Centered on Health 4-24-25 - Discussing Vocal Cord Dysfunction with Susan Mathews, speech pathologist
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Speaker 1 (00:01):
It's now time for Centered on Help with Baptist Help
on use Radio. Wait forty tell me jas now here's
doctor Jeff Tumbler.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Help here on news Radio eight
forty whas. I'm your host, doctor Jeff Tublin, and we're
joined from the studio bioproducer mister Jim Finn. He's a
waiting to take your calls to talk to our guests
this evening. Our phone number for the show tonight five
(00:32):
oh two, five seven one eight four eighty four. That's
five oh two, five seven one eight four eighty four
if you want to call in and be a part
of our show. We do take a lot of things
for granted until they don't work as well as they should.
One of those things is the intricate way that we talk, breathe,
and swallow without interfering with each other. So our guest
(00:54):
tonight is Susan Matthews, who's a speech pathologist, and we're
going to learn quite a bit about what that actual means.
She graduated from Spalding University Communicative Disorders Program with an
MS from u of L. She received a certified and
clinical competency degree from the American Speech Language and Hearing Association.
(01:14):
She works with Baptist Hospital and has been on our
show before. Susan, how are you tonight?
Speaker 3 (01:22):
I'm good. How are you?
Speaker 4 (01:23):
I'm doing great.
Speaker 2 (01:24):
Welcome back to I don't know if you know this,
but you are actually on our show three years almost
to the day, so welcome.
Speaker 4 (01:31):
Welcome back.
Speaker 3 (01:33):
Well, thank you. I did not realize that.
Speaker 2 (01:35):
Yeah, it's your anniversary, So welcome back. And I'm going
to jump right in and ask you to give us
a high level view of what a speech pathologist is
and kind of the range of things in that field.
Speaker 3 (01:52):
Thank you for having me number one. I appreciate it
and I'm glad to be back. So, a speech pathologist
or speech language pathologists, we work in a variety of
settings with a variety of populations.
Speaker 4 (02:09):
We work.
Speaker 3 (02:09):
We have a nick you at Baptist South Floyd that's
actually two years old. We'll be having a two year
anniversary celebration this weekend for that. So we work with infants,
we have pediatrics, we work in the schools at the hospital.
I mainly work with adults with strokes that have dementia,
(02:34):
I work a lot with voice disorders, and there's a
disorder that is very common but a lot of people
don't know about it called vocal cord dysfunction, and that
is something that I wanted to talk about tonight. If
your listeners are interested, I know they.
Speaker 4 (02:52):
Will be, and it's definitely something we're going to talk
about tonight. A couple of things. First of all, just
hearing you say all.
Speaker 2 (02:59):
The different things that a speech pathologist does is really incredible.
And I also want to congratulate you and Baptist for
the anniversary of the Nikki. We actually have had some
of your colleagues on I think to talk about the
nick you previously and it's such a remarkable thing that
you're doing. So congratulations on your two year anniversary. How
(03:21):
did you decide to become a speech pathologist?
Speaker 3 (03:25):
Oh? Wow, I always knew I wanted to be in
the medical field, and I when I was in high school,
I was very interested in sign language or something along that.
Realm and Spaulding had a degree in communicative disorders and
(03:45):
I looked into that and was fortunate enough to get
to go there and just the whole world of speech
pathology and all that we do opened up. And then
when I went to the University of Louisville and our
placement that we were exposed to, I got to work
with the adults, which I never really thought. I didn't
(04:06):
even think about that, And once I worked at a hospital,
I just fell in love with it, and that's where
I am today.
Speaker 4 (04:17):
Well, we're very grateful that you are.
Speaker 2 (04:20):
I know we're going to be talking a lot about
vocal cords and sort of larynx and things, So could
you give us a little brief anatomy for us to
understand how things are supposed to work so that we
can appreciate when you teach us about how they aren't.
Speaker 3 (04:38):
So we are mouth, and our larynx aka the voice box,
and our throat. We use all of those for eating
and for speaking, So that's why speech pathologists work on speaking,
but we also work on swallowing as well. So all
of the structures that we use for talking we use
(05:02):
for eating. So we use our lips, our tongue, our teeth,
part of the nasal cavity, the nose area uh, and
then we use our voice bops to make the sound,
and then we formed the words with our lips their teeth,
our tongue and all of those cavities. So those structures
are used for for tooth functions, for speaking, and for swallowing,
(05:25):
and again that's why speaks. Pathologists work on both of those,
both of those disorders.
Speaker 2 (05:33):
So for an example, we've all had that sensation of
coughing or choking and sometimes the food quote unquote goes
down the wrong way.
Speaker 4 (05:40):
What's what's happening there?
Speaker 3 (05:44):
So there there could be several things. Usually for for us,
if we're taking a sip of our coffee and it
quote goes the wrong way, or eating peanuts and one
slips down the wrong way, it's probably a timing issue, uh,
missed timing. Things went back into our throat before we
were actually ready. There's a series of closures that have
(06:07):
to happen when you swallow, and so the food or
liquid goes back before we're able to get all those
things closed that we need to do now with some
of our patients. As some of it is as we
get older, things those muscles don't work as well, so
our risks of aspiration food or liquid going into your
(06:30):
airway increase. But also if you've had a brain injury,
if you've had a stroke, if you've had cancer, radiation
to the mouth or the neck, any of those things
and probably a lot of other things can certainly affect
someone's ability to swallow safely. And that's where we would
(06:53):
come in and do an assessment. We can do an
X ray of their swallow so that we can actually
see what's happening. We give them different foods or liquids
mixed with barium, and we take an X ray of
them actually swaggling, and we see in real time what's
going on. Try to figure out what's happening, and then
(07:15):
how we can help them to work on that.
Speaker 2 (07:19):
And you know, people don't you know, wake up in
the morning and say, you know what, I think I
need to see a speech pathologist today. So who identifies
these patients typically?
Speaker 4 (07:28):
How do they get to you.
Speaker 3 (07:32):
Well, a lot of times working in the hospital and
acute care, if a patient presents with a possible stroke
or stroke symptoms, then we typically get a referral right away.
But like I said, patients that have maybe a mouth
cancer or a throat cancer and they're getting treatment for that,
(07:54):
maybe radiation or chemotherapy or surgery, right they don't just
wake up one day. Usually that's a gradual process, but
it may be slow. Sometimes I'll have a patient say, wow,
I've been coughing for the past two or three weeks,
so I didn't realize it until now. But typically the
(08:14):
nurses will let us know, Hey, I've got a patient.
They were coughing and choke in today when they were eating.
Can you take a look.
Speaker 4 (08:21):
At them.
Speaker 2 (08:23):
Fantastic, Well, you did mention vocal cord dysfunction, and I
know that we're excited to kind of talk about that.
We are going to take a quick break. We're going
to jump into that vocal cord dysfunction when we come back.
You are listening to Centered on Health with Factors Help
here on news radio eight forty whas. I'm your host,
(08:43):
doctor Jeff Tavlin. We are talking tonight with Sue and
Matthew's speech pathologists, and we're learning all about our ability.
Speaker 4 (08:50):
To speech speak and swallow properly.
Speaker 2 (08:52):
Our phone number five oh two, five seven one, eight
four eight four our producers.
Speaker 4 (08:56):
Online to take your calls. We'll be right back.
Speaker 2 (09:13):
I want to welcome everyone back to cent it On
Help with Baptist Help here on news radio eight forty whas.
I'm your host, doctor Jeff Tumblin, and we're talking tonight
with Susan Matthews, speech pathologist, and our phone number five
oh two, five seven one eight four eighty four. Our
producers on standby, mister Jim Benn to take your calls
(09:34):
and to speak to our guests.
Speaker 4 (09:36):
So, Susan, we did have a caller call in. He
wanted to ask a question.
Speaker 2 (09:40):
He preferred not to come on the air, but I
would like to ask that question on his behalf and
I hope Mark that you are still listening. But he
will have a question about patients with Parkinson's and why
their voice may be getting soft and.
Speaker 4 (09:54):
If they need to go to therapy and how that works.
Speaker 3 (09:59):
Oh, that's a really good questions. So, yes, Parkinson's can
definitely affect the muscles and the way the muscles work,
and the vocal cords and most of the structures that
we use for speaking are mainly made up of muscles.
So you can see you can see a person with
(10:20):
parkinson sometimes they'll have a shuffling gait, which means their
their walk has a particular look to it. They their
hands will tremor, and similar things happen to their vocal
cords as well. So you'll see some weakness that might
be why their voice is softer, and also maybe some
(10:40):
tremors in their voice. So if it is causing the
person difficulty, it can also cause their effect they're swallowing
as well. Again because those two processes are run by
the same body parts. So if it is causing the
(11:01):
person difficulty, I would highly encourage them to reach out
to their doctor to get a referral for a speech
language pathology consult.
Speaker 4 (11:11):
So thank you for answering that question.
Speaker 2 (11:13):
So Mark, I hope that you are still with us
and you've got that answer and if you need to
have your provider refer for speech pathology, which is what
we're talking about and why we want everyone to.
Speaker 4 (11:24):
Hear about it.
Speaker 2 (11:25):
So, Susan, you've mentioned a couple of times the phrase
vocal cord dysfunction, so let's jump into that. I know
it's something that a lot of people can actually relate
to because some versions of it affect just every day
people using their voice. So let's start with what is
the vocal cords? Where is it and tell us about
what it is.
Speaker 3 (11:45):
Gosh, Okay, that's a really good question. So the vocal
cords are basically muscles that make the sounds for us
to talk. They're you know, in the voice box, so
we need to use those for speaking. So the vocal
cords at rest are open. The only time the vocal
(12:06):
cords come together are for swallowing. Again that I've talked
about series of closures that have to happen to protect
our airway so that food doesn't go the wrong way.
So the vocal courts come together when we swallow and
when we talk. So vocal cord dysfunction is actually a
breathing disorder that looks a lot like asthma. And I'll
(12:29):
have patients present to me with they'll complain of difficulty
breathing when they're performing an activity. One of the first
patients that I worked with was several years ago that
one of our er doctors who's he's actually a sports
(12:50):
medicine doctor as well, came to me and we were
talking about this vocal cord dysfunction, what is this and
could he have this? This guy he was a cross
country runner and when he would get a certain link
into his races, he would have trouble breathing and he
(13:11):
went to an nt GI doctor, his primary career doctor.
He was on medication for asthma, because vocal cord dysfunction
looks like asthma and frequently it's not. So he was
on an inhaler, he was on allergy medicines, he was
on reflux medicines, and during his race, when he would
(13:31):
get to that point where he would have trouble breathing,
he'd go over to the rescue tint or the med
tint and they would work with him and treat him.
And so anyway, we evaluated him and found out that
he in fact does not have any of those things.
He doesn't have asthma, and he didn't have reflex, he
didn't have allergies, he had vocal cord dysfunction, and we
(13:55):
were able to work with him. He was able to
get off of all of those medicines, practices, breathing exercises,
and went on to win state that year. So he's
my big process.
Speaker 2 (14:06):
Story, I would say, so and well and well deserved
as well. And speaking from the GI perspective of where
it wasn't that problem, what was the trigger for you
to notice that it wasn't any of those things? How
did you know it was vocal cord dysunction.
Speaker 3 (14:23):
So there's Uh, there's a questions. When I do a
case history, I asked a lot of questions to read out.
Could it be askthma, I'll ask some questions. Could it
be a GI thing, I'll ask a few questions there. Uh, definitely,
they are themed by physician, a primary care doctor for sure.
(14:44):
They may need to be seen by a GI doctor
and have that ruled out. And oftentimes they're seen by
an anti and or an allergist because all of those
things that I just mentioned post natal record reflux allergens
can trigger a vocal cord dysfunction on set. So we
(15:07):
want to look at those things and definitely treat those
if appropriate. But if they're still not getting better, they're
still having breathing problems, and the inhaler's not working, the
meds for reflux aren't working, then let's do our assessment
and see could it be vocal cord dysfunction. And that's
(15:29):
what led him to us. We kind of ruled everything
else out while they were trying all these things. But
then when we were actually able to look at his
vocal cords and see them, we got him on the treadmill,
had him run, and then I was able to use
the scope to look at his vocal cords, and when
he was breathing, we could see his vocal cords moving
(15:50):
together and they're not supposed to do that. When you're breathing,
your vocal cords are supposed to stay open.
Speaker 4 (15:56):
So let's back up. That is fascinating.
Speaker 2 (15:58):
So as the speech pathologist, you're you're doing the actual
scope in the office, yes m hm. And you're looking
and you're looking, and you're seeing that the vocal cords,
while they're supposed to be staying open, are closing.
Speaker 1 (16:14):
Right.
Speaker 3 (16:14):
So we'll have them I have them say E so
I can look and see what's going on with their
vocal cords, make sure they're moving together when they say E.
And then I'll have them just breathe at rest and
then just watch and see what the vocal cords do.
Sometimes I will have to uh get induce some vocal
(16:36):
cord dysfunction. So with with him, we had him on
a treadmill because he was a he actually at one
point he started doing cross country running, so we had
to get him and share exercise and a little bit
yes stressed all of that. So once he got to
a certain point, he would his vocal cords because they
were get they would get so close together he would
(16:57):
make a strider, which is always when you're breathing. And
so when we heard that, then we got him off
the treadmill and we scoped him and then just at
just at rest, just natural breathing. His vocal cords were
just coming to the center, coming to the center, and
they're supposed to stay open. So he was a great
(17:18):
patient and just took our exercises and went with them
and did absolutely wonderfully that that is fantastic.
Speaker 4 (17:26):
And I was going to ask you how this condition
is diagnosed.
Speaker 2 (17:30):
You talked about the things you rule out, But is
the diagnosis made by looking directly with the scope as
you described to us, or are there other ways to
diagnose the condition?
Speaker 3 (17:42):
That's the main way is to look at it. Sometimes
I don't get the best view of the vocal cords,
so I kind of put what they're telling me together
with everything else, you know, and I look at do
they respond to an inhaler if the doctor says, spects,
that's asthma? Are they getting better lesson symptoms when they
(18:09):
take their reflex medicines? Do the allergy medicines help? So
we it's kind of a rule out diagnosis, but I
can see it with the scope. That's one of the
main things that we can do. And one of the
points that I want to make with vocal cord dysfunction
is a lot of doctors think it's exercise induced asthma,
(18:30):
and that's what it looks like. So that's why one
of the first treatments they'll give them as a inhaler
or a rescue inhaler. And it can be asthma and
vocal cord dysfunction. It could just be asthma, but it
can also just be vocal cord dysfunction itself. So that's
why it's probably a lot more out there. We just
(18:52):
don't know about it as much.
Speaker 2 (18:55):
And so you mentioned we've mentioned reflex a few times
and that's just induced asthma.
Speaker 4 (19:01):
Are there other man, any main triggers to a vocal
cord dysfunction that we haven't mentioned or pretty much the
big ones.
Speaker 3 (19:10):
Well, there are so many. It could be, like I said,
as a reflux, post nasal drip. People can get it
when they have upper respiratory infection. Exercise is a big one,
but strong odors or fumes. I've had patients that work
(19:31):
in a particular office, and every time they go into
the office they start having trouble breathing. And it may
just be the environment.
Speaker 4 (19:39):
It could be.
Speaker 3 (19:41):
The cleaning products that are used, colognes, strong emotions, and stress.
So there are several different things that can bring about
an episode of the vocal cord dysfunction.
Speaker 2 (19:59):
And and so once somebody has this, what's like the
first thing to do when you find this?
Speaker 3 (20:08):
So the first thing we want to do is find
out what the trigger is. If it's exercise then and
most of my patients are it is exercise, we want
to find out what is it? Is it basketball? I
have my seventy plus year old little pickleball playing lady
that she started having trouble playing pickleball because of the breathing.
(20:29):
So we want to find out what is the trigger.
So is it exercise? Is it the fumes? I have
them journal If we aren't really sure what it is,
I have them bright down, Well what were you doing
right before this happened? And where were you? I had
two patients that when they would drop in the south
(20:52):
end of Louisville in where they make the tires around
that area of town. Every time they drove down that way,
it was the irritants in the air caused them to
have trouble breathing. So we look to see what it is,
what's the trigger, if we can figure it out, and
(21:12):
then try to eliminate or control the trigger, and then
I work with them on some breathing exercises. We work
on those day one, if this is what we think
it is, and then I give them a list that
they go home and practice. And I've had just really
(21:33):
good success with most of my patients.
Speaker 2 (21:37):
That's fantastic, and we might want to hear a little
bit about some of those breathing techniques. I'm excited to
tell you that we've got several questions coming in, so
we're going to take a break and jump into some
of those questions and you doing. Obviously people love this topic,
which is great to know. We're going to take a
short break, and this is doctor Jeff Toblin talking to
you tonight with Susan Matthews, speech pathologists about vocal cords
(21:58):
and vocal cord dysfunction to cen It on Health with
Baptist Health News Radio eight forty whas We'll be right back.
(22:21):
Welcome back to center It on Health with Baptist Health
here on news radio eight forty whas. I'm your host,
doctor Jeff Tublin, and if you're just joining us, we
are talking tonight to Susan Matthews, who is a speech
pathologist with Baptists and has been teaching us a lot
about how we swallow, how we talk, and how we
protect our airways. So we do have a caller on
(22:44):
the line, Jennifer, who has a question about a swallowing issue. Jennifer,
if you are there, you are on with Susan.
Speaker 1 (22:52):
Thank you, Hi, Susan. My baying for you is I
have echlesia and I had surgery about fifteen years ago
where my state or muscle was cut and as a
result of that, definitely has swallowing issues, zero percent motility.
So it's totally fine and I, you know, live my
life fully. It's no you know, but when I eat,
(23:13):
I have to eat very small portions. I eat a
few bites and then I have to rest my swallowing
and then I come back and eat again. And I
didn't know, I didn't even know speech pathologists worked on swallowing.
But is that something that can be fixed through, like
you know, work with you or is that something just
sort of deal with it. And it's as I say,
it's not the you know, it could be so many
(23:34):
worse things in the world.
Speaker 3 (23:36):
That is a great question. Thank you for asking. So
one of the things that we do is is work
closely with geophysicians because some issues could be in the
esophagus and they present like they're in the area that
(23:57):
we work with, and vice versa. We can have patients
that have trouble in the oral or parential phases which
are higher that look end up but feel like they're
a gang. So I am familiar with akalaysia that that's
really not in our area. We can certainly do a
(24:17):
swallow evaluation where we look at your mouth and your throat.
We do an esophageal scan, but it's not a full
esophageal workup for sure. But doctor Tevlin that ekilasia would
be more in your area. Am I correct?
Speaker 4 (24:34):
Yeah, you absolutely are.
Speaker 2 (24:35):
I'll just piggyback on what you said, because, Jennifer, the
way you described it is actually the key components of
the condition that you have, which is a kalasia. The
initial problem is the fact that the sphincter, the muscle
between the esophagus and the stomach is too tight. The
secondary problems is over time, the motility or the way
the esophagus pushes the food.
Speaker 4 (24:57):
Down can become impaired.
Speaker 2 (25:00):
Where really speech pathology might come into plays, as Susan said,
is if the esophag.
Speaker 4 (25:06):
Is dilated, you might be at risk for aspiration and.
Speaker 2 (25:10):
They can help evaluate the way things are swallowed and
if the esophagram or the X ray picture is.
Speaker 4 (25:15):
Showing that condition to get you back into the care
of a GI physician. So, thank you so much for
calling in.
Speaker 3 (25:24):
Thank you.
Speaker 4 (25:26):
Have a great night.
Speaker 2 (25:27):
We had another question coming about throat clearing and they
wanted to ask they hear people and that clear their
throat a lot, and some members of their family do that.
Do they need to be worried that their family member
may have vocal cord dysfunction.
Speaker 3 (25:44):
Oh, that is a great question. Gosh. Throat clearing and
chronic coughing is something that we can work on and
address as well. It can be a voice disorder. Sometimes
it's just a habit of thing. I'll have a patient
that maybe had an upper respiratory infection and they did
(26:06):
a lot of coughing with that, A lot of throat clearing,
and as the infection goes away, sometimes that cough and
that throat clear will still be there. Sometimes it's a
necessary cough or throat clear, but other times it's just habitual.
It's just become a habit and they don't know it.
And I'll have patients come in frequently and i will
(26:30):
be talking with them and they're doing this, and I'll
say said, do you cough and clear your throat a lot? No,
not at all, and they absolutely just don't realize it.
So bringing that upfront and saying, well, in the past
three minutes you've cleared your throat about twenty times. Just
(26:51):
being aware of it is one thing, and so that
is something that we can address. But another thing too
is finding out why are they having reflex And doctor
Tovilin you would know about that. That can certainly cause
them to cough and clear their throat a lot. Is
it post natal drip? Is there something else? Could there
(27:14):
be something on the vocal cord that's making them cough
and clear their throat and that gives them that sensation
that they need to So there's a lot of reasons
why someone might be coughing and clearing their throat a lot,
and it would be worth investigating fantastic.
Speaker 2 (27:34):
I do want to circle back to something you mentioned
before the break, which is about breathing techniques.
Speaker 4 (27:40):
How do you use breathing techniques in your practice?
Speaker 3 (27:45):
Oh, that's great. So I tell my patients that air,
the air is the gas that drives the car, so
we have to take deep breaths. And if you're only
filling up your tank partially, so you're only getting in
of half of the breath that you need, that you're
only going to be able to drive part of the
(28:07):
way that you know, maybe up to Scottsburg, whereas if
you get a full breath of air, you can drive
all the way to Indianapolis. So that's one of the
things that we work on, is learning how to get
better breaths so we can It helps up with our speaking.
But one of the things that we do with the
(28:29):
exercises for vocal cord dysfunction is we learn to take
the tension off of the vocal cords and move that
tension somewhere else, and then that relaxes the vocal cords
so that hopefully they're able to go about their activities
without that sort of breath feeling.
Speaker 4 (28:49):
That's fantastic. And so.
Speaker 2 (28:52):
You do you see them on a regular basis, Like
do you see them once a week, once a Month's
what's sort of a typical process of how long something.
Speaker 4 (29:01):
Like this might take.
Speaker 3 (29:03):
It's usually very quick. Several of my patients I can
see them in one session. I get them the exercises,
I tell them what to do, and I say call
me if you have any questions or you need to
come back. And I will have people come back maybe
(29:24):
a time or two more just to kind of tweak it.
My cross country runner while he was doing track first,
and he came back like a year later because at
that point he was doing the cross country and we
just had to tweak a couple of things, and then
he goes on and finishes his cross country running. So
(29:45):
most of my patients were able to get them done.
I mean, I get like I said, I give them
the exercises, I show them how to do it in
the office, and then it's pretty much you've got to
incorporate this in your daily routine. And it's it's rare
that somebody will come back more than once or twice.
Speaker 4 (30:06):
Well that's very encouraging.
Speaker 2 (30:08):
So I hope everybody is hearing that we're going to
take another break right here, and I want to remind
everybody that you are listening to cend It on Help
with Baptist Health here on news radio eight forty whas
our guest this evening, Susan Matthews, speech pathologist. If you've
missed any part of tonight's show or want to hear
all of this excellent information in its entirely entirety, download
(30:31):
the iHeartRadio app.
Speaker 4 (30:32):
It's free, it's easy to use, and I'll give you
access to tonight's show. We'll be right back.
Speaker 2 (30:50):
Welcome back to send It on Help with Baptist Help
here on news radio eight forty WHS.
Speaker 4 (30:56):
I'm your host, doctor Jeff Tublin.
Speaker 2 (30:58):
We're talking tonight with Susan Matthews speech Pathologists. Remember to
download the iHeartRadio app. It's free, it's easy to use.
It'll give you access to all of the shows that
we have done. So, Susan, you've done such a great
job teaching us about vocal core dysfunction. I want to
expand the issue to more people because all of us
(31:20):
have had an experience where we've quote lost our voice
quote and I'm trying to think about what does that
actually mean? How do we lose our voice and what's
happening when we've lost our voice.
Speaker 3 (31:33):
Oh, that's a great question. That's a very scary feeling
when you lose your voice, especially for someone that needs
to use their voice every day. So we will see
people that lose their voice for a variety of reasons. Again,
typically it's an infection that kind of lingers on. And
(31:55):
I've had patients that I'll say had an upper resiratory
I lost my voice, I got larynge itis, that came back,
I lost my voice again. The next time it came back,
and then the next time they lost their voice and
it never really came back.
Speaker 1 (32:10):
Uh.
Speaker 3 (32:11):
So, there can be an inflammation of the muscle or
the outer lining of the vocal chords. They can get
what's called nodules, which h usually you'll get like a
little bump on each one of your vocal cords and
that hits together and that will that's certainly something that
(32:33):
can cause difficulty with speaking. A lot of singers will
get that. I think Steven Tyler, I think that was
one of his issues. Yeah, And so when these singers
talk about their voice therapist, I mean they they are
really life saving for them because that's their livelihood. So
(32:57):
it's anybody that uses their voice pre professionally or a lot,
so teachers. I will have teachers that by Friday their
voices are just were out those muscles. We expect our
vocal cords sometimes to do things that maybe we wouldn't
expect our legs to do. So they're using their voice
(33:19):
all day long, every day for five days, and by
Friday they should be wore out. But we're not expecting
that person to walk a marathon five days in a row.
And that's what I tell our patients. Your vocal cords
are just muscles, so we have to warm them up.
We have to treat them like there are other muscles
(33:40):
in our body and give them time to warm down.
Speaker 2 (33:45):
You know, it's a fantastic analogy to help us think
about that overuse. So, given the fact that most people
who tend to overuse can't not work right, they have
to work and teach five days a week, what could
they do to prevent it from happening?
Speaker 4 (34:04):
And once it is happening, are there.
Speaker 2 (34:05):
Any tricks or trades that people listening could do to
kind of speed up the recovery?
Speaker 3 (34:12):
So care of the voice. Learning how to take care
of your voice. Water is one of the biggest things,
and that's one of the first things I ask when
I'm speaking with a patient. How much water do you drink?
How much coffee do you drink? How much soda because
caffeine drives out, so the vocal cords need a nice
(34:36):
moist environment. And if it's dry and sticky in their throat,
and we've dried them out by talking and overuse, and
we've dried them out because we've had four mountain dews
and three tups of coffee and maybe a swig of
water when we took our medicines, then we're not setting
those vocal cords up for success that I don't take
(35:02):
things away from people. You know, if you have to
have that cup of coffee, then you drink that cup
of coffee, But we need to supplement with that much,
if not more, water. So learning how to take care
of our voice. Given your voice vocal breaks, just like
you would if you were training for a marathon. You're
going to run three miles to day, five miles the
(35:22):
next time, six miles the next time. You just don't
go out and do a marathon and so we have
to give our voice vocal breaks. So we do a
lot about caring for the voice, that's the first thing,
and then changing modifying the environment as we need to breathing,
making sure you have a full tank of gas to
(35:43):
drive that voice. So those are some of the things
that we address in therapy.
Speaker 2 (35:49):
Yeah, you know, I thought g I was a wild
wide field of things we had to know how to do,
but peace pathology.
Speaker 4 (35:56):
Just might have as beat.
Speaker 2 (35:57):
I do want to ask you about the nodules that
you mentioned, so are those are those pre cancerous at all?
Speaker 4 (36:05):
Are they dangerous at all? Do they have to be removed?
Speaker 3 (36:09):
So that requires a doctor to diagnose that, but typically
once an e INT looks at it and feels like
they are nodules, we want to be able to get
rid of them by therapy. They can be surgically removed.
But the bad thing about that there's several things. But well,
(36:30):
one thing, you don't want to have surgery. Number two,
you're going to have scar tissue on those vocal cords
so they won't move as well. And number three, if
you haven't learned how to take care of your vocal cords,
then they can recur. So we want to take care
of them, do some therapy to get rid of them,
(36:52):
and then teach them, teach the patient how for them
to not come back.
Speaker 2 (36:58):
So did I hear you say that with the therapy
the nodules can actually disappear once they've formed.
Speaker 4 (37:05):
Yeah.
Speaker 3 (37:06):
Yes, I've actually had two therapists in our department over
the years that have had nodules and we kind of
treated each other and they did go away. And nodules
are not cancerous. But typically you get vocal vocal cord
nodules for over use or misuse of your vocal cords.
(37:29):
Like you know the people that go out yelling at
the football game on Friday night and then wake up
Saturday morning, why don't I have a voice? Well, you
abused your voice. Your vocal cords are not before them,
that's why. So if you do that repeatedly, repeatedly, repeatedly,
then you can develop nodules.
Speaker 4 (37:49):
Huh. Well, we have just a little time left.
Speaker 2 (37:52):
But what's the most common thing that you have to
send somebody for surgery after you've evaluated them.
Speaker 3 (38:02):
I guess not real common. But when I do my
scopes and look at the vocal cords, sometimes I will
see something that shouldn't be there, and I will refer
them to to the E and T usually for maybe
a biopsy to see if it is something that needs
(38:22):
further investigation.
Speaker 4 (38:25):
Susan, thank you so much for joining us tonight. That
is going to do it.
Speaker 2 (38:29):
For tonight's segment of centered on Help with Baptist Health.
I'm your host, doctor Jeff Tomlin. I want to thank
our guest Susan Matthew speech pathologists, just a ton of
information tonight, our producer mister Jim Benn and of course
the listeners and our callers Mark and Jennifer join us
every Thursday. Next week we are going to be talking
about new treatments for Alzheimer's disease with doctor Patrick Matisson.
Speaker 4 (38:51):
So join us then and have a great weekend.
Speaker 2 (38:57):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment. Always
seek the advice of your physician with any questions or
concerns you may have related to your personal health.
Speaker 4 (39:19):
Or regarding specific medical conditions.
Speaker 2 (39:22):
To find a Baptist health provider, please visit baptistealth dot
com
It's now time for Centered on Help with Baptist Help
on use Radio. Wait forty tell me jas now here's
doctor Jeff Tumbler.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Help here on news Radio eight
forty whas. I'm your host, doctor Jeff Tublin, and we're
joined from the studio bioproducer mister Jim Finn. He's a
waiting to take your calls to talk to our guests
this evening. Our phone number for the show tonight five
(00:32):
oh two, five seven one eight four eighty four. That's
five oh two, five seven one eight four eighty four
if you want to call in and be a part
of our show. We do take a lot of things
for granted until they don't work as well as they should.
One of those things is the intricate way that we talk, breathe,
and swallow without interfering with each other. So our guest
(00:54):
tonight is Susan Matthews, who's a speech pathologist, and we're
going to learn quite a bit about what that actual means.
She graduated from Spalding University Communicative Disorders Program with an
MS from u of L. She received a certified and
clinical competency degree from the American Speech Language and Hearing Association.
(01:14):
She works with Baptist Hospital and has been on our
show before. Susan, how are you tonight?
Speaker 3 (01:22):
I'm good. How are you?
Speaker 4 (01:23):
I'm doing great.
Speaker 2 (01:24):
Welcome back to I don't know if you know this,
but you are actually on our show three years almost
to the day, so welcome.
Speaker 4 (01:31):
Welcome back.
Speaker 3 (01:33):
Well, thank you. I did not realize that.
Speaker 2 (01:35):
Yeah, it's your anniversary, So welcome back. And I'm going
to jump right in and ask you to give us
a high level view of what a speech pathologist is
and kind of the range of things in that field.
Speaker 3 (01:52):
Thank you for having me number one. I appreciate it
and I'm glad to be back. So, a speech pathologist
or speech language pathologists, we work in a variety of
settings with a variety of populations.
Speaker 4 (02:09):
We work.
Speaker 3 (02:09):
We have a nick you at Baptist South Floyd that's
actually two years old. We'll be having a two year
anniversary celebration this weekend for that. So we work with infants,
we have pediatrics, we work in the schools at the hospital.
I mainly work with adults with strokes that have dementia,
(02:34):
I work a lot with voice disorders, and there's a
disorder that is very common but a lot of people
don't know about it called vocal cord dysfunction, and that
is something that I wanted to talk about tonight. If
your listeners are interested, I know they.
Speaker 4 (02:52):
Will be, and it's definitely something we're going to talk
about tonight. A couple of things. First of all, just
hearing you say all.
Speaker 2 (02:59):
The different things that a speech pathologist does is really incredible.
And I also want to congratulate you and Baptist for
the anniversary of the Nikki. We actually have had some
of your colleagues on I think to talk about the
nick you previously and it's such a remarkable thing that
you're doing. So congratulations on your two year anniversary. How
(03:21):
did you decide to become a speech pathologist?
Speaker 3 (03:25):
Oh? Wow, I always knew I wanted to be in
the medical field, and I when I was in high school,
I was very interested in sign language or something along that.
Realm and Spaulding had a degree in communicative disorders and
(03:45):
I looked into that and was fortunate enough to get
to go there and just the whole world of speech
pathology and all that we do opened up. And then
when I went to the University of Louisville and our
placement that we were exposed to, I got to work
with the adults, which I never really thought. I didn't
(04:06):
even think about that, And once I worked at a hospital,
I just fell in love with it, and that's where
I am today.
Speaker 4 (04:17):
Well, we're very grateful that you are.
Speaker 2 (04:20):
I know we're going to be talking a lot about
vocal cords and sort of larynx and things, So could
you give us a little brief anatomy for us to
understand how things are supposed to work so that we
can appreciate when you teach us about how they aren't.
Speaker 3 (04:38):
So we are mouth, and our larynx aka the voice box,
and our throat. We use all of those for eating
and for speaking, So that's why speech pathologists work on speaking,
but we also work on swallowing as well. So all
of the structures that we use for talking we use
(05:02):
for eating. So we use our lips, our tongue, our teeth,
part of the nasal cavity, the nose area uh, and
then we use our voice bops to make the sound,
and then we formed the words with our lips their teeth,
our tongue and all of those cavities. So those structures
are used for for tooth functions, for speaking, and for swallowing,
(05:25):
and again that's why speaks. Pathologists work on both of those,
both of those disorders.
Speaker 2 (05:33):
So for an example, we've all had that sensation of
coughing or choking and sometimes the food quote unquote goes
down the wrong way.
Speaker 4 (05:40):
What's what's happening there?
Speaker 3 (05:44):
So there there could be several things. Usually for for us,
if we're taking a sip of our coffee and it
quote goes the wrong way, or eating peanuts and one
slips down the wrong way, it's probably a timing issue, uh,
missed timing. Things went back into our throat before we
were actually ready. There's a series of closures that have
(06:07):
to happen when you swallow, and so the food or
liquid goes back before we're able to get all those
things closed that we need to do now with some
of our patients. As some of it is as we
get older, things those muscles don't work as well, so
our risks of aspiration food or liquid going into your
(06:30):
airway increase. But also if you've had a brain injury,
if you've had a stroke, if you've had cancer, radiation
to the mouth or the neck, any of those things
and probably a lot of other things can certainly affect
someone's ability to swallow safely. And that's where we would
(06:53):
come in and do an assessment. We can do an
X ray of their swallow so that we can actually
see what's happening. We give them different foods or liquids
mixed with barium, and we take an X ray of
them actually swaggling, and we see in real time what's
going on. Try to figure out what's happening, and then
(07:15):
how we can help them to work on that.
Speaker 2 (07:19):
And you know, people don't you know, wake up in
the morning and say, you know what, I think I
need to see a speech pathologist today. So who identifies
these patients typically?
Speaker 4 (07:28):
How do they get to you.
Speaker 3 (07:32):
Well, a lot of times working in the hospital and
acute care, if a patient presents with a possible stroke
or stroke symptoms, then we typically get a referral right away.
But like I said, patients that have maybe a mouth
cancer or a throat cancer and they're getting treatment for that,
(07:54):
maybe radiation or chemotherapy or surgery, right they don't just
wake up one day. Usually that's a gradual process, but
it may be slow. Sometimes I'll have a patient say, wow,
I've been coughing for the past two or three weeks,
so I didn't realize it until now. But typically the
(08:14):
nurses will let us know, Hey, I've got a patient.
They were coughing and choke in today when they were eating.
Can you take a look.
Speaker 4 (08:21):
At them.
Speaker 2 (08:23):
Fantastic, Well, you did mention vocal cord dysfunction, and I
know that we're excited to kind of talk about that.
We are going to take a quick break. We're going
to jump into that vocal cord dysfunction when we come back.
You are listening to Centered on Health with Factors Help
here on news radio eight forty whas. I'm your host,
(08:43):
doctor Jeff Tavlin. We are talking tonight with Sue and
Matthew's speech pathologists, and we're learning all about our ability.
Speaker 4 (08:50):
To speech speak and swallow properly.
Speaker 2 (08:52):
Our phone number five oh two, five seven one, eight
four eight four our producers.
Speaker 4 (08:56):
Online to take your calls. We'll be right back.
Speaker 2 (09:13):
I want to welcome everyone back to cent it On
Help with Baptist Help here on news radio eight forty whas.
I'm your host, doctor Jeff Tumblin, and we're talking tonight
with Susan Matthews, speech pathologist, and our phone number five
oh two, five seven one eight four eighty four. Our
producers on standby, mister Jim Benn to take your calls
(09:34):
and to speak to our guests.
Speaker 4 (09:36):
So, Susan, we did have a caller call in. He
wanted to ask a question.
Speaker 2 (09:40):
He preferred not to come on the air, but I
would like to ask that question on his behalf and
I hope Mark that you are still listening. But he
will have a question about patients with Parkinson's and why
their voice may be getting soft and.
Speaker 4 (09:54):
If they need to go to therapy and how that works.
Speaker 3 (09:59):
Oh, that's a really good questions. So, yes, Parkinson's can
definitely affect the muscles and the way the muscles work,
and the vocal cords and most of the structures that
we use for speaking are mainly made up of muscles.
So you can see you can see a person with
(10:20):
parkinson sometimes they'll have a shuffling gait, which means their
their walk has a particular look to it. They their
hands will tremor, and similar things happen to their vocal
cords as well. So you'll see some weakness that might
be why their voice is softer, and also maybe some
(10:40):
tremors in their voice. So if it is causing the
person difficulty, it can also cause their effect they're swallowing
as well. Again because those two processes are run by
the same body parts. So if it is causing the
(11:01):
person difficulty, I would highly encourage them to reach out
to their doctor to get a referral for a speech
language pathology consult.
Speaker 4 (11:11):
So thank you for answering that question.
Speaker 2 (11:13):
So Mark, I hope that you are still with us
and you've got that answer and if you need to
have your provider refer for speech pathology, which is what
we're talking about and why we want everyone to.
Speaker 4 (11:24):
Hear about it.
Speaker 2 (11:25):
So, Susan, you've mentioned a couple of times the phrase
vocal cord dysfunction, so let's jump into that. I know
it's something that a lot of people can actually relate
to because some versions of it affect just every day
people using their voice. So let's start with what is
the vocal cords? Where is it and tell us about
what it is.
Speaker 3 (11:45):
Gosh, Okay, that's a really good question. So the vocal
cords are basically muscles that make the sounds for us
to talk. They're you know, in the voice box, so
we need to use those for speaking. So the vocal
cords at rest are open. The only time the vocal
(12:06):
cords come together are for swallowing. Again that I've talked
about series of closures that have to happen to protect
our airway so that food doesn't go the wrong way.
So the vocal courts come together when we swallow and
when we talk. So vocal cord dysfunction is actually a
breathing disorder that looks a lot like asthma. And I'll
(12:29):
have patients present to me with they'll complain of difficulty
breathing when they're performing an activity. One of the first
patients that I worked with was several years ago that
one of our er doctors who's he's actually a sports
(12:50):
medicine doctor as well, came to me and we were
talking about this vocal cord dysfunction, what is this and
could he have this? This guy he was a cross
country runner and when he would get a certain link
into his races, he would have trouble breathing and he
(13:11):
went to an nt GI doctor, his primary career doctor.
He was on medication for asthma, because vocal cord dysfunction
looks like asthma and frequently it's not. So he was
on an inhaler, he was on allergy medicines, he was
on reflux medicines, and during his race, when he would
(13:31):
get to that point where he would have trouble breathing,
he'd go over to the rescue tint or the med
tint and they would work with him and treat him.
And so anyway, we evaluated him and found out that
he in fact does not have any of those things.
He doesn't have asthma, and he didn't have reflex, he
didn't have allergies, he had vocal cord dysfunction, and we
(13:55):
were able to work with him. He was able to
get off of all of those medicines, practices, breathing exercises,
and went on to win state that year. So he's
my big process.
Speaker 2 (14:06):
Story, I would say, so and well and well deserved
as well. And speaking from the GI perspective of where
it wasn't that problem, what was the trigger for you
to notice that it wasn't any of those things? How
did you know it was vocal cord dysunction.
Speaker 3 (14:23):
So there's Uh, there's a questions. When I do a
case history, I asked a lot of questions to read out.
Could it be askthma, I'll ask some questions. Could it
be a GI thing, I'll ask a few questions there. Uh, definitely,
they are themed by physician, a primary care doctor for sure.
(14:44):
They may need to be seen by a GI doctor
and have that ruled out. And oftentimes they're seen by
an anti and or an allergist because all of those
things that I just mentioned post natal record reflux allergens
can trigger a vocal cord dysfunction on set. So we
(15:07):
want to look at those things and definitely treat those
if appropriate. But if they're still not getting better, they're
still having breathing problems, and the inhaler's not working, the
meds for reflux aren't working, then let's do our assessment
and see could it be vocal cord dysfunction. And that's
(15:29):
what led him to us. We kind of ruled everything
else out while they were trying all these things. But
then when we were actually able to look at his
vocal cords and see them, we got him on the treadmill,
had him run, and then I was able to use
the scope to look at his vocal cords, and when
he was breathing, we could see his vocal cords moving
(15:50):
together and they're not supposed to do that. When you're breathing,
your vocal cords are supposed to stay open.
Speaker 4 (15:56):
So let's back up. That is fascinating.
Speaker 2 (15:58):
So as the speech pathologist, you're you're doing the actual
scope in the office, yes m hm. And you're looking
and you're looking, and you're seeing that the vocal cords,
while they're supposed to be staying open, are closing.
Speaker 1 (16:14):
Right.
Speaker 3 (16:14):
So we'll have them I have them say E so
I can look and see what's going on with their
vocal cords, make sure they're moving together when they say E.
And then I'll have them just breathe at rest and
then just watch and see what the vocal cords do.
Sometimes I will have to uh get induce some vocal
(16:36):
cord dysfunction. So with with him, we had him on
a treadmill because he was a he actually at one
point he started doing cross country running, so we had
to get him and share exercise and a little bit
yes stressed all of that. So once he got to
a certain point, he would his vocal cords because they
were get they would get so close together he would
(16:57):
make a strider, which is always when you're breathing. And
so when we heard that, then we got him off
the treadmill and we scoped him and then just at
just at rest, just natural breathing. His vocal cords were
just coming to the center, coming to the center, and
they're supposed to stay open. So he was a great
(17:18):
patient and just took our exercises and went with them
and did absolutely wonderfully that that is fantastic.
Speaker 4 (17:26):
And I was going to ask you how this condition
is diagnosed.
Speaker 2 (17:30):
You talked about the things you rule out, But is
the diagnosis made by looking directly with the scope as
you described to us, or are there other ways to
diagnose the condition?
Speaker 3 (17:42):
That's the main way is to look at it. Sometimes
I don't get the best view of the vocal cords,
so I kind of put what they're telling me together
with everything else, you know, and I look at do
they respond to an inhaler if the doctor says, spects,
that's asthma? Are they getting better lesson symptoms when they
(18:09):
take their reflex medicines? Do the allergy medicines help? So
we it's kind of a rule out diagnosis, but I
can see it with the scope. That's one of the
main things that we can do. And one of the
points that I want to make with vocal cord dysfunction
is a lot of doctors think it's exercise induced asthma,
(18:30):
and that's what it looks like. So that's why one
of the first treatments they'll give them as a inhaler
or a rescue inhaler. And it can be asthma and
vocal cord dysfunction. It could just be asthma, but it
can also just be vocal cord dysfunction itself. So that's
why it's probably a lot more out there. We just
(18:52):
don't know about it as much.
Speaker 2 (18:55):
And so you mentioned we've mentioned reflex a few times
and that's just induced asthma.
Speaker 4 (19:01):
Are there other man, any main triggers to a vocal
cord dysfunction that we haven't mentioned or pretty much the
big ones.
Speaker 3 (19:10):
Well, there are so many. It could be, like I said,
as a reflux, post nasal drip. People can get it
when they have upper respiratory infection. Exercise is a big one,
but strong odors or fumes. I've had patients that work
(19:31):
in a particular office, and every time they go into
the office they start having trouble breathing. And it may
just be the environment.
Speaker 4 (19:39):
It could be.
Speaker 3 (19:41):
The cleaning products that are used, colognes, strong emotions, and stress.
So there are several different things that can bring about
an episode of the vocal cord dysfunction.
Speaker 2 (19:59):
And and so once somebody has this, what's like the
first thing to do when you find this?
Speaker 3 (20:08):
So the first thing we want to do is find
out what the trigger is. If it's exercise then and
most of my patients are it is exercise, we want
to find out what is it? Is it basketball? I
have my seventy plus year old little pickleball playing lady
that she started having trouble playing pickleball because of the breathing.
(20:29):
So we want to find out what is the trigger.
So is it exercise? Is it the fumes? I have
them journal If we aren't really sure what it is,
I have them bright down, Well what were you doing
right before this happened? And where were you? I had
two patients that when they would drop in the south
(20:52):
end of Louisville in where they make the tires around
that area of town. Every time they drove down that way,
it was the irritants in the air caused them to
have trouble breathing. So we look to see what it is,
what's the trigger, if we can figure it out, and
(21:12):
then try to eliminate or control the trigger, and then
I work with them on some breathing exercises. We work
on those day one, if this is what we think
it is, and then I give them a list that
they go home and practice. And I've had just really
(21:33):
good success with most of my patients.
Speaker 2 (21:37):
That's fantastic, and we might want to hear a little
bit about some of those breathing techniques. I'm excited to
tell you that we've got several questions coming in, so
we're going to take a break and jump into some
of those questions and you doing. Obviously people love this topic,
which is great to know. We're going to take a
short break, and this is doctor Jeff Toblin talking to
you tonight with Susan Matthews, speech pathologists about vocal cords
(21:58):
and vocal cord dysfunction to cen It on Health with
Baptist Health News Radio eight forty whas We'll be right back.
(22:21):
Welcome back to center It on Health with Baptist Health
here on news radio eight forty whas. I'm your host,
doctor Jeff Tublin, and if you're just joining us, we
are talking tonight to Susan Matthews, who is a speech
pathologist with Baptists and has been teaching us a lot
about how we swallow, how we talk, and how we
protect our airways. So we do have a caller on
(22:44):
the line, Jennifer, who has a question about a swallowing issue. Jennifer,
if you are there, you are on with Susan.
Speaker 1 (22:52):
Thank you, Hi, Susan. My baying for you is I
have echlesia and I had surgery about fifteen years ago
where my state or muscle was cut and as a
result of that, definitely has swallowing issues, zero percent motility.
So it's totally fine and I, you know, live my
life fully. It's no you know, but when I eat,
(23:13):
I have to eat very small portions. I eat a
few bites and then I have to rest my swallowing
and then I come back and eat again. And I
didn't know, I didn't even know speech pathologists worked on swallowing.
But is that something that can be fixed through, like
you know, work with you or is that something just
sort of deal with it. And it's as I say,
it's not the you know, it could be so many
(23:34):
worse things in the world.
Speaker 3 (23:36):
That is a great question. Thank you for asking. So
one of the things that we do is is work
closely with geophysicians because some issues could be in the
esophagus and they present like they're in the area that
(23:57):
we work with, and vice versa. We can have patients
that have trouble in the oral or parential phases which
are higher that look end up but feel like they're
a gang. So I am familiar with akalaysia that that's
really not in our area. We can certainly do a
(24:17):
swallow evaluation where we look at your mouth and your throat.
We do an esophageal scan, but it's not a full
esophageal workup for sure. But doctor Tevlin that ekilasia would
be more in your area. Am I correct?
Speaker 4 (24:34):
Yeah, you absolutely are.
Speaker 2 (24:35):
I'll just piggyback on what you said, because, Jennifer, the
way you described it is actually the key components of
the condition that you have, which is a kalasia. The
initial problem is the fact that the sphincter, the muscle
between the esophagus and the stomach is too tight. The
secondary problems is over time, the motility or the way
the esophagus pushes the food.
Speaker 4 (24:57):
Down can become impaired.
Speaker 2 (25:00):
Where really speech pathology might come into plays, as Susan said,
is if the esophag.
Speaker 4 (25:06):
Is dilated, you might be at risk for aspiration and.
Speaker 2 (25:10):
They can help evaluate the way things are swallowed and
if the esophagram or the X ray picture is.
Speaker 4 (25:15):
Showing that condition to get you back into the care
of a GI physician. So, thank you so much for
calling in.
Speaker 3 (25:24):
Thank you.
Speaker 4 (25:26):
Have a great night.
Speaker 2 (25:27):
We had another question coming about throat clearing and they
wanted to ask they hear people and that clear their
throat a lot, and some members of their family do that.
Do they need to be worried that their family member
may have vocal cord dysfunction.
Speaker 3 (25:44):
Oh, that is a great question. Gosh. Throat clearing and
chronic coughing is something that we can work on and
address as well. It can be a voice disorder. Sometimes
it's just a habit of thing. I'll have a patient
that maybe had an upper respiratory infection and they did
(26:06):
a lot of coughing with that, A lot of throat clearing,
and as the infection goes away, sometimes that cough and
that throat clear will still be there. Sometimes it's a
necessary cough or throat clear, but other times it's just habitual.
It's just become a habit and they don't know it.
And I'll have patients come in frequently and i will
(26:30):
be talking with them and they're doing this, and I'll
say said, do you cough and clear your throat a lot? No,
not at all, and they absolutely just don't realize it.
So bringing that upfront and saying, well, in the past
three minutes you've cleared your throat about twenty times. Just
(26:51):
being aware of it is one thing, and so that
is something that we can address. But another thing too
is finding out why are they having reflex And doctor
Tovilin you would know about that. That can certainly cause
them to cough and clear their throat a lot. Is
it post natal drip? Is there something else? Could there
(27:14):
be something on the vocal cord that's making them cough
and clear their throat and that gives them that sensation
that they need to So there's a lot of reasons
why someone might be coughing and clearing their throat a lot,
and it would be worth investigating fantastic.
Speaker 2 (27:34):
I do want to circle back to something you mentioned
before the break, which is about breathing techniques.
Speaker 4 (27:40):
How do you use breathing techniques in your practice?
Speaker 3 (27:45):
Oh, that's great. So I tell my patients that air,
the air is the gas that drives the car, so
we have to take deep breaths. And if you're only
filling up your tank partially, so you're only getting in
of half of the breath that you need, that you're
only going to be able to drive part of the
(28:07):
way that you know, maybe up to Scottsburg, whereas if
you get a full breath of air, you can drive
all the way to Indianapolis. So that's one of the
things that we work on, is learning how to get
better breaths so we can It helps up with our speaking.
But one of the things that we do with the
(28:29):
exercises for vocal cord dysfunction is we learn to take
the tension off of the vocal cords and move that
tension somewhere else, and then that relaxes the vocal cords
so that hopefully they're able to go about their activities
without that sort of breath feeling.
Speaker 4 (28:49):
That's fantastic. And so.
Speaker 2 (28:52):
You do you see them on a regular basis, Like
do you see them once a week, once a Month's
what's sort of a typical process of how long something.
Speaker 4 (29:01):
Like this might take.
Speaker 3 (29:03):
It's usually very quick. Several of my patients I can
see them in one session. I get them the exercises,
I tell them what to do, and I say call
me if you have any questions or you need to
come back. And I will have people come back maybe
(29:24):
a time or two more just to kind of tweak it.
My cross country runner while he was doing track first,
and he came back like a year later because at
that point he was doing the cross country and we
just had to tweak a couple of things, and then
he goes on and finishes his cross country running. So
(29:45):
most of my patients were able to get them done.
I mean, I get like I said, I give them
the exercises, I show them how to do it in
the office, and then it's pretty much you've got to
incorporate this in your daily routine. And it's it's rare
that somebody will come back more than once or twice.
Speaker 4 (30:06):
Well that's very encouraging.
Speaker 2 (30:08):
So I hope everybody is hearing that we're going to
take another break right here, and I want to remind
everybody that you are listening to cend It on Help
with Baptist Health here on news radio eight forty whas
our guest this evening, Susan Matthews, speech pathologist. If you've
missed any part of tonight's show or want to hear
all of this excellent information in its entirely entirety, download
(30:31):
the iHeartRadio app.
Speaker 4 (30:32):
It's free, it's easy to use, and I'll give you
access to tonight's show. We'll be right back.
Speaker 2 (30:50):
Welcome back to send It on Help with Baptist Help
here on news radio eight forty WHS.
Speaker 4 (30:56):
I'm your host, doctor Jeff Tublin.
Speaker 2 (30:58):
We're talking tonight with Susan Matthews speech Pathologists. Remember to
download the iHeartRadio app. It's free, it's easy to use.
It'll give you access to all of the shows that
we have done. So, Susan, you've done such a great
job teaching us about vocal core dysfunction. I want to
expand the issue to more people because all of us
(31:20):
have had an experience where we've quote lost our voice
quote and I'm trying to think about what does that
actually mean? How do we lose our voice and what's
happening when we've lost our voice.
Speaker 3 (31:33):
Oh, that's a great question. That's a very scary feeling
when you lose your voice, especially for someone that needs
to use their voice every day. So we will see
people that lose their voice for a variety of reasons. Again,
typically it's an infection that kind of lingers on. And
(31:55):
I've had patients that I'll say had an upper resiratory
I lost my voice, I got larynge itis, that came back,
I lost my voice again. The next time it came back,
and then the next time they lost their voice and
it never really came back.
Speaker 1 (32:10):
Uh.
Speaker 3 (32:11):
So, there can be an inflammation of the muscle or
the outer lining of the vocal chords. They can get
what's called nodules, which h usually you'll get like a
little bump on each one of your vocal cords and
that hits together and that will that's certainly something that
(32:33):
can cause difficulty with speaking. A lot of singers will
get that. I think Steven Tyler, I think that was
one of his issues. Yeah, And so when these singers
talk about their voice therapist, I mean they they are
really life saving for them because that's their livelihood. So
(32:57):
it's anybody that uses their voice pre professionally or a lot,
so teachers. I will have teachers that by Friday their
voices are just were out those muscles. We expect our
vocal cords sometimes to do things that maybe we wouldn't
expect our legs to do. So they're using their voice
(33:19):
all day long, every day for five days, and by
Friday they should be wore out. But we're not expecting
that person to walk a marathon five days in a row.
And that's what I tell our patients. Your vocal cords
are just muscles, so we have to warm them up.
We have to treat them like there are other muscles
(33:40):
in our body and give them time to warm down.
Speaker 2 (33:45):
You know, it's a fantastic analogy to help us think
about that overuse. So, given the fact that most people
who tend to overuse can't not work right, they have
to work and teach five days a week, what could
they do to prevent it from happening?
Speaker 4 (34:04):
And once it is happening, are there.
Speaker 2 (34:05):
Any tricks or trades that people listening could do to
kind of speed up the recovery?
Speaker 3 (34:12):
So care of the voice. Learning how to take care
of your voice. Water is one of the biggest things,
and that's one of the first things I ask when
I'm speaking with a patient. How much water do you drink?
How much coffee do you drink? How much soda because
caffeine drives out, so the vocal cords need a nice
(34:36):
moist environment. And if it's dry and sticky in their throat,
and we've dried them out by talking and overuse, and
we've dried them out because we've had four mountain dews
and three tups of coffee and maybe a swig of
water when we took our medicines, then we're not setting
those vocal cords up for success that I don't take
(35:02):
things away from people. You know, if you have to
have that cup of coffee, then you drink that cup
of coffee, But we need to supplement with that much,
if not more, water. So learning how to take care
of our voice. Given your voice vocal breaks, just like
you would if you were training for a marathon. You're
going to run three miles to day, five miles the
(35:22):
next time, six miles the next time. You just don't
go out and do a marathon and so we have
to give our voice vocal breaks. So we do a
lot about caring for the voice, that's the first thing,
and then changing modifying the environment as we need to breathing,
making sure you have a full tank of gas to
(35:43):
drive that voice. So those are some of the things
that we address in therapy.
Speaker 2 (35:49):
Yeah, you know, I thought g I was a wild
wide field of things we had to know how to do,
but peace pathology.
Speaker 4 (35:56):
Just might have as beat.
Speaker 2 (35:57):
I do want to ask you about the nodules that
you mentioned, so are those are those pre cancerous at all?
Speaker 4 (36:05):
Are they dangerous at all? Do they have to be removed?
Speaker 3 (36:09):
So that requires a doctor to diagnose that, but typically
once an e INT looks at it and feels like
they are nodules, we want to be able to get
rid of them by therapy. They can be surgically removed.
But the bad thing about that there's several things. But well,
(36:30):
one thing, you don't want to have surgery. Number two,
you're going to have scar tissue on those vocal cords
so they won't move as well. And number three, if
you haven't learned how to take care of your vocal cords,
then they can recur. So we want to take care
of them, do some therapy to get rid of them,
(36:52):
and then teach them, teach the patient how for them
to not come back.
Speaker 2 (36:58):
So did I hear you say that with the therapy
the nodules can actually disappear once they've formed.
Speaker 4 (37:05):
Yeah.
Speaker 3 (37:06):
Yes, I've actually had two therapists in our department over
the years that have had nodules and we kind of
treated each other and they did go away. And nodules
are not cancerous. But typically you get vocal vocal cord
nodules for over use or misuse of your vocal cords.
(37:29):
Like you know the people that go out yelling at
the football game on Friday night and then wake up
Saturday morning, why don't I have a voice? Well, you
abused your voice. Your vocal cords are not before them,
that's why. So if you do that repeatedly, repeatedly, repeatedly,
then you can develop nodules.
Speaker 4 (37:49):
Huh. Well, we have just a little time left.
Speaker 2 (37:52):
But what's the most common thing that you have to
send somebody for surgery after you've evaluated them.
Speaker 3 (38:02):
I guess not real common. But when I do my
scopes and look at the vocal cords, sometimes I will
see something that shouldn't be there, and I will refer
them to to the E and T usually for maybe
a biopsy to see if it is something that needs
(38:22):
further investigation.
Speaker 4 (38:25):
Susan, thank you so much for joining us tonight. That
is going to do it.
Speaker 2 (38:29):
For tonight's segment of centered on Help with Baptist Health.
I'm your host, doctor Jeff Tomlin. I want to thank
our guest Susan Matthew speech pathologists, just a ton of
information tonight, our producer mister Jim Benn and of course
the listeners and our callers Mark and Jennifer join us
every Thursday. Next week we are going to be talking
about new treatments for Alzheimer's disease with doctor Patrick Matisson.
Speaker 4 (38:51):
So join us then and have a great weekend.
Speaker 2 (38:57):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment. Always
seek the advice of your physician with any questions or
concerns you may have related to your personal health.
Speaker 4 (39:19):
Or regarding specific medical conditions.
Speaker 2 (39:22):
To find a Baptist health provider, please visit baptistealth dot
com
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