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Loa’s Blog

October 17, 2018

Cat Got Your Tongue?

“Work on your enunciation.”

We all know teachers who have had an impact on us. There are those who leave you inspired (or uninspired), those who teach life lessons, those who teach no lessons, and those we remember for a single turn of phrase. For me, in response to a presentation that I gave, a professor told me, “Work on your enunciation.” These days, I would not be affected by a comment like this, but I was still a little sensitive because I was recently injured and still adjusting to life with a trach and a ventilator.  

Prior to the presentation, I met with the professor to discuss the logistics of giving a public speech. I was very nervous since this was the first time I was required to give an oral presentation in class following my injury. I struggled speaking with a natural cadence, and had difficulty controlling my breathing, volume, and enunciation. After assuring me that she understood the limitations imposed by the ventilator, I proceeded with the assignment knowing I would do my best.

And yet, “Work on your enunciation.” You can imagine the initial shock I felt from this critique given that this was the very reason I felt hesitant to even attempt the assignment. Her comment has become fodder for many family jokes, as well as the perfect excuse for less-than-perfect diction!

I was always a confident public speaker before my spinal cord injury. It was tough to be confident initially after the accident. However, the ridiculous response at my first attempt post injury compelled me to put in the time to regain this ability. Despite the lack of positive feedback on my first attempt to speak publicly, it kindled my drive to relentlessly improve my speaking and, at the least, I got a good grade on the assignment!

Over the years - and after a lot of experimenting with equipment and exercises - my speaking ability has drastically improved and various muscles have gotten stronger. People that I see infrequently often comment on how much my speaking has improved. Even though the progress is so slow that I often do not notice that things are changing, it is nice to know that my hard work is not insignificant and that things continue to improve.

I found that when using the LTV, my speech was broken up with pauses waiting for breaths. I also noticed my speaking volume would fluctuate up and down depending on how much of each breath I had used. Now I use VOCSN and my speech has gotten a more natural flow. I have made some setting changes that support better speech flow and consistency in volume and cadence. Because VOCSN is quieter than the LTV, it also reduces background noise that I have to compete with in order to be heard. It may have taken a while and a new ventilator, but it was worth it.

How I Have Improved My Speaking Ability

  1. I use a Passy-Muir® valve to increase the amount of air passing over my vocal chords. This not only improves speaking flow, but increases my speaking volume.
  2. I did exercises to strengthen my vocal muscles. One of the things I did was to sing a lot. No healthcare professional ever recommended this as an exercise, but it seemed to help and certainly kept my spirits high.
  3. Temporarily changing settings (breath rate, tidal volume, and inspiratory time) can improve flow and cadence for special speaking engagements. A respiratory therapist or other healthcare professional can help you find the right settings. If you are an actual singer, unlike me who enjoys singing but should never do so publicly, you can have a singing mode in your ventilator presets.
  4. In finding my optimal daily settings, I adjusted to optimize my speaking ability within comfortable physiological limits.

My Favorite Song List

  • When I Fall in Love by Nat King Cole
  • American Pie by Don McLean
  • Can’t Help Falling in Love by Elvis Presley
  • Last Christmas by Wham!
  • We Built This City by Starship
  • Forever Young by Alphaville
  • After All by Cher and Peter Cetera
  • Break Away by Kelly Clarkson
  • Smile by Nat King Cole
  • Changes by Tupac
  • Just a Kiss by Lady Antebellum
  • I Want to Spend My Lifetime Loving You by Marc Anthony and Tina Arena
  • Crash and Burn by Savage Garden
  • I’ll Be Missing You by Puff Daddy
  • Whitney Houston - DUH!! (Greatest Love of All, Didn’t We Almost Have it All, I Wanna Dance With Somebody, and even though the list could continue I will end with everyone’s favorite… I Will Always Love You)


The views expressed by Loa are not necessarily the view of the Ventec Life Systems, its members or the clinical board. These blog posts are the personal experiences of Loa. The blog posts are not intended to provide clinical advice or training related to VOCSN. Always consult a physician or trained clinician prior to using VOCSN. Please refer to the VOCSN Clinical and Technical Manual for detailed instructions, including indications and contraindications for use. VOCSN is available by prescription only.

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