This post originally appeared on February 3, 2015, and is re-posted at this time in memory of my dear friend, Kate Kelsall, who died on July 29, 2018 after a courageous life with Parkinson’s disease.
February 3, is Saint Blaise’s feast day, which in Catholic tradition, includes the Blessing of the Throats. Saint Blaise’s protection of those with throat troubles comes from a legend that a boy was brought to him who had a fishbone stuck in his throat. The boy was about to die when Saint Blaise healed him. Saint Blaise is also the patron saint of wild animals because of his care for them and of those with throat maladies. Since voice and swallowing problems are common symptoms of Parkinson’s, we thought we’d take today to share our insights.
Kate Kelsall, blogger, Shake, Rattle, and Roll and Mary Spremulli, blogger, voiceaerobicsdvd.blogspot, began a correspondence in 2008 that evolved into a deep friendship. Kate has been living with Parkinson’s for 20 years, and in her blog posts shares her trials and triumphs, along with current information that can help others manage their disease and manage their lives. Mary has been a medical speech-language pathologist for 30 years, and her blog posts include information about available speech and swallowing treatments for persons with Parkinson’s and other neurological diseases. She also frequently discusses the concerns of patients and their families that arise in her day to day private practice.
A message from Kate and Mary:
A few years ago, in our shared posts we responded to each other’s questions, and invited you to follow our blogs. We hope the information we provide offers support to others living with Parkinson’s and some guidance for improving or maintaining Your Great Voice and spirit!
Kate and Mary
Below are Kate’s responses to my questions. To View Kate’s questions for me and my responses, please visit her website by following the link at the end of today’s post.
Mary asks Kate: You have lived with Parkinson’s Disease (PD) for 20 years, now, in fact, exceeding the prediction of your first neurologist. What do you wish therapists and other health care providers understood about YOU, the person living with PD?
Kate: After living with Parkinson’s for 18 years, I had exceeded my first neurologist’s prediction that I would live for ten years after my diagnosis. Every day during my 10th year of PD, I worried if today was the day that I would die. Thankfully, the neurologist was wrong in her prediction.
I would like therapists and other health care providers to understand that I am strong-minded, resilient, and am determined to make the best of my life despite PD. I am involved in meaningful and purposeful activities such as writing my blog, Shake, Roll and Roll. During the past eight years, I have co-founded and co-lead the Bionic Brigade DBS Support Group. The secret of my longevity with Parkinson’s is keeping my body and mind active.
Mary: You underwent Deep Brain Surgery (DBS) surgery nine years ago, and have really become quite the champion of that procedure because you have had such a good outcome. What are the main things you tell someone who is considering undergoing DBS?
Kate: The main things that I tell someone who is considering DBS are the following: DBS helps to relieve the motor symptoms of PD. It reduces stiffness and improves the ability to move. DBS may also reduce the severity of tremor. DBS is not a cure for PD. There is currently no cure for PD, and PD continues to be a progressive and chronic disease.
It frequently can take up to six months or more for optimum DBS programming and adjustment of your medication.
Don’t expect that DBS can relieve ALL of your motor symptoms such as tremor, dyskinesia, dystonia and rigidity ALL of the time. But do expect DBS to manage SOME of your motor symptoms SOME of the time.
Don’t expect that DBS to be a treatment for your non-motor symptoms of PD such as speech and swallowing problems. These problems, in addition to gait difficulties, sometimes worsen as a result of DBS.
I’m not saying that you have to lower your expectations, but it’s important that you at least clarify these expectations and those of your spouse, family, and DBS team. You need to discover the similarities and differences of your expectations and have some consensus among these expectations.
Mary: Why did you decide to enroll in speech therapy? Did you notice your speech or voice was changing, or was it simply the recommendation of your neurologist at the time?
Kate: Before being diagnosed with PD, I was involved with Toastmasters and gave presentations to the group and also within the community. The feedback that I received was that my voice was quiet, that my voice and face lacked expression, and that my left hand shook. In order to get treatment for my soft voice, I obtained a referral from an ENT who referred me for vocal cord augmentation surgery. I had unsuccessful vocal cord surgery in February 1996, and I was diagnosed with PD shortly thereafter in May 1996.
None of my neurologists have ever recommended speech therapy for me. It was only through my own initiative that led to getting a referral for LSVT®.
Mary: One of my pet peeves is when at PD conferences; the organizers refer to persons with PD as “the patients.” How has the diagnosis of PD changed your self-perception?
Kate: These are the labels that I find upsetting when referring to a person with PD:
Patient (when I’m not his/her patient)
Sufferer (and other derivatives of suffer)
It is important to let others know which words are preferable to you as a person living with PD. At first after being diagnosed with PD, I developed a self perception of being an imposter, denying and not accepting that I had PD. I thought I could PD beat with a positive mental attitude. Later in the PD journey, I developed a-perception that my identity is far greater than that of a PD patient. I am a person living with PD who is also a wife, blogger, writer, counselor, volunteer, dog-lover, daughter, sister, aunt, cousin, niece, friend, dancer, musician and much more.
Mary: When someone’s voice is changing, becoming softer, because of PD, their spouse often begins to do a lot of the talking. How have you and Tom, your husband, struck a balance between you speaking for yourself, and him offering help at those times when you may be having more difficulty with your voice.
Kate: Tom and I have developed strategies to deal with the changes in my voice, and we’ve been able to strike a balance between speaking for myself and other times accepting Tom offers for help when I’m having more difficulty with my voice.
The following are some of the strategies that Tom and I have used:
When I hear or understand only part of what Tom is saying, I don’t say “what?” or “huh” but instead say the part of the message that I heard in the form of a question. This allows Tom to clarify his or her message and creates a respectful communication exchange.
I have often felt left out or isolated in group situations because my voice is quiet, and I sometimes can have difficulty hearing or understanding what others are saying. I might have trouble formulating my thoughts and keeping up with the pace of the discussion and adding my comments on a timely basis, I occasionally have problems with finding the right word and sometimes have difficulty interpreting and responding to the non-verbal aspects of the discussion.
When I attempt to communicate within a group environment, it is important to develop verbal and non-verbal signals that indicate when I want others to help and when I want to communicate on your own. For example, signals might include the following:
- A nod to your partner might indicate “yes, I want your help and please speak on my behalf.”
- An index finger up or a palm facing out might indicate “please give me a minute to collect my thoughts.”
- I might verbalize “let me try saying that again” because I want an opportunity to restate my communication so that it’s clear.
Mary: Speaking of marriage, how have you and Tom, your husband, kept Parkinson’s from becoming the most important thing in your relationship?
Kate: At times, Parkinson’s is the most important thing in our relationship. The priorities competing for the “most important thing” in our relationship are constantly shifting. Sometimes it’s my health, other times, it’s Tom’s health; sometimes it’s financial issues; other times it’s how to spend our leisure time. Throughout our 40 years of marriage, we have been active, but now our pace of life is a little slower. Sometimes, it’s difficult to tell if the normal aging process has slowed us down or if it’s the progression of PD that caused this. We can’t blame every little ache and pain on PD.
We both have individual interests. Tom loves fly-fishing and bike riding, and I like Broadway dancing and walking and reading. We also have joint interests: travel, attending movies, sharing meals together; and dog-walking our English Springer Spaniel, Rusty.
Mary: What do you mean about saying a prayer to St. Blaise? Is there some spiritual component to integrating a chronic disease diagnosis into your persona? What gives you hope and trust about what the future will bring?
Kate: At first I was angry at God for getting diagnosed with PD. Then I wondered, if not me, who would be a better choice? I need to have a spiritual connection to know that I’m not alone and to maintain my hope and trust about the future with PD.
To View Kate’s questions for me and my responses, please visit her website: