murray's mumbles musings from the

3/31/08 1:03 PMWhispers on the Web - October 2004

of 18http://www.webwhispers.org/news/oct2004.htm

October 2004

Name Of Column Author Title Article TypeVoicePoints Messing, Farrell, Dietrich-Burns Part I: Pneumatic Artificial Larynx Education-MedWebWhispers Columnist WW List Discussion Thread- Oral Cancers ExperiencesNews, Views, & Plain Talk Pat Sanders Comments About A Long Storm ExperiencesCampfire Philosophy Paul Galioni Inside - Outside ExperiencesBits, Buts, & Bytes Dutch Computer Tips ExperiencesWelcome New Members Listing Welcome News & Events

Murray's Mumbles ... Musings from thePresident There will be no "Murray's Mumbles" column thismonth.

Our WebWhispers President, Murray Allan, underwent two prettytough spinal surgeries in September and is still in the recoveryprocess. WW members wish Murray a speedy and complete recoveryand look forward to his return to "duty" and to "Murray's Mumbles".

VoicePoints [ ? 2004 Dan H. Kelly, Ph.D. ]

coordinated by Dr. Dan Kelly, Retired Associate Professor ( [email protected] ) Department of Otolaryngology, Head & Neck Surgery 7700 University Court, Suite 3900, West Chester, OH 45069

? September 2004 Barbara P. Messing, M.A., CCC-SLPStephanie Farrell, M.A., CCC-SLP,

Katie Dietrich-Burns, M.S., CCC-SLP,

First in a Three Part Series:

Foundation Skills for the Artificial LarynxPart I: Pneumatic Artificial Larynx



Stephanie Farrell, M.A., CCC-SLP, Katie Dietrich-Burns, M.S., CCC-SLP,Barbara P. Messing, M.A., CCC-SLP. All authors are affiliated with the

Milton J. Dance Head and Neck Rehabilitation Center at the Greater Baltimore Medical Center, Baltimore, Maryland

Verbal communication connects us to our families, friends, and others in our daily lives. Losing the ability to produce voice is a devastating life event. If communication options arenot made available to the laryngectomized patient then feelings of social isolation may leadto depression.

It is important for the patient to receive pre-surgical counseling to discuss theircommunication options which vary from artificial larynges to tracheoesophageal voice andstandard esophageal voice. Post surgery, the Speech Pathologist and the patient will beginthe rehabilitation process. Initial steps include introducing the patient to the different typesof communication methods and beginning instruction and practice on the chosenmethod(s). The Speech Pathologist must stay informed on all available communicationoptions to optimally meet the patient?s communication needs.

The series will highlight the instructional necessities of training artificial larynx using theprotocol outlined by Shirley Salmon (1983). Using the mnemonic I PAT PAL, Dr. Salmondescribes the important elements and hierarchy of teaching patients how to use an artificiallarynx with the intent of maximizing speech intelligibility (see Figure 1). Information on thevarious artificial larynges must be proved to patients. Placement is addressed so the patientis not only consistent but also accurate in placing the device. Articulation work enhancesspeech intelligibility. Timing (on/off voicing) addresses the need to be able to turn on andturn off voicing appropriately for improved speech intelligibility. Pitch work allows thespeaker to produce voice that is more gender appropriate given device limitations. Patientsoften have their own personal preference on acceptable pitch levels. Lastly,loudness/volume variations provide the patient with a way to voice at an appropriate volumelevel for the conversational situation or occasion.

Figure 1. Instructional Method for Teaching Use of an Artificial Larynx

I = Information. The patient is informed on benefits of artificial larynges and selection ofthe proper device. Influential factors: purchase price and upkeep, availability, possiblemodifications, expediency, post-operative complications, patient preference.

P = Placement of the device to achieve. For example, with artificial larynges, the ?sweetspot? is the place in at the best clarity of sound and resonance is achieved. With intra-oral devices appropriate placement of the intra-oral tubing is discussed.

A = Articulation. Shaping sounds into speech using the articulators for precise soundproduction. Over articulation or exaggerated movements of the articulators is oftenrecommended to increase speech intelligibility level. Placement of the artificial larynxshould favor lip reading.

T = Timing. Appropriate ?on-off? timing consistent with syllable initiating and releasing,positions of phonemes in words and phrases results in optimum sound production and



positions of phonemes in words and phrases results in optimum sound production andgreater speech intelligibility level.

PAL = Pitch and loudness. Modify pitch to more closely resemble gender appropriatepitch level. Loudness ? volume should be adequate for the communication setting. Changes in one will usually show changes in the other.

(S.J. Salmon, Ph.D., 1983)

This is part one of a three part series to provide information on the various types of ArtificialLarynges. This article will focus on lung powered, intra-oral artificial larynges known aspneumatic devices.

Pneumatic Artificial Larynges

A ?pneumatic? artificial larynx is designed to use lung air for sound generation through anexternal device. Pneumatic devices require some form of coupling the device with thetracheostoma. Upon exhalation, lung air travels through the cup-like (rubber or metal)attachment device covering the tracheostoma. The lung air continues to travel through acylindrical vibrating chamber where the sound is ?generated?. The sound is transferredthrough an external tube positioned in the oral cavity. It is classified as an intra-oral devicebecause the tube is placed into the mouth. The laryngectomee then shapes the sound intowords for speech production.

Instruction on the use of a pneumatic artificial larynx using the ?I PAT PAL? method:

I = Information. The patient is informed on benefits of a pneumatic device as well as otherartificial larynges. The patient is then able to make an informed decision on proper deviceselection. The discussion should include: device costs, availability, model options (Tokyovs. Tone Air II), design differences between models and purchasing information. Ideally, theSpeech Pathologist will have a demonstration device or a device for purchase.

P = Placement of the device to achieve. Demonstrate coupling the device to thetracheostoma with and without proper placement. Strive for good seal with tissue. Acquireconsistent placement. Practice placement of the intra-oral tubing inside of the mouth forgood sound resonance. Demonstrate the tube directed toward the middle of the palate foroptimum resonance. (S. J. Salmon, Ph.D., 1983)

A = Articulation. Placement of the artificial larynx should favor lip reading. Instruct thepatient to place the intra-oral tubing towards the side of the mouth rather than towards themidline of the palate. This will better enable the listener to pick up cues from lip reading andimprove speech intelligibility level. Position the intra-oral tubing to the side of the oralcavity without obstructing the tongue tip. Other considerations for improved speechintelligibility would be to check for appropriate fit of dentures and assess the patient?s oralmotor skills with respect to strength and range of motion of articulators.

Over articulation or exaggerated movements of the articulators is often recommended toincrease speech intelligibility level. (S.J. Salmon, Ph.D., 1983). Articulatory precision isaccomplished through structured exercises targeting voiced-voiceless cognates at theword, sentence, paragraph and conversational speech levels. Exaggerating articulatory



word, sentence, paragraph and conversational speech levels. Exaggerating articulatorymovements is often necessary to improve speech intelligibility. A slow, yet natural rate ofspeech should be emphasized.

T = Timing. Battery-operated artificial larynges were designed with an on-off switch. Thereis no ?on-off control? on a pneumatic device. Instruction with on-timing of a pneumaticdevice should include: coordinating the timing of placement of the intra-oral tube in themouth whilst coupling the device to the tracheostoma with exhalation for initiation ofvoicing. Voicing begins, or on-time occurs, as the patient exhales. Pneumatic devicesrequire sufficient lung capacity to activate the vibratory membrane and produce a sound ofsufficient duration for articulation.

Off-timing with a pneumatic device occurs when the patient ends a word or phrase. Instruction on off-timing should include teaching the patient to break the coupling withthe tracheostoma or stop exhaling into the stoma cup at the ends of phrases orsentences. Undesirable sound generation will occur if the patient continues toexhale after speech is stopped and the device remains in place.

On-off timing too rapid. Staccato speech pattern may occur if the patient voices eachword individually. Practice exercises should focus on natural phrasing. To speak with amore natural pattern of production, the patient should briefly cease exhalation betweenphrases. (Minnie S. Graham, Ph.D., 1997).

PAL = Pitch and loudness. A modification of pitch in a pneumatic device as well as all AL?sis done in an attempt to match the patient?s voice more closely with their genderappropriate pitch level. Loudness ? volume should be adequate for the communicationsetting. (S.J. Salmon, Ph.D., 1983).

Initial set-up of the pneumatic device should include modifying the pitch/fundamentalfrequency by changing the width and thickness of the rubber vibratory membrane. Usinga thicker, wider rubber membrane will yield a lower fundamental frequency tone ascompared to a thinner, tighter vibrating member that will produce a higher tone. As withesophageal and tracheoesophageal voicing the patient who uses a pneumatic devicegenerally produces a ?hoarse? vocal quality.

Volume range for the pneumatic device is quite good since sound is produced fromlung- powered air. Less expiratory volume of air results in a softer volume. A personcan go from a whisper to a shout depending on the volume of expired air they choose toproduce. In comparison to battery operated, neck and intra-oral artificial larynges thereis no mechanical background noise when speaking with a pneumatic device.

Variations in both pitch and loudness can also be accomplished by varying breathpressure. Changes in one (pitch or loudness) will usually show changes in the other.

Historical Perspective of Pneumatic Devices

There have been numerous variations and modifications to the pneumatic type of artificiallarynges over the years. The initial prototype dates back to the late 19th century when aVienna surgeon named Julius Hochenegg fashioned an artificial larynx that used air from abellow positioned under the patient?s arm-pit. (Henslee, J.)



bellow positioned under the patient?s arm-pit. (Henslee, J.)

Over the years various types of pneumatic artificial larynges were developed andredesigned. The devices available today are the Tokyo Artificial Larynx and the ToneAire IIPneumatic.

Tokyo Pneumatic Artificial Larynxhttp://www.limcosolutions.com/

The Tokyo Artificial Larynx is made of chrome plated brass for the tracheostomaattachment and a cylindrical housing with a rubber diaphragm to generate sound. This isattached to air tube for mouth placement.

Reprinted with permission fromMark Welch, Limco Solutions, Omaha, NE

ToneAire II Pneumatic Artificial Larynxhttp://www.communicativemedical.com/

The ToneAire II Pneumatic device is available from Communicative Medical.

http://www.limcosolutions.com/

http://www.communicativemedical.com/



Reprinted with permission fromCommunicative Medical Inc,

Vancouver, Washington

Like the Tokyo, the ToneAire II uses lung air to generate a sound from a rubber membraneor diaphragm. A tube is attached to externally transfer the air from the lungs to the oralcavity for speech production.

Reprinted with permission fromCommunicative Medical Inc,

Vancouver, Washington

How much do pneumatic artificial larynges cost?

The Tokyo Artificial Larynx package costs approximately $160.00 and the ToneAire II costsapproximately $86.00. They are relatively inexpensive as compared to the other artificiallarynges which range from $375.00 to $700.00. The other cost savings with the pneumaticdevices is that batteries do not need to be purchased or charged.

Advantages and Disadvantages of Pneumatic Artificial Larynges

The advantages of pneumatic devices are as follows:

simple in design

limited number of parts



inexpensive cost

durable

requires no batteries

?hoarse? voice rather than a mechanical sounding voice

The disadvantages of pneumatic devices are:

external tube wide in diameter

highly conspicuous

An initial period of practice is required to learn to use the device as with allcommunication options available to the patient.

saliva will clog the air tube frequently.

One or two hands required to work the device. The patient must hold theattachment over the stoma when speaking and sometimes hold the air tube in themouth.

Conclusion

Communication choices made by the laryngectomee must be selected with consideration oftheir daily communicative needs, financial situation, lifestyle and patient preference. Thepneumatic artificial larynx offers the patient an excellent option for use either as a back-upor primary communication tool. The attractive features are low device cost, durability, lowmaintenance, simple design and excellent voice quality.

Part two of this three part series will discuss intra-oral artificial larynges.

References

Graham, Minnie, S. The Clinician?s Guide to Alaryngeal Speech Therapy, Newton, MA, Butterworth-Heinemann, 1997.

J. Henslee, History of the Artificial Larynx, http://www.larynxlink.com/Library/Laryngectomee/history.htm

Keith, Robert, L. Darley, Frederic. L., Third Edition, Laryngectomee Rehabilitation, Austin, Texas, Pro-Ed, 1994.

Salmon, S. J. Post-Laryngectomy Rehabilitation. Help Employ Laryngectomized Persons: H.E.L.P., Unit 7,Using the Artificial Larynx: A Presentation on Instruction. Indiana University School of Medicine, MedicalEducational Resources Program, 1983.

http://www.larynxlink.com/Library/Laryngectomee/history.htm



WebWhispers

Columnists Contributions from Members

Since our archives for the WebWhispers list is saved for only a year, we lose being able torefer back to discussions threads that are very informative. Here is one that took place backin October, 2002. It started under one title and continued under another but you can read itstraight through here.

A WW Discussion Thread on Oral Cancers

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Just had a phone call from a friend whose husband turned up with a little blood in hismouth in the morning for several days, and then noticed a lump in his throat. His pcpreferred him to someone at a local hospital who did a CT scan and said "it is a growth at thebase of the tongue and if it is cancer it would be inoperable, so we'll do a biopsy next weekand then meet a week after that to start treatments." They were, of course, panicky withsuch a negative prognosis before it was even biopsied. They further came away with theidea that if they did radiation there could never be any surgery. And felt that they weren'teven going to have a say about what treatment they would have done, if it malignant. They feel a lot better now having talked with us, but I wondered if anyone else was hitwith something like this in the beginning. (I do believe, however, that if an ENT seessomething he "thinks" is cancer, it usually is) I guess it is a fast growing thing, which Bob'swasn't, but "inoperable"? Come on! They are now going to call one of Bob's surgeons atMEEI to set up a date hopefully for him to do the biopsy and take over. Just wondered ifanyone had a "base of the tongue" problem and what you went thru before landing onWebWhispers. They need all the survivor information they can get at this point.ThanksBarb Stratton~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I had a my vocal chords removed and a right neck dissection. they also took half mytongue..... ouch..... some folks have there tongue remove all together..... I think Dr. Singer orHaymaker have done reconstruction to build a new tongue. Having even part of your tongueremoved makes it very difficult to talk.... but you can.later, Rich~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Also my soft palette was removed. I haven't been able to use any of the speaking aiddevice effective enough so people can understand me. It has now been over 5 years, withpen and paper. Peace VMark~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I had part of my tongue removed as well as my soft palate, and found that the lack of asoft palate had a far greater negative impact on intelligibility: the harshly nasal soundproduced in the absence of the soft palate totally overwhelms everything else and destroys



produced in the absence of the soft palate totally overwhelms everything else and destroysintelligibility. I was able to be fitted with an obturator - essentially an upper denture-likedevice with a plastic plug that extends back into the throat and closes the gap where thesoft palate was - and it made a world of difference. It takes a bit of searching to findsomeone who can construct one, or even knows what it is, but the results are well worth theeffort.Tom Harley~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Hi Tom, I had one for a while, in fact I think I still have it some where, but with all the radiation Ihad, my mouth kept changing and it wasn't working properly. Plus I can only open mymouth about a 1/2 inch and when I could manage to get it in, it hurt like hell. I might havetried to keep having them fine tune it, but my insurance was not covering it at the time, thedoctor was 3 hours from my home and I couldn't drive out of town alone. Then my wife wasworking part time and going out of town to college, and I was staying home, taking care ofthe house, watching out 3 kids, ages 3, 9,12. Now I'm getting all of my treatment at the VA and can drive again, maybe they will want totry fixing up my mouth again, or at least I'm hoping for some help with getting a lightwriter. All the years of surgery's, chemo, radiation, other treatments, and all the trips to differenthospitals and clinics got to me and I don't know how much of that I am willing to go throughagain. I guess time will tell. I'm going to be 53 the end of this month and I kind of feel like Ishould be 73. Thanks Tom for you input. God Bless. Peace VMark~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Hi Mark, I know what you mean, you get to a point where you have to balance the pros and cons,and then maybe decide that enough is enough, or at least that it's time to step back for a bitand take a break; there are worse things than being mute, and it sounds as if you managedpretty well. I had my one successful obturator made after my first cancer of the throat whenI was relatively young, before I got the unrelated laryngeal cancer 10 or so years later. Itseems like the making is an art rather than a science, the doctor who made it was a faci-maxillary something or other (long title), and he was associated with a large teachinghospital; which is no guarantee, I spent six months commuting back and forth from world-renowned Sloane-Kettering hospital in New York City and ended up with a piece of junk;which is not to denigrate Sloane-Kettering, I'm sure it's a fine hospital, it was the luck of thedraw, or timing or something else. So it's a matter of luck and/or persistence; maybe if youget your second wind or just happen to run into someone, or hear about someone whoknows someone, etc., ; sometimes life works out that way. In any case, the best of luckwhatever you decide, and keep contributing to the group, we're all in this together. By theway, I also had part of my jaw removed along with the soft palate and part of my tongue,and could barely open my mouth post-op. They gave me this little plastic stubby screw(pink) about 2 inches long with a tab on the end that I was to use every day, the idea beingthat you literally screw/jack your mouth open; my first impression was that is was amedieval instrument of torture, that it was some kind of cruel joke, but it made surprisinglygood sense. I'm not really sure how much it helped, but such was the state of technology in1987. Again, good luck and best regards,Tom Harley~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ----the doctor who made it was a faci-maxillary something or other (long title),The miracle workers are maxillo-facial prosthodontists. Dr. James Nethery, my dentaloncologist, was also a maxillo-facial prosthodontist. He made a palate for a woman who had



oncologist, was also a maxillo-facial prosthodontist. He made a palate for a woman who hadlost hers to cancer, and she immediately went from unintelligible to speaking clearly withjust a slight nasal twang, and she was unbelievably pleased. I met her months later at amovie theater, and she told me that if it hadn't been for Dr. Nethery, she probably wouldn'tbe there, or out in public at all. Those people can do wonders for a patient's quality of life.---Ron~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Thank you for your response. I have my tongue and soft palate and know little ofrestorative efforts. It is just such a gift--to have members with this information to share andeducate. Janna~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~We agree with Janna. Having members and friends to write and share with each other is agift we give and a gift we receive just being part of the WebWhispers list. (Editors)

News, Views, & Plain Talk by Pat Wertz Sanders, WebWhispers VP - Web Information

Some Comments about a Long Storm

I am one of the lucky ones who didn't get hurt or lose friends or pets or houses or cars anddo not presume to understand the horror and hurt others have gone through.

Roger Jordan writes about leaving Biloxi and going to Chattanooga but Ivan followed. Howdo you get away from a storm the size of Texas that is relentless in it's march through onestate after another, spinning off tornados from it's edges and keeping it's strength long afterit should have settled down to just a bad storm. It was windy and wet everywhere. Scarywith the wind gusts and the trees swirling. A friend had a neighbor's tree to come down onher house and has been told they don't know when the insurance company can sendsomeone because of all the calls. I imagine the roofers and all other workmen will be thesame. And, the damage in this area was nothing compared to other areas.

Judy Ramboldt was going to write something about living through the storms and here isshe emailed about that: "Too many of our friends had bad luck with Ivan. I was going tosort of put a fun-exciting spin on the article. Cannot do that now. I do have a sillyobservation about being without power for a lot of days. If anyone makes an artificialarrangement to be hung over the bed, take care. I created a marvelous arrangement to beabove our new bed with its new headboard. I used sprayed eucalyptus as the base of thearrangement. But.......the green eucalyptus does not like hot weather. What happened wasthat the leaves started to weep with green color. I now have to repaint the wall to cover thegreen streaks on my white walls."

Even those who came through these storms without damage to self and property still have"green streaked" walls, gutters overflowing, unbelievable trash down in their yards, leaksthey didn't have before, water damage, stopped up plumbing, power losses, freezers andrefrigerators to be cleaned out, streets flooded and closed, contaminated water in someareas. Preparations of bringing in lawn furniture, plants and anything that might cause



areas. Preparations of bringing in lawn furniture, plants and anything that might causeproblems outside now all have to be moved back.

I feel like I have been running a marathon. When I gave up on power and decided to go staywith a friend who lived nearby, I had to pack a small bag, close down the house, getsomeone to open my garage door because without power, I cannot lift it, and drive carefullyto my friend's. Traffic lights were not working. (I saw more courteous drivers than I haveseen in years!) and stores along the way were closed. My power came back on later thatnight and the following day, I had company who didn't have power at their home. We takehelp when we need it and give it when we can.

The problem with power outages is so many things don't work that we normally take forgranted. A sort of funny one...some people are so used to their portable telephones thatneed electricity that they had to be reminded that a wired telephone would still work on theirlines. What? A telephone that you have to go to when it rings, one that doesn't walk withyou all over the house.

Those of us who were inconvenienced are so fortunate that all we lost is the cost in time,money and labor to do a clean up. Maybe sometime we can write up suggestions aboutitems that we, as laryngectomees, might have in our supplies and medicine chests to makelife easier for us in times of power outage, contaminated water, and when stores are closed.

In the meantime, we'll remember the folks who had losses that cannot ever be replaced.

Campfire Philosophy by WW Member Paul Galioni

Inside - Outside

A very good friend, since childhood, once said to someone in high school so very manyyears ago, "How DARE you judge my inside by my outside?"

Over the years I have learned what he meant. I knew about his crazy mother who would flipout at any moment and suddenly we couldn't spend the night - let alone go over there. Oneday there was going to be a party and my friend and his sister (my girl friend at the time)and I were going to be getting the front room and living room ready.

Now this was a Victorian house that was built by one of the first judges to sit on theCalifornia Supreme Court - and he built his home on a hill so that it would overlook both thegold domed county courthouse in Auburn with Lady Justice holding a gold leaf scale, butwould also allow him to see the glowing golden dome of the State Capital in Sacramento asthe morning sun caught it and it burst into golden glory. This was from the 'sitting room' -which was just off the front steps and hallway of the Victorian. Across the street was therailroad - the Southern Pacific Line - and down about a half mile, the Auburn Train Station.



railroad - the Southern Pacific Line - and down about a half mile, the Auburn Train Station. In his days as a judge, he had the power to simply put out a flag from a second storywindow and the train would stop and he would be able to take the train directly to downtownSacramento.

Of course, time took its toll on both the prestige of Supreme Court judges but upon thewealth of those who accumulated so much during the boom of the Gold Rush that theending of that seemingly tireless stream of gold was unimaginable - as unimaginable thenas the scarcity of oil was in the 1950's.

So my friend, his sister, and I were getting the house ready for some partying. We hadstraightened up the sitting room and were working on the living room, moving furniturearound, splitting wood for fires in both fire places -- in three hours we expected to have anice party - of the 1960's variety - the smoking was not cigarettes, though there was thattoo, and both were done on the front porch overlooking Auburn and what was then aSmokey and Smoggy Sacramento Valley.

Suddenly, into the house comes my friend?s mother and his brother with the idea that therewas a fortune hidden in the house. They were going to find it. Chef?s knives and cleaverswere first - they were plunged into all the chairs and sofas and divans and window seats. Then came the crow-bars - claw and straight - and then the hammers and axes and wedges. By this time my best friend?s oldest sister had joined in and the youngest sister, my sister?s best friend, had fled the house for our house.

From the outside the house looked like a fairy tale of Victorian ginger bread, wrap aroundporches, small porches off the corner turrets almost hidden in the ginger bread decorations,and facing North and South were great gables and turrets from the third story where therewas a single room, the size of the entire house, floored with virgin California Black Oak. From the great gables one could look across the American River Canyon and see themountains of Lake Tahoe - but more importantly - look upon the lode mines which made theoccupants of the house so very wealthy.

The lawn leading up to the home was terraced and planted with roses and herbs andgrasses which gave hidden coves with stone benches and bird baths. There were fourterraces to reach the bottom of the Entry Stairway which went up fifteen feet, had a landing,and then continued up another twenty feet or so to the porch proper. The house was thestandard Victorian white and would, on those amazing autumn days, reflect the colors ofsunrise or sunset. It had an attic large and tall enough to serve as a dance floor should theoccasion ever arise, which it did every few months for the various holidays. It was also a'smoking room' for the men. The far side had not one, but two slate billiard tables for onlyruffians played pool.

The house was the embodiment of success and good living. Even in its decline, it imbuedan air of achievement, accomplishment, and ultimate Victory.

Inside that house my friend?s mother and his brother and his sister had gone stark ravingmad and were destroying it, literally, before our eyes. Axes were taken to the hand sandedand stained oak and mahogany walls, the polished floor boards were ripped up and thrownaside as the frantic seeking of the imagined hidden treasure of Gold continued.

From the outside the house was the embodiment of Victorian Splendor. On the inside it was



From the outside the house was the embodiment of Victorian Splendor. On the inside it wasthe embodiment of the darkest Victorian Insane Asylum. The scene being acted out wasone of genetic necessity - not one of greed. It was simply nothing more than my friend?smother having one of her more serious breakdowns and it threw the genetic switch in hisbrother and older sister and they joined in, it was an orgy of delusional destruction wherethe energy was synergistic - that is, each person gave each other person the energy theyreceived plus the energy they produced - so the whole of the insanity was greater than the sum of its parts. Mother plus Son plus Daughter was greater than the three of them actingon their own.

The three of us would have fled, but we had to stay there and warn off friends and tell themthat the party had been canceled - as if it weren't obvious by the chairs hurled through thecurved glass at the corners of the sitting room and the insane chatter and laughter fromwithin. My friend ran to his father?s office to tell him ;the first thing to go was the phonelines, and this being a family of great California lineage, using a neighbors phone to call inthe outbreak of an insane episode simply was not done. And from his father?s office hewas able to reach most of the people we were going to smoke and party with that evening.

And so it is with us - we have outward appearances, and internal realities. We hold imagesand embody them with great power - just as the Victorian that my best friend grew up in wasembodied with grace and power of a time gone by,

Even though the original builder and Supreme Court Judge might have been somewhatmore normal, he still had wood shipped from the interior of South America, mirrors shippedfrom Europe - remember this is the 1850's - and it was a crazy expense. And, he hadmarried into a crazy family - the daughter was crazy because early on it was her job tooversee the wash-room of the mine her family owned and they used mercury to process thegold - so while I have seen photographs of her, and can testify that she was a pricelesssterling princess made of Beauty itself - she was, by her early 20s completely insane fromthe mercury which would always find it's way onto the clothes of the miners - for in hard-rock mining even the clothes were washed and sluiced and processed for gold dust - 'fines'they call them because they are so small that only in the hand of an expert panner wouldyou ever recover the gold. In the end, she died of mercury poisoning, after being confinedfor years to the 'downstairs room'. It was what we called it. It had been, in effect, aconfinement room for his great-grandmother and the chains and cuffs still hung on thewalls when each of us took our turn living in the 'downstairs room' sometime or another inour youth.

My best friend?s mother came not from that kind of insanity, but from a nearby family, alsovery wealthy and owners of several very well producing mines. Her insanity was genetic. And every single child, my best friend included, suffers from the same devastating internaldevils and dragons. And, yet, from the outside he is extremely attractive. So much so thathe spawns envy in many. He is like the Victorian on Borland Avenue. It looks beautiful, and we dream about havingthat Beauty.

Now in addition to his barely controlled madness he has the broken body of a mid fifty yearold contractor. He is not what he appears to be, so never judge his inside by his outside.



Dutch's Bits, Buts, & Bytes (1) Home Computer Security (A Personal Summary)

Over the past sixty days or so, I have encouraged ourmembers to make sure their systems are up-to-dateand secure by (1) installing and using Antivirus

software, (2) installing and using Anti-Spyware software, (3) installingand using an Internet Firewall, and (4) making sure their operatingsystems are current (eg: Windows XP, etc.). Having done these thingsmyself, you might be interested to know what these steps have donefor my systems (a desktop PC and a laptop).

My Norton Antivirus program now protects me from over 68,115 knownviruses and screens all out-going and incoming Emails, even thosewith attachments. Since installing and using this system, I haveNEVER contracted an Internet virus. When I first installed "Spyware -Search & Destroy", I discovered that my system contained over 250spyware programs ... some good, but most bad (unwanted). Using"Spyware - Search & Destroy", the number of spyware programs hasbeen reduced to under 10 - and all from companies with which I dobusiness and that support my interactions with them. In the eightweeks after installing the free "ZoneAlarm" firewall, the software has"hidden" my PC and laptop from Internet "bad guys" and stopped over22,000 unsolicited "intrusions", 380 of which were rated "highlysuspect." Finally, my installation of the Windows-XP SP2 patch wentrelatively well. Both the download and installation were easy and user-friendly. The only compatibility problem I found was a small issue withMicrosoft Money - which I corrected using the hints provided onMSMoney's web site. In short, these steps made sense for me andperhaps would make sense for you.

(2) Do you find using the "Google" or "Yahoo" search engines toocomplicated or too comprehensive? A new search engine, four yearsin development, debuted on the Internet on 30 September 2004. It iscalled "Clusty" -- because it "clusters" its results in a way that mayhelp users more easily find what they are looking for. If you get achance, you may wish to check out this new search engine at: http://clusty.com/

(3) The Latest Urban Legends, Email Rumors, Internet Hoaxes, etc.

Courtesy of "Urban Legends & Folklore":http://urbanlegends.about.com/library/blxnew.htm, below are some ofthe major new ones that surfaced during September 2004:

I Can Read Your Mind!

http://clusty.com/

http://urbanlegends.about.com/library/blxnew.htm

http://urbanlegends.about.com/library/bl_card_trick.htm



Here is a well-traveled card trick/mindreading illusion that has popped up again andagain on the Internet. (Added 09/22/04)

Procter & Gamble Boycott (Homosexual Rights)American Family Association email flier urges 'pro-family' readers to boycott Procter& Gamble due to the latter's support for repealing Cincinnati's anti-gay rights charteramendment. (Added 09/20/04)

T. Bubba Bechtol on the Torture of Iraqi PrisonersEmail flier claims T. Bubba Bechtol, supposedly a part-time city councilman inPensacola, Florida, was ejected from a radio studio for remarks defending the tortureof Iraqi prisoners. (Added 09/13/04)

Hillary vs. ArnoldDid Hillary Clinton and Arnold Schwarzenegger exchange insulting witticisms during achance encounter at a party? (Added 09/10/04)

The Hands of God (Hurricane Charley Photo)Emailed image purports to show the 'hands of God' in a cloud formation associatedwith 2004's Hurricane Charley. (Added 09/07/04)

ListServ "Flame Warriors"

Terms of Importanceflame 1. n. A hostile, often unprovoked, message directed at a participant of an internetdiscussion forum. The content of the message typically disparages the intelligence, sanity,behavior, knowledge, character, or ancestry of the recipient. 2. v. The act of sending a hostile message on the internet.

flame warrior 1. n. One who actively flames, or willingly participates in a flame war ... (Another ExampleBelow) ...

GARBLE

http://urbanlegends.about.com/library/bl_procter_gamble_boycott.htm

http://urbanlegends.about.com/library/bl_t_bubba_bechtol.htm

http://urbanlegends.about.com/library/bl_hillary_arnold.htm

http://urbanlegends.about.com/library/bl_hands_of_god.htm



Garble is a mystery: Is he a foreigner with only tenuous grasp of English?Is his brain addled by some powerful drug? Does he suffer a serious mental debility? Is he typing wearing a catcher's mit? Garble's rampanttypos, malapropisms and seemingly aggressive use of execrable grammar can't be explained merely in terms of poor typing skills or thelack of a spell checker. Even non-English speakers generally do a betterjob of punctuation grammar and capitalization, and Garble is all the more puzzling because if one goes to the trouble of wading throughthe muddle of his messages a discernable idea will usually emerge. For example, in a forum discussion about a painting he might say, "Sorry the picchr the har is wrog. The culir. I liike the lips bot teh Paintngis sucs". When attacked for his random capitalization Garble might respond, "oPS i HITTED THE CAPDLOCK". Not surprisingly, he drives usall absolutely nuts, but he is utterly impervious to any sort of correction and if our attacks persist he will sign off in a huff with something like, "yuor forum si stupef. bYE!"

Above courtesy of Mike ReedSee more of his work at: http://www.winternet.com/~mikelr/flame1.html

Welcome To Our NewMembers:I would like to welcome all new laryngectomees, caregivers andprofessionals to WebWhispers! There is much information to begained from the site and from suggestions submitted by ourmembers on the Email lists. If you have any questions orconstructive criticism please contact Pat or Dutch [email protected].

http://www.winternet.com/~mikelr/flame1.html

mailto:[email protected]



[email protected].

Take care and stay well!Murray Allan, WW President

We welcome the 20 new members who joined us during September 2004:

JoAnne Beecher - CaregiverDubuque, IA

John BergvallInternational Falls, MN

Annette Cartman - CaregiverChicago, IL

Tom DavinMechanicville, NY

David FelskeSun City West, AZ

Alexis FigueroaNew York, NY

Bob HanksBullhead City, AZ

Hal KingOrient, WA

Regina Kahnert - R.N.Cleveland, OH

Gerald KennedySaint Clair Shores, MI

Richard KromerSandusky, OH

Kevin & Cindy KuckerCatonsville, MD

Teresa Loffer - CaregiverLindsborg, KS

Kathy LutmanSalina, KS

Michael MacMahonCorofin, Co. Clare, Ireland

Hugh McGrathHitchin, Hert., UK

Richard Palmquist - CaregiverScottsdale, AZ

Byron RegnierMarshall, MN

Ursula StriderWaynesboro, VA

Brandon Whitesides - Vendor (ATOS)Milwaukee, W

WebWhispers is an Internet-based laryngectomee support group. It is a member of the International Association of Laryngectomees. The current officers are: Murray Allan..............................President Pat Sanders............V.P.-Web Information Terry Duga.........V.P.-Finance and Admin. Libby Fitzgerald.....V.P.-Member Services Dutch Helms...........................Webmaster

WebWhispers welcomes all those diagnosed with cancer of the larynx or who have lost their voices for other reasons, their caregivers, friends and medical personnel. For complete information on membership or for questions about this publication, contact Dutch Helms at: [email protected]

Disclaimer:The information offered via the WebWhispers Nu-Voice Club and in

http://www.webwhispers.org is not intended as a substitute for professional medical help or advice but is to be used only as an aid in

understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

As a charitable organization, as described in IRS § 501(c)(3), the WebWhispers Nu-Voice Clubis eligible to receive tax-deductible contributions in accordance with IRS § 170.

mailto:[email protected]



? 2004 WebWhispersReprinting/Copying Instructions

can be found on ourWotW/Journal Page.

http://www.webwhispers.org/pages/Journal.htm

murray's mumbles musings from the

Documents