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There are three phases of management for laryngectomy: pre-operative, operative, and post-operative management. Each phase has its advantage and goals. A speech therapist plays vital roles in the first and last phase.
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Consulting a speech therapist during the first phase is equally important with seeing a therapist during the last phase, which is when voice rehabilitation really begins.
A speech therapist also has different roles in each phase, that’s why it is vital for a therapist to know the two phases he plays a role in.
Pre-operative Management
Pre-operative management includes informing the patient of the anatomical changes, and expectations regarding swallowing, voice, and the family as a part of the team. The therapist also informs the patient on the different speech options he has after the operation.
During this phase, the speech therapist should initiate ordering of the hardware or alternative means of communication. The therapist should also be open to questions that the patient may come up with. This is also the time for him to establish rapport with the patient.
The therapist can also offer re-assuring consultation with appropriate laryngectomee volunteers. This is also the time where he assesses the pre-laryngectomy speech and cognition of the patient. The laryngectomee is also informed with his prognosis, where the potential for recovery and long-term rehabilitation is discussed.
The advantages of this phase would be the evaluation of preoperative speaking skills such as speaking rate, articulation errors, accent patterns, oral opening degree when speaking, and vocal parameters. Cognition and hearing is also evaluated, along with oral-peripheral-mouth strength and sensation. The family can also get emotional support in this phase.
Assessment is done by the use of modified barium swallowing or Fiberoptic Endoscopic Evaluation of Swallowing. The patient’s communication needs are also assessed where living situation, occupation, social requirements and hobbies are looked at.
Postoperative Management
During this phase, the therapist is given an opportunity to help lessen the patient’s fears, and depression. He should also help the patient to accept the loss of voice and swallowing difficulties. The motivation of the patient should be increased, so that he can easily learn how to use alternative speech. Social implications are also addressed. Arrangements for voice rehabilitation are also done during the early parts of this phase.
Firs off, the therapist should confirm if the patient is already medically cleared for therapy. Then he should review the treatment procedure, re-evaluate the patient’s swallowing function then give diet recommendations, and create a treatment plan.
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Problems Encountered During Postoperative Management
After the operation some problems may still occur. With regards to Tracheostomy, the patient and therapist should always be watchful of stoma hygiene, cannula hygiene, stoma covers, excessive mucus in the trachea, mucus encrustations in the stoma, and stoma safety and first aid.
There could also be problems related to taste, swallowing, smell and digestion. The patient may find it difficult to trap air within the lungs. This can lead to difficulties in creating internal subglottic pressure, elimination of body waste and childbirth.
Problems of social adjustment may also be present. The patient may find it hard or embarrassing to use alaryngeal speech in public. The altered physical appearance of the patient may also be an issue. Sometimes, the laryngectomee also has unrealistic expectations regarding acquisition of alaryngeal speech.
Commercial Waste Management
If you are like me, you’ve often wished there were 48 hours in a day instead of just 24. There never seems to be enough time to get everything done that you want. Since we just have about 16 hours a day not counting sleep time, it’s important how we use the time we have.
On the average, people waste about 2 hours a day. This is mainly from poor planning. If a person is unorganized, they waste time trying to find things, they miss appointments, they only do one thing at a time when they could be doing two.
Good time management is a major building block to success. Oftentimes, it’s not how much time we spend working but how efficiently we do the work. The key to successful time management is careful planning and setting priorities.Plan your day, your week, and your month in advance. Know when things need to be done. A great way to “buy time” is to multi-task. Do more than one thing at a time. There are many things that do not require concentrated mental effort. These are more easily combined.
“Failing to plan is planning to fail,”
-unknown
Even though I am a big pro football fan, I can’t justify sitting down and spending three hours watching a game. I have to be doing other things while I do it. Thank goodness for instant replay! I’ve found this is a good time to spend icing injuries or some other busy work. I can also record the games and watch them while exercising. I exercise about 30 minutes a day so during the football season I can watch a game during the week without wasting any time doing it.
When you run errands try to do as many as you can on one trip. If you are self-employed, you can combine personal errands that are on the way to a business errand and have the mileage written off as a business expense.
I’ve been fortunate to have been able to work at home for the past ten years. It’s been great because I hate to waste time commuting. If you must commute, you can use the time to listen to audio self-improvement tapes, audio books or anything educational.
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If you are a regular exerciser and belong to a gym, think about working out at home. If you lack the space and money for exercise equipment, try traditional body weight exercises. A little research on the Internet can show you websites devoted to this subject.
Even though I lifted weights for 20 years, I’ve converted to body weight exercises. I’ve found they feel better and get the same if not better results. Of course, if you go to the gym to socialize or network, that’s okay. You’re doing more than one thing at a time. You can go walking with your wife. That way you’re getting exercise and husband / wife interaction at the same time.
Setting priorities enables you to get the most important things done. Keep you eye on the big picture. Don’t let low priority things bump off the higher priority tasks from your schedule. If you’ve only got so much time, it’s imperative you spend your time doing the things that bring you the most benefit.
“Things which matter most must never be at the mercy of things which matter least.”
– Goethe
Time is so precious. If you want to be successful in life you need to be spending more time being productive and doing things that are moving you forward. Spending hours a day watching TV, playing computer games, or surfing the Internet is not productive time usage.
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We all need downtime but you need to determine how much is really necessary. If you use your productive time efficiently then you will have more time to relax and do the fun things.
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Having effective time management skills means that you are able to utilize your time and get a list of things done in an established time frame. When you are able to accomplish all tasks on a list in the given time, you know you have good time management skills.
You can see the problems it would cause if the time management skills are lacking or missing all together. Because things are accomplished on time, or there is time not accounted for the day can be wasted and your job could be impacted. There are effects emotionally when we have the feeling of failure, and that we have wasted away a day when we could have been doing something else.
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Planning your day to day activities can become a lot easier if you keep a planner. Before you start planning in a day to day planner you have to examine the things you are doing to waste time, and eliminate them. Once you have done this you can go onto the next step; when you plan out your day stick to some basic rules, and good old common sense. You shouldn't plan over 168 hours of your week.
Also, remember to take sleeping and eating into account, or other necessary activities. Another good rule is to be realistic with your goals. If you know a project is going to take you 20 minutes, don't write 15 minutes down.
Employers like to see people who have good time management skills. If an employee doesn't use good time management skills than profits could be lost, and the boss is not likely to be happy with that outcome. People who do not have good time management skills are usually deemed lazy and unproductive. It will be hard to hold down a job with those qualities on your resume.
If you would like your life to be more productive and more rewarding then you should consider adopting good time management skills. To successfully acquire these skills you need to follow the plans and goals you set for yourself each day. It is not hard to develop good time management skills, but it does take some time. You will need to have discipline to convert old bad habits, into positive new ones.
When you use your time effectively then you will find yourself feeling less stress, and having more time in the long run to enjoy your life, and also your work.
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How To Travel And Still Recycle
There are so many ways that we can choose to stay environmentally contientious when we travel that there really is no excuse for not doing it.
Here are a few ideas for families that are traveling and still want to stay in their recycle-conscious state of mind.
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Before you even leave your home there are ways that you can help save energy and waste. Turn your thermostadts down on your home and your hot water heater. Some heaters have a "Vacation" setting right on them that can be used to set the temperature when no one will be around to need the heat. Just keep in mind the plants that are left behind and as long as they will not be killed off due to the temperature change, you're set.
Be sure to turn off your outside water source, in the event that there is a pipe break while you're away, this will minimize the damage. When you return home, turn the water back on slowly, where you will be able to be aware of any issues or leaks that may have occurred.
If you are going to be away from home for a few days, stop your newspaper delivery. That way the paper won't be left to end up in the trash receptical and waste your time when you return home, sorting through what is relavent mail and what is not. You may even want to check to see if your paper can be donated to a school or non-profit organization, where it will be used in your absence.
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If you or someone else in your home sleeps on a waterbed, turn the temperature down on that while you're away, you can go as low as a ten degree difference and it will impact your energy useage. If you have a refridgerator with the ability to make ice cubes, be sure to turn that part off by lifting the wire, and you can lessen the risk of flooding should it break while you're away.
There are airlines that offer electronic ticketing and by using these services will cut back on the paper waste generated by the airline, on a daily basis. There are even some airlines that charge a fee if you have lost a paper ticket, so rid yourself of any of those problems by opting for the paper-less airline ticket options.
If you are heading out of town, before you leave, go around the house and unplug the items that you would normally leave plugged in, like the TV, the computer, cable converter boxes, appliances, VCRs, stereos, etc. If these items are left plugged in to the outlets they can still draw or "leak" energy, even up to 40 watts per hour, even if they have been turned off.
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I think this is one of the most important messages to get across before you leave for a vacation; even if your electronics are turned off, they can still cost you money if they remain plugged in. Do yourself a big favor and always be sure to check these items before walking out the door to your vacation.
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10 Profitable Ways To Recycle Your Content
1. Repackage your web site content in to different products to sell. You could create speeches, audio books, classes, and video tapes with your content.
2. Divide your content up and use it for promotional articles.
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You could submit them to other web sites or ezines for publicity. Just add your resource box.
3. Allow people to link to your web site's content. This is a fast way to get hundreds of people linking to your web site.
4. Add to your content and create an ebook to sell. You don't want to sell your free content, but if you add to it you can. It's an extra profit stream.
5. Compile it into a free ebook. You could submit it to free ebook directories. Use it as a bonus for when people subscribe to your e-zine.
6. Use your free content as a lead in product for your fee based content or private site. Just allow them the option of up grading to the paid version.
7. Place it on follow-up autoresponders from your web site. This is a great way to remind people to come back and revisit your web site.
8. Create a free bonus out of your content for your main product. When you add new content, remove the old content and create a bonus product with it.
9. Use the content to create a press release. This works well if you need extra information for your press release announcement.
10. Trade content with other web sites. It will give you the chance to get new content and promote your web site at the same time. ----
