October 2009




Name Of Column Author Title Article Type
News Views Pat Sanders Beachin' It News & Events
VoicePoints Julie Bishop-Leone, MA CCC-SLP Separated Party Wall Education-Med
WebWhispers Columnist Joe Hewitt Sights/Sounds Of Farm Experience
Between Friends Donna McGary Pascal's Wager Commentary
Practically Speaking Elizabeth Finchem Effortless Esophageal Speech Education
PS Len A.Hynds The Speechless Poet  Poetry
Ramblings Of A Loopy Lary Mike Burton To C Or Not To C Commentary
Editor's Mailbox Max Hoyt Mid Atlantic Conference Education
New Members Listing Welcome News & Events





Beachin’ It


I am spending a little time at the beach as I try to do every year. It gives me some time for reflection and setting priorities. I take my computer so I am always in touch but try to stay away from everyday communications. I check in, read most email, and answer a few.

I read, walk every day, have lunch out and have a few visitors… lead a more normal life than usual. At least I hope it is normal to take some time for things you want to do.

This year the condo complex where I stay has had a plan to change over their Internet connections before also changing the telephones, installing VOIP, and going to a type of direct TV. I got caught in the start of the changeover of the ISP connections and have had intermittent Internet service until a few days ago, when the new WiFi throughout the building finally got the bugs out. They came by with a booster that can also be used for plugging in directly if you don’t have WiFi capabilities. It worked great for a little while and then as they continued to make changes, I am offline half the time because they don’t have the signin worked out properly. It is a frustration I don’t need!

Having company here reminds me of one of the repetitive type experiences we have as early laryngectomees. For those who live alone, it is easy to forget what it is like to be with non-larys on a daily basis. I am re-acquainted with the idea that people who live together don’t talk to each other by stopping and looking at the other person. They talk to the to air, to the chore they are doing with back turned, or from the other room, never watching for a re-action. They actually talk to each other facing away from each other. We used to do that.

I recall now that one of my earliest phrases in learning to talk again was, “Look at me.” There was a reason for that and there still is. We do not talk with just words. We talk with gestures, facial expressions, pointing, shrugs, nods or shaking of the head. We indicate with a hand to the ear that we can’t hear you; we show sympathy with a tilt of the head, a set of the mouth and a closing of the eyes; we smile and nod in agreement or frown and move the head side to side to show equal disapproval.

When we don’t watch people, we miss a lot, even though we hear their voices. When they don’t watch us, they miss most of what we have to say and we lose the chance to participate more in everyday conversation.


Pat W Sanders
WebWhispers President



VoicePoints written by professionals 

Coordinated by Meaghan Kane Benjamin, M.A., CCC-SLP





The Separated Party Wall: The Good, the Bad and the Ugly

Julie Bishop-Leone, MA CCC-SLP
Clinical Specialist
Atos Medical Inc.



What is a separated party wall? The tracheoesophageal party wall is the wall formed from the posterior tracheal and the anterior esophageal walls. Sometimes this wall separates causing voicing difficulties and possible medical complications. There are many different etiologies for this occurrence including infection, inflammation, recurrence and/or trauma. The patient typically reports that they have a weaker voice post-fitting or that their voice has gradually deteriorated. These complaints may also be paired with that fact the patient experienced difficulty when placing the prosthesis and/or dilator.

An interdisciplinary approach should be taken between the speech pathologist, nurse and the patient’s physician when managing this problem. The patient should be seen as soon as possible to prevent the tracheoesophageal puncture (TEP) from closing and to have a medical examination performed by their physician. If this problem is not addressed in a timely manner, an abscess, mediastinitis, infection, necrosis of the tracheal tissues, and/or closure of the TEP can occur. It is important that the patient be examined by their physician to rule out these medical complications prior to fitting the patient with a prosthesis. Once medical management is performed, the next key step is to fit the patient with the appropriate length prosthesis. In all likelihood, the length of the TE tract is going to be longer than their length would be typically. Therefore, you need to resize the TE tract length accurately before replacing the prosthesis. When inserting the measuring device, make sure that it is within the esophageal lumen before taking a measurement. You can do this by either pushing the measuring device flush against the puncture or pointing it downward prior to taking the measurement. Once you have determined the appropriate size, place the prosthesis and instruct the patient to clean it in situ and not remove it. Upon placement you may feel two “pops” as the prosthesis enters through the posterior tracheal wall and the anterior esophageal wall. If you have difficulty placing the prosthesis, don’t cause more trauma by applying excessive pressure during placement. In this case, you should dilate the patient for a longer period of time first (maybe even overnight) and then attempt to replace. The patient should then be instructed to return to see you once the prosthesis appears long, it begins to leak and/or if their voice starts to deteriorate. This could be a matter of a few days to a few weeks before they return to see you. Upon their return visit, you should proceed in the above mentioned manner to ensure a good prosthetic fit.

Remember: the key is to fit the patient with the appropriate length prosthesis even if that means that the patient never returns to their original size.





Sights and Sounds of a Farm

Joe Hewitt of Rockwall, TX

Kids who had no farm experience missed some of life’s most interesting moments. Granted, they are not essential, but I believe these things colored my life. For example:

The smell of a horse’s breath and the crunchy sound as he eats hard corn off the cob on a frosty morning.

The relish with which a calf sucks his mother’s udder, losing some of the milk in his excitement to get more, and roughly pushing the udder to get it to flow faster.

The sound of milk squirted into the bottom of a bucket, and how it changes pitch as more milk squirts in by the hands of an experienced milker.

A cat, hungrily watching the milk and hearing the squirt squirt squirt into the bucket, then opens her mouth to receive some when the tit points her way.

The sound of a grunting pig as he shovels the ground with his snout , throws the dirt aside, and eats a root with slobbering relish.

The sound of soil being turned over by a plow and the fresh earth smell that rises from it.

The slap of leather reigns on a mule’s back and the sight of rippling muscles under his skin as he leans into his burden and pulls the plow.

The satisfied cluck of hens as they promenade and pick and choose what they want to peck.

The sound of his shrill announcement to wake the world and proclaim his machismo by a rooster standing tall with neck stretched high.







Pascal’s Wager

I have a hard time believing in God. I have been a Methodist, a Unitarian-Universalist, an atheist, a Brother Julius cultist, and an agnostic. I have toyed with a lot of religions and several have toyed with me, but God has remained elusive. I suspect that is part of His grand plan. I use the male pronoun deliberately. I have done a lot of the research about the Goddess, read the books about “When God Was A Woman” and I am convinced that God may have been a woman in the beginning, but He is definitely a guy nowadays and She is sitting on that celestial couch watching “American Idol” saying, “Fool, I told you so”.

I am concerned that God may be paralyzed by indecision; perhaps He/She/They bit off more than He can chew. We humans are simply out of control. I know that is irreverent, but I am a non-believer, so just indulge me for a moment. Imagine that God Mom and Dad had, in their youth, a bunch of kids (us) and now we are ranging from babies and teenagers to middle-age and beyond. That means that God is worrying about young beautiful daughters and wildly irresponsible sons while He dandles the irrepressibly sweet and sassy grandchildren of the self-satisfied and smug mid-life crisis crew and don’t forget those attitudinal elders who don’t listen to anybody. He and Mom have never agreed on the right approach…an eye for an eye or forgive and forget...ask your Mother…ask your Father…I SAID, this discussion is over. Now, go to bed.

I can’t say that I blame them for silently sneaking out the back door and leaving us all to fend for ourselves. It’s a very tough job.

God needs our help. That is not as blasphemous as it sounds. I am not Jewish but I have many Jewish friends and the middle of September is their New Year. There is a concept in Judaism, celebrated this time of year, that G-d and His goodness is known primarily through His creation. If we live good lives we make manifest G-d’s goodness. I may be wrong but I think they are saying we need each other. I can live with that.

I do wish God was not so difficult. I resent that He is so elusive and makes me work so hard to please Him. I have to admit He reminds me of more than one bad boyfriend. I have often said that my years in the cult ruined both God and marriage for me.

Still I admit, there is something to be said for even a difficult God. This old atheist/agnostic has to wonder at the extraordinary beauty of both the Grand Canyon and the toothless smile of a baby. There may be a plan, after all. I just wish God was more accessible. Maybe that is why the Brother Julius cult was so appealing.

Let’s face it- God is NEVER going to be accessible.

I am thinking I will find my God in the heart-melting giggles of my grand-daughter, the self-sowing seeds of cosmos in my gardens, watching the grace of my parents as they grow old and a well-told tale of Winnie the Pooh. I will find God, if He is to be found, in surprising and unexpected places. I will find Him in an afternoon of re-arranging furniture with an old friend and a late night conversation over a bottle of wine.

Most likely, it will be where the grey Atlantic crashes relentlessly against equally grey rocks that God will talk to me. He will speak in a mournful voice that only I can hear and it will piss me off. Lose the free will crap and do something about the misery, I will think. In my head I will hear, “If it were only that easy.”

I feel sorry for the guy. We humans have been a big disappointment, I suspect. He can be surprisingly bloodthirsty, in the old texts; moderate and forgiving in the new. I am thinking, all in all, very parental. It would be so comforting to think that God the Father was actually in control, but I think that is unlikely. Much more likely is that we humans, in our own weak and limited ways, are responsible for this life. And, human nature likes nothing better than to blame someone else for its shortcomings. Poor old God.

A world without God the Father is not necessarily godless. Pantheism embraces the idea that the god/spirit lives in every natural thing. . That sounds an awful lot like “the kingdom of God is within” {Christianity} or Yahweh revealed as a “still small voice” {Judaism and in the original text a “soft, whispering murmur”}. Many indigenous cultures refer to “The Great Spirit”. Notables from Rachel Carson to Albert Einstein subscribed to this belief.

I, myself, am still skeptical about any “theism”. But I do like Pascal’s Wager. The basic premise, proposed by French philosopher, Blaise Pascal, is that even though the existence of God cannot be proved by reason, one should live as though God does exist, because you have everything to gain and nothing to lose. This philosophy is deeply flawed if you happen to be a sociopath, but for the rest of us it is quite workable.

So I am getting more comfortable with the idea of God these days. Maybe He and I are like old lovers…we have unfinished business. One of these days I might just pick up the phone and say, “Hey, we need to talk.”






Effortless Esophageal Speech & Other Options

It has been several months since I’ve written about esophageal speech as a viable speech option. Reading the weekly list of new WebWhispers members and their introductions three things have caught my eye: 1) so many are in the same age bracket of my children, 2) they are seeking information pre-op, and 3) they are undecided about which method of speaking they will select as their primary voice. We know they have several options available to them, and I hope for their sakes that these options are all available for them locally.

In the beginning it is common practice for a new laryngectomee to learn to use an electro larynx (EL), pre-op if possible. An intra oral type, or a neck type with an intra oral adopter makes speech possible from day one for some, but not all, for various reasons. As healing progresses the type of aide or placement may change.

There are some doctors and hospitals that include a primary puncture as part of the laryngectomy; preparatory for sizing and placement of a tracheal-esophageal prostheses (TEP) later by a speech/language pathologist (SLP). Other doctors and hospitals choose to wait and do the puncture as a secondary procedure. This allows the patient time to heal and adjust to the changes following larynectomy. It is helpful to learn as much as possible about all the options available for speech restoration. Before the advent of the TEP esophageal speech (ES), and a variety of ELs were the most used options. There is also a pneumatic artificial larynx (AL) called the Tokyo that uses lung air. The WW website has pictures and voice samples of all these options.

My method of choice, since I set my goal to achieve it 32 years ago this month, is effortless esophageal speech. The statement “it’s too hard and takes too long to learn” is simply not accurate. Recently a new laryngectomee told me that “the SLP wouldn’t even talk about ES; TEP or EL were the only choices” on the table. I wondered why, but I can guess at least two possible reasons for not discussing where to find a local ES instructor. Sometimes, I am called upon to teach SLPs how to teach ES.

As an instructor and coach who has been teaching ES since 1982 I can tell you that no two students are alike. It can take three weeks, three months (which is normal), or three years. Health issues can delay the mastery of ES. The desire to achieve a fluent voice that is effortless for conversation is all the drive you need. Many esophageal speakers tell me they are self-taught. I believe them. With a little instruction and a good manual to work from, it is possible. The key ingredient no matter how they learn ES is to spend a little private time figuring out how to coordinate the air in and sound out on demand. Practice, or reading a list of words, won’t help if they never figure out how ES works for them.

Most people are surprised to learn how little air is required to produce effortless esophageal voice. Bare in mind we are not trying to shout. It should be clear that “swallowing” or “gulping” air as a first step sets you up for failure. This much air will enter the top of your esophagus and head straight to your stomach, making is much lower than it needs to be for voice. With a stomach full of air we know you will eventually “burp”, and perhaps feel the rising air in time to get a word, phrase, or sentence spoken before you’re out of air. Some might assume this process makes sense since the lungs we used for speaking pre-op are close to the same level anatomically as the stomach. However, for esophageal speech (ES) the air must get down the esophagus to a place that is usually just above the stoma. You can see the air inflate the esophagus by looking in the mirror. The air is injected into the esophagus and the walls will vibrate as the air rises back up producing sound. The vibration begins about where the larynx was pre-op. This area is the new sound, or tone generator for ES (as well as TEP).

Fluent esophageal speakers use three methods for air intake: 1) consonant injection, 2 ) tongue (glossal) press, and 3) inhalation (nasal/mouth air drawn into the esophagus when the swallowing sphincter (cricopharyngus) pops open breaking the vacuum. You can hear the click as the sphincter opens when initiating a yawn.

For those who haven’t thought about vowels or consonants since you left school let us review briefly. Vowels are: a,e,i,o,u, and sometimes y. Consonants are all the rest of the letters in the alphabet; some are voiced and a few are voiceless. Esophageal speakers need to learn a few tricks to compensate for “h”, for example.

Beginners usually start with a combination: a powerful consonant such as “p” or “t” and a long vowel such as “P-ah”, or “T-ah”, and “P-ie”, or “T-ie”. Try saying, “Pop” or “Pop Corn”. This combo will usually get the air down to the sound generating spot and ES voice will be heard. The initial consonant sent the air backward into the esophagus, and the vowel sound uses up the air as it returns up and out of your mouth as a word. Begin by speaking softly and slowly so the vowel sounds have time to move up and out with some duration.

The most common self-defeating behavior esophageal speakers have to overcome is the tendency to speak as we used to with lung air. Pushing out, or trying to exhale to get voice out tightens the neck and shoulder muscles, which cuts off esophageal sound. Stoma blast, or exhalation can be heard instead. It is helpful to learn how to speak without stoma blast or exhaling while using an electro larynx to speak.

Help with all the options I’ve mentioned may be found with your SLP, WW, your local laryngectomee support group, or by attending a conference in your region. The IAL Voice Institute played a very important role in my total rehabilitation, including ES instruction. I highly recommend it. Attending the IAL Annual Meeting, VI, and WW Annual Dinner meeting in June of 2010 will be worth your effort and expense. The registration information can be found on www.theIAL.com. I hope to see you there.

Elizabeth Finchem





To C or Not to C


Another month gone by and I am feeling radical or am I?

A couple of weeks ago the night was a rather different one for me. I could not get to sleep; the harder I tried the worse it got with various things going on in my head that simply would not stop. This ended up with a song endlessly going through my brain by a UK singer and composer whom I have always held in great esteem. His name was Cat Stevens. In his heyday he was immense in the UK churning out hit after hit, album after album of superior quality. Anyway, Cat Stevens wrote one song which I particularly love and was called “Father and Son”. The lyrics are deeply embedded in my head and here is just a sample.

How can I try to explain, when I do he turns away again.
It's always been the same, same old story.
From the moment I talk I was ordered to listen.


How poignant. With the wonder of hindsight, everything is.

I remember when I was a small boy my Dad said to me “Mick, do not ever smoke.”
My Mum and Dad always have called me Mick as my birth name is Michael, but I like to be known as Mike, a choice I only have with anyone outside of my family. I never really understood why my Dad said this and kept going on about it. Everybody smoked, my Mum, Dad, Aunts, Uncles, the Grandad I remember (the other had passed on when I was too young) and both of my Grandmas.

My Dad is now 83 years young, still complains about his aching knees, is nearly deaf (only because he refuses to get his friggin ears washed out) and stopped smoking eventually after a number of failed attempts when he was over 60, Then the pack it in thing really took hold which is why those words above are so poignant, as I had already been smoking for over 15 years.

My Mother is 80 years young and still has the occasional one or two ciggies but is recovering from cancer of the bowel after two doses of chemotherapy. My Dad would never say anything to her about packing it in, unless he wanted to wear his dinner that evening!

My wife Susie’s favourite Aunt Lilly never smoked a cigarette nor took any alcoholic beverage in her entire life. Well, that’s not really true; she tried them both once and decided that neither of them did anything for her. She passed away after a two year battle with bowel cancer. Uncle Archie passed on two years later; we thought he never really came to terms with the loss of his beloved wife Lilly after 50 years of marriage and in reality we think he gave up and just “lost the will to live”, no cancer involved. Susie did a reading at both funerals and ensured that their ashes were put together for eternal peace.

I was on 20 a day. I never listened until it was too late. In the words of the singer “from the moment I could talk I was ordered to listen”. Perhaps I did and ignored it as if he was talking rubbish; it was never going to happen to me after all.

Going back to thinking about Susie’s Aunt Lilly, you could not have led a cleaner lifestyle if you had gone out of your way to try and that has led me to theories of my own about cancer in general not only Larys.

When I was a kid knocking around the block, food was always seasonal. I had strawberries in the summer and new potatoes when they were picked. In winter I could have sprouts and other fresh vegetables of the season, the list is endless. I can now get them nearly all year round from all over the world at anytime from my local supermarket. What pesticides do they spray on them so they arrive fresh for our consumption? Is it good for us? Is it a question that should be asked? Surely the Canadian singer/ composer Joni Mitchell was not wasting her time when she penned and sang these words from “Big Yellow Taxi”:

Hey farmer John, put away the D.D.T. now,
give me spots on my apples,
but leave me the birds and the bees, please!


I am now rapidly becoming a believer that maybe we could be born with a cancer ‘trigger’ within us and no matter what we do something sets it off, Maybe it has to do with all the additives that are routinely introduced by the manufacturer of the things we eat; what the hell are they? Do we REALLY know what effect they have upon us and our health and bodies? What do colourings, pesticides and other additives do for you? I am not trying to scaremonger here, I have been consuming these substances since I was knee high and what’s the first place it or any food hits after you have chewed it? You got it ………..your throat! After that the stomach or the bowel is a good resting place. I am not pointing the finger at any one thing in particular, just indicating a general principle. Then there is alcohol and the possible effect it has on us.

If we do ask the question what are the chances of getting a straight answer?

This is probably a definitive no or something a politician would say that leads you around in circles and never really answers the question. All it does to put you off the scent, as maybe telling the truth may affect sales and profits - paramount to shareholders’ returns. After all, how long did it take to squeeze the link between smoking and cancer out of the manufacturers? Although there was a secret band that knew all of the time of the effects they had, they were too concerned over the backlash in law suits and the subsequent effects on their returns.

Lung Cancer is a different issue altogether. True, that’s where the cigarette smoke goes and gets expelled from. But what else goes into your lungs. Imagine you are a young Mum pushing a buggy with her darling daughter or son in it. Then you are passed by some fuel guzzling 4 wheel drive car or a lorry. The fumes and crap that go into the air from its exhaust we all breathe in is bad enough, but a great deal of it is at street level. Exactly a child’s height in the buggy and she or he is copping the lot first hand, oblivious to what is being taken in. Obviously we cannot stop this going on altogether, but with factory plant emissions adding to the problem of the air we breathe its not surprising that lung cancer exists. But it is not all necessarily to do with smoking. We should consider the other pollutants in the air. The powers that be have the audacity to tell us that it’s not only smoking, it is secondary smoking that is a major factor as well. What they do not want to admit is that again in that chase for the shareholder return and the economy in general, they have an easy cop out in just blaming smoking.

You, like me, used to carry on your lives as normal in supreme ignorance until those dreaded words hit your ears, “I am afraid it’s Cancer”. I am, like you, a Lary and my cancer was a direct result of cigarettes according to my surgeon or was it????

It’s nearly time for me to get off my soap box, folks, but just before I go, it matters not what race or creed you are or what God you follow, we all have the common denominator threat in the form of cancer of one sort or another. So I wish the world at large would stop bickering about what they consider important, things like oil, war, politics, shareholders’ returns and concentrate their efforts upon one of the biggest killers amongst us all - Cancer. Our children and our children’s children deserve better!

May your God always go with you.


Thought for the month:

The only difference between me and a madman is that I am not mad.






Mid Atlantic Conference


I attended the subject conference this past weekend and what an experience. It is not the usual type of conference that we have at the IAL.

Session 1 - My first session was an evaluation of my Head/Neck dysfunction and Lymphedema Screening. The evaluation resulted in findings of some weakness and recommendation was to obtain a thorough Physical Therapy evaluation.

Session 2 - Basics: Laryngectomee Communication Equipment and Supplies by Jennifer Thomas, Inhealth Product Support Specialist

Session 3 - Stoma Care by Linda Schiech, RN, MSN,AOCN

Session 4 - Doctors Panel

Session 5 - "Ask an Expert" Panel Panel included SLP'S, RN, and MSW

Session 6 - Leaking around the T.E.P. Prosthesis: 5 Causes by Dennis Fuller, PhD, CCC-SLP

Session 7 - Veterans Benefits for the Laryngectomee by Don Richardson, MS, CCC-SLP

Other sessions included that I didn't have time to attend:

  • Hands Free Speaking Valve and HME Fittings
  • Caregiver/Spouse
  • Partial Laryngectomee
  • Swallowing Changes Following Total Laryngectomee
  • Coping with Change
  • The Listeners Role
  • Pre/Post-op Peer Visitation Training
  • Team approach to caring for the New Laryngectomee
  • Laryngectomee Panel
  • Nutrition
  • Esophageal Speech

One session was given for the professionals in attendance:
Discharge Needs for the Laryngectomee

The meetings were all very good and informative.

As you can tell from the topics offered, this was a very comprehensive conference with something for just about everyone.

The vendors were there setting up at 0715 and still there at 1700 when we went into the last session for closing remarks and door prizes. There were no WW brochures that I saw but you can rest assured, WW was mentioned on more than one occasion.

Max Hoyt






Some of you may recall welcoming new member, Len Hynds, from Ashford, Kent, England back in the beginning of September. He is an active member of the Ashford Laryngectomee Club and is known as "The Speechless Poet". We are very pleased to publish his first two submissions to us and hope to have more from him for future issues.
~The Editors~

As a new boy, may I contribute to the emotional side of being a Laryngectomee, in the way of poetry. The very first poems I wrote, lying speechless and recovering, were tributes to my nurses and my surgeon.


My Nurse

By Len A. Hynds


I thought the cancer would kill me.

The doctorwould try his best,

but who gave me the courage, to calmly,

face the knife, with my mind so at rest.

T'was Sarah my nurse, on that fearful night,

who knew my every thought.

Her soft spoken words,to stop my fright

The soft hand, as fear I fought..

Who gave me the will to laugh at pain,

that nurse with the angel face.

Who gave me the will to live again,

that nurse with the boundless grace.

Doctors may carve, cut and sew you,

but the soul they can never reach.

It takes the heart of a woman true,

as love they give to each.




Healing Hands

By Len A. Hynds


There are hands that caress,

and those that repel.

There are hands that can bless,

and those that teach well.

There are those that fight,

and those that pray.

There are those so white,

and those old and grey.

There are hands full of love,

and some point the way.

There are those in a glove,

just hidden away.

There are hands that write music,

so gently they sway.

But the hands I admire,

I can see you all nod,

are the hands of a surgeon,

that were touched by his god.


Len..... The Speechless Poet.



Welcome To Our New Members:


I would like to extend a "Warm Welcome" to our most recently accepted laryngectomees, caregivers, vendors, and professionals who have joined our WebWhispers community within this past month. There is a great wealth of knowledge and information to be accessed and obtained from our website, email lists, and newsletters. If ever there should be questions, concerns or suggestions, please feel free to submit them to us from the "Contacts" page of our website.


Thanks and best wishes to all,


Michael Csapo

VP Internet Activities

WebWhispers, Inc.


We welcome the 48 new members who joined us during September 2009:


Dean Baggett
Repton, AL

Linda J Battaglia
Ronkonkoma, NY

Helen Bennett
Kennett Square, PA

Paula Blosser - (Caregiver)
Repton, AL
Mary Bryson
Magnolia, TX
Thomas Colvin
Arlington, TX

Ronald David Comis - (Returning)
Letbridge, Alberta, CAN

Frederick Conn
Dalton, GA

Phyllis Conn - (Caregiver)
Dalton, GA


Ted Cottrell
Highlands Ranch, CO

Glenn Dellmann
Paynette, WI

Lois Demcoe
Athabasca, Alberta, CAN


Dr. Philip C. Doyle - (SLP)
London, Ontario, CAN

Mary Helen Duggar
Andalusia, PA

Roman Espino - (SLP)
San Antonio, TX


A. Paul Evrard
Simi Valley, CA

Rob Fleetwood
Rockville, MD

Malcom Franzen
Walpole, NH


Suzanne Goldberg
Marcus Hook, PA

Gary Henneman
Ocala, FL

Leonard Arthur Hynds
Ashford, Kent, UK


John P. Jones
Fremont, IN

Vickie K. Jones
Greeneville, TN

Joe Kern
Palm City, FL


Robert A. De Long
Rudy, AR

Sandy De Long - (Caregiver)
Rudy, AR

Marie MacNeill
Vancouver, BC


Howie McCarrol
Ontario, CAN

Phyllis McNicoll - (Caregiver)
Brunswick, GA

Irwin Metz
Haverford, PA

Nicole Midkiff - (SLP)
Minneapolis, MN
Ralph Nelson
Oklahoma City, OK
Bill Newbern
Ponte Vedra, FL
Rita M. Perl
Laguna Woods, CA
Henry R. Roberts
Cherry Valley, CA
Neil Rodger
Kings Lynn, UK
Daniel Romero
Santa Maria, CA
William Daniel Sewell JR
Robbinsdale, MN
Billie Trussell
Dallas, GA
Kathy Tully
Hudson, FL
John F. Walsh
Montgomery Village, MD
Amanda Ward - (Registered Nurse)
St. John's, Canada
Joyce Whitehead - (Caregiver)
Hawthorne, FL
Patricia Williams - (Caregiver)
Robbinsdale, MN
June Willis - (Caregiver)
Dallas, GA
Joanna Wyckoff - (SLP)
Witchita, KS
Charles M. Zumwalt
Davenport, IA
Diana Zumwalt - (Caregiver)
Davenport, IA


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           Editor - Donna McGary



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