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Screenings for speech, hearing to be held by Heather Woolwine Public Relations In observance of Better Hearing and Speech Month (May), MUSC’s Evelyn Trammell Institute for Voice and Swallowing (ETIVS) and the Department of Otolaryngology will host a free speech, language, voice, swallowing, and hearing screening to raise public awareness of speech and language disorders affecting millions of Americans each year.   The screening will be held from 8 a.m. to 4 p.m., May 5 on the second floor of Rutledge Tower at the ETIVS. Screening participants can park for free in the Ashley Avenue patient parking garage.   The institute collaborated with the MUSC Department of Otolaryngology, Hospital Therapeutic Services, and the American Speech-Language-Hearing Association in an effort to highlight these often underreported disorders.   “These disorders are not reportable diseases, meaning that the incidence statistics are not always reliable,” said Bonnie Martin-Harris, Ph.D, ETIVS director. “Communication disorders involve problems in receiving spoken, printed or gestured symbols and expressing your thoughts, needs and desires. They can range from relatively benign issues such as mild problems with articulation or voice to severe disorders with speech production and hearing. These disorders impair people’s ability to function in the world or their own environment. We hope that by spreading awareness of communication disorders, we are also demonstrating that treatment is available.”   Communication disorder treatment involves behavioral and learning strategies that are noninvasive and are tailored to each patient’s needs. Speech-language pathologists and audiologists involved in this type of treatment gauge a treatment’s success based on what the patient wants to accomplish. And by using treatments rooted in evidence-based literature, Martin-Harris and collaborators with the ETIVS ensure methodical and appropriate patient experiences.   “MUSC is fairly unique throughout the country because of the specialists we employ for the various areas of communication disorders,” Martin-Harris said. “We have professionals who specialize in cognitive issues, others in pediatric language development, and others in voice disorders. Once a patient is referred to our nationally recognized program, the collaboration amongst our specialists, physicians, and the help of research projects and clinical protocols set that patient on the path to success.”   A strong commitment exists on behalf of speech, language and audiology specialists. Meanwhile, an intricate web of teamwork also exists among those that deal with communication. The physicians who treat patients suffering from traumatic head and neck injury  and patients with head and neck cancer are key members of the rehabilitation team. Speech and language pathologists frequently work with stroke, brain injury and trauma patients.   “Fortunately, most people with speech and language problems can be helped,” said Kikki Thayer, MUSC speech pathologist. “Even if the problem cannot be eliminated, we can teach people with speech and language problem strategies to help them cope. People may not fully regain their capacity to speak and understand, but a speech-language pathologist can help them live more independently.”   Thayer suggested some symptoms or issues that may indicate a communication or hearing disorder include: recent memory loss, difficulty understanding or speaking language, difficulty word-finding, voice hoarseness, stuttering, vocal fatigue, loss of volume or pitch range, coughing or choking often when eating or drinking, slowed speech, and a family history of stroke.   “For children, it’s important to notice whether they understand directions or adult speech, whether they are communicating well with their peers, if they are pronouncing sounds, if they’re having trouble with textured foods, if they don’t respond to sound, or if by one and a half years old they still have not said any words yet,” said Diane Andrews, speech-language pathologist. A patient’s story: Adolph “Doc” Norris The Monday after Mother’s Day three years ago started like any other for Doc Norris, an electrician in Georgetown. He and work partner Jimmy Jacobs checked on a job in the morning and decided to part ways around lunch time. After dropping Jacobs off at the local Huddle House restaurant, Norris drove home with the intent of paying some bills and tending to his dog. When he arrived, he quickly noticed that the dog wasn’t around, so he began to look throughout the house. He saw suitcases piled on his bed filled with valuables and his wife’s jewelry. As he headed back toward his kitchen, Norris confronted a 19-year-old man who was  armed with Norris’ hunting rifle. “I told him that I had $500 cash on me and that he could take that and the rifle and just be on his way,” Norris recalled. “He told me that he couldn’t do that, because he couldn’t afford to leave any witnesses. That’s when he aimed the rifle, and shot me in the face.”   Speech pathologist Becky McCown visits with Doc Norris. The bullet entered the lower half of Norris’ left side of his face and, before exiting out the right side, caused damage so severe to the jaw and neck area that the bottom half of Norris’ face was, in a blink, gone.   Miraculously, he hung on long enough to be found and then transported to a nearby hospital, which promptly referred him to MUSC.   “I was losing so much blood that they almost lost me twice on the way to Charleston,” he said. “I’m told that once I got here, Dr. Day [Terry Day, M.D., Otolaryngology-Head and Neck Surgery] started the first operation that lasted 14 hours. My second operation was 12 hours long and they honestly didn’t think that I was going to make it.”   Norris’ family, friends, and community waited for word about his condition while doctors placed him in a medication-induced coma to allow his body time to heal, and spare Norris from the intense pain associated with his wound. Norris’ prognosis wasn’t too optimistic. He’d survive, but probably never talk or eat on his own again. He needed a tracheostomy to breathe and would probably require a feeding tube for the rest of his life.   With the continued expertise of Day, and the reconstructive surgical knowledge of Adam Ross, M.D., Otolaryngology-Head and Neck surgery, Norris underwent 17 more reconstructive surgeries to rebuild the lower half of his face and neck.   Then, speech pathologist Becky McCown joined Norris’ treatment team. “When I first met Mr. Norris, everyone felt that he’d never come off the trach or eat again,” she said. “And our original goal was a small step, really. He was having trouble handling saliva. It wasn’t long after we began our therapy that I realized that he was a star patient. He did everything I asked him to while here and at home. He was really motivated and that’s when I realized that we could meet his next goal.”   Norris’ next goal was to be able to eat again. His elderly mother’s last wish was to be able to cook him one more meal before she passed away. McCown approached Ross about surgery to remove Norris’ tracheostomy, thus allowing him to breathe on his own and further, swallow and eat normally once again. “Dr. Ross was phenomenal and was a wonderful help,” McCown said. “And Mr. Norris hit it really hard. His therapy required us to observe and compare each time he swallowed to determine the good swallows from the weaker ones and over time and home exercises, he became strong enough to not only handle his saliva, but have his trach and feeding tube removed.”   A gentle and humble soul, Norris was thrilled with his progress and also explained the bump in the road that could have derailed all his efforts. During his communication therapy, Norris was diagnosed with cancer and had to undergo radiation and chemotherapy. A study in survival, Norris strode on, determined that God had a plan for him that wouldn’t allow him to give up yet. Now, even faced with the difficulties of dealing with the Social Security Administration and its unwillingness to cover the expense of Norris’ dentures he would like to purchase, he still has nothing but kind words and praise for those who helped him. If he can find a way to pay for his dentures, solid food that requires chewing can be added to his ever-expanding menu of soft foods like eggs and grits.   “I wouldn’t be here if it weren’t for all of the incredible people who helped me, and I’m so grateful to Dr. Day, Dr. Ross and Becky for everything they’ve done,” he said. Patience, dedication help student overcome voice disorders by Michael T. Vagnini, Furman University student Throughout high school, I was actively involved with choir and musical theatre. I had been singing since elementary school, and music still is one of the great joys in my life. But I had some odd voice problems that I started to notice in the ninth grade. I was speaking in a very high, raspy, unnatural voice that definitely did not fit me as a growing young adult. I tolerated the problem throughout high school and the minimal vocal therapy I received did not help. When I became a freshman in college, however, I started having trouble singing, and I realized the importance of correcting my problem.   In general, our society is not aware of voice disorders, and often times not very understanding of the great stigma that voice disorders cause. We also tend to judge others quickly based on their voice; and my high, squeaky voice certainly did not allow me to command much attention or respect. I felt that, at times, my classmates would make snap judgments about me based on the way I spoke, and sometimes that socially isolated me. During my own journey in correcting my problem, I’ve become more sensitive to this social issue; and although I don’t encounter people with voice disorders every day, whenever I do I am able to share some advice or support.   After my freshman year of college, I had my first session of therapy with Drs. Bonnie Martin-Harris and Lucinda Halstead at MUSC. We discussed several options, including some invasive procedures, since my vocal exercises did not initially seem to be working. My voice would continuously hyper function, perhaps due to a muscular issue in the larynx. Dr. Martin-Harris, however, encouraged me to keep practicing my voice therapy exercises, consisting of words and phrases that relaxed my larynx and helped my real voice to come forth. She helped me to work through my problem and taught me the importance of patience during this process. After about four months of practice, I met again with Dr. Martin-Harris in Charleston . . . and this time I brought a different voice with me. ‘Michael, you’ve found your voice,’ she exclaimed that day, and since then we’ve met occasionally to track my progress and to make sure that my voice has properly stabilized in its new way of working.   Now, I speak comfortably at a pitch that fits my age, body, and personality. It’s my natural voice, which never made it out during my adolescence, and perhaps would not have made it out at all without the help of Drs. Martin-Harris and Halstead at MUSC. Dr. Martin-Harris especially provided immense encouragement along the way and gave me the tools I needed to correct my problem. Her kindness and upbeat personality kept me thinking positively during some very tough times. I don’t really have the vocal stamina to sing in choir these days, but my journey with my voice has allowed me to appreciate music on entirely new levels. During my time of vocal therapy, I took up piano and will continue playing.  I’ve also learned to connect better with people through service work and teaching.  I’ve come to appreciate the true magic that can happen through interacting with others, something that I saw while Dr. Martin-Harris worked with me, and over the last few years I’ve learned the importance of reaching out to others. After graduating, I plan to study chemistry in graduate school, and my ultimate aim is to work as a professor, conducting renewable energy research and sharing the joy of learning with others.   I suppose that if my voice had transitioned normally during my teenage years, I would still be singing and enjoying it. But, my challenges have instead brought me closer to the multitude of wonderful experiences and people that life offers. MUSC Evelyn Trammell Institute for Voice and Swallowing Free screening 8 a.m. to 4 p.m. Friday, May 5 2nd Floor Rutledge Tower Do you have concern with hearing, communication (voice, articulation, language, fluency), feeding/swallowing? Pediatric or adult referral accepted.   Call 727-6400 with questions or to make an appointment. Walk up appointments are welcome.   For additional information on the MUSC Evelyn Trammell Institute for Voice and Swallowing, visit http://www.musc.edu/etivs/.     Friday, April 28, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publication at 849-1778, ext. 201.