February 2005


 

Name Of Column Author Title Article Type
Musings From The President Murray Allan Club Med For Cats News & Events
VoicePoints Dr. Jeff Searl Articulation Education-Med
WebWhispers Columnist Dutch WebWhispers Archives Education
Between Friends          Donna McGary My Journal Experiences
Musings From The President Murray Allan Casey-Cooper Nominations News & Events
Bits, Buts, & Bytes Dutch Computer Tips Experiences
Welcome New Members Listing Welcome News & Events

 

 

 

                Murray's Mumbles ... Musings from the President
 
 
There's an old saying that when you call a dog it comes running.  When you call a cat it takes a message and gets back to you later.  We cat lovers know that this is true.  I have always had a warm spot for animals but cats of any shape or color were my first choice.  When I was barely six and out on a Halloween night some nice folks asked me If I liked cats.  What could I say? They deposited two small white kittens in my pillow  case (that's what we used in the old days) and I marched merrily home with my two new friends to "surprise" my mother.  Fortunately, my Mom was also a feline lover so Snow White and Sabrina became beloved members of our family and we had these lovely girls or their offspring for many years.
 
When I retired a few years ago I was looking for something to do to keep my idle hands busy.  Of course, I did have a laryngectomy, WebWhispers, the IAL and my local club among other related things.  I was walking through the local mall and came upon a display table with cats and kittens.  There was a big sign that said Richmond Homeless Cats.  I talked to some ladies who were volunteers at this shelter and I was immediately hooked.  I couldn't wait to get down to this cat paradise which was providing a safe haven and home to at that time more than 500 beautiful cats.  I learned that everyone involved in the Shelter was a volunteer.  And that there were more than 90 individuals involved in playing with (very important!) and caring for the cats which includes feeding ,watering, medicating the ill and an incredible amount of "scooping".  There are many trips to the veterinarian and the cat food store.  There was also a segregated section for those with feline AIDS.  The shelter has a strict "no-kill" policy and we have blind, deaf, three legged and insulin dependant diabetic cats to mention some of the afflicted.  We also have kittens which always seem to be adopted first.  We adopted a three year old named Rusty.  I truly believe the older cats know that some day they will get a home.  When some one comes in with a cat carrier they hang around the door and try to look  "cute".
 
One advantage to being a laryngectomee in a cat shelter is that when you "scoop" you can't smell a thing!
 
If you like cats and kittens check out these fabulous felines at:
http://www.richmondhomelesscats.com/about.html .
 
Take care and stay well.
 
Murray
    


 VoicePoints [ ? 2004 Dr. Jeff Searl ]
  
  coordinated by  Dr. Jeff Searl, Associate Professor ( jsearl@kumc.edu )
                               Hearing and Speech Department, The University of Kansas Medical Center
                               MS3039, 3901 Rainbow Blvd., Kansas City, KS 66160

Minding our P's, Q's, and S?s in Alaryngeal Speech Training:
Focusing on Articulation - Adequacy to Excellence

by Jeff Searl, Ph.D., CCC-SLP
University of Kansas Medical Center
Kansas City, KS

     Author?s note to put the article in context: In Part 1 on the topic of articulation training for laryngectomee speakers, I present the argument that perhaps more time should be devoted to articulation training.  In Part 2, which will follow in the next few months, there will be more specifics regarding the ?how-to? of evaluating and treating articulation post-laryngectomy.  The topic is one that is near and dear to my heart as both a clinician and a researcher.  It is partly reflective, regarding where I think our profession is, and partly informative and educational.

     I have no real ax to grind. I simply want to remind myself and others to not settle for merely useable speech, but rather to work toward the best speech possible for each laryngectomee.  Because of the reflective nature and the lack of empirical data for some parts of my argument, I have kept the writing style somewhat loose.

     This article is intended to re-focus attention on a topic that often is overlooked or, at best, receives short-shrift in alaryngeal speech rehabilitation.  The issue is articulation training for individuals using esophageal (ES), tracheoesophageal (TE), or artificial larynx (AL) speech.  Textbooks on alaryngeal speech training invariably have a section, albeit small, about needing to train more precise articulation.  Experts in the field speak and write about it - though, not all too often.  When asked if articulation training is an important component of alaryngeal speech training, practicing clinicians wouldn?t dare respond, ?No.?  However, my suspicion is that as clinicians and researchers we offer more lip-service than time to the evaluation and treatment of our clients? articulation abilities.  To those speech pathologists and those laryngectomees who routinely give thought and time to maximizing articulation abilities post-laryngectomy, this article is not meant for you.  Nor is it meant to scold, but simply to remind myself and others that establishing a voice is not the end of laryngectomy rehabilitation training.

     The impetus for this article stems from two sources ? reflection on my own clinical practices and informal discussions and polling of clinicians and patients.  Establishment of an audible and consistent voice of acceptable quality that can be produced without significant effort is generally one of the first therapeutic targets with a laryngectomy patient.  This is certainly necessary whether one is working with an artificial larynx or with training ES or TE speech.  At times I have been so thrilled (and relieved!) to get a good voice that I lost sight of all the other aspects of alaryngeal speech production that are needed for good-to-excellent speech.  Usually these have been patients for whom establishing a voice has been difficult.  For others, it has been a more practical issue of distance, time, or finances.  They live too far away, are not overly enthusiastic about refining their speech, or insurance coverage for therapy has run out.

     In an informal poll of 14 clinicians and 12 laryngectomees, taken this past year, I was able to glean some information regarding the focus of therapy and the percentage of time spent working on issues such as establishing a voice source, training on the technical aspects of prosthesis management (if tracheoesophageal patients are being treated), articulation training, etc.  Nearly all of the clinicians discussed the importance of evaluating and working on articulation, but very little time was actually spent doing it, although this reportedly varied by the chosen mode of alaryngeal communication.

     For TE patients, 11 of 14 clinicians reported that they did not spend more than one therapy session on articulation or other non-voice/non-prosthesis activities.  The general sentiment was that establishing TE voice was primary, followed closely by training in prosthesis care.  Several commented that with the voice consistently present, patients were encouraged to use their new speech as much as possible.  Any other non-voice issues would be addressed on an as needed basis.  But per the clinicians? reports, rarely, if ever, did they formally evaluate or provide therapy related to maximizing articulation.

     For AL patients, there seemed to be a greater emphasis on more direct articulatory training that followed along with, or soon after, instruction in the technical use of the artificial larynx.  However, five therapists out of 14 indicated that they provided one therapy session or none  related to articulation when using an AL device. Based on interactions with larger numbers of laryngectomees at the IAL conferences over the past three years, the provision of an AL (or a TE prosthesis, for that matter) with little to no articulation training is certainly not uncommon.

     None of the folks with whom I?ve spoken in this informal survey have seen individuals for esophageal speech training within the past 3-5 years, so I won?t speculate on that issue here.

     It may be that clinicians truly value the need for articulation training but only limited time is actually needed or available to adequately address it.  However, there are a few considerations here that suggest perhaps greater emphasis should be placed in this area.  First, the alaryngeal speech literature has a number of studies indicating that speech intelligibility is generally lower than that for non-laryngectomized speakers (more details follow below).  Second, articulation abilities are known to be strong influences on intelligibility in a variety of clinical populations such as those with dysarthria (weakness and incoordination of speech muscles) or apraxia (inability to voluntarily control muscles for speech) associated with stroke, or children with altered articulation associated with clefts of the palate.  Finally, evidence has been emerging over the past 40 years indicating that articulation is, in fact, altered in TE, ES, and AL speakers (again, more details to follow).

Speech Intelligibility in Alaryngeal Speech

     Speech intelligibility reductions for artificial larynx users have been documented in a number of studies with deficits ranging from just a few percentage points below non-laryngectomized speakers to greater than 50% reductions (e.g., Cady, 1981; Knox & Anneberg, 1973; Ng, Kwok, & Chow, 1997; Weiss & Basili, 1985; Yiu, et al., 1994).  A large number of studies have been reported for ES speech intelligibility, and reductions ranging from less than 5% in superior speakers to greater than 50% in others have been documented (Doyle, Danhauer, & Reed, 1988; Most, Tobin, & Mimran, 2000; Yiu, et al., 1994).  Finally, TE speech intelligibility is reduced relative to non-laryngectomized speakers in the controlled studies reported to date (Cullinan, Brown, & Blalock, 1986; Doyle, et al., 1988; Hammarberg, 1992;  Max, de Bruyn, & Steurs, 1997; Most, et al., 2000; Searl, Carpenter, & Banta, 2001; Smith & Calhoun, 1994).

     While there is a popular perception that TE speech is more intelligible than the other two alaryngeal speech modes, some studies have found no difference depending on the speech sample (e.g., Max, et al., 1997; Ng, et al., 1997).  Others have even shown lower intelligibility scores for TE compared to ES or AL depending on the listening conditions (e.g., Clark, 1985; Clark & Stemple, 1982).  Kalb and Carpenter (1981) have suggested that individual speaker characteristics may play a larger role than mode of alaryngeal speech in terms of intelligibility.  Regardless, the literature is consistent in noting reduced intelligibility for all three modes of alaryngeal relative to non-laryngectomee speech.

Articulation in Alaryngeal Speech

     The question is, ?What contributes to the reduced intelligibility??  Certainly issues such as audibility, speaking rate, quality and consistency of voice, other extraneous noises, certain listener characteristics, etc. are all likely to have an impact.  However, articulation ability is also a prime candidate as its importance to intelligibility have been well documented across a variety of other speech conditions such as apraxia, dysarthria, and speech outcomes following oral-lingual resection.  Specific to the laryngectomee population, Dugay (1999) stated, ?The single most important factor that contributes to intelligibility of esophageal speech is articulation.? (p. 192).  Haroldson (1999) and Shanks (1986) have both described a fairly direct relationship between articulatory precision and esophageal speech intelligibility.  Relative to AL speech, Salmon (1999) re-iterated this point by stating, ?Because judgments of intelligibility are most closely related to articulation, attention must be directed to this specific speech parameter? (p. 96-87).  After reviewing the TE speech intelligibility and articulation literature, van As (2001) wrote, ?Apparently, the intelligibility of the different consonants is important for the intelligibility of the spontaneous speech; the redundancy in spontaneous speech most probably only compensates for part of the consonant errors? (p. 28).

     When you ask listeners to judge the speech of a laryngectomee, there are certain articulation errors that are expected to occur with greater or lesser frequency depending on the alaryngeal speaking mode.  Knowledge of expected error patterns can serve as a starting point for evaluating and treatment planning (addressed in Part 2 of this series).  To assist the reader in understanding the text that follows, Table 1 provides a listing of many of the different consonants in American English and how they are categorized.  Confusion of voiced for voiceless sounds (listeners perceive ?d? when ?t? was intended, or ?b? for ?p?) is a common error in ES speech (Hyman, 1955; Sacco, Mann, & Schultz, 1968; Shames, Font, & Matthews).  Other common errors are noted for fricatives such as ?s? (misperceived as stops such as ?t? or affricates such as ?ch?), nasals (for example, ?m? heard as ?b?), and ?h? (perceived as being absent).  In TE speech, voicing errors are also noted to be the most common (Doyle, et al., 1988; Searl, et al., 2001) although errors of omission (not perceiving a sound when it should be present) and manner of production (perceiving fricatives like ?s? as stops like ?t?) also occur.  For AL speech, voicing errors are again the most common (Cady, 1981; Weiss & Basili, 1985). In addition, stops, fricatives and affricates are less intelligible than nasals, liquids and glides which are highly intelligible.

Table 1 -  Categorization of some of the speech sounds in American English.

Speech Sound Category Consonant
stop b, p, t, d, k, g
fricative f, v, th, s, z, h
affricate (combination of a stop followed by a fricative) ?ch? (like in ?chair?), j
nasal m, n
liquid and glide l, r, w

     If one goes beyond asking what listeners hear, to investigating how the laryngectomee speaker actually produces speech sounds, it becomes apparent that articulatory movements are typically different than the non-laryngectomized person.  Again, this appears to be true regardless of the method of alaryngeal communication, although fairly little is known about AL speech.  For example, the duration of consonants and vowels tend to be longer (Christensen & Weinberg, 1976; Robins, Christensen & Kempster, 1986;Searl & Carpenter, 2002), the amount of air pressure in the mouth is generally greater (Searl, 2002; Swisher, 1980), the timing of the start and stop of voicing for certain consonants is different (Christensen, Weinberg, & Alfonso, 1978; Searl & Carpenter, 2002), and movements of the soft palate and shape of the oral cavity may be altered for certain consonants and vowels (Christensen, Fletcher, & McCutcheon, 1992; Diedrich & Youngstrom, 1966).  Some of these changes may be inherent to the anatomical and physiological changes that come about because of the surgery itself.  Some articulatory alterations might be an attempt by the person to compensate for the anatomical and physiological changes so that speech intelligibility is maximized.

     Such compensations might be intuited by the laryngectomee speaker without specific instruction or they might result from some formal therapy.  Formal therapy that focuses on increasing the precision with which speech sounds are made could account for several of the articulatory changes noted in the literature.  We will have to keep in mind that some compensations (whether intuited by the patient or instructed by the speech-language pathologist) could have both positive and negative effects on communication.  This will be addressed in Part 2 of this series.

     Certainly, any given individual may have their own unique articulation strengths and deficits that will require an individualized plan of care.  In the second part of this series, more specific methods for evaluating and treating articulation in the laryngectomee patient are reviewed.  This article serves as a reminder that articulation should not be just a secondary concern in alaryngeal speech rehabilitation.  Some folks may need very little training, while others may require substantial therapy time to sharpen their articulation to be able to produce speech with acceptable intelligibility.  Once a laryngectomy patient has adequate intelligibility, further work on articulation could be what propels them from mere adequacy to excellence.  When working with stroke patients with unintelligible speech, a reduction of even 10% intelligibility is often considered to be substantial enough to warrant direct training because of the degree of functional impact on that person.  For some reason, we seem relatively content to let an intelligibility deficit of this magnitude (or greater!) go unaddressed in the laryngectomee patient.  There is no reason to accept even a 5% or 10% reduction in intelligibility without at least attempting to maximize articulation abilities.

     More to come on direct training suggestions in Part 2.


   WebWhispers Columnist
                                                                                  
Contribution from a Member
 


The WebWhispers Archives - A Basic Primer

by Dutch Helms, Webmaster

     As many of you know, our Mail List Manager maintains Archives for all of our Emails sent via the WebWhispers and the WWHealthHelp Lists.  After an Email is sent to either List it is retained in the Archives for a full year.  These archived Emails can be a great source of information ... to catch up on past correspondence or to search for specific topics that might have been discussed over the previous months.  Many members may be reluctant to use the Archives or simply be intimidated by trying the "unknown".    Hopefully, what follows may assist members in accessing and using these Archives efficiently and easily.

The web site addresses for the Archives are simply "http://archive.mail-list.com/webwhispers/" and "http://archive.mail-list.com/wwhealthhelp/" respectively.  These are protected files so prior to being permitted access, you will be prompted for the appropriate UserID and Password.  Once you have provided this information, you will be granted access and presented with a page similar to the one pictured below (taken off the WW Archives on January 11th); this picture shows the top portion of the page.

Let's briefly examine this page and see what options it presents to you.   Normally, the initial page you will see will be the  first page of the "webwhispers archive (by date)" listing ... in the "Date Directory.  This page begins a series of pages displaying all Emails sent by date, beginning with the current date and progressing backwards for a full year.  The Email's title and author are displayed underneath each day and you can access the actual Email by "clicking" your mouse on it's SUBJECT.  You can scroll down the page as you search or select one of the other options at the top of the page ... "First Page", "Last Page", "Next Page" or "Prev Page".  You can also search the Archives using the other options available at the top of the main screen:

1.  "Subject Directory" - takes you to a listing of all Emails in the Archive by Subject, listed in alphabetical order.

2.  "Author Directory" - takes you to an alphabetical listing of Names/Email addresses of all those who have sent an Email during  the previous year.  "Clicking" on a name/address will take you immediately to a complete listing of that author's Emails, by Subject and date.

3.  "Author Index" - takes you to an expanded authors page which not only lists the authors alphabetically, but also UNDER the names/addresses is a list of all the Emails they have sent during the previous year (its Subject and date).

4.  "Thread Index" - takes you to an alphabetical listing of our Emails (by Subject) and highlights any "threads" the system has noticed ... a "thread" means "related Emails", such as an initial question and the answers that followed.

5.  MOST IMPORTANT ... the SEARCH box - Let' say you are searching for Emails that deal with a specific Subject, such as "Barton Mayo Button",  Stoma Cover Designs",  "Yeast Infections", etc.   You can simply type your "key words" into the box and hit "SEARCH".  The system will then search all the Emails and those containing your "key words" in the Subject line or in the actual text will pop up on your screen.   You can then "click" on each displayed Email and read it to see if it meets your needs.  The search capability involved and the results produced are very similar to what one gets on a standard Internet Search Engine.

And THAT'S IT!!  Like anything new, it likely takes a few trips into the Archives to get used to how it works but it IS user-friendly and can be a great source of information - allowing you to see what has already been written about your issue or "subject" over the previous year.  I hope the above is useful to you in accessing and using our Archives!



 
 BETWEEN FRIENDS          Donna McGary
                                     "That which does not kill us makes us stronger"
 

April 23, 2000 - My Journal

The first thing you learn when you find out that you are sick, really sick, life-altering kind of sick, that it is not going to go away without a fight, indeed, may never go away and for sure will change your plans, is that life goes on.  Not your life, but everyone else?s.  Even though they all say and truly mean that they want to be there for you, they cannot help the fact that their life goes on and yours has just stopped?dead in its tracks, which is an unfortunate metaphor that just happens to be true for you.

You stop being the person you were the second before you heard the news and you become your diagnosis.  It defines you the way that other more traditional and hopefully pleasant life passages define you: spouse, parent, grandparent, business person, academic, community activist, horse lover, church volunteer?You add to the list- survivor / fighter / advocate / teacher for a cause you never wanted to know about.  That?s what happens to you if, when your life stops, you want to jump-start it again.   That is, if you have the strength and the concentration, which is no small feat, when your life has stopped and all the cheerfulness you can muster is necessary to encourage all the people you love, who also love you, to believe that you are going to be fine.  When, in fact, you are not sure at all that you are going to be fine.  As a matter of fact, you are never going to be fine again and life has just tilted at such a crazy angle that you think you are going to be sick to your stomach, possibly forever.

But that is not something you can tell these sad, loving, friends, nor your crying mother or your sweetly encouraging father or your newly adult son who cannot believe that anything bad could happen to his ?weird Amazon mother?.  Your life has just stopped, but theirs goes on and that is okay in a way, because it reminds you that yours must, too.  You need to pick up the pen, the book, the diaper, the dish, the shovel?whatever it was that defined you before the ?diagnosis? and redefine your life.  Change is the only constant in life and some of us are forced to confront that truth rather dramatically.  I do not wish that confrontation on anyone, nor have I come to terms with my abrupt face- time with this reality.  To be honest, I hate the fact that your life goes on in such a sweet, safe, and mundane way while I can still smell the rubber burning as mine screeched to a halt.  I don?t want to be either a victim or a survivor and I can tell it?s going to take all of my strength to rise above both.  

Present       

I wrote this above journal entry exactly one month after my diagnosis of sub-glottic adenoid cystic carcinoma and as I was starting to make the rounds of doctors to assess my options.  I had just turned 47 and was in my first year of graduate school.  I was at UMass Boston studying gerontology and hoped that in five years I would have my PhD and be doing research, possibly in the area of cognitive changes in healthy aging adults and the types of interventions and techniques that might mitigate the slowing down of mental processes that occur naturally during the aging process.  Instead, I was forced to withdraw from the program, go on Social Security Disability, and now work part-time as a van driver and activities assistant at a retirement community outside Boston.  I have a permanent tracheotomy and speak with an electrolarynx.   It goes without saying that this represents an enormous change in my identity, self-image, and the future plans for my life I am not alone in this and that is why I wanted to call this column, ?Between Friends?.  It will be an opportunity for us to explore and hopefully share the challenges and triumphs of this journey, of which only one part, albeit an enormously significant part, is cancer. 

Grieving is a highly individualized and personal process.  No two people do it the same way or on the same schedule.  We can grieve the loss of a home or job or identity as profoundly and deeply as the loss of a friend or family member.  Sometimes the grief over the loss of one?s voice can be even more difficult to manage because in many cases our support network of friends and family simply can?t identify with us. They may be so relieved we are alive and so worried about what?s next that as long as we can find some method of communication, they are happy.  They remember the long days of uncertainty and silence when our only method of ?talking? was writing everything down.  I have friends who never knew ?my old voice?.  They only know me now, and they understand me.  We joke about my ?distinctive voice?.  But they don?t know how much I miss being able to have a good old belly laugh and not sound like the cartoon character ?Har de Har Har?.  They don?t know how much I miss being able to join in singing Christmas Carols or Happy Birthday or belt out the blues along with Bonnie Raitt on the car radio.

But I?m willing to bet every one of you does. 

Grief is a complicated emotion.  Most of us are familiar with the concept in psychology of the stages of grief: usually identified as shock, despair, anger, denial, bargaining, guilt withdrawal, acceptance and adjustment.  Professionals agree that many of these emotions are present at some point during the process, but the degree and order in which we experience them varies widely.  There is no right or wrong way to grieve, although it is generally accepted that one must fully experience the loss in order to come to terms with it and individuals who do not grieve are simply delaying the experience not forgoing it entirely.  Oftentimes we may be surprised when intense grief resurfaces, long after we thought we had dealt with it.  It may be triggered by a loss totally unrelated to the first one, but the experience triggers the same feelings of despair and loss of control.  This explains why we sometimes see people who seem to take significant losses in stride, only to fall apart at a seemingly minor one.  Loss is cumulative and if you don?t have the time and energy to fully process each experience, the cascade of emotions can be devastating, incapacitating and unexpected.  It is important that you give yourself and your loved ones permission to grieve.  When we see someone we love hurting, our instinct is to want to ?make it better?.  Sometimes people make the mistake of minimizing the pain ?You are going to be fine??or, ? I?m fine, it could be a lot worse?.  While those sentiments are sometimes both true and useful, they can also be ways to deny that, if the truth be told, the situation sucks.  Once we accept that, then we can really move on.

I look forward to continuing this discussion in the following months and invite members  to Email me, Donna McGary, directly at my WW Email address with comments and suggestions.  Non-members may send to my attention at: editor@webwhispers.com

Until then, my friends, remember

?The drawback to a journey that has been too well-planned
is that it does not leave enough room for adventure?
~Andre Gide~

 

2005 Casey-Cooper Award Nominations

     The nominating period for this year's award, which will be presented at our annual banquet during the IAL meetings in Boston in September 2005, is now open.  A full description of the award and the procedures involved can be found on our web site at:  http://www.webwhispers.org/pages/reports/caseycooper.htm

     The Casey-Cooper award shall be presented to the WW member who has been chosen by the Awards Committee.  Nominations will be from the membership who will be asked by the Committee Chairman to write an Email with their nomination and send it to the Awards Committee. This nomination must include detailed information as to why this WW member should be considered for this award.  To be considered by the Awards Committee, a member might have performed such services as work for WebWhispers or for other larynx cancer patients, assistance to other support groups, providing help to individuals through visitations, educating children through speaking engagements at schools, volunteerism to the ACS, the IAL, or to other national or international organizations or other services to the community.

     Therefore, if you know of a WebWhispers member who might be deserving of such recognition, please send nominating Email to this year's Chairman, Dutch Helms, at: FantumTwo@aol.com, who will then share it with the other members of  the committee - Pat Sanders, Mary Jane Renner, and Herb Simon.  The nominating period will remain open until the 1st of June 2005 ... but don't procrastinate ... if you have someone in mind, let the committee know now ... you can always add to your "nominating information" later, if necessary.

     Thanks sincerely for your interest and participation.


                          Dutch's Bits, Buts, & Bytes
 
 (1)  Some Interesting Figures

At the end of 2004, North America's population was estimated at roughly 325 million with about 222 million classified as "Internet Users" -  about 68% of the population.  The rest of the world's population was estimated at about 6.06 billion with around 591 million classified as Internet Users -  9.7% of that population.  The European nations within the European Union have a population of 456+ million with about 206 million using the Internet - about 45% of that population.  The Non-European Union European countries have only about 9% of their populations using the Internet.  Latin American and Caribbean countries use the Internet at about a 10% rate.  Asia's user rate is about 7.1%; the Middle East about 6.7%; and Africa is about 1.4%;    Overall, of the world's TOTAL population, only around 13% actively use the Internet.  ( Source: "INTERNET USAGE STATISTICS - The Big Picture" at: http://www.internetworldstats.com/stats.htm )

(2) 
Q: What are "cookies", and should I allow a Web site to place one on my hard drive?

A: Cookies are small text files put on your hard drive that contain information used by a Web site.  Cookies have raised some privacy concerns because they can be used to track a user's movements within a site.  However, most cookies do not associate a user with a name. For example, if you go to a Web site and receive a cookie without entering your personal information in a form on that site, the site doesn't know who you are. You are simply User X.  Most cookies are used for several purposes: (a) Web site operators use cookies to tell what areas of a site are visited and in what order. (b) Advertisers use them to tell where a user was on a site when he or she clicked on an ad. (c) They are used to keep those who've registered to use a site -- such one that requires a logon and password -- from having to log on over and over as they move from page to page on a site.  Cookies cannot grab personal information from elsewhere on your hard drive, so merely visiting a Web site is not going to expose personal information to the operators of the site.

(3)  Q: I just got a new computer and can't get the light on the mouse to go out even when the computer is turned off.  It is a Microsoft optical mouse connected to the PS2 port.  Is this normal?

A: A little-known fact about computers is that the PS2 ports are powered even when the computer is turned off.  This means that if you have an optical mouse connected to the PS2 port on your computer it will stay lit even when you power off the PC.  For the record, this is not a problem.  If it is something you can live with, there is no danger in leaving the optical mouse connected to the PS2 port.  If this is a problem you will need to connect to the mouse to a USB port or purchase a mouse with a USB connector.  Most mouse devices sold today are USB and come with a PS2 converter.  Remove the converter and just connect the mouse to your USB port.  If your mouse is a true PS2 device, you will need to purchase a new USB mouse or a converter to change the PS connection to USB.

(4) "Kruise Knews":

  Royal Caribbean has just released the new DECK PLANS for their ship, Enchantment of the Seas, on which we will be sailing out of Boston after the 2005 IAL meetings.  You can read more about this ship and its renovations AND see the new Deck Plans on our 2005 WW Cruise Pages (deck plans are at the very bottom):

http://www.webwhispers.org/pages/cruise/WWCruise05_2.htm
 

 

   ListServ "Flame Warriors"   


                                                                               
Terms of Importance
flame

1. n.   A hostile, often unprovoked, message directed at a participant of an internet discussion forum.  The content of the message typically disparages the intelligence, sanity, behavior,  knowledge, character, or ancestry of the recipient.
2. v.   The act of sending a hostile message on the internet.

flame warrior
1. n.   One who actively flames, or willingly participates in a flame war ... (Another Example Below) ...

Therapist

Therapist can be a highly annoying and therefore very effective
Warrior.  Instead of making a frontal attack, Therapist attempts
to shift the focus of the conflict to the combatants'
psychological motivations and problems.  He will freely
speculate about other Warriors' insecurities, personalities and
relationships, but he will almost never directly engage the
subject of the dispute.

Above courtesy of Mike Reed
See more of his work at: http://redwing.hutman.net/%7Emreed/  
 

   Welcome To Our New Members:

I would like to welcome all new laryngectomees, caregivers and professionals to WebWhispers! There is much information to be gained from the site and from suggestions submitted by our members on the Email lists.  If you have any questions or constructive criticism please contact Pat or Dutch at Editor@WebWhispers.org.

Take care and stay well!
Murray Allan, WW President

     We welcome the 33 new members who joined us during January 2005:

Paula Amsler - Caregiver
Corpus Christi, TX
Willette Austin
Lufkin, TX
Joyce Baumunk - Caregiver
Rawson, OH
Gerald Bryce
Alamogordo, NM
Brenda Chamberlain
Novi, MI
Stephanie Cox - Caregiver
San Diego, CA
John Dodsworth, Jr.
Lumberton, NJ
Jennifer Dratch - Caregiver
Brooklyn, NY
Paula Duggan
Upper Coomera, Qld, Australia
Mike Erwin
Germantown, TN
Judy Evans
Montgomery, AL
James Floore
Chicago, IL
Gretchen Galvin - SLP
Athens, GA
Hannah Kaplan - Caregiver
Gainesville, FL
Gillian Lambert - Caregiver
Cullompton, Devon, UK
Jane Langton - SLP Student
Heaton, Newcastle, UK
Gordon Mackie
Croydon, Surrey, UK
Rosalie Miles - Larynx Cancer Patient
Colchester, Essex, UK
Carrie McBreen - SLP
Chicago, IL
Tammy Morris - SLP
Windsor, Ont, Canada / Dearborn, MI
Sandra Niedzwiecki - Caregiver
Malden,MA
Karen Osborne - Caregiver
North Fort Myers, FL
Leslie Quong
Singapore
Robert Rasure
Concordia, KS
Kevin Riley
Plano, TX
Anthony Russo
Lake Worth, FL
Patti Shanes - SLP
Edison, NJ
Arnold Sharp
Perry, MO
Elizabeth Solomon - Caregiver
LasVegas, NV
William Stevens
Walnut Creek, CA
Glenn Sylvester
Union, NJ
 
Judy Thiede - Caregiver
Toledo, OH
 
Kacy Whitesmith
Vendor, Communicative Medical
Vancouver WA
 



 
WebWhispers is an Internet-based laryngectomee support group.
  It is a member of the International Association of Laryngectomees.        
  The current officers are:
  Murray Allan..............................President
  Pat Sanders............V.P.-Web Information
  Terry Duga.........V.P.-Finance and Admin.
  Libby Fitzgerald.....V.P.-Member Services
  Dutch Helms...........................Webmaster
      

  WebWhispers welcomes all those diagnosed with cancer of the
  larynx or who have lost their voices for other reasons, their
  caregivers, friends and medical personnel.  For complete information
  on membership or for questions about this publication, contact
  Dutch Helms at: webmaster@webwhispers.org   

 

Disclaimer:
The information offered via the WebWhispers Nu-Voice Club and in
http://www.webwhispers.org is not intended as a substitute for professional
medical help or advice but is to be used only as an aid in
  understanding current medical knowledge.  A physician should always be   
consulted for any health problem or medical condition.



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.



  ? 2005 WebWhispers
Reprinting/Copying Instructions
can be found on our
WotW/Journal Page.