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HINTS & TIPS     last modified November 3, 2011

ALOE VERA AND RADIATION

This advice was posted on the internet by Paul Galioni in the US.
I am a firm believer in Aloe Vera Gel for use during all phases of XRT ( radiation treatment ). While it may seem very hippy-dippy there is firm medical evidence that it helps prevent scarring and helps reduce the swelling that goes along with all kinds of burns.
When I was undergoing XRT I was using aloe vera a couple to a few times a day (morning-noon-evening) and when I would run out, I found that my voice which had remained very near 'normal' was suddenly 'raspy'.
When resumed the Aloe Vera (about 2 ounces three times a day -- ALWAYS AFTER RADIATION) I found that within a few days my voice returned to near normal again.

This is PURE Aloe Vera gel or gel mixed with something like Spanish moss as a thickener. Don't drink Aloe Vera sun cream or aloe vera shampoo etc -- just plain aloe vera. You can buy it at a health food store, and it should come in a dark glass bottle. This keeps the air and the sunlight from changing the chemical structures of the substances which help you. It also keeps it from going rancid on you.

The texture is sometimes a turn off and often people find the taste not to their liking. I found, however, over time, that I came to enjoy both. Like my mother said about Scotch: it is an acquired taste which drives men mad" -- and I found the same is true of aloe vera, much as with pasta or rice -- a day without aloe vera is a day without the sun.
It will not work magic overnight -- but it will reduce a lot of the swelling and you should notice that the voice has become noticeably less raspy over the course of several days to a week.

Sometimes people may experience loose bowels after using aloe vera in elevated amounts. This is because the layer right under the skin is a substance which was the main ingredient in laxatives until well into this century and many laxatives still use it as one of the active ingredients. But some companies use more of it than others -- either the cutting and slicing is done by machine, or they are trying to exploit as much of the product as they can. It will not give you loose bowel movements if just used as a topical (on the skin) lotion, but if you drink it, the aloe vera that has the layer right under the skin may give you loose bowels. Just use less.
It can be mixed with other juices if you find that sipping it cold and straight from a shot glass isn't pleasant.

I liked mine very cool, and would let it just dribble down my throat -- it helped cool the burn and I imagined that it was sticking there and doing more good than if I had just slammed back a couple of ounces. Radiation burns make tissue swell up, and that includes the tissue that makes up your vocal chords. Aloe Vera not only helps take away this swelling, it also prevents scarring of the area -- which might lead to a very radically hoarse voice post XRT. Aloe Vera is not a wonder drug -- it just happens to be one of the many botanicals which has a good history of helping and a past history of actual scientific trials which support the two abilities I mentioned above: anti-inflammatory and anti-scarring.

So, no wild claims here -- just that Aloe Vera will probably help more than it would hurt -- and of course the proviso: tell your doc. Most likely aloe vera will be viewed as a very benign thing and the doc will say: well if you want to waste your money go ahead. Some might recognise it's potential and say: well It won't hurt the process. I would be surprised to see any doc say NO! WHAT A STUPID IDEA. But it is only courteous to ask your doctor.
Good luck. Don’t worry, it is common to swell and scar a little during XRT.

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ARTIFICIAL LARYNX PLACEMENT

A large number of Laryngectomees use an electronic artificial larynx device for communication. These devices are placed against the neck or cheek to generate a tone that is used for speech.

There are a number of variables that determine the success in using an artificial larynx and the major one is finding the "Sweet Spot", that one particular spot that makes all the difference. The Speech Pathologist's job is to find the Sweet Spot, the one or two locations that most effectively transfers the speech signal into the pharynx and mouth for speech. Failure to make proper placement will result in unintelligibility, excessive noise, poor signal transfer and a frustrating lack of clear communication. After surgery the Sweet Spot may be hard to find and changing position. This is mostly due to edema in the head and neck region, which can last for weeks or even months after the operation. Because of these changes it is good to recheck for optimal placement.

When a Sweet Spot is found, the patient should practice to consistently and automatically place the device. Using a mirror and/or marking the spot can be helpful in achieving the objective. Ear training and audio-recording could also assist in consistently locating the Sweet Spot.

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CANDIDA

This subject has been covered before and there is nothing new to add at this time, however, new laryngectomees using a voice prosthesis could find the information useful.

Candida is the yeast infection which colonises the voice prosthesis and eventually causes leakage of liquid into the windpipe and/or makes voice production difficult. There are a number of strategies you can adopt to eliminate or at least control candida. Take Nilstat "Nystatin" oral drops; an eyedropper comes with the bottle, swill an eyedropper full around your mouth, and gargle, for at least four minutes before swallowing. Use as often as you consider necessary, personally I use it once a day before going to bed. Also available in tablet form is Fungilin which in my case proved the most effective.

When changing your prosthesis, coat the inside of the internal flange of the fresh prosthesis with Daktarin Oral Gel before insertion. The removed prosthesis should be thoroughly cleaned and then soaked in Hydrogen Peroxide solution or Milton for at least 24 hours. Always rinse thoroughly after soaking, and always use a fresh solution each time you soak a prosthesis. As you can see it pays to use two prostheses in rotation. Bear in mind that Hydrogen Peroxide is not specifically recommended by manufacturers and may even degrade the silicone, however, I have never experienced any significant problems.

Reduce your consumption of alcohol, especially beer. Cut down on lollies, cakes and sugary foods. After drinking beer or eating cakes drink water or lemon juice to rinse your mouth. A good idea is to keep a jug of water containing slices of lemon in your fridge. You can use a syringe to clean your prosthesis in situ. Squirt water through the prosthesis to flush out food particles and liquids which contribute to yeast build up.

Reflux can also encourage Candida growth, slippery elm powder mixed into a little milk or a number of proprietary remedies can be used to combat this Acidophilus yogurt is a good way to finish a meal with a view to attacking Candida, Vinegar has also been suggested to me (revolting but Cider Vinegar with a little honey is quite palatable). Also Pro-Biotic tablets (Acidophilus)

An indwelling prosthesis is now on the market which has a small amount of silver oxide in it. Silver oxide is known to have anti-fungal properties and so should help limit yeast development. This product is now showing up in the clinical population and more should be published about the effectiveness or otherwise of the device. The 'Voice Master' prosthesis from Holland has a body which consists of a titanium sleeve which is apparently resistant to the growth of Candida.

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CHRISTMAS GIFT IDEAS FOR THE LARYNGECTOMEE

Support the Cancer Council by buying a present from one of their stores. They have a range of products including sun hats, sunglasses and sunscreens etc. The Cancer Council has stores in the City, Chatswood, Hornsby, Miranda and Brookvale. The City shop is located at Shop 35 at Centrepoint. For merchandise information and catalogues ring 02 9334 1953.

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COVER-UP

In addition to the aesthetic consideration and the possibility of offending some people’s sensitivities, some of the main benefits that flow from wearing them are:

  1. Stoma covers perform some functions that used to be carried out by the nose and mouth, such as filtering airborne dirt, bacteria and other harmful particles.
  2. They help in retaining a little moisture from the lungs that would otherwise be dissipated.
  3. They hold a little warm air to mix with the incoming cold air.

The main reason given for not wearing a stoma cover was that it interfered with the intake of air. In fact, some resistance to breathing is beneficial to pulmonary (lung) function, which is why Heat/Moisture Exchange (HME) filters are recommended.

Apparently, not wearing a stoma cover can increase your susceptibility to respiratory ailments such as pneumonia; cause you to cough more; increase mucous production which in an extreme case could give rise to a life threatening mucous plug; increase bleeding with the potential for infection; more crusting, with the potential of a blockage in the airflow; reduce pulmonary function with the lessened air resistance.

If you are one of the non-stoma cover wearers, here is a four step plan to get you into the habit of wearing one.

  1. Begin with an open weave cover such as a lightweight, lint-free crocheted one
  2. Wear it when you’re not engaged in any physical activity, including talking.
  3. Gradually lengthen the time you wear it.
  4. When comfortable with that one, go for a tighter weave, or a foam one.

And yes Ladies - a stoma cover can look attractive!

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EMERGENCY CALL

I have been advised by the Department of Communications, Information Technology and the Arts that there is now a facility for dialing 000 when you are unable to speak.
This feature is known as the 'Caller No Response' process, which is designed for people who, through impairment, injury, illness or other circumstances, are not capable of speech at the time of calling 000. This process follows the standard Telecom procedure of asking each 000 caller: 'Emergency: Police? Fire? or Ambulance?' If there is no response, the question is repeated. If there is still no response, the call is then transferred to an Interactive Voice Response (IVR) system that will advise callers: 'You have dialed Emergency 000. If you require emergency assistance please press or dial '55' and your call will be connected.'

If the caller presses or dials '55', the call will be transferred back to the Telstra operator and on to the police.
Police will then take action to trace the location of the caller and provide emergency help. If the caller does not press or dial '55' after being asked three times to do so, the IVR will disconnect the call. I guess that is in case a baby or animal accidentally dials 000.

( I have some reservation as to whether this is still available and am currently checking it out and corresp;onding with the minister for health (Jan07))

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EnableNSW notes November 3, 2011

EnableNSW provides aids and equipment (assistive technology) to eligible residents of NSW with a permanent or long term disability. Assistance is provided in the areas of communication, mobility, self care and respiratory support. Programs administered by EnableNSW are: Aids and Equipment (formerly PADP); Home Respiratory Program (HRP); Prosthetic Limb Service (PLS).

Requesting assistance through EnableNSW involves the submission of an application form and an equipment request form. EnableNSW then reviews the information to assess whether the device can be provided within program guidelines.

There is a co-payment for accessing most services through EnableNSW. The co-payment for adults on a pension or low income and for children under 16 years is $100 in each year that additional assistance is provided. For adults on higher incomes the co-payment is 20% of the cost of the device. Please note that adults on higher incomes are not eligible for devices costing less than $800.

For more information about EnableNSW please visit www.enable.health.nsw.gov.au, or contact EnableNSW by email, enable@hss.health.nsw.gov.au or phone, 1800 ENABLE (1800 362 253). The following is their link to the Aids and Equipment Program (formerly PADP).

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FLU VACCINATION

Talk to your Doctor about flu vaccine early in the year. It is strongly recommended for those over 65 and is available free of charge to pensioners. The best time to be vaccinated is in autumn. For most people influenza is a moderately severe illness but the dangers of flu are the complications. The most common complication after flu is pneumonia (infection in the lungs). It can also worsen heart conditions, asthma, chronic bronchitis, diabetes and kidney disease by making a weak body work harder. People with lasting health problems such as these, people over 65 years of age, and anyone undergoing treatment that may suppress their immune system are advised to have flu vaccine. Also the pneumovac is important and this is only every a 5 year injection.

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GLOSSARY OF TERMS

Artificial Larynx (AL): An Artificial Larynx works by electronically or pneumatically producing a tone that substitutes for the vocal chords. The Artificial Larynx produces a voice that would not otherwise be there. There are a large number of electronic Artificial Larynges but a more restricted range of pneumatic ones.

Biopsy: Taking a sample of tissue for examination to determine whether or not cancer cells are present.
www.cancerguide.org/pathology.html

Calcium: Calcium is not only essential for healthy bones but also aids muscle contraction, heart action, vitamin B-12 absorption and blood clotting. Hypoglycemia (low calcium) can affect the nervous system and cause spasms, muscle cramps, abdominal cramps etc. Calcium deficiency can lead to poor mineralisation of bones, osteoporosis etc. Foods containing calcium include dairy products, broccoli, spinach, salmon, oysters, tofu etc. The ideal daily intake of calcium is 1,000 to 1,300 milligrams. Over 2,500 milligrams per day can lead to hyperglycemia and associated problems.
www.wellsphere.com/wellpage/dangers-of-low-calcium-levels-after-thyroid-cancer-surgery

Cancer: A group of different and distinctive diseases. Cancer refers to cells which grow abnormally in an uncontrolled fashion. Any tissue in the body can be involved and there can be many different forms of cancer in each area of the body.

Candida: Variety of thrush that colonises voice prostheses causing them to leak. Controlled by soaking prosthesis in hydrogen peroxide or Milton, coating flange of fresh prosthesis with Nystatin gel, gargling with Nystatin drops, using slippery elm powder, Fungilin (on prescription) and eating acidophilus yogurt. Avoid consuming yeasty food and drinks.
altmedicine.about.com/od/popularhealthdiets/a/candidadiet.htm

Chemotherapy: Anticancer drugs can be given into a vein, muscle or orally. Chemotherapy is usually given in cycles i.e. a period of treatment followed by a period of recovery. Side effects can include loss of appetite, vomiting, hair loss and mouth sores. The side effects tend to go away after treatment stops. In younger people, chemotherapy can result in a loss of fertility.
medicinenet.com/chemotherapy/article.htm

Depression: Depression often goes undiagnosed and untreated. Emotional reactions including depression are experienced by most people who are diagnosed with cancer. Depression is readily treatable with medications, counseling, or a combination of both. See your family doctor, psychiatrist or psychologist for diagnosis, referral, and/or treatment.
www.healthyplace.com/communities/depression/nimh/co_occurence_depression_cancer.htm

Dry Mouth: See Xerostomia.
www.medicinenet.com/dry_mouth/article.htm

Fistula: A fistula is an abnormal passageway in the body. For laryngectomees we are usually referring to the hole running from the stoma to the oesophagus.
en.wikipedia.org/wiki/Tracheo-oesophageal_puncture

Granulation: Is the part of the healing process where rough pink tissue, which contains new connective tissue and capillaries, form around the edge of a wound. Granulation is normal and desirable.

Grief: Psychiatrist Elizabeth Kubler-Ross describes a five stage grieving process, and becoming a laryngectomee represents one or more losses we have to work through. The five stages are: Shock and Denial, Anger, Bargaining, Depression and Acceptance. When you reach acceptance you are ready to get on with your life.
www.recover-from-grief.com/kubler-ross-stages-of-grief.html

Laryngectomee: A person with a permanent stoma resulting from a laryngectomy operation.

Laryngectomy: This is the surgery to remove all or part of the larynx or voice box with a stoma being created in the front of the neck. A partial laryngectomy preserves the voice as only part of the voice box is removed and the stoma is only temporary. With a total laryngectomy the whole of the voice box is removed and the stoma is permanent.

Larynx: This is the voice box, located between the pharynx and trachea and is used in speech, breathing and swallowing.
www.medicinenet.com/larynx_cancer/article.htm

Lymph Glands: Small, bean shaped organs in the lymphatic system which contain cells that can trap cancer cells and bacteria being transported in the lymph fluid.
www.cancerhelp.org.uk/about-cancer/what-is-cancer/body/the-lymphatic-system

Oncology: Is the field of medicine concerning cancer. Medical oncology is the treatment of cancer with chemotherapy. Surgical oncology covers biopsy, staging and the resection of tumours. Radiation oncology is the treatment of cancers with radiotherapy.

Prosthesis: A prosthesis is any artificial replacement of a body part and can be temporary or permanent. In laryngectomees we usually refer to a voice prosthesis, which is a one-way valve connecting the airway to the oesophagus which supplies air for producing a voice.

Radiotherapy: Use of high-energy rays to destroy cancer cells, stopping them from growing and dividing. Radiotherapy can be by machine or by implants of radioactive material in or near the tumour. Side effects include tiredness, skin reactions, loss of appetite etc. Most laryngectomees receive radiotherapy around the neck area after surgery.
www.cancer.gov/cancertopics/factsheet/Therapy/radiation

Reflux: Gastro-oesophageal reflux disease (GORD) { or Gastroesophageal reflux disease (GERD) US } is where acid from the stomach is regurgitated back up the oesophagus, sometimes reaching the throat. This causes coughing attacks from the burning sensation that is created, damage can occur to the lining of the oesophagus. There are many proprietary medicines to combat GORD, slippery elm powder can also be effective.
http://www.heartburn.com.au/

Stent: A stent is a tube that is used to keep a passageway in the body open, for example in keeping the fistula between the airway and oesophagus open when there is no prosthesis in place.

Stoma: Any opening into the body from outside that is created by a surgeon. In our case it is the entry for the direct airway to the lungs.

Sweet Spot: Refers to the one or two locations on the neck or cheek that most effectively transfers the speech signal of an electronic artificial larynx into the pharynx and mouth for speech.

TEP: Tracheosophageal puncture. This is the fistula between the airway and the oesophagus, where the prosthesis sits.
www.larynxlink.com/Library/Laryngectomee/tep.htm

Thyroid: Often removed in total laryngectomy, the thyroid is located around the trachea below the larynx. Hormones that regulate growth and metabolism are made and stored in the thyroid, controlling heart rate, blood pressure, body temperature and the rate food is converted to energy. The correct dosage of thyroid hormone replacement tablets must be taken each day after thyroidectomy.
www.thyroid.org.au

Tracheostomy: This is the surgical operation that creates the stoma in your windpipe when the larynx is removed. They are also performed to create a temporary airway in an emergency.
www.medicinenet.com/tracheostomy/article.htm

Vapourisers: A vapouriser is useful in helping to keep your stoma and airway from drying out, particularly in winter. Radiators and heaters can make for a dry environment, a bowl of water placed near the heater can maintain humidity.

Vitamin C: An essential nutrient found in fruits and vegetables that must be replenished daily. Vitamin C or Ascorbic Acid helps produce collagen, a protein needed to develop and maintain healthy teeth, bones, gums, cartilage, vertebrate discs, joint linings, skin and blood vessels. It also promotes healing of wounds, fights infection, dilates blood vessels, regulates cholesterol levels, aids iron absorption among numerous other things that keep you healthy.

Vitamin E: An antioxidant vitamin that binds oxygen free radicals which cause tissue damage. Vitamin E deficiency can cause anaemia. Research is being conducted into the role of Vitamin E in preventing heart disease and cancer of the lung and prostate.

Xerostomia: From the Greek meaning 'dry mouth'. Associated with hypothyroidism and radiation, xerostomia results from inadequate function of the salivary glands and can lead to increased tooth decay and thrush. There are a number of proprietary products that combat xerostomia.
www.medterms.com/script/main/art.asp?articlekey=6041

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PALLIATIVE CARE - WHAT IS IT?

When a person is suffering from an illness such as cancer, and it will no longer respond to treatment, they can receive a special kind of care called palliative care. The word "palliate" means to alleviate without curing.

WHAT DOES IT AIM TO DO?
The main aim of palliative care is to provide the patient and their family the best quality of life. Coping with a terminal illness will obviously bring with it many different kinds of problems such as physical pain and spiritual or emotional problems. Palliative care not only provides medical services but also a support network for the patient and his family and friends. It can help to ease the physical pain and also refer the patient to specially trained palliative care workers such as chaplains and counselors who can help the patent to deal with other more personal spiritual or emotional problems they may be facing. Palliative care also tries to help the patient's family and friends during this difficult time. They too will have particular problems to cope with. They will need to be prepared for the eventual passing away of their loved one and they may also need help and support during the grieving process.

WHO PROVIDES PALLIATIVE CARE?
Because the patient can receive care from a range of medical and other services, the people providing the care need to coordinate and work together as a team together with the patient. The kind of people involved in palliative care services include doctors, nurses, chaplains, carers and volunteers. Family members can also play an important part in this team. All of these people consult with the patient to make important decisions such as the kind of care that the patient would like to receive, the best time to begin care, where it will take place and who will be involved. Palliative care aims to maintain the person's independence by including them as much as possible in decision making related to their care.

WHAT KIND OF SERVICES ARE PROVIDED?
Many different services are available for the benefit of patients and their families such as medical care, nursing, spiritual guidance, loan of equipment, physiotherapy, occupational therapy, day care, counseling, diet advice, bereavement support and social workers.

CAN PALLIATIVE CARE BE IN YOUR OWN HOME?
The patient can choose where they would like to access palliative care. Depending on their circumstances a patient may prefer to be cared for in their own home. Hospitals and other types of medical institutions may be rather threatening to some people. Some people may prefer to stay at home because it may be easier to continue their usual way of life with fewer disruptions and they may of course feel happier and more comfortable at home in their normal surroundings. They may feel worried about losing their independence if they go to a hospital or similar institution where they feel more dependent on others. For older people a hospital may be difficult to adjust to as everything is unfamiliar. However, people who are unable to continue living at home because they don't have assistance from family or friends, or are too frail to look after themselves, may prefer to receive palliative care in a nursing home, hospital, hospice unit or other health care facility.

WHAT IS A HOSPICE?
This is a place where specially trained doctors, nurses, or other health workers care for people who are terminally ill. Sometimes a person can go into a hospice for just a short time to give their carers a rest or receive medical attention and have their symptoms eased, and return home again.

WHEN IS PALLIATIVE CARE GIVEN?
This is discussed with the patient. As the aim of palliative care is to help the patient remain in control of their life, important decisions such as these are made in cooperation with the patient who may prefer to have palliative care at the beginning of their illness or later in the course of the disease.

WHO CAN GET THIS KIND OF CARE?
Anyone can receive this kind of care. It doesn't matter what race, culture or background a person comes from or what religious beliefs a person has. Palliative care aims at providing for the special needs of people from non English speaking backgrounds and indigenous people. If a person comes from a particular culture or belongs to a particular religion for which there are special needs palliative care can provide assistance.

HOW CAN I GET PALLIATIVE CARE?
A persons doctor can give them a referral or it can be arranged through a hospital or community based palliative care service such as the one below.

WHERE CAN I GET MORE INFORMATION?
Further information can be obtained from the State or Territory Palliative Care Association listed in the "Contact Us" area of the following web site:
http://www.pallcare.org.au
Or
The Palliative Care Association of N.S.W
153 Dowling Street
Woolloomooloo 2011
PO Box 572
Kings Cross, 1340
Tel {02} 9334-1891
http://www.palliativecarensw.org.au

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RADIOTHERAPY AND TEETH

Radiotherapy in the head and neck area can play havoc with your teeth with xerostomia or dry mouth being the most common side effect. Your salivary glands are highly susceptible to radiation and if they are affected their full function, generally, will not return.
To counteract Xerostomia a number of medications, gels, sugarless chewing gum and sugarless lollies are available. Probably the best approach is to have frequent sips of plain water throughout the day to maintain the moisture inside the mouth. Severe Xerostomia can cause cavities which start at the gum line and strangulate the teeth.

Saliva serves a number of functions for your teeth:
1) it washes the teeth, removing food particles, sugars and starches
2) it contains antibodies and enzymes that kill or prevent cavity forming bacteria
3) it works as a neutralizer for acids produced by plaque bacteria.

Prior to radiotherapy a careful dental examination must be undertaken to determine if any teeth need to be extracted. Any poor or doubtful teeth should be extracted then two to three weeks must elapse after an extraction, especially in the lower jaw, before starting radiotherapy.
To prevent cavities in any remaining teeth, daily fluoride treatment should be employed for the rest of the patient's life even if some salivary function returns.

Should you ever require a tooth extraction, DO NOT let your dentist perform the extraction without first consulting your radiation oncologist. One possible complication of radiotherapy can be osteoradionecrosis which causes disruptions in the blood supply where a tooth extraction could destroy the jaw bone which would then not heal.

Any tooth extraction or other surgery would need to be preceded with hyperbaric oxygen treatment. This increases the blood supply and allows for more successful healing.

To conclude, scrupulous care of your mouth and teeth, before, during and after radiotherapy should help maintain your teeth long after radiation. Make sure that any dentist you see understands the ramifications of your condition and remember that these considerations will prevail for the rest of your life.

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SHOWER SHIELD REPAIR

Do you have a Medmart Shower Shield that has come to the end of it’s usefulness because the velcro is no longer holding while you take your shower? If the stoma guard is still in good condition then rather than buy a new Shower Shield, consider replacing the velcro. Buy a length of 20mm wide velcro from a sewing shop or department store. Carefully unpick the old velcro from the Shower Shield. Cut lengths of new velcro to match the discarded pieces. Stick the new velcro in place on the Shower Shield and hand sew through the holes left from the previous cotton. There, you have a new Shower Shield, or as good as new.

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SKIVVIES

Instead of wearing stoma covers and scarves, in the winter a skivvy or polo neck shirt doubles as a stoma cover and shirt. In the summer, just shorten the sleeves by cutting them off and hemming them about 6 inches or 20 centimetres from the shoulder seam. This will turn your skivvy into a short sleeved t-shirt with no need to wear a stoma cover. The "Solutions" brand from K Mart ( about $15 ) is good as the neck stretches comfortably.


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SLIPPERY ELM (A.T Krasnodebski)

I have been a big fan of Slippery Elm powder since soon after my laryngectomy. After my laryngectomy I had trouble eating anything acidic such as tomatoes, capsicums, onions etc or drinking beer and orange juice as I would suffer acid reflux. And once the reflux started I had coughing fits that seemed to trigger more reflux and so on. It was getting to a point where I didn't look forward to meal times at all and was living on a more and more restricted diet.

Once I was put onto Slippery Elm I used it whenever I suffered from acid reflux and each night before going to bed. I mixed a heaped teaspoon of Slippery Elm powder with about half a cup of milk, stirring very thoroughly before drinking.
I used Slippery Elm at least once a day for about two years and since then I only use Slippery Elm powder if I suffer acid reflux, which thankfully is not very often these days. In fact it would be at least three months since I last took it.
Slippery Elm ( Ulmus rubra or Ulmus fulva ) is a native of North America. The inner bark is the part of the tree that has medicinal properties, it is extracted from a ten year old tree and dried. The subsequently ground bark is sold in two forms; a coarse powder for use in poultices and a fine powder for making a mucilaginous drink. It also has nutritive properties and can be used as a food for infants and invalids.
Red Indians were well versed in the use of poultices of Slippery Elm bark powder for wounds, boils, ulcers and burns. During the American Revolution, surgeons treated gunshot wounds with a bark poultice. Toothache can also be treated with a bark poultice.
A drink made from Slippery Elm is effective against coughs and soothes the throat. It is also used to treat gastric problems including GERD and acid reflux, for which I am recommending it. The high mucilage content adheres to the wall of the oesophagus and soothes any irritation and tends to sit on top of the stomach contents preventing further reflux.

http://www.sfp.forprod.vt.edu is a good site to read more about this product, it contains a number of further references including
http://www.botanical.com/botanical/mgmh/e/elmsli09.html

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SWEET SENSATION

ylitol apparently combats the formation of dental caries and ear infections because somehow it neutralizes harmful bacteria such as 'Streptococcus Mutans' in the mouth and 'Streptococcus Pneumoniae' and 'Hemophilus Influenzae' in the ear.
Just think, the day could be coming when we will be encouraging children to eat more lollies to protect their teeth.

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TRAVEL TIPS by John Chaloner

The other day a lady asked me about overseas air travel with a laryngectomee - would an eight hour flight present a problem. I could only relate my experience. In 1995 we went to Europe and the return flight was London-Bangkok-Sydney, two sectors, each of eleven hours. The air-conditioning on an aircraft is very high so my wife bought a spray bottle of Evian water. We used this to spray our faces at regular intervals (it dries in moments) and I also sprayed my stoma cover. I still coughed a little more than usual (as you do if your lungs get dry) and I had some crusting around my stoma but it really wasn't a problem. Apart from that there were no problems that I wouldn't have had on the ground.

It can be quite cold on a flight so if you have circulation problems take some gloves and a scarf and wear warm socks - but don't take your shoes off. It may be very comfy but your feet will swell and when you put your shoes on for landing it's agony. If you don't need oxygen at home you shouldn't need it on the flight either. However, if you think you may need oxygen, notify the airline in plenty of time, in writing, so they can have the different mask available on your flight - although I think the major airlines carry them as standard and I think the normal mask would be adequate anyway. That's it for the traveler's tales - enjoy your trip!

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VAPORISERS

If you haven’t already got one, it may be a good idea to buy a vaporiser (about $35 from your chemist) for use during winter. Regular use of a vaporiser will help stop your stoma from drying out.

If you don’t want to use a vaporiser, you can use steam. Just boil some water, put it into a warmed up dish or bowl, cover your head and the bowl with a towel and inhale the steam.

Regular use of radiators or heaters in winter can dry the air, and your stoma and skin. To counteract this dryness, simply keep a bowl of water in the room where you use your heater. This will help to replace moisture in the air.

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WHAT IS PADP?

EnableNSW has informed us that this article is no longer current. See November 3, 2011 note above.

The Program of Appliances for Disabled People (PADP) is a NSW Government program for people with disabilities. The role of PADP is to assist eligible residents of NSW who have a permanent or long-term disability to live and participate within their community by providing appropriate equipment, aids and appliances. Adults and children are eligible to apply. PADP is administered locally from Lodgement Centres.

Am I eligible?
You are eligible if you: have a long-term or permanent disability and need equipment to live and participate in the community, live permanently in NSW, are unable to obtain equipment, aids or appliances from any other government program, have not received compensation or damages in respect of the disability, have been discharged from hospital for at least one month and are not eligible for the provision of equipment under a loan arrangement or on a permanent basis by a hospital or health service for the condition for which the equipment is required. For more information on whether you are eligible for PADP contact your local PADP Coordinator. Contact details are available in Appendix 4 of the PADP policy which is available on the NSW Health Web http://www.health.nsw.gov.au.

What types of items are available?
PADP provides a wide range of equipment, aids and appliances. Children and young people under 16 years of age and people on low incomes are eligible for the full range of equipment provided by PADP. People on higher incomes are eligible for PADP equipment, aids and appliances which cost in excess of $800. Your prescriber or your Lodgement Centre can advise you whether the item you need is available

How do I apply?
All applications for assistance should be made on a PADP application form available from your PADP Lodgment Centre. The application must be accompanied by a prescription from a specialist medical practitioner. Your application must also include either a copy of your latest Australian Tax Office Notice of Assessment or details of your Centrelink pension or Health Care Card. You should send your completed application form to your local PADP Lodgement Centre.

How much will it cost?
Most people who receive assistance through PADP are required to make a payment of $100 towards the cost of the items they have received. You can only be asked to make one payment of $100 in any given financial year. Some higher income earners are required to make a payment of 20% of the cost of the item. Your PADP Coordinator will be able to advise you what payment will apply given your particular circumstances. If you would like an item that is more expensive than the one prescribed, you will need to meet the additional cost.

How will my application be assessed?

Your application will be assessed by your PADP Coordinator in the first instance, and may be considered by the local PADP Advisory Committee. Equipment is available based on priority according to need and your financial situation. Program of Appliances for Disabled People (PADP) Consumer Guide Better Health Good Health Care Fact Sheet
Margaret Patterson
Speech Pathologist


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MORE ON YEAST

With all the talk about yeast some of you might like to take this simple free at home test that you can do over any-time you are wondering how your yeast is doing...if you are wondering, it is probably thriving! Might you have a problem with Candida Yeast?
You can try this simple test to find out. First thing in the morning, before you put ANYTHING in your mouth, fill a clear glass with room temperature Bottled Water. Work up a bit of saliva, then spit it into the glass of water. Check the water every 15 minutes or so for up to one hour. If you have a potential problem, you will see strings (like legs) traveling down into the water from the saliva floating on the top, or "cloudy" saliva will sink to the bottom of the glass, or cloudy specks will seem to be suspended in the water. If there are no strings and the saliva is still floating after at least one hour, you probably have Candida under control, and have nothing to worry about What can you do if the test shows positive? Talk this over with your health care provider, as soon as possible. Be aware that a Candida Yeast problem can be pretty difficult to deal with, especially after it has had enough time to get established and can be causing you problems.
It may not be easy, and it may take a while to impact the situation, be patient, and work on it everyday. (Web Whispers)
Your good health is at stake ( The above test information was obtained from: Web whispers)



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