Mumble Grumble

“Speak up, please?” “I can’t understand you.” “Louder.” This is a chorus that I began to hear fourteen years ago. Those requesting I increase my volume were not always patient. My brain dubbed this the “Mumble, grumble” Parkinson’s problem.

Welcome to Parkinson’s problem number two, speaking so that one is heard– and understood.  Vocal cords like the muscles controlling leg movement become victims of PD. In my case, my voice became softer and softer and less clear. This started before I was diagnosed with PD and before I thought about the disease. My reading about soft voice led me to consult an eye, ear, nose and throat specialist.  I received no clarification of why I had a problem, but I did get the verdict that I did not have cancer, a fear raised by another doctor who noticed “thickening” of the vocal cords. No one mentioned Parkinson’s Disease.

Next visit was to allergist. Does any of this sound familiar? Friends, coworkers and finally strangers described my voice as gravelly or hoarse. They asked, “Did I have a cold?” “Sinus or allergy problems?” I had a history of bouts of spring and fall allergies, and it was possible that they had become year-round. The allergist confirmed this. I took the cure, weekly shots.  My voice continued to weaken, losing tone, as well as volume. I was nearly inaudible to anyone with a hearing problem.

I remember sitting next to an elegant woman at a gala. She requested me to speak up. I did.

“Louder,” she said. I complied.

“Still louder.” By now, I’m shouting and others are staring at me.

She became very apologetic, “I’m terribly sorry. I’m completely deaf in that ear. Could you switch chairs with me?”

We laugh about this and make sure I sit on the correct side of her. The story is relevant. I include it to remind all friends of Parkinson people to turn up your hearing aids.

Back to my voice problem, I was frustrated. I, who as a professor, lectured classes of 70 plus graduate students, never had a problem with volume or enunciation. Since 1971, I gave investment presentations and speeches without a microphone. Now, I feared I would need to carry a microphone for everyday conversation.  The odd thing was I did not perceive I was speaking softly. There was a mismatch in the feedback loop between what my brain heard as my volume and what the listener heard. To be honest, I was shocked and alarmed.

To the rescue came my delightful “deaf” PD doctor. A man who kept asking me to speak louder and louder. I accused him of turning down his hearing aid once. He offered no defense. Just, “Please, speak LOUDER.” We both laughed, for now it was 2010, and I was a PD patient. I was ready for a solution aimed at PD. The technique is called “Lee Silverman Voice Technique—LOUD.” I learned it during that summer and still practice several times a month, or whenever I find someone saying, “Please speak up.”

I spend most days sounding close to normal. I believe in the technique and encourage others to give it a go. It is physically painful. The vocal cords like the legs don’t want to work. The reward is big, for once you can be both heard and understood, you are back in the game!

One of my co-workers accuses me of not being able to judge between speaking LOUD and yelling.  Since this comes up when I’m annoyed, I have to conclude that my vocal cords still rumba with displeasure. To learn about the LOUD Silverman Technique, view:  https://www.lsvtglobal.com/patient-resources/what-is-lsvt-loud

Here’s a sample of what I do now.  First, I start by always thinking LOUD, as taught by my teacher.  Second, whenever I find myself slipping I PRACTICE.  Thirdly, I take a deep long breath, and then say “ahhhhhhhhhhhhhhhh” for long as possible.  Finally, I practice the “ahhs” for a high pitch and a low pitch, which quite frankly hurts a lot.

Here is what it sounds like from an instructor:

http://s3.amazonaws.com/lsvt-global/videos/11716/hw-ah.mp4

http://s3.amazonaws.com/lsvt-global/videos/11717/homework-helper-high-low.mp4

I still mumble, because sometimes, it is too much work, I’m tired, and my friends grumble. That is part of my life as a PD person. But I can speak normally.  If you, or your loved one has PD and has trouble being understood, learn about the LOUD Silverman Technique of speaking LOUD. It works, but one must stick to it.

Next up on my schedule is to write about eating and sleeping, the other two linchpins. Presently, the eating blog is entitled: Chew, Swallow, Choke and Cough.  I suspect to those of you familiar with PD, you know how accurate the title is. Till then, I welcome your comments.