Re: CHAT: Smokes was Re: CHAT: postcodes

Hi, all!

When I was training as a speech therapist, the prof I had for voice
disorders recommended that, if we smoked heavily, we should drink heavily
too.  That way, we wouldn't have to get a laryngectomy, because we'd be dead
first.  Doing only one or the other increased the chance of living long
enough to get throat cancer.

Personally, I'd rather have a laryngectomy than be dead.  But a missing
larynx is a bigger inconvenience than most people realize.

I'm a school speech therapist, so I'm not up on the cutting edge of therapy
for laryngectomees, but the following is true AFAIK.

People who've had laryngectomees breathe through stomas (surgically created
holes) at the base of the neck.   They cannot breathe through their mouths
or noses.   Worse, they have no valves to protect their lungs.   With the
larynx, we have three:  the epiglottis, which folds down and covers the
airway when we swallow;   the ventricular folds, which protect the lungs
from particles of various kinds;  and the vocal folds, which also protect
the lungs, and allow us to produce the voice.

Aspirating food is NOT a problem with a laryngectomy, since the mouth is no
longer connected to the trachea.  But if any particles get into that stoma,
the laryngectomee has no organ to cough them out with;  the particles
endanger the lungs.  Most laryngectomees wear cloth over their stomas as a
kind of filter.

AFAIK, most laryngectomees don't dare swim;  they have no organ to hold the
airway shut when they enter the water.  I've heard of snorkels that fit the
stomas, but I have to wonder how many people would take that kind of risk
just to have a dip in the pool.  Showering isn't that big a problem,
provided that the laryngectomee keeps his or her stoma covered as the water
drops come down.

As for communication, most movie portrayals of laryngectomy are grossly
inaccurate, depicting the recipients of this surgery as capable of producing
a voice with a full range of intonation.  Dramatic license for the actors, I
suppose.

In reality, without the larynx (voice box), the voice is gone;  any speaking
you do has to be done with a substitute for the voice.   For example, we
have the electrolarynx, a buzzer you hold against a certain spot on your
throat that allows you to speak in a machine monotone, though I hear newer
models can vary the pitch a little.   I think some work has been done on
valves on the stoma that produce a buzz that resonates in the oral cavity.
(I don't know where this work is now;  most of my students are working on
articulation and language issues.)

Laryngectomees can also use esophageal speech, literally talking as they
belch.  This is not as gross as it sounds.  With much practice and some
talent, a good esophageal speaker can sound like someone with severe
laryngitis, and can speak with better intonation than he or she could with
an electrolarynx.

AFAIK, people get laryngectomies chiefly because of a) throat cancer
associated with heavy smoking, b) throat cancer associated with heavy
drinking, or c) emergency surgery when the larynx is crushed in an accident.

With sincere hope that all is well,

Jim G.

> Oh dear! I am quite a heavy smoker myself. Mostly French tobacco,
sometimes
> a cigar and rarely a pipe. Am I the only one here?
> On the other hand, I (almost) don't drink, except for huge amounts of milk
> and coffee.