Will this HELP me?  FAQ's

Over the last few years, I have received numerous emails asking me questions about the Voice Aerobics™ products and whether they would be of help. I have created this page to share with you some of those questions and my responses, and in doing so, hope that you gain a better understanding about how to best benefit from your purchase.  ~ Mary Spremulli, MA, CCC-SLP

Voice Aerobics & Voice Therapy

Question:  I have been seen by a voice specialist. They have prescribed voice therapy. I have inflamed muscles in my throat causing some compression on my vocal cords, and that combined with laryngeal reflux. I am a singer and a minister. The way it is affecting me is pain, vocal strain and lost vocal stamina. I don't think my insurance is going to be very helpful in getting the therapy. Also, the area I live in, I don't think I will be able to find someone with knowledge with this particular issue. Do you think this could be helped by your program?

Answer:  Hello, I'm sorry to hear about your voice problem. Like a lot of the people I work with, you have various factors that are contributing to the problem, and first, you need to manage the medical and environmental factors, and then the voice treatment. Hopefully your Dr is working on reducing the effect of reflux, hydration, and self-monitoring for throat clearing and other bad habits is a first step.

When you mention "strain, and loss of stamina," it suggests to me that you are trying to push inflamed or weak vocal folds beyond their limit. Have you thought of using amplification for your day to day work? One of the advantages is that it allows you to be speaking in a very soft, confident voice, and not pushing to try to get volume. It might go a long way to reduce your vocal fatigue.

As for your specific question regarding Voice Aerobics: although I originally designed it for persons with voice changes from Parkinson's disease, once available on a DVD, I have used the program with many of my voice patients. In particular, parts 1 and 3 which focus on posture, breath work, and resonant voice production. It can help to heighten your awareness about all of those measures that are important for voice production. I would NOT use the Voice Aerobics DVD as a substitute for voice therapy, and encourage you to consider at least a few visits, even if it means paying out of pocket. You sound motivated, and a voice therapist should be able to provide you with vocal function exercises that you can be doing on your own at home, reducing the need for extended visits. I hope this helps.

Question:  I was told by an ENT that I needed to go to voice therapy for 4 sessions due to tight muscles knotted together in my throat. I was told the sessions would help loosen up muscles. Would the Voice aerobics DVD help me? Please do not try to just sell me the DVD I need something that will help.

Answer:  Hello, I can never tell an individual what will or won't help them until I have met them. I will tell you that voice treatment is largely about vocal hygiene education helping to reduce behaviors that are contributing to your voice problem, and guiding you in some home practice.

Having said that, I do use Part 1 and Part 3 of my DVD with many of my patients with functional voice problems, including muscle tension dysphonia. You should begin treatment with a licensed speech pathologist/voice therapist. The DVD would enable you to practice some of the breath work at home and heighten your awareness regarding diaphragmatic breathing and resonant voice. It is not meant to take the place of voice therapy/treatment.

Voice Amplifier Avoiding Feedback

Question:  I recently purchased some of your products for a relative of mine with Parkinson's disease. We had some difficulty with howling and squeaking when using the Voice Amplifier. We tried it on the lowest setting as recommended, and also with the front of the unit facing away from the microphone.

Please advise! As a Speech-Language Pathologist and as a relative of someone with PD, I am thrilled to have found your site! Thank you for the important work that you do.

Answer:  I occasionally have problems with feedback with my own patients, particularly those with some postural problems and a tendency to drop their head, and have tried a few things to improve performance and eliminating squealing. If ambulatory, the best position seems to be on the hip opposite to the microphone. When I am teaching, I almost have it on the back of my hip and I can have it at the loudest volume, put my head down, and have no feedback at all. If in a wheelchair, placing on the back of the seat of the w/c works great, and the volume setting can be quite high.

Voice Amplifier / Teacher

Question:  My speech doctor recommended your portable amplifier for use in my classroom. I don't see any strap to hold it on, or any headset. Do you sell the headset also, or does it come with the amplifier. I need it by next Monday because school is starting. Thank you for your time.

Answer:  The amplifier has a belt clip and also a neck strap. It comes packaged with a lightweight headset microphone and also an auxiliary cord that can be used with your computer or other electronic devices. Amplifiers ship priority, so, if you order it in the next day or two, you should have it before the start of school depending on where you live.

Question:  My husband has Parkinson’s and I can hardly hear his voice. Will your amplifier help? I don’t want him to become dependent on using it.

Answer:  Amplification is a wonderful assist for persons with weak or soft voice from any condition, including Parkinson’s. I think of it in much the same way as people use a cane or walker for ambulation, sometimes only for long distances and sometimes they use a device all of the time. An amplifier is nothing more than power for your voice. Wouldn't it be nice to be able to participate in family gatherings without having to repeat yourself? When I see a person put on their amplifier, I don't view them as "dependent" on a device; rather, I view them as desiring independence in communication.

Speech and Parkinson's Disease

Question:  My husband has Parkinson’s disease. He has had speech therapy, but his voice is still poor. Would he benefit from using your product?

Answer:  It is difficult without knowing or seeing your husband if my products would be of any help. Vocal function exercises can be of help to most anyone when the focus is on breath support and general voice strengthening, which is the focus of the Voice Aerobics™ products.

Has your husband participated in formal therapy? If so, his therapist might be the best person to advise him regarding further voice practice or exercise. There are several Voice Aerobics short clips on YouTube which show a small portion of the class, and it may help you to view those and then judge for yourselves if the products would be of benefit.

Question:  Please help! My mother is a Parkinson patient. The disease has affected her voice, swallowing, walking and sight. I'm caring for her at my home and after caring for her I hide and cry daily because I missed not having that quality of life with her that I had become accustomed to for so many years. She is 87yrs. old and had the disease now for about four years. The loving active, precious and caring mother that I once know is not there anymore. I'm thankful that she is still with us but the wonderful spirit is not there anymore.....Help me please!

I did take my Mom to a doctor (Neurology) here in the Land O'Lakes, Fla. area where we live and am awaiting a follow up appointment. As for myself, I'm trying to keep it together and with prayers I will be fine. Can you please let me know of any programs of your kind in my area that is not too expensive as most of the programs through the hospital are too high for us because my Mom does not have any insurance? However, let me know of your programs in this area and cost that may help my Mom.

Answer:  I am sorry to hear about your mom's decline in function. It is indeed sad to see a parent lose function and enjoyment in things no longer possible. Please tell me how you think I may help. It sounds as if she is having a variety of motor symptoms, and management of those symptoms can be a precarious balance of medications, physician skill and the individual patient response. Swallowing decline, of course, poses a risk, and so should be addressed. Has your mom received formal intervention? Have you considered talking with a neuropsychologist familiar with Parkinson's who may help you support your mom, while at the same time care for yourself?

Having just helped to rehabilitate my own mother post stroke, I know the sadness and concern you feel when a parent's health is declining. But, I also want you to know that there may be some things to help speech and swallowing that do not cost a lot of money. First, is to make sure that your mom is being medicated appropriately. Second, is an assessment to see what her specific issues are and then to develop a plan that she is interested in and can perform at home.

The Parkinson's Research Foundation out of Sarasota is opening a center in Sarasota this fall, called: Parkinson's Place. They will have a variety of educational programs and weekly, all at NO COST, available for persons with Parkinson's and their care partners. I will be offering a Voice Aerobics™ class and may also be available to offer some consultation thru the center. I am going to forward your email address to the program directors at PRF and ask for you to be added to their emails.

Swallowing and Parkinson's Disease

Question:  During a hospitalization, my father who has Parkinson’s developed swallowing problems and aspiration and a feeding tube was placed. He is back home and recovering, and I wonder if your products would help him regain his swallow function. He hates having a feeding tube and finds it very depressing. My father actually has been able to eat some soft solids and drink liquids; however, the bulk of his nutrition is still derived from high protein drinks given to him via the food tube. We are working hard to make the transition for him to oral feeding. It has been about 4 months since his aspiration pneumonia episode, and we are still hopeful he will be able to get off the feeding tube. Would it be possible to add on the BREATHER to my order that I just placed yesterday?

Answer:  Glad to hear you father is recovering from his illness. Swallowing issues are certainly the demise of many a person with Parkinson's. The problem is that many people have probably had changes in swallowing going on for years, but have accommodated the changes and only in the face of another, more serious illness, do the swallowing problems create havoc.

With regards to your specific question: There is a growing body of research that focuses on the timing of respiration (breathing) and swallowing. In fact, a way to think of aspiration is as a mis-timed swallow, allowing food or liquid to enter into the airway. Many people with Parkinson's mis-time their swallows, and aspirate. This problem may be in addition to weakness or stiffness in the vocal folds, and weak cough effort which fails to do the job of protecting the airway. So, to answer your question, YES, I believe strengthening breathing muscles and voice muscles may improve efficiency of the swallow. The Voice Aerobics DVD can help your dad begin a general strengthening program.

BREATHER®

Question:  I have a question about the use of the Breather which I hope you can help me with. I started with resistance levels set at 1, and noted that even at this level, I would occasionally get a "growling" noise at the back of my throat during exhalation, accompanied by decreased force (and shorter expiration times). I took this to mean that I was losing air through my nose and sure enough, when I held my nose, the noise stopped. When I increased to a resistance level of 2 or 3, the growling noise was always there and I wonder if I am getting any benefit from the training when it is always performed while holding my nose? Do non-Parkinson's people have difficulty maintaining pressure in the airway?

One more question is about the Songbirds CD. Is there a reason why the exercises are mostly in the lower registers?

Answer:  Regarding your "growl" on exhalation, resolved with holding your nose, it sounds as if you may have a weak soft palate that is allowing too much airflow to escape thru your nose. The "growl" may be the rumbling of our palate think snore). There is not a problem with pinching your nose, also make sure that you are not puffing your cheeks. The higher resistance is requiring a greater amount of intra oral pressure, and you apparently are losing it. Have you ever seen a speech pathologist?

As for your question regarding the Songbirds CD - It is in the lower register primarily because that's where my voice is most natural. I actually recorded it with a friend, who is a tenor, but in the final editing, the sound engineer faded his voice out thinking it might be confusing for people to hear both voices. Practice the exercises in the key that is most comfortable for your voice. I don’t mind a little harmony:)

Question:  My father is 75 years old. He has COPD, and now was recently diagnosed with Parkinson's. Would the BREATHER® help him?

Answer:  Both COPD and Parkinson's Disease can cause some decline in the use of the respiratory muscles. Studies evaluating the benefit of resistive devices for inspiratory muscle training in patients with COPD found improved Quality of Life scores following 6 weeks of training. Study participants typically complete the training in no less than 15 minute sessions twice daily, or 30 minutes/day, and this type of respiratory muscle endurance training has proven effective for persons with COPD. When persons with COPD perform pursed lip breathing this promotes a slower and deeper breathing pattern both at rest and during exercise, while prolonging exhalation. (Chest 2005;128;640-650) Since exhalation is the phase of respiration we speak on, and also the phase of respiration interrupted to swallow, training the expiratory muscles may benefit both of these functions. The BREATHER® offer both inspiratory and expiratory muscle strength training.

Shipping

Question:  Do you ship your DVDs and CDs to the UK and if so what would the shipping cost be?

Answer:  Yes, I do ship to the UK. Approximate cost: $6.15-$7.77 US, depending on item and quantity. I would suggest you complete an order via the shopping cart and you will obtain shipping rates prior to check-out.

The Voice Aerobics™ Songbirds audio CD is now available as an MP3 download through CD baby. So, you can save shipping costs, order wherever you live in the world and practice wherever you go!

Visit CD Baby & download your Voice Aerobics™ Songbirds MP3 now!

Medical Disclaimer:  The information contained herein should not be construed as medical advice and is not intended to replace the medical advice of your physician or other licensed healthcare provider in your state. You should continue to consult your physician for matters regarding your health and prior to beginning any new exercise program.