July 2004


 

Name Of Column

Author Title Article Type
Musings From The President Murray Allan Largest Club In IAL News & Events
VoicePoints T Wigginton M.S., CCC-SLP Pt 3-Hard Pill To Swallow Education-Med
WebWhispers Columnist Judith & Bill Ramboldt No One Will Be Left Speechless Experiences
WebWhispers Columnist Richard Crum Want A TEP/Prosthesis? Education-Med
Bits, Buts, & Bytes Dutch Computer Tips Experiences
Welcome New Members Listing Welcome News & Events

 

 

            Murray's Mumbles ... Musings from the President
 

WebWhispers - Largest Club in IAL

It is truly amazing what the Internet has done to connect people, countries and continents together.  The International Association of Laryngectomees has approximately 250 clubs world wide.  Of these clubs, WebWhispers is truly the largest, with over 1,170 laryngectomee/caregiver members.  This year that number has been growing by an average of 31 new members each month.  When Dutch Helms informally started this club back in 1996 little did he realize the tremendous growth potential or what would develop from the few founding members.  Kudos are also in order for Pat Sanders, Vice President of Web Information, who developed the WWHealthHelp line so that members could ask questions and get advice from professional Otolaryngologists, Speech Language Pathologists and other specialists.  Pat is also a valued and frequent contributor to the site and her knowledge of laryngectomy issues is truly phenomenal.   Dutch started the site because he couldn't find adequate laryngectomy information on the Web and all laryngectomees owe him and the others who now actively participate on the site a great deal of credit.

See you next month, or, if you are attending the IAL convention in Anaheim I will see you there.  Don't forget the WebWhispers banquet on Friday, July 9, when the winner of the Casey-Cooper Award will be presented with an engraved pewter bowl in recognition of being named the WW Laryngectomee of the Year.  The first annual winner was Dutch Helms (2001) followed by Pat Sanders (2002) and Mary Jane Renner (2003).  And the WINNER for 2004 IS ... a surprise!

Take care and stay well.

Murray

PS: Take a "sneak peek" at our new WebWhispers Brochure - to be available at and after IAL 2004 in Anaheim.  Click HERE!


 VoicePoints [ ©  2004 Dan H. Kelly, Ph.D. ]
  
  coordinated by   Dr. Dan Kelly, Retired Associate Professor ( dy_kelly@msn.com )
                                Department of Otolaryngology, Head & Neck Surgery
                                7700 University Court, Suite 3900, West Chester, OH  45069

© May 2004 Tammy L Wigginton; M.S., CCC/SLP, Charlottesville, VA 

That's a Hard Pill to Swallow
Part III

     Ongoing assessment of nutritional status and swallowing function is an important aspect of laryngectomee treatment and rehabilitation. Ideally assessment of nutritional status and chewing/swallowing function should begin during the pre-operative consultation.  It is important to take note of the patient's current nutritional and dental status as well as oral motor and chewing/swallowing function. It is imperative to have an idea of what sort of the resection the surgeon has planned. This information will help the clinician anticipate issues that may interfere with the recovery process; initiate treatments that may help prevent or reduce the likelihood of complications and provide the patient with realistic expectations regarding the recovery process. 

    
Although most laryngectomees do not have significant swallowing problems and frequently manage their swallowing issues by modifying their diet, taking smaller bites, and eating more slowly, it is important for clinicians to keep in mind that some laryngectomees do have significant issues that compromise their ability to meet their nutritional needs. It is crucial for clinicians to remember direct treatment should not be initiated until the surgeon has cleared the patient for evaluation and treatment. Moreover, oral feedings should not be attempted until the surgeon has given approval. 

     Many of the difficulties laryngectomee patients experience involves the oral stage of the swallow. Diagnosis of oral stage deficits generally involves taking a thorough patient history, observing the patient eat/drink a variety of consistencies and may also include a Modified Barium Swallow.  Side effects from radiation therapy seem to be the primary cause of many of the oral stage swallowing problems observed in the head and neck cancer population. Radiation therapy can result in short and long term difficulty with chewing and swallowing. In this circumstance, as in so many other circumstances, an ounce of prevention may very well be worth a pound of cure.

     There is some recent and very compelling research that Amifostine (Ethyol) a radioprotectant, which was approved by the FDA for use in the treatment of head and neck cancer patients in 1999, may be effective in preventing or lessening many of the damaging side effects involving the oral cavity and generally associated with radiation treatment. Ethyol is an agent that protects healthy cells from being killed by radiation therapy, but does not protect cancer cells from being killed by radiation therapy. Ethyol has also demonstrated protective effects with the chemotherapy agent Platinol (cisplatin). Ethyol is approved for the use in patients with head and neck cancer to reduce the incidence of xerostomia (dry mouth) since radiation therapy in the head and neck region can result in permanent changes in saliva production (Xerostomia), radiation induced tooth decay, and trismus.

     Xerostomia or dry mouth is very common long-term problem associated with radiation treatment. Pilocarpine (Salogen) is a medication that seems to help some patients who suffer from dry mouth but recent literature suggests Pilocarpine may be more effective if it is initiated prior to or shortly after radiation therapy is started. However, Pilocarpine can be expensive and may not be appropriate for every patient. Patients with dry mouth should drink plenty of water. Adding a small amount of glycerine to the water can offer longer lasting relief. Sucking on ice chips or sugar free candies or gum may also provide relief. Alcohol based mouthwashes and peroxide solutions often result in further dryness and irritation. Baking soda and water is a good inexpensive oral rinse.  Salivart, OraLube, Biotene, and Glandodane are some commercially available products that may help relieve symptoms in some patients. Some patients find meat tenderizer (papase) is effective at reducing thick and ropey saliva. However, caution must be used when using papase. If the patient has an open lesion the papase will attack that tissue and destroy cell structure. Many patients find Coca-Cola Classic to be helpful in decreasing the viscosity of thick and copious mucous.  Patients who still have their teeth may want to choose a soda water over a sugary beverage. Patients with Xerostomia especially individuals with removable dental appliances seem to be particularly prone to developing oral bacterial and/or fungal infections. Report any signs of infection to your physician.  Immediate treatment is important. Nystatin and chlorhedrine are frequently used to treat oral infections.  It is very important to thoroughly clean and disinfect dental appliances to prevent ongoing infection or re-infection. Dental adhesives should be avoided because they can harbor bacteria.

     Changes in saliva production and consistency can result in tooth decay. It is important for patients who still have their natural teeth, to see their dentists prior to beginning radiation treatment. The dentist may need to extract teeth that cannot be restored, as it is unadvisable to extract teeth after a patient has undergone radiation treatment. Radiation therapy can result in permanently decreased blood supply to the jaw.  This generally reduces the bones ability to heal and resist infection. Dentists will usually prescribe fluoride treatments and a daily cleaning regimen. In spite of attempt to prevent decay some patients may still have problems with decay. Every attempt should be made to salvage teeth and prevent decay and infection. There are no contraindications to having teeth filled, having root canals or having teeth crowned.

     During the early phase of radiation treatment patients often experience mucousitis, which is an inflammation and ulceration of the soft mucous membranes of the oral cavity, and the pharynx. If possible it is best not to wear dental appliances while undergoing treatment as they may result in further irritation, and tissue breakdown. Patients who do not have their teeth clean the tongue and oral cavity with gauze or a soft toothbrush several times a day. Anesthetic rinses, sprays and lozenges that contain lidocaine may help numb the mouth and throat. Many facilities have a
'house-cocktail' which they prescribe to treat oral mucousitis.  This cocktail usually contains some form of lidocaine and/or benadryl mixed with an anti-fungal or antibacterial agent.  Certain foods and spices may cause a burning sensation and further irritation. In general, it is best to avoid alcohol beverages, acidic foods and beverages, and anything that is hot, rough, spicy, salty, dry or grainy textured.

     Trismus is the loss of elasticity in the jaw muscles. Trismus can be very painful and can result in difficulty opening the mouth and chewing. Once again it is important to try to prevent difficulties before they arise.  If the jaw is going to be in the radiation field it is important to stress to patients the importance of jaw
'range of motion' exercises 1-2 times per day to reduce the risk of developing trismus. Some patients will develop trismus in spite of preventative measures. Therabite and TMJ Oral-Flex are commercially available exercise products/programs for the treatment of trismus. 

     In addition to treating difficulties such as xerostomia, oral mucousitis, and trismus as symptoms appear, changing diet consistency can improve oral stage function.  Since the degree of difficulty varies it is important to determine the patient
's degree of function.  Some patients may need to blend their food in a blender while other patients may just need to avoid certain foods. Lubricating food by putting gravy, sauces or condiments on it, or even spraying it with a very thin coating of vegetable oil can be very helpful.  Taking small bites and alternating bites and sips can facilitate improved oral swallowing function.

     For patients who have had to undergo oral resections in addition to a total laryngectomy it is very important to assess dentition and oral motor function i.e. the integrity of the tongue, lips, and jaw including strength, endurance, range of motion, precision, and sensation. The clinician needs to examine the patient
's ability to hold food in their mouth without spillage, the ability to chew and form a cohesive food or liquid ball (bolus) and the ability to move this bolus from the front of the oral cavity to the back of the oral cavity in an efficient and timely manner. It is important to examine the oral cavity after the swallow to take note of residue in the oral cavity. The clinician may find the patient is able to manipulate certain consistencies more easily than other consistencies.  Moreover, the clinician and patient may find compensatory techniques such as tipping the head back or to one side or the other may facilitate improved bolus control and anterior to posterior movement. In some instances adaptive spoons or cups may be indicated. Oral prosthetics are generally necessary for patient's who have undergone palatal resections and can often improve bolus control and anterior to posterior movement for partial and total glossectomies.  In some circumstances oral motor exercises may be indicated to improve lip closure, tongue strength and coordination, and overall jaw range of motion.

     Pharyngeal stage swallowing problems occur less frequently but tend to be somewhat more difficult to treat than oral stage dysphagia. Diagnosis of pharyngeal stage deficits generally includes taking a thorough history, an oral motor assessment, and videofluoroscopic evaluation. This study allows the speech pathologist and radiologist to assess oral cavity and the upper aerodigestive tract. During the study the patient eats and drinks a variety of textures of foods and liquids combined with barium. This allows the clinician to assess structural and movement abnormalities as well as consistencies that are more easily tolerated and maneuvers that may improve the efficiency of the swallow. The swallowing study is generally tape-recorded.  At the conclusion of the study the speech pathologist should review the tape with the patient and provide recommendations regarding appropriate textures and feeding techniques.  The speech pathologist will also send a report to the referring physician.  If structural abnormalities are observed additional testing may be indicated. Pharyngeal phase swallowing deficits may include fistula, pseudo-epiglottis or diverticulum, esophageal stricture, and pharyngeal constrictor spasm.

     The development of a fistula is not an uncommon postoperative complication especially in patients who have had previous radiation therapy, diabetes, are elderly and/or frail. On rare occasions fistulas have developed months or years after treatment. Items that have been eaten and/or drank can leak into the surrounding tissues or structures through the fistula. This can result in aspiration and infection if the leakage is into the lungs or infection and wound breakdown if the leakage is into the surrounding tissue. A fistula may be able to be visualized or may require a videoflouscopic swallowing study. The etiology of the fistula must be determined in order to plan an appropriate treatment strategy.  The etiology is generally more obvious when the fistula occurs immediately following surgery and may be more difficult to determine if the fistula occurs months or years after treatment. Most small fistulas will heal with tincture of time, antibiotic therapy and not eating or drinking. This means the patient will require alternative nutritional support (PEG, NG or stoma-gastric tube) until the wound heals. Larger fistulas or fistulas that are resistant to healing may require surgical intervention.

     A pseudo-epiglottis diverticulum is simply a band of scar tissue at the base of tongue, with a pouch or a pocket below it. This pouch has a tendency to collect foods. A large pseudo-epiglottis can cause foods and liquids to back up into the oral cavity and sometimes all the way up into the nasal cavity. A pseudo-epiglottis can be visualized during videofluoroscopic swallowing study.  Postural and dietary adjustments may help reduce symptoms.  However, if the pouch is very large and troublesome and the patient is an appropriate candidate for surgery, resection of the scar tissue may be the best treatment option.

     A stricture or narrowing of the esophagus can significantly impair a laryngectomees ability to swallow. An esophageal stricture may remain static or evolve or time. Difficulty can range from mild difficulty with certain foods such as bread or meat up to a complete inability to swallow anything at all. While a stricture can usually be effectively visualized during a videofluoroscopic swallowing study, the physician may recommend further assessment in order to rule out recurrent or secondary disease. The physician may recommend an EGD.  An EGD is a procedure, which is usually done on an outpatient basis.  The patient is usually given a local anesthesia and a scope with a camera on it is passed through the oral cavity into the dilated esophagus.  The physician will visually examine the esophagus for abnormalities and a may take a biops
y of any suspicious looking tissue.  Once recurrent or secondary disease has been ruled out an appropriate treatment plan can be established. Depending upon the severity of blockage, treatment may include dietary and postural modification, esophageal dilation, and placement of an esophageal stent, or radical surgery that may reconstruction the esophagus with a portion of the patient's jejunum or a radial forearm flap. The treatment approach will vary depending upon the severity of the problem, the patient's motivation to eat/drink, willingness to modify their diet and candidacy for surgery.

     Pharyngeal constrictor spasm is an involuntary contraction of the reconstructed esophagus segment. This involuntary spasm can result in difficult or dysfluent standard esophageal speech/tracheoesophageal speech as well difficulty swallowing.  The best way to evaluate spasm is by evaluating the patient
's voice production or lack of voice production in combination with a videofluoroscopic swallowing assessment. The patient swallows barium and is then asked to 'voice'. The area of spasm will appear as a constricted bar, with barium a puddle at the top. The lower end of the constricted bar is identified as the esophagus is inflated with air. Treatment for spasm may include a Botulinum toxin injection (Botox).  If the spasm is resistant to treatment with Botox, a myotomy may be indicated. 

     It is often helpful and advisable to refer patients to a dietician. A dietician can determine whether or not the patient's nutritional needs are being met via oral intake.  Moreover, the dietician should determine the nutritional needs of the patient and offer suggestion regarding how those needs can best be met. Often supplements such as Ensure or Boost can be used to supplement meals. Alternative nutritional support (PEG, NG and stoma-gastric tubes) can be used to supplement a patient's oral intake, temporarily provide nutrition support during nutritionally compromised periods of time, and when necessary permanently meet a patient's nutrition and hydration needs.

     It can be very challenging to treat swallowing disorders in the head and neck cancer population.  It is important for professionals to realize total laryngectomy does not preclude serious swallowing difficulties.  While the typical structural risk of aspiration is eliminated by surgical separation of the respiratory system from the digestive system, dysphagia cannot be eliminated. In order to effectively treat swallowing problems in the laryngectomee population, a clinician must have an excellent understanding of head and neck anatomy and physiology, surgical interventions employed in the treatment of head and neck cancer, short and long term side effects of radiation/chemotherapy, appropriate instrumental and non-instrumental evaluation techniques and effective treatment strategies. Moreover, is very important to develop a good working rapport with the members of the patient's treatment team.  The team will included the patient's otolaryngologist/head and neck surgeon, and may also include various medical personnel such as the patient's primary care physician, radiation oncologist, oncologist, gastroenterologist, dentist, oral maxillary prosthodontist and dietician.  At times it can be difficult to balance the medical and nutritional needs of the patient with their wishes.  However, in the end it is up to the patient to decide how they wish to meet their nutritional needs.

     Laryngectomees and their families should understand the importance of immediately reporting any change in swallowing status to their medical team.  They should not suffer in silence or try to independently resolve serious swallowing issues. Delaying treatment can result in malnutrition and dehydration which can in turn result in a host of serious medical complications.  In general the earlier treatment is sought, the better the overall outcome.


   WebWhispers Columnist
                                                                                  
Contribution from a Member
 

No One Will Be Left Speechless
By Judith and Bill Ramboldt, WW Loan Closet Custodians

     When Libby Fitzgerald, WebWhispers VP Member Services, asked if any WebWhisper member would be able to take over the Loan Closet, it was a no-brainer for my husband Bill and me to volunteer. I have been the loan closet custodian for the Nu Voice Club of Daytona Beach along with my vice president, Amy Jo Kiger.  All that was needed was more shelving for storage.

     We used to have a two bedroom house but now we have a one bedroom house with a great storage room and shelves - shelves - shelves.  My fabric boxes are on one wall with a rack of costumes. On the other wall are our Christmas Decorations and the WW Loan Closet inventory.

     The work required to maintain the loan closet is very easy. We get a request for a unit, I decide what unit is needed and pack it up with a few other goodies (foam covers, and fancy covers) and Bill goes to the Office Depot to mail them. Okay, that is the manual work that has to done and Bill and I do this work with a smile on our faces and a song in our hearts. When we took over the responsibility of the loan closet, we committed ourselves to a great way to serve our fellow laryngectomees. Bill has been a rock for this lary to lean on. 

     The WW policy is, to receive an electrolarynx, the laryngectomee or lary-to-be needs to be a member of WebWhispers.  A member SLP or other professional can also request one and be the one to be responsible for the unit. In an emergency we try to work out a way.

     I am glad to say that we have not lost a unit yet. And along with the returns, we often get letters of thanks. This is the great part. I would like to share some of the thank you notes.

     From one caregiver, "Thank you so much for the loan of the TruTone. Robert has received his Tele-Talk (communication unit attached to a telephone available to Florida Residents). I am returning the unit so you can help someone else."  

     A survivor wrote, "Thank you for sending me the Servox and all the information and supplies. It is so nice to know there are other people like me out there. Thank you again for your generosity, because we are having a hard time with my HMO insurance."

     From another lary, "Thank you for lending me the TruTone. I hope I can learn to use it." This man sent me some drawings - he calls them the propeller flower."

     And from another, "Thank you so much for loaning this Servox so my husband could speak. You guys are great, so supportive. My husband died June 19, 2003 of cancer of the larynx. I had the unit refurbished so everything will work."

     And the most touching, "I want to thank you for the fast delivery of the Servox for my husband. (We sent it overnight). He can now talk again since his TEP won't work anymore. He was able to talk to his son which he had not been able to do for a long time. For three weeks, until his death, he was able to communicate using the Servox. Thank you again." I spent a lot of time corresponding with this man's wife and I was very thankful that we were able to help them.

     Our loan closet is in great shape. Many families of deceased laryngectomees donate instruments to our loan closet and these are most appreciated by newcomers who would have no method of speech without them.

     When the batteries we had in the closet would not hold a charge, I alerted Libby. She put a call out to our vendors after which I received 20 batteries for our Servox units from ?Fat Freddie? and ?Gorgeous? George.  Then, Richard Najarian of Bruce Medical promised that he will handle the repair of any units.  We thank everyone for their generosity.

     Bill and I enjoy every time we can help a new lary. It fulfills our knowledge that God is not done with us yet. We have more to give and we are honored to be the custodians of the WW loan closet. Thank you for having faith in us.


   WebWhispers Columnist
                                                                                  
Contribution from a Member
 

Why One Would Want a TEP/Prosthesis
by WW Member Richard Crum

     There has been some discussion on the list serve about why anyone would want to have a Tracheoesophageal puncture and voice prosthesis or a TEP. I have worked for InHealth, the Blom Singer manufacturer, as a laryngectomy consultant since 1992. In that time I have never told anyone that they should have a TEP, rather I have tried being there to supply as much information as possible, so that each person can make up his or her own mind. While the decision to have the TEP has been very good for me, I know enough about people that it may not be the best for everyone.

     I think that a little history needs to be discussed in connection with this issue. Back in the 60's and early 70's the prime method preferred by the speech professionals was esophageal speech. It has been reported that many doctors and speech pathologist may have discouraged the use of an electro-larynx. At this time the health care establishment did not understand that some people would never be able to be fluent esophageal speakers. They did not understand that some people, due to their constrictor muscles, could try for years and would never develop good esophageal speech.

     Edmund Lauder, a Laryngectomee as well as a speech pathologist, knew from his own experience that this was not the way it should be. He started, along with others, introducing the use of the electro-larynx and it quickly became a popular way of speaking for many Laryngectomees.

     In the late 1970's, Eric D. Blom, PhD and Mark I. Singer, MD developed the TEP approach to speech after a total laryngectomy. They soon found that some patients could speak right away while others could not make a sound. They developed the insufflation test to determine if there were constrictor muscles that would prevent good esophageal speech. With this discovery most of the health professionals understood why some people had no trouble producing good esophageal speech while others never could achieve good esophageal speech.

     This change opened the way not only for TEP speech but the acceptance of the use of an electro-larynx. In the 16 years since I became a member of the laryngectomy community, I have met other laryngectomees that are great esophageal speakers as well as great electro-larynx speakers. Earl Mogk from South Florida has great esophageal speech that is so good it is hard to know he is a laryngectomee. And who can forget Jewel Hoffman from
Louisiana. Jewel once sang happy birthday to me at the Florida laryngectomy meeting, unbelievable. Then there is Tom Beneventine whose use of the Servox cannot hide his Brooklyn accent.

     All of this brings us back to why would anyone chose to be a TEP speaker. For me I was 46 years old, self employed as an auctioneer/real estate broker and I needed to work. I had learned to use the electro-larynx after my surgery, and with the help of Ed Lauder's book and tapes, I learned esophageal speech well enough to be understood but not well enough to work in my profession. The TEP gave me smooth fluent speech and enabled me to go on with my profession as an auctioneer/real estate broker.

     Are there problems with being a TEP speaker? You bet. Does it take practice to manage the system? Yes it does. Does it take time, effort and patience to be a good hands free speaker? It sure does. Is it worth it to me? Yes it currently is.

     The many problems that some have with the TEP overshadows the many people that use the TEP as their primary means of speech. It is like the issue of good news and bad news. We always hear of the bad news and never hear of the good news. Those who have learned to manage the system do not give feed back because the system is working for them.

     Whatever works for you is fine with me but I would caution anyone that is faced with the decision to consider TEP speech to look at all of the options with an open mind. There are pluses and minuses with each form of speech after a total laryngectomy.

     Use of an electrolarynx is quick and easy to learn and relatively inexpensive. Some people have a problem with the electronic sound. There are some maintenance problems and batteries must be kept charged. Esophageal speech, when done well, is great since there is nothing to worry with. Some people find this type of speech very hard to learn and even with good esophageal speech, volume is a problem. With TEP speech the person is able to speak fluently with better volume than with esophageal speech. The learning curve to produce speech is a lot shorter than with esophageal speech. On the other hand, if the TEP is not done at the time of the laryngectomy, a second minor surgery is required. Leaning to manage the system can be challenging. There is also the cost to maintain the system, however Medicare and most insurances will reimburse for this expense.

     I guess what it comes down to is would I have the TEP done if I were a new laryngectomy and I would answer with a very positive yes. The benefits I have experienced are well worth the inconvenience of learning how to manage the system. If you have the opportunity to make the choice look at all your options, ask questions, and talk with as many laryngectomees as possible and then make an educated decision.


                          Dutch's Bits, Buts, & Bytes

(1)
Need Help Remembering Passwords or Filling Out Online Forms?  You may wish to check out ROBOFORM ( http://www.roboform.com ).  This software was first called to your Webmaster's attention by WW member E. John Norris of Garland, TX (ejn11@verizon.net).

Publisher's Description (Siber Systems):

     Named Best Software of 2003 by CNET.com, RoboForm memorizes and types passwords for you, and it can perform the entire login sequence automatically.  RoboForm fills in online forms from your personal profile in several languages.  You can store ATM passwords and software-activation codes in encrypted RoboForm Safenotes.  RoboForm automates your daily password-entering routine and gives your passwords and other personal data security, portability, and complete manageability; passwords can be printed, copied to another computer, backed up, and restored.
 
CNET Download.com's Review of Roboform:

     This tool reduces the time you spend filling out Web forms and logging onto subscription sites.  RoboForm's plain interface distills form filling to one click and is accessible from a special browser toolbar, the context menu, a tray icon, or a desktop shortcut.  Categorize personal information such as name, location, and credit card number, with identity.  You can have multiple identities--for example, one for registering for free stuff and another for making real purchases on the Web.  Unfortunately, you cannot categorize your identities, passcards, or Safenotes, so you may get lost in your list.  RoboForm handles check boxes and radio buttons and fills out forms in about 20 languages.  It uses triple DES encryption to protect your data and includes a password generator.  All your data is stored in a single folder that can be easily copied or deleted.  The program is a reasonably priced time-saver for the active Web surfer.
 
My Comments:

     The RoboForm download file is about 1.7 MB in size and is fully functional for the first 30 day FREE TRIAL.  After 30 days, some capabilities are limited (see: http://www.roboform.com/why-pro.html).  Full capabilities can be restored by purchasing the "Pro" version of the software for $29.99.  RoboForm now has almost 1 Million users world-wide.

(2) The Aluminum Foil Deflector Beanie:
     
(Practical Mind Control Protection for Paranoids)

     This site (http://zapatopi.net/afdb.html) is dedicated to spreading the word about the Aluminum Foil Deflector Beanie and how it can help the average human.  Here you will find a description of AFDBs, how to make and use them, and general information about related subjects.  I hope that you find the AFDB Home Page to be an important source of AFDB know-how and advocacy.

What Is An AFDB?

     The Aluminum Foil Deflector Beanie (AFDB) is a type of headwear that can shield your brain from most electromagnetic psychotronic mind control carriers.  AFDBs are inexpensive (even free if you don't mind scrounging for thrown-out aluminum foil) and can be constructed by anyone with at least the dexterity of a chimp. This cheap and unobtrusive form of mind control protection offers real security to the masses.  Not only do they protect against incoming signals, but they also block most forms of brain scanning and mind reading, keeping the secrets in your head truly secret.  AFDBs are safe and operate automatically.  All you do is make it and wear it and you're good to go!  Plus, AFDBs are stylish and comfortable.

     What are you waiting for? Make one today!
J

 

   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) ...

Yuk Yuk

Apparently there is no joke too lame, too lurid or too inappropriate
for Yuk Yuk, and he's absolutely determined to share with you
every gobbet of stale drollery, every tired urban legend and every
goofy web site on the internet. Yuk Yuk seldom contributes to any
discussion, preferring instead to forward witticisms and bon mots
culled from his voluminous archive.  Of course, should any other
Warriors object to his off topic inanity they are accused of lacking
a sense of humor.

Above courtesy of Mike Reed
See more of his work at: http://www.winternet.com/~mikelr/flame1.html 
 
 

   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 30 new members who joined us during June 2004:

Mike Alexander
Dodge City
, KS
Carl Andrews
Westmont
, NJ
Daniel Benjamin
Southbury, CT
Bob Booker
Huber Heights
, OH
Ruby Brass
N. Las Vegas
, NV
Carolyn Chenault - Caregiver
Decatur, AL
Nina Dailey - Caregiver
Fairfield
, CT
Pascual De La Torre - Cancer Patient
Los Angeles
, CA
Bill DeVanna
Chula Vista, CA
Jenny Favaro - Caregiver
Hoppers Crossing, Victoria, Australia
Fr. Marian Fernandes
Mumbai,
Maharastra, India
Cheryl Haines - Caregiver
Bridgetown
, N.S., Canada
Richard Hennenfent
Marietta
, GA
Marilynn Hirtle
Niagra Falls, Ont. Canada
Kimberly Iagmin - Caregiver
Watauga
, TX
Art & Bea LeQuin
Ocala, FL
Stanley Lipscomb
Seat Pleasant, MD
Brenda Martin - Vendor (ATOS)
Coralville
, IA
Ann McKennis - RN
The Woodlands, TX
Don Neis
Lake Villa
, IL
Alma Owens - SLP
Atlanta
, GA
Don Page
Lake St. Louis
, MO
Steve Perry
Worland
, WY
John Popson
Solon, OH
Beverly Rains - Caregiver
Peotone, IL
Skip Scheurman
Schaumburg
, IL
Roger French
Sitka
, AK
Tom Sprecher
West Palm Beach, FL
Derek Tattersall
Mebane
, NC
Tracie Wilson
Farwell, MI



 
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.



  ? 2004 WebWhispers
Reprinting/Copying Instructions
can be found on our
WotW/Journal Page.