I had my laryngectomy over 15 years ago. From the outset I was aware of the possible speech options and was very keen to use a valve to speak. I was the first patient to receive a primary puncture at my local hospital. Though for the first few months it was not possible, I was keen to be able to change the valve myself. I was comparatively young and happily had no other health issues, which could impact on managing this myself. At that time the Nurse Specialist or ENT Clinic Sister took responsibility for this matter rather than a Speech and Language Therapist.
I have been very lucky and have had few complications along the way so I can still change the valve myself at home, when needed. The duckbill valves are very cheap compared to indwelling valves, which can only be replaced by a clinician. Carrying a couple of spares, I can change my valve without a visit to an ENT clinic or far worse to A&E, wherever I am in the country should the need arise.
The NHS is under great pressure at the moment. Changes are being made to where and when specialist services are available under sustainability and transformation plans. I recently became aware that one hospital trust has advised its laryngectomee patients that, in the event of a valve problem, if they turn up to an ENT clinic without an appointment, they may have to be admitted to a ward, depending on availability or otherwise of staff.(Just pray this doesn’t happen on a Friday when that may mean 3 nights in hospital!)
This situation raises several questions:
Are patients being encouraged to use valves they can manage themselves as much as they were ten years ago?
Would patients welcome the chance to be more independent of their hospital?
Of course some patients have complicated circumstances making self-management impossible. It may be the puncture is in a place that makes it impossible for them to change a valve themselves. There may be other medical or capability reasons why a clinician is needed to do this. The changes in the service since my laryngectomy may well mean more patients can be considered eligible for a valve and the quality of speech has notably improved I think. However, considering the benefits in terms of cost to the NHS and convenience for the patient Eric Blom’s original solution still seems to have a lot to offer.
The August edition of Whispers on the Web has an item looking at this topic – see the link below
The Joint Council on Vaccination and Immunisation has declined to recommend the extension of the vaccination programme to boys. The medical community is far from happy. Please clink on the link below for more information.
This decision will mean that in some years time many men will unnecessarily develop hpv related throat cancer.
A busy spring and summer programme came to a close with another trip on Chesterfield canal. This time the destination was The Mill, a hostelry that supplied us with excellent food, most of which had never seen the inside of a freezer! There was plenty to see on the journey with swallows frequently darting down onto the water and mallards squawking with disgust as they had to move out of the way of the barge.
We now have our annual break but will be back with our regular meetings in September, when we have also planned a Coffee Morning to mark European Head and Neck Cancer Awareness Week.
On Monday 26 June we were given the use of the Information Point at the hospital.
The picture shows Chairman, Ray Mountain presenting a boogie board to Head and Neck Nurse Practitioner, Mary Green. This device is for the use of any patient admitted onto Devonshire ward unable to communicate verbally, through being a laryngectomee, tracheostomee or for other reasons.
A boogie board is a thin tablet with a liquid crystal display. You can write on it with a stylus or finger and wipe it clean in an instant using a delete button. It can assist communication between the patient and both their clinicians and families.
We also raised some funds and promoted awareness of early signs of head and neck cancer. As usual at such days there were many valuable conversations with patients, visitors and staff.
On Wednesday June 7th, the Joint Committee for Vaccinations and Immunisation will be discussing extending the HPV vaccination programme to boys as well as girls.
Here is NALC’s view:
From statistics published in 2014, head and neck cancer incidence has increased by 30% since the early 1990s. Though the reduction in smoking has had benefits this has been eclipsed by the contribution of HPV to head and neck cancer incidence.
The Center for Disease Prevention and Control estimates over 70% of oropharyngeal cancer is due to HPV. The % of cases of laryngeal cancer attributable to HPV is lower but still significant, according to International Agency for Cancer Research reports.
NALC strongly supports the proposal for the inclusion of boys in the HPV programme. If the JCVI is convinced of the efficacy of the long-standing programme for girls, why is it resisting its extensions to boys? Like leading clinicians in the field, as well as relevant professional organisations and other patient groups, NALC is convinced the proposal would lead to a reduction in people developing the awful disease that is head and neck cancer.
Members had been looking forward for some months to a trip to the National Memorial Arboretum, near Burton on Trent, Derbyshire. We were very fortunate that after 24 hours of rain the day started and remained sunny and warm.
The Arboretum offers a variety of different experiences ranging from imposing memorials to the fallen to quiet riverside walks with abundant sights of nature to look for. For those who cannot or don’t wish to walk great distances there is a land train which visits the key spots.
One memorial that attracts many visitors is Shot At Dawn, the one remembering the 300 or more serviceman who were executed by firing squad for failing to follow orders. In 2006 all these were given an official pardon . Each post displays the details of the serviceman shot and the vast majority were around 20 years old.
The Arboretum is well-worth more than one visit and the unanimous view was we need to organise a second trip next year. Roy O’Neill was especially delighted to find the memorial for members of the Royal Tank Regiment, in which he served.
The experiences of head and neck cancer patients improved after the publication of NICE’s Improving Outcomes Guidance around a dozen years ago Not long afterwards a national audit of head and neck patients called DAHNO was introduced.
It collected many details of the treatment of patients and this enabled clinicians and others who analysed the data to make recommendations to improve the patient experience.
For a patient group like NALC it is valuable to know the facts about the numbers of patients adopting a particular method of speech after a laryngectomy or how many had radiotherapy as opposed to laser surgery for early cancer of the larynx and variations across the country.
In 2015 DAHNO was replaced by a new audit, HANA.
Sadly NHS England will not be providing funding beyond the current year, but the group, led by Professor Iain Hutchison, are seeking to continue the audit. They deserve the support of everyone who is concerned about improving the standard of care for head and neck cancer patients.
HNChelp is very grateful, once again, for the support it has received from The Rotary Club of Clay Cross.
Our Secretary, Malcolm Babb was invited to a meeting where the Rotary Club presented its donations to several local charities. In his thanks for the donation Malcolm spoke about our new initiative, giving boogie boards to patients who have no voice, to allow them to communicate with their families and hospital staff.