital Servox shown by several vendors.  While it requires getting used to, it has a number of features including the ability to fine tune the tone and volume of the two buttons.  The buttons can be "tuned" in terms of both pitch and volume.  This can be done manually, or via a computer interface.

     I wouldn't trade the experience for anything.

     I loved all of the free stuff I got from the vendors!

     The delight in meeting such a variety of wonderful people from all over the world.

     As new members of Web Whispers and attending our first IAL Annual Meeting we enjoyed getting acquainted with other members. The agenda each day was very interesting with very good speakers.

     This is my fourth convention.  I cannot imagine missing one.  I gain so much value from them.  The benefits are educational (the knowledge is valuable to me, but I can also pass on what I learn to others), social (I feel like I now know at least half of the people who typically come to the Meeting, and get to meet the new other half), recreational (it is a mini-vacation).  Each time I have gone I have returned feeling that I more than got my money's worth...and on so many different levels.

      As a VIP (at the Voice Institute), I got knowledge from meetings and one-on-one contact with an SLP.  Next was being able to put faces and "voices" with the "words I've lived by" for over a year through e-mail from WW.  After this, my first, my plans are NOT TO MISS another one, as long as I am able.

     I will keep coming as long as there is a conference and I am able to attend.  It is "medicine" for new larys I know.  So many have gone to a lot of the conferences and it is old hat.  They come for the fellowship and the general business of the club.  But for a newcomer it is completely different.

(Thanks to Rita Burfitt, Dawn Douglas, Doris Gifford, James and Janet Gilbert, Patty Jones, Roger Jordan, Merritt Oakes, and Mary Glyn Spivey for contributing.)

Hands-Free, Glue-Free II

     One of the many interesting sessions at the Vancouver Meeting provided a reminder of an alternative solution for those who have tried to use an HME (Heat/Moisture Exchange) filter and/or hands-free valve but who experienced various problems including losing the seal or allergic reactions to the glue.  Many can use the glue-free Barton-Mayo Button in combination with an HME and hands-free valve (see "Hands-free, Glue-free" in http://www.webwhispers.org/news/oct2000.htm).

     Using the Barton-Mayo does require that the stoma be pretty regular in shape (circular), and have regular and even surfaces on both sides of the stoma.  However, there are some alterations which a clinician can make to the Button to compensate for some irregular stoma surfaces.  It is also possible to get the Barton-Mayo custom made for the contours of an individual stoma.  ATOS, Bivona and InHealth sell the Barton-Mayo ready to use Buttons (in the $80 range). 

     These come in short, medium and long, and in diameters of from size 9 to 14.  The Barton-Mayo is a prescription item and you must be measured for both a correct diameter and length in order to get a proper fit.  Those who already use lary tubes will probably need to get the next larger diameter size in order to get an airtight fit, and the shortest tube you can use will help in obtaining the desired tightness and seals on both sides of the stoma wall.

     The Barton-Mayo Button can be used in two different ways.  One is with the HME filter.  The HME filters from both ATOS and InHealth fit the Button.  The filter cassette from ATOS (which now requires a prescription) can be used by any of those who use the three major ways of alaryngeal speech: TEP (Tracheo-Esophageal Puncture) with prosthesis, standard esophageal, and artificial larynx.  For TEP speech you use your finger to temporarily redirect the air from your lungs through the prosthesis and into your esophagus for speech.  Artificial larynx users and esophageal speakers can also get the benefits of an HME filter used with the Barton-Mayo.


     But for TEP speakers to obtain hands-free speech they need to use the handsfree valve or valve/HME combination.  The one from InHealth is called the "Adjustable Tracheostoma Valve" (ATV), and the ones from Bivona are the Tracheostoma Valve and Tracheostoma Valve II.

     For those who have attempted to use an HME filter and/or handsfree valve with a glued on housing but abandoned it because of problems in keeping the seal, allergic reactions to the glue, or just because of the additional hassle of using them, might want to see their clinician and see if they are a candidate for the Barton-Mayo.

The WebWhispers Banquet

   The annual WebWhispers reception and banquet was held on Friday evening, July 12th.  The reception was hosted once again this year by Richard Najarian of Bruce Medical.  The banquet was organized by IAL Vice President for Member Services, Libby Fitzgerald.  The menu and facilities were excellent.

       Pat Wertz Sanders was announced as the winner of the Casey-Cooper Laryngectomee of the Year Award for 2002 in recognition of her ongoing service to laryngectomees.  Congratulations, Pat!

     Individuals receiving Achievement Certificates for "their dedication, initiative and willingness to serve all laryngectomees and assist in their total rehabilitation" were: David Blevins, Elizabeth Finchem, Paul Galioni, Jim Lauder, and Marianne Peereboom-Kooijman.  Lorrance Lancaster was recognized as the individual traveling the longest distance to attend the Meeting--- 8,315 miles from Sale, Victoria, Australia.
    


 Philip Clemmons and Janice Hayes in Anti-Smoking Video

     WebWhispers members Philip Clemmons and Janice Hayes are featured in a new anti-smoking television film, "Fatal Addiction: Tobacco's Deadly Grasp."

      Philip, who was just elected to the IAL Board of Directors in Vancouver, is shown in the videotape trying one of the safety harnesses his business manufacturers, and later in an interview.


     Janice, who is a member of the host club for the 2003 IAL Annual Meeting in Atlanta, is shown speaking to students as well as in an interview.

     The video clips can be seen at this Internet address:

http://www.fataladdiction.tv/videoclips.html

     Congratulations Philip and Janice.

Learning to Smell Again

     As we know, the laryngectomy operation separates our trachea and lungs from the upper part of the respiratory system--the nose, mouth, and throat.  A side effect of this is to stop the intake of respiratory air which also conveyed odors.  In addition to being deprived of one of the senses, we also lose a portion of the role the nose played in enhancing the taste sensation.  The taste sensation is a combination of sensations conveyed by the tongue and nose.  Additionally, not being able to smell can constitute a safety concern in not being able to smell smoke or spoiled food.  An additional function of smell is to trigger salivation, which aids in digestion.

     A session in Vancouver on restoring the ability for laryngectomees to smell was conducted by Dr. Corina van As of the Netherlands Cancer Institute.  Dr. van As, along with other researchers in Europe, has shown considerable interest in helping laryngectomees retain optimal breathing efficiency as well as restoring the ability to smell.  These aspects of the "total rehabilitation of laryngectomees" has received less attention in North America.  Dr. van As described an experimental treatment program for laryngectomees which taught them new ways of moving air into the nose for the purpose of smelling.

     The basic idea of the approach to learning to smell is to create a vacuum in the mouth area.  The method is taught in three stages.  The first is a very large movement.  The jaw is lowered while keeping the lips closed.  The soft palate (roof of the mouth) is relaxed.  The patient also focuses on lowering the tongue along with the lower jaw.  The movement needs to be practiced in a relaxed manner with calm breathing.  The movement resembles a large chewing motion.  It creates a vacuum, and air moves into the nose.  Nearly 90% of the patients in the study could learn the movement after just one therapy session.  But since the movement is attention-getting, the same vacuum needs to be created in a less obvious way. 

     The second step is to make it less obvious by not lowering the jaw, but to create the vacuum primarily with the back of the tongue.  The back of the tongue is raised to the roof of the mouth (back of the palate).  Then it is lowered.

     The third stage has been previously described as the "polite yawn" method.  If you yawn with your mouth closed there is a subtle increase in the size of the nasal and mouth cavity.  This creates the vacuum and permits some air to enter the nose for the purpose of smelling.

     During the study patients were given visual feedback that they were moving air into the nose by means of a device called a water manometer.  The vacuum created in the nose moves water contained in the device towards and then away from the nose as air is moved in and out of the nose.  This helped the patients learn the methods. 

     Dr. van As concluded that patients in the study reported improved taste and appetite, as well as increased ability to smell.  Approximately one half of the patients continued to use the method over time.

Additional findings from the WHO Report

     In June 2002, the World Health Organization's International Agency for Research on Cancer (IARC) released the findings from a group of researchers who reviewed all the significant scientific evidence related to tobacco use and cancer.  In the new report from IARC, which will be published late this year or early in 2003, additional sites for tobacco-related cancer have been confirmed -- cancers of the stomach, liver, cervix, renal cell carcinoma, and myeloid leukemia.  These are in addition to lung, larynx, and a number of other cancers previously linked to tobacco use.

     The research also indicates that passive smoking causes lung cancer, with an increased risk of 20% to 30% among those exposed to environmental tobacco smoke who never smoked themselves.  The new IARC report also discusses the overall disease burden caused by tobacco. Half of all long-term smokers are killed by a tobacco-related disease, with half of those deaths occurring between the ages of 35 and 69 years.  Those killed by tobacco lose on average 20-25 years of life expectancy.

New Technologies in the Works

     In the June 24th issue of Newsweek an article reported on technologies being worked on at Massachusetts Eye and Ear Infirmary by Dr. Robert Hillman and others.  One project would attach a sensor to the neck muscles of a laryngectomy which would pick up the impulse that the user was speaking.  This signal would be wirelessly transmitted to something resembling a Walkman player worn on the waist.  It would transmit a signal to a very small and inconspicuous tone emitting device which was attached to the neck.  While the technology is similar to an AL, efforts are being made to make the voice more easily modified in both volume and pitch.

     While this hands-free technology is only now being worked on and it will be some time before it is commercially available, it is heartening to know that, despite the fact that there are few laryngectomees, that improving our lives is on the agenda of the research community.

Welcome New Members 

    We welcome the 29 new members who joined us during this past month:
 

As a charitable organization, as described in IRS § 501(c)(3), the
WebWhispers Nu-Voice Club
is eligible to receive tax-deductible contributions
 in accordance with IRS § 170.

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