Speech Therapy Is Done, aka I Graduated from Talking School

I still have the remnants of dysarthria, the speech condition that makes talking tough after the stroke and affects the muscles in the face, particularly the mouth, and respiratory system. But I went to a speech therapist to get help and who I didn't like at first. She was all grim and business-y. Like when she corrected me when I called her a speech therapist instead of the more la-de-da-sounding speech and language pathologist. Drama queen, I said to myself.

Slowly, after two months, she got around to cracking a smile. When she and I were done a month later, she told me that her husband was an egomaniac, that her partying son flunked out of Harvard, and that her stressed-out daughter couldn't get pregnant. I sat there calmly, but I had my own problems.  

Anyway, there were four things I had to remember from the speech wizard: "HOSE." Permit me to explain.  


I started to develop that habit in 11th grade to be sure I could remember all the chemical symbols. When I was in college, and then when I started to work as a professional--a professor, a columnist, a technical trainer--I made lists of words to remind me what should be on the final or what was up for the day. The words didn't have to be in the dictionary. My only job was remembering what they were.  

For example, on the final exam in Sociology, "BIDS" meant sociology was the study of Behavior,  Interaction, Development, and Structure of organized groups of human beings. Or if I were going to teach a beginner class in Microsoft Word, I'd remember "NOPS" which stands for how to open a New file, Open an old file, Print, and Save a current one.  

It was the same way in speech therapy. Thus, "HOSE."

The H stands for Hydration. Make sure your water consumption has been sufficient after you sleep. Your tissues are dehydrated after sleep, naps as well, so it is important to sustain the water in our system. Aside from flushing out waste and and keeping other body parts lubricated, you'll need more water to hydrate your voice if you sleep with your mouth open, if you're sleeping with air conditioner or heating, or if you are allergic to dust particles.

The Institute of Medicine (IOM) recommends about 91 ounces of water per day for women and 120 ounces for men. You may need more if you're exercising, so if you are, Gatorade is good for replenishing the electrolytes in your body, but if you have none available, good ol' water is fine, too, in the meantime. Most people struggle to even come close to IOM's recommendations, so you have to focus on drinking, even if you're not thirsty.

The O stands for Overarticulation and the S stands for Speak Slower. They're a package deal. Mostly all dysarthria patients will need both overarticulation and a  general slow down for best quality of speech because the mission of the dysarthria patients is to be understood. 

Let's give it a test. If you really, really do both--overarticulate and slow your speech down, see how many people don't ask to say your request again. If I was to lay odds, I bet you don't have to repeat yourself at least 50% of the time. 

When I was horrible in the beginning after I had my stroke, and I just started to speak after 5 weeks of having not, I was speaking so fast, not overarticulating at all. But 5 years later, when I learned from the speech therapist, it actually made a difference. Some people are bad listeners and they ask me to repeat myself, but I know it's not from articulation or fast speech.

And finally, the E stands for speak on the Exhale. From creativespeechcentre.com (CPC), comes this: "[The students] have difficulty coordinating their breathing with their speaking; they exhale first and then speak. As a result, they speak in a low volume and they constrict their stomach, chest and throat muscles to create speech, resulting in tense sounding speech.

"What surprises them is that when we speak, we actually exhale, and that coordinating these two actions automatically results in louder, clearer speech. They learn to breathe deeply, then speak until much of their breath is exhaled and repeat the process."

The best explanation yet is our voice, not to get to the mumbo-jumbo, technical jargon used by speech therapists everywhere, is like a wind instrument, says CPC. When we exhale, our  vocal cords vibrate our voice box and allow us to produced sounds, plain and simple.

Here's a simple test: try saying the word "well" on the inhale and again on the exhale. When you say it on the inhale, the word sounds strained, as if you are running out of air, which you are. When you say "well" while expelling your breath, it come out relaxed. The same applies to everything you say. Speaking on the exhale takes practice. But I think you'll find it easier once you get your breathing coordinated.

H-O-S-E. That's one that I'll remember always. And the speech therapist said the same 4 things. Share my method if you like. It's free, and free is almost always good. 

My PT and the Marathon, aka I Want to Be a Contender

I was watching On the Waterfront the other day when Marlon Brando laments and, dare I say, whines, "You don't understand. I coulda had class. I coulda been a contender." 

Coulda been a contender. Huh. Brando's lines were about boxing, but my brain works funny now. I started to think about marathons (I was a runner, but never ran in any races) and that started me thinking, why not? My brain was going into hyper speed with the thought of being in a marathon and I missed the rest of the movie.

Anyway, I had a new physical therapist who used to be a fitness trainer and wasn't used to my weird questions, so I asked: "I want to be a contender," borrowing that line from Brando, "so could you train me to run in a marathon?" 

And surprisingly, she said, "Yes."

I made it clear. "Without a wheelchair, I mean." It could be my imagination, but I think she was sorry she replied so quickly.

The marathon is a running event with a distance of 26 miles and change. The Greeks had the first one back in the day when there were Olympics but no TV. 

Some runners do not participate in a marathon to be victors. Their personal time to finish the race is key, and some runners just want to finish the godforsaken race. Ten years ago, for example, the average marathon time in the U.S. for men was 4 hours, 32 minutes, 8 seconds, for women, 5 hours, 6 minutes, 8 seconds. I might do it in around 3 days, give or take. 

The PT still looked uneasy.  "I'll have to train you for a year," hoping, I think, that I would change my mind.

Of course, after her physical therapy session, I researched and found out that two weeks before the race, I'd have to load up on carbohydrates without increasing caloric intake to enable my body to store glycogen, an energy source, aided by carbohydrates, like potatoes and rice.

After the marathon, the recommendation is to eat carbohydrates for glycogen restoration and lots of protein to prevent muscle failure. So basically, fish and steak, potatoes and rice. I could live with that.

 And after the race, it is also advisable to soak your legs in cold water to get the blood flowing again.

Cold water. That was how Alfred Hitchcock got Janet Leigh to shriek in Psycho. Unbeknownst to her, he directed his assistant to turn off the hot water while she was positioned in the shower, and Janet let out a blood-curdling scream. Cold water does that. I'd do the same thing.

Staying hydrated during marathons is advisable, but over-consumption of water during marathons is not. 

"Drinking excessive amounts of fluid," one article in the New York Times said, "during a race can lead to dilution of sodium in the blood, a condition called exercise-associated hyponatremia, which may result in vomiting, seizures, coma, and even death." 

I barely survived the hemorrhagic stroke, which is not a small achievement in itself, but a year of training, frigid water, and possibly death. Nah. I didn't hear enough yet to change my mind. And I didn't finish my physical therapy sessions yet. So I'll let you know.

The big question is, why would I take the time, and a risk of cold-water shock and death, to run a marathon. The hip and flip answer is, it's on my bucket list. Flying in a hot air balloon over the Loire Valley, going tandem skydiving, or riding a mechanical bull are not. They were but not now.

But when I think more deeply about it, I want to spread stroke awareness so other people affected by stroke in the world could run the race, too, and I'd collect money for every mile I ran, preferably all 26 and change miles, and donate all the proceeds to stroke research. Running a marathon would do that.