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Found 11 results

  1. I am writing on behalf of my father, an 82-year-old PD patient, in hopes of gaining some insight into what may have triggered a sudden and significant improvement in his ability to speak after several years without being able to produce sounds above a soft whisper. He woke up four days ago and found that he had a voice. The change is extremely dramatic--he was able to leave me a voice mail message that was perfectly intelligible for the first time in at least three years, with tone and inflection. He is extremely grateful to be able to communicate again but is very worried that his voice will go away again as suddenly as it came. He doesn't currently have a neurologist (he's been shuffled from one to another). He's had PD for about 17 years and had DBS about 8 years ago. No changes to his PD meds in the last couple of years; he has also taken benzodiazepines for sleep on and off since the 1980s. Would appreciate any thoughts this community might have. Many thanks, Lynn
  2. Hi, my 92-year-old father has advanced Parkinson's disease, and he is having more and more difficulty talking which is really disconcerting, because I had to relocate for work and I can no longer communicate with him on the telephone. We had to wean him off of Sinemet due to serious side effects, so the only medication that he takes regularly now is clonazepam. He takes a 1/2 pill every other night. He also takes Atrovent via a nebulizer when needed for excessive drooling and mucus in his throat. However, my mom says he does not drool much anymore, so mucus does not seem to be the problem. When he had bad days and had difficulty speaking, we treated him by giving him an Atrovent treatment, some mucinex and have him suck on some ice or sugarless candy. However, since mucus does not seem to be the problem now, I wanted to know what you suggest. I know our options are limited. We have a caretaker, and I told my mom to make sure she continues to give him some vocal exercises, as there are no speech therapists in the area trained to help people with Parkinson's, but is there anything else we can do? I read that some people get collagen injections, but I don't think my mom would go for that, and I don't think there is any ENT in the area that is trained to do that. Also, if he is not drooling much anymore, does it make sense to continue his Atrovent treatment? All of his food is pureed, but I know that he could still have food stuck in his throat due to the slow down in his ability to swallow. I am at a loss as to what to do at this point. I would appreciate any advice you can offer?
  3. I was reading through some of the posts & read one that is similar to me. He had asked if Sinemet was causing his speech problems. I don't think it is the Sinemet per se but when I am "off", my speech is fine & when my meds are working, my speech is terrible. I can't be understood at all - extremely garbled. I was wondering if you knew why this is happening ? Seems like when my body works, my speech goes bad. Why can't they be on the same page ? I know - it is probably yet another unknown of PD. I also have another question. What do you feel is the best system, curriculum, program (not sure what word I am looking for) for garbled speech ? I have done the LOUD program & felt that all it did was make me talk louder- at times I need that. I've also had sessions with a speech therapist & all I did was repeat (or read) words. It did not help. It is very discouraging & I have gotten to the point that I hardly talk anymore. That's not good. Any advice ? Thank you !
  4. As I progress through the day, my speech becomes more slurred and softer such that even my wife has trouble undestanding me! I had DBS in July 2011. I still take about 8-10 25/100 L'Dopas per day. My question is the speech problem a result of too much L'Dops, not enough, or do I need a DBS adjustment. Or sorry this is normal progression!
  5. Speech and voice characteristics typically associated with PD include reduced loudness, hoarse voice quality, monotone, imprecise articulation, and vocal tremor. The underlying physiology of these perceptual characteristics is partly attributable to: Bowed vocal folds (Baker et al., 1998; Smith et al., 1995) Low amplitude desynchronized muscle activity as measured by EMG (Luschei et al., 1999) Decreased coordination of respiration and phonation and decreased respiratory support for speech (Stathopolous, 1993) Small mouth opening (Ho, A.K., Iansek, R., & Bradshaw, J.L. 1999) Hypokinesia and bradykinesia of speech muscles that can compromise articulation This means that people with PD are typically significantly quieter than their age-matched peers (Fox & Ramig, 1997). This study found that not only are people with PD quieter, they are also less likely to initiate conversation and are not understood as clearly as their peers. Sensory deficits associated with PD also contribute to changes in speech. Sensory deficits in PD include problems with internal cueing and self-perception of performance that is evidenced in walking, writing, posture, and speaking (Ho, Bradshaw, Iansek, & Alfredson 1999; Ho, Iansek & Bradshaw, 2000). When a person with PD speaks at normal loudness they may "feel" that they are being loud or shouting but they are only being trained to speak at normal loudness. Motor and sensory deficits need to be addressed in treatment for long-term carryover to functional communication (Fox et al., 2002; Ramig et al., 2002; Sapir et al., 2011).
  6. The impact of deep brain stimulation on speech is variable. There is no significant change in speech for some people while others may experience a worsening of speech symptoms. If you are considering this surgical procedure, then I suggest you discuss the possible impact on speech with your surgical team. It may be appropriate to have a speech evaluation prior to surgery.
  7. Medical treatments to improve the symptoms of PD include pharmacological management and more recently, neurosurgical procedures such as the placement of an electrical stimulator in globus pallidus or subthalamic nucleus. Although there have been documented improvements in limb and axial symptoms with medical treatments, the improvement in speech has not been documented as consistently. The consensus is that medical management has a more positive outcome for limb movement than speech function (Kompoliti, Wang, Goetz, Leurgans, & Raman, 2000; Trail, Fox, Ramig, Sapir, Howard & Lai, 2005). Therefore, there is a strong need for people with PD to receive efficacious behavioral treatment from a speech-language pathologist to improve speech. The selection of any speech treatment should be based on the results of an individual evaluation. Specifically, stimulability testing of the impact of different treatment strategies on voice and speech characteristics will determine which treatment approach is most appropriate for a given individual. The treatment chosen should include principles of motor learning such as intensity of treatment and using salient (meaningful) materials in real speech tasks for treatment benefits to last. If you or a family member or friend have noticed a change in your speech then talk to your doctor about getting an evaluation from a speech-language pathologist. You will learn about your individual situation and can use this information to decide which treatment is right for you. Sincerely, Leslie Mahler, PhD, CCC-SLP
  8. Many people underestimate the value of communication until it is changed by Parkinson disease. Changes in walking and balance are easy to identify but gradual changes in communication ability man not be so obvious. After all, communication is heard by not seen. However, the impact of decreased communication ability on quality of life is significant. Most people with PD will experience some changes in the ability to communicate (about 90%). We encourage you to start speech exercises before there is a serious problem because these can improve your speech intelligibility. If you have any questions about speech and speech changes related to Parkinson disease, then please write to us on this forum. Sincerely, Leslie Mahler, PhD, CCC-SLP
  9. I am a caregiver along with my husband for his father, a 71yo with PD who was diagnosed @10 years ago - last week his day help and we all noticed his pallor change and he complained of burning, we had him taken to the ER where he was diagnosed with a UTI (he gets these alot) and a blocked catheter-since we caught this one early enough to forego any hospital stay or rehab, after some IV antibiotics, he got to come home - but now he can barely stay awake, he has lost what little strength he had, he is unable to stand, sit (slides out of his wheelchair), and his coordination (hand to mouth, forgetting food is in hand, grasping utensils with only 2 fingers etc..) has worsened - we are not sure if this is due to the uti which appears to be clearing up with the oral rx meds or something else such as a TIA or the PD has advanced - or...? is this common after a infection? Is this a sign of worsening PD? What if anything can we do to assist him? He is "out of it" so to speak, falls asleep mid mouthful, we carefully monitor his food and swallowing etc to eliminate choking but we are worried this may be a new level of PD and we are not sure which way to go. He can only concentrate on one thing at a time and even then looses focus of the task at hand. He can not be left alone even for a few minutes, his caregiver and we are worried. His next Neuro appt is in 3 weeks. Any information would be helpful.
  10. May is Better Speech & Hearing month. This is a great time to raise awareness about how changes in speech associated with PD can negatively affect quality of life. Talk to your physician about a referral to a speech-language pathologist to get an expert evaluation of your speech and swallowing abilities. You have important things to say and should be understood when you say them. You also want to keep swallowing safely so you can take pills on time and stay healthy. Leslie Mahler, PhD, CCC-SLP