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Still Talking Dedicated to the welfare of Laryngectomees and those with similar vocal disorders.
ALL CORRESPONDENCE : The Secretary, The Laryngectomee Association of NSW, 65/9 Col Drewe Dr,
STH Bowenfels, NSW, 2790. Email: [email protected].
The Laryngectomee Association of NSW© Issue No. 281 April 2017
OFFICE BEARERS
PRESIDENT: Les Byrnes, 82/79-87 Boyce
Road, MAROUBRA, 2035. PH. (02) 9344 0445
VICE PRESIDENT & WEBSITE ADMIN:
Greg Joss 61 Morrice Street, LANE COVE
2066 (02) 9427 0509
VICE PRESIDENT: Peter Tierney,
11 Berrico Place, BANGOR, 2234.
Ph. (02) 9543 0478
SECRETARY/TREASURER: Raymond
Chappelow, Villa 65/9 Col Drewe Dr, STH
BOWENFELS, 2790 Ph. (02) 6352 5826
WELFARE OFFICER: Cathy Edwards PO
Box 54, ALLAWAH, 2218. Ph. (02) 9587 9636
SPEECH AIDS COORDINATOR:
John Chaloner, PO Box 31, SUMMER HILL,
2130. Ph. (02) 9560 2852
EDITOR: George Southgate,
[email protected] Ph. 04176 79651
BATTERIES FOR SERVOX, LOAN SPEECH
AIDS, ADVICE ON REPAIRS
John Chaloner P.O. Box 977, PETERSHAM
NSW 2049. - Ph. (02) 9560 2852
SHOWER SHIELD, STOMA COVER
MATERIAL & WELFARE MATTERS:
Cathy Edwards, PO Box 54, ALLAWAH, 2218.
Ph. (02) 9587 9636
ACCOMMODATION ASSISTANCE WHEN NEEDED
OUT-PATIENT TREATMENT AWAY FROM
HOME:
Cancer Council NSW, 153 Dowling St,
WOOLLOOMOOLOO, 2011 (PO Box 572,
Kings Cross, 1340), Phone: 13 11 20.
(Information & Support) Or contact Social
Worker at hospital you will be attending.
www.cancercouncil.com.au
ASSOCIATION WEBPAGE:
www.stilltalking.org
INTERNATIONAL ASSOCIATION OF
LARYNGECTOMEES:
www.theial.com/ial
WEB WHISPERS:
www.webwhispers.org
NEXT MEETING
19th April 2017 at the
Sydney Mechanics Institute, 280 Pitt St,
SYDNEY at 11 am.
The meeting will be followed by light
refreshments.
Laryngectomees, Friends, Families,
Professionals all WELCOME.
Regional Meetings Pg. 2
1
Pg 2
2
A few weeks ago the LANSW website received an email from a Danielle Douglas, a student at Macquarie University. The sender asked could she assist the LANSW by way of donations pledged and raised at the celebration party of her "Pops" Golden Wedding Anniversary! ( a lary since 2005) It was totally her idea to request guests and relatives invited to celebrate their 50 years together to donate to the LANSW rather than give gifts to her Grandparents. Contacted the only "Douglas" on our books and found John and Diane Douglas who knew of their granddaughter's generous and beautiful idea. The LANSW has accepted Danielle's offer and has provided some information to assist in her quest. By the way, the 50th is on April 29th and if you would like to send best wishes and congratulations etc., the address is 41 Quintana Ave., Baulkham Hills 2153. Phone 96243110. All the Committee take this opportunity to wish both Diane and John a happy and memorable celebration and a great trip to Japan to continue their anniversary.
Les Byrnes.
ありがとう (Thank You)
Regional Meetings
NSW Association: 3rd Wednesday of month
(February - November)
Sydney Mechanics Institute, 280 Pitt St, SYDNEY,
2000 at11am.
NEW ENGLAND: Meets 2pm 1st Wed December
Conference Room, Rehab Unit, Tamworth Base
Hosp.(02) 6767 8369
NEWCASTLE: 3rd Tuesday. Monthly Mayfield
Bowling Cub, Ingall St, Mayfield. Start 12.30 - 2.00
Contact John Lovett (02) 4954 8308
NORTHERN RIVERS: 4 times annually in
Lismore. Contact Speech Pathologist Allison Grady
(02) 6629 4523 or (02) 6620 2157
ALBURY: Meets alternate months from
February. Contact Norma Teasdale
(02) 6021 1749
SOUTHERN DISTRICTS: Last Wednesday of
month 10am. Thomas Rachael Moore Education
Centre, Liverpool Hospital. Contact Hei Lan Byun
0477 330 719 or Joanne Bartley 0439 813 807
MID NORTH COAST: Port Macquarie
Community Health Centre. Last Wed of March.
June. September. & 1st Wednesday December.
1.30 start Contact Jodie Bowles (02) 65801828
CENTRAL COAST: 3rd Thursday of the month,
Cancer Council Community Hub, The Hive,
Erina Fair 10am - 12 noon. Head and neck cancer
nurse (02) 4320 9823 Cancer Council 4336 4500
Facilitator Gary Marr 0412 262 145
gsm18@!ive.com.au
COFFS / CLARENCE: Shearwater Lodge, Coffs
Health Campus. 2pm every 3rd Thursday,
Bi-monthly Contact: Rachel Urquhart
(02) 6656 7605
WOLLONGONG Hospital Block C level 8:
11am -12.30 Tri-monthly 22/1/16, 23/4/16, 23/7/16
Lisa Le Cussan (02) 4253 4500
Letters to the Editor
Pg 3
3
Minutes March
Laryngectomee Association of NSW Inc
Minutes of Meeting of 15 March, 2017.
The Meeting opened at 11.01 a.m. with the President, L Byrnes occupying the Chair.
Attendance - Laryngectomees
R Chappelow; F Campbell; L Byrnes: J Chaloner; P Tierney; G Joss
Attendance – Non-laryngectomees
C Edwards; C Gardner.
Apologies
G Tierney
Note
G Joss failed to sign the attendance book at the February, 2017 Meeting
New Members
Kahlil Achkar of Yagoona, Nick Buttaro of Sylvania Waters, Jodi-Anne Gibson of Hazelbrook.
The Minutes of Meeting of 15 February adopted (C Gardner/C Edwards)
Reports
CBA balance as at 31 January, 2017. $17,177.46
Add Income
Subscriptions $150.00
Patients' Supplies $395.00
Sub-total $17,722.46
Less Expenditure
Still Talking Postage $327.75
Insurance $1,163.55
Stationery/Printing $1,030.90
Other Freight/Postage $131.69
Lunch $30.00
Patients' Suppies $350.00
Sub-total (2) $3,033.89
Add unpresented cheques
#625 $30.00
#626 $632.50
#630 $350.00
Sub-total (3) $1,012.50
CBA balance as at 28 February, 2017 $15,701.07
Pg 4 4
Reports received C Edwards/C Gardner
Correspondence
Outgoing.
1. Letters of welcome to new members:
Khalil Achkar of Yagoona; Nick Buttaro of Sylvania Waters; Jodi-Anne Gibson.
2. Frank Campbell – requesting information re Wollongong group meeting
3. Crompton – requested new members subscription
4. Vin Keshow – requested reason for deposit into CBA
5. Vicki Pedras – sent membership application form
6. Standring household – regarding recorded phone message
7. Lovey Tuhou – reply to her letter
Incoming
Australian Charities and Not- for- Profits Committee – survey
Vicki Pedras – request to join
Lovey Tuhou – Subs. payment
Eric McFarland - 5 x subs. including 2 new members
APIAS (ACT Government) – re new invoicing arrangements
Carol Gardner – thanking Meeting for Gift presented at previous Meeting
Minutes March
Welfare Report
Patient Packs despatched –
6 - Nepean Hospital
5 - John Hunter
4 – Grafton
Stoma Covers and Accessories
5 - K Kennelly
Foam Squares - L Tuhou
12 - M Gianetti
2 x S. Shields/2 x Covers - N Buttaro
2 - J McMillan
1 - S. Shield/3x Covers to G Wells
Packs for New Members
Khalil Achkar of Yagoona
Nick Buttaro of Sylvania Waters
Postage Cost Total - $105.05
Pg 5
5
Claims for Payment
Previously Paid
Forestville Printing – printing of Invoice & Receipt Books $632.50
SMSofA – rent of Meeting Room $40.00
National Pens – LANSW pens (200) $235.24
Wendy Tyrell – stoma covers $350
Claimed
R Chappelow – Taxi fare (Hunter Branch Meeting) $13.00
Postage $27.00
Australia Post – Mail Redirection notice $????
C Edwards- Post $105.05
R Chappelow Post $27.00 Transport $13.00
C Gardner Lunch $30.00
NSW Fairtrading Fee $44.00
It was decided not to continue with Mail Redirection
Claims approved C Edwards/C Gardner
Discussion re Non-Financial Members ensued
2017 Election of Office Bearers
As there were 2 written nominations submitted on time, L Byrnes was declared elected
President and J Chaloner declared Speech Aids coordinator
The President then declared positons vacant and called for nominations for vacant positions
President L Byrnes (nominated R Chappelow/P Tierney)
Vice-Presidents G Joss (nominated C Edwards/R Chappelow)
P Tierney (nominated J Chaloner/C Edwards
Secretary R Chappelow (nominated F Campbell/C Edwards)
Treasurer R Chappelow (nominated F Campbell/C Edwards)
Speech Aids Coordinator J Chaloner (nominated C Edwards/F Campbell)
Welfare Officer C Edwards (J Chaloner/C Gardner)
Assistant Welfare Officer W Bak (L Byrnes/R Chappelow)
The Audit of 2016 was received on the motion of C Gardner/C Edwards
The Secretary tabled his Annual Report which was adopted unanimously.
Minutes March
Pg 6
6
Secretary’s Annual Report
I was at last getting into my stride by last year’s AGM, and amongst other things, had
introduced Microsoft Excel spreadsheets for Membership, Income, Expenditure and
Treasurer’s Reports, etc. Every month the Executive gets these updated & emailed. The
Welfare Officer & Speech Aids Coordinator are updated with the Membership List every time
we have a new member, at least! Our Auditor receives our spreadsheet, too!
The positions of President, Editor & Welfare Officer (plus several other positions) remained
vacant following the election, but sometime later Les Byrnes put his hand up for President and
was duly elected. Then, Cathy Edwards volunteered as Welfare Officer, but for a couple
months we were sadly not producing a newsletter. I sent word around the traps via emails that
an Editor would not need to live close to our Sydney meeting venue or attend them regularly.
This resulted in an email from a new member & recent laryngectomee, George Southgate of
Glenn Innes. He came to Sydney where Les met him and his wife, Sue - so Les recommended
to our Meeting that he be elected which occurred. (George & Sue attended our last meeting.)
Nowadays, “Still Talking” is printed in Glenn Innes as are the envelopes it is mailed in. There
has been a very positive response to George’s (& Sue’s) work.
All of the above had much to learn, but we have got our “act together” now. Having the
back-up of Carol “Guru” Gardner helps a lot. If you don’t know something –“ask Carol”.
Membership is at 284 including many unfinancials and “missing in action”. Some have not
been heard from since 2011! Les is pursuing the unfinancial. I realise how easy it is to miss
personal renewals as when I received the membership file as the new Secretary, I discovered I
was two years in arrears – very embarrassing as I had been ineligible for election!
One disappointment however, was the attendance at our Christmas Luncheon. Consequently
the day has been changed to the last Saturday of November for this year at least.
Our financial position is strong and is the least of our worries.
Most of you would be familiar with the work of Carol & the late Brian Gardner. At our most
recent meeting, Carol received a Gift Presentation in commemoration and appreciation of her
years of service to us. Originally, Carol was the “lady who brought the sandwiches, cakes, tea,
etc. to our meetings”. Over time she had “greatness thrust upon her” becoming Welfare
Officer, Secretary, Treasurer, generally just about anything going. She continues to be a help
to yours truly.
Our meetings are attended by a small contingent of faithful members. I came to realise that
they were mostly what I would term - “inner Sydney people”. One couple, however travel from
Sutherland, one member from south of Wollongong and me -from Lithgow. I depart home at
6.30am, returning at 5.30pm, so I would suggest that more members could make an effort to
attend if I can make it 10 times per year from 160 kms away. Why not make it a day out in
Sydney?
Finally, my thanks to the Executive for putting up with me for another year and my apologies to
those who have phoned me and not been able to understand my voicing. Oh, how I miss my
larynx!
Minutes March
Pg 7
7
General Business
L Byrnes commented on the article by F Campbell in February “Still Talking” and raised his
own experiences with Voice Prosthetics – discussion ensued.
John Chaloner updated members regarding “bionic speech” for Laryngectomees, advising
there is still a fair way to go with the research.
Cathy Edwards reported on problems encountered with customers calling on the phone and
leaving orders which cannot be understood. Several suggestions were given
L Byrnes offered to inquire of Atosmedical re prices shower guards and shields which have
differing costs from various suppliers. New order is now due.
C Gardner confirmed long term membership of E McFarland & L Hass. When their renewal
cheque arrived, R Chappelow was unable to find membership cards or computer entries.
(Matter to be resolved.)
Discussion continued about living as a Laryngectomee.
Meeting closed at 11.55a.m.
Speech Aids Coordinator’s CHANGE OF POSTAL ADDRESS!
Our Speech Aids Coordinator, John Chaloner, has a new POSTAL Address – no longer at Summer Hill, it is now – P.O. Box 977, PETERSHAM NSW 2049. (a redirection is in place for a few months)
Minutes February
Pg 8
8
1) Russia has a larger surface area than Pluto.
2) Oxford University is older than the Aztec Empire.
3) France was still executing people by guillotine when Star Wars: A New Hope hit theatres.
4) If the sun were the size of a white blood cell then the Milky Way Galaxy would be the size
of the United States.
5) For every human on Earth there are 1.6 million ants.
6) The total weight of all those ants, however, is about the same as all the humans
7) On Jupiter and Saturn it rains diamonds.
8) Your chances of being killed by a vending machine are actually twice as large as your
chance of being bitten by a shark.
9) Nowhere in the Humpty Dumpty Nursery Rhyme does it say that Humpty Dumpty is an
egg.
10) Scotland’s national animal is the unicorn..
11) There are more fake flamingos in the world than real ones.
12) A strawberry is NOT a berry.
13) A banana IS a berry.
14) There is enough water in Lake Superior to cover all of North and South America in one
foot of liquid.
15) Handshakes were originally meant to make sure that the person you were meeting wasn’t
carrying a concealed weapon. The hand clasp proved that your hand was empty and
shaking was meant to dislodge any weapons hiding up the sleeve.
Pg 9 9
BLESS THE AUSTRALIANS AND THEIR SENSE OF HUMOR.
THESE WERE POSTED ON AN AUSTRALIAN TOURISM WEBSITE, AND THE ANSWERS
ARE THE ACTUAL RESPONSES BY THE WEBSITE OFFICIALS, WHO OBVIOUSLY HAVE A
GREAT SENSE OF HUMOUR (NOT TO MENTION A LOW TOLERANCE THRESHOLD FOR
CRETINS!
Q: DOES IT EVER GET WINDY IN AUSTRALIA? I HAVE NEVER SEEN IT RAIN ON TV, SO
HOW DO THE PLANTS GROW? (UK).
A: We import all plants fully grown, and then just sit around watching them die.
Q: WILL I BE ABLE TO SEE KANGAROOS IN THE STREET? (USA)
A: Depends how much you've been drinking.
Q: I WANT TO WALK FROM PERTH TO SYDNEY, CAN I FOLLOW THE RAILROAD
TRACKS? (Sweden)
A: Sure, it's only three thousand miles. Take lots of water.
Q: Are there any ATMs (cash machines) in Australia? Can you send me a list of them in Bris-
bane, Cairns, Townsville and Hervey Bay? (UK)
A: What did your last slave die of?
Q: CAN YOU GIVE ME SOME INFORMATION ABOUT HIPPO RACING IN AUSTRALIA?
(USA)
A: Af-ri-ca is the big triangle shaped continent south of Europe. Aust-ra-lia is that big island in
the middle of the Pacific which does not ... Oh, forget it. Sure, the hippo racing is every Tues-
day night in Kings Cross. Come naked.
Q: WHICH DIRECTION IS NORTH IN AUSTRALIA? (USA)
A: Face south, and then turn 180 degrees. Contact us when you get here and we'll send the rest
of the directions. Continued next page
Q: CAN I BRING CUTLERY INTO AUSTRALIA? (UK)
A: Why? Just use your fingers like we do.
Q: CAN YOU SEND ME THE VIENNA BOYS' CHOIR SCHEDULE? (USA)
A: Aus-tri-a is that quaint little country bordering Ger-man-y, which is ... Oh, forget it. Sure, the
Vienna Boys Choir plays every Tuesday night in Kings Cross, straight after the hippo races.
Come naked.
Q: CAN I WEAR HIGH HEELS IN AUSTRALIA? (UK)
A: You are a British politician, right?
Q: ARE THERE SUPERMARKETS IN SYDNEY AND IS MILK AVAILABLE ALL YEAR
ROUND? (Germany)
A: No, we are a peaceful civilization of vegan hunter/gatherers. Milk is illegal.
Q: _PLEASE SEND A LIST OF ALL DOCTORS IN AUSTRALIA WHO CAN DISPENSE RAT-
TLESNAKE SERUM. (USA)
A: Rattlesnakes live in A-mer-ica, which is where YOU come from. All Australian snakes are
perfectly harmless, can be safely handled, and make good pets. Continued next page
Q: I HAVE A QUESTION ABOUT A FAMOUS ANIMAL IN AUSTRALIA, BUT I FORGET ITS
NAME. IT'S A KIND OF BEAR AND LIVES IN TREES. (USA)
Pg 10
10
A: Its called a drop bear because it drops out of trees and eats the brains out of anyone walking
underneath them. You can scare them off by spraying yourself with human urine before you go
out walking.
Q: Do you celebrate Christmas in Australia.
A: Only at Christmas.
Q: _Will I be able to speak English most places I go? (USA)
A: Yes, but you'll have to learn it first. (Courtesy of Wally Bak)
Hi there, here's a fantastic link for the website and newsletter with a host of resources for laryngectomees. http://www.speechtherapytoolbox.com/laryngectomy.html regards.
A.T.K. (courtesy of Antoni Krasnodebski)
Excellent site for new members. Also interesting, for older members.
George
Courtesy of Jill Leach
Quite a few members who are not financial for 2017, have asked how they can renew their
memberships. So we have once again inserted this application, into this issue. You can cut it out
of your newsletter and mail it with a cheque or money order to the treasurer. Otherwise pay it
through the commonwealth bank, or by internet banking
APPLICATION FOR CONTINUATION OF MEMBERSHIP for 2017
THE LARYNGECTOMEE ASSOCIATION OF NSW
Please accept for continuation of membership. My subscription is enclosed OR paid direct.
NAME……………………………………………………………………...PHONE……………………
ADRESS…………………………………………………………………………………………………
POSTCODE………………….. Email……………………………………………………………………
Annual subs $10 Due 1/1/2017
Please post to The Treasurer, LANSW, Villa 65/9 Col Drewe Drive, SOUTH BOWENFELS, 2790
Payment can be made by cheque or money order
Or at any Commonwealth Bank to account of LANSW—BSB:- 062 595 A/c No 00905579.
or by internet banking transfer
Cheque enclosed Payment made to Bank: Date of Payment / /201
Money Order enclosed I require a receipt
PLEASE ADVISE NAME/SUBURB as reference for direct payments or payments into bank.
Pg 11
11
CAUSES OF VOICE PROSTHESIS LEAK
There are two patterns of voice prosthesis leak - leak through the prosthesis and leak around it. Leakage through the voice prosthesis is predominantly due to situations in which the valve can no longer close tightly. This may be due the following: colonization of the valve by fungus; the flap valve may get stuck in the open position; a piece of food, mucus or hair (in those with a fee flap) stuck on the valve; or the device coming in contact with the posterior esophageal wall. Inevitably, all prostheses will fail by leaking through, whether from Candida colonization or simple mechanical failure.
If there is continuing leakage through the prosthesis from the time it is inserted, the problem is generally due to the fact that the flap valve remains open because of negative pressure generated by swallowing. This can be corrected by using a prosthesis that has a greater resistance. The trade-off is that having such voice prosthesis may require more effort when speaking. It is, nevertheless, important to prevent chronic leakage into the lungs.
Leakage around the voice prosthesis is less common and is mainly due to trachea-esophageal puncture tract dilation or inability to grip the prosthesis. It has been linked to shorter prosthesis life time. It may occur when the puncture that houses the prosthesis widens. During insertion of the voice prosthesis, some dilation of the puncture takes place, but if the tissue is healthy and elastic, it should shrink back after a short time. The inability to contract may be associated with gastroesophageal reflux, poor nutrition, alcoholism, hypothyroidism, improper puncture placement, local granulation tissue, incorrectly fitted prosthesis, TEP tract trauma, recurrent or persistent local or distant cancer and radiation necrosis.
Leakage around the prosthesis can also occur if the prosthesis is too long for the user ’s tract. Whenever this occurs, the voice prosthesis moves back and forth in the tract (pistoning), thereby dilating the tract. The tract should be measured and prosthesis of more appropriate length should be inserted. In this circumstance, leakage should resolve within 48 hours. If the tissue around the prosthesis does not heal around the shaft within this time period, comprehensive medical evaluation is warranted to determine the cause of the problem. Another cause of leakage around the prosthesis is the presence of narrowing (stricture) of the esophagus. The narrowing of the esophagus forces the laryngectomee to swallow harder using greater force, so that the food/liquid goes through the stricture. The excess swallowing pressure pushes the food/liquid around the prosthesis.
Several procedures have been used to treat persistent leakage around the prosthesis. These include temporary removal of the prosthesis and replacement with a smaller-diameter catheter to encourage spontaneous shrinkage; a purse-string suture around the puncture; injection of gel, collagen or micronized AlloDerm® ( LifeCell, Branchburg, N.J. 08876); cautery with silver nitrate or electocautery; autologous fat transplantation; and inserting a larger prosthesis to stop the leak. Treatment of reflux (the most common cause of leakage) can allow the esophageal tissue to heal. Increasing the diameter of the prosthesis is generally not recommended. Generally larger diameter voice prosthesis is heavier than a smaller one, and the weakened tissue is often not able to support a bigger device, making the problem even worse. However, some believe that using a larger diameter prosthesis reduces the speaking pressure (larger diameter allows better airflow) which allows greater tissue healing to occur while the underlying cause (most often reflux) is treated.
The use of prosthesis with a larger esophageal and/or tracheal flange may be helpful, as the flange acts as a washer to seal the prosthesis against the walls of the esophagus and/or trachea, thus preventing leakage. Both types of leakage can cause excessive, strenuous, coughing which may lead to the development of abdominal wall and inguinal hernias. The leaked fluid can enter the lungs and causing aspiration pneumonia. Any leakage can be confirmed by direct visualization of the prosthesis while drinking colored liquid. If leakage occurs and cannot be corrected after brushing and flushing the voice prosthesis, it should be
Pg 12 12
Removed as soon as possible. With the passage of time, voice prosthesis generally tends to last longer before it begins to leak. This is because the swelling and increased mucus production are reduced as the airway adapts to the new condition. Improvement is also due to better prosthesis management by laryngectomees as they familiarize themselves with their device. Patients with a TEP need to be followed by a SLP because of normal changes in the tracheo-esophageal tract. Re-sizing of the tract may be needed as it can change in length and diameter with time. The length and diameter of the prosthesis puncture generally change over time as the swelling generated by creation of the fistula, surgery, and radiation gradually decreases. This requires repeated measurements of the length and diameter of the puncture tract by the SLP who can select a properly sized prosthesis. One of the advantages of having voice prosthesis is that it can assist in dislodging food stuck in a narrow throat. When food get stuck above the prosthesis, trying to speak or blowing air through the voice prosthesis can sometimes force the stuck food upward and relieve the obstruction. The prosthesis may have to be changed if there is an alteration in the quality of the voice, especially when the voice becomes weaker or one needs more respiratory effort to speak. This may be due to yeast growth which interferes with the opening of the valve. PREVENTING THE VOICE PROSTHESIS FROM LEAKING
It is advisable to clean the voice prosthesis’ inner lumen at least twice a day and after each meal. Proper cleaning may prevent and/or stop leakage through the voice prosthesis:
1. Before using the brush provided by the manufacturer, dip it in a cup of hot water and leave it there for a few seconds.
2. Insert the brush into the prosthesis (not too deep) and twist it around a few times to clean the inside of the device.
3. Take the brush out and rinse it with hot water and repeat the process 2-3 times until no ma-terial is brought out by the brush. Because the brush is dipped in hot water one should be careful not to insert it beyond the voice prosthesis inner valve to avoid traumatizing the esophagus with excessive heat.
4. Flush the voice prosthesis twice using the bulb provided by the manufacturer using warm (not hot!) potable water. To avoid damage to the esophagus sip the water first to make sure that the water temperature is not too high.
Warm water works better than room temperature water in cleansing the prosthesis probably because it dissolves the dry secretions and mucus and perhaps even flushes away (or even kills) some of the yeast colonies that had formed on the prosthesis.
Part 1 of article Courtesy of The New Voice (Robyn Stark & Lorrance Lancaster)
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Lawyers Don't Lie.
A Lawyer Had A Wife And 12 Children And Needed To Move As His Rental Agreement Was Coming To An End, for The home where he lived but was having difficulty in finding a new home.
When he said he had 12 children, no one would Rent A Home To Him because they knew that the children would destroy the home.
He could not say that he had no children, He Could Not Lie, After all, Lawyers Cannot And Do Not Lie.
So, he had an idea : he sent his wife for a walk to the cemetery with 11 children.
He took the remaining one with him to see homes with the Real Estate Agent.
He liked one of the homes and the agent asked :
"How Many Children Do You Have?"
He answered, "12 children."
The agent asked, "Where are the others?"
The Lawyer answered, with a sad look, "They are in the Cemetery with their Mother."
And that's the way he was able to Rent A Home For His Family Without Lying.
MORAL : It is not Necessary To Lie, One Only Has To Choose The Right Words.
Lawyers Don't Lie ...They Are Creative .......and don't forget: Most politicians are lawyers.....
Courtesy of Phillip Richards
Barbara Walters, of 20/20, did a story on gender roles in Kabul, Afghanistan, several
years before the Afghan conflict. She noted that women customarily walked five paces behind
their husbands.
She recently returned to Kabul and observed that women still walk behind their husbands.
Despite the overthrow of the oppressive Taliban regime, the women now seem happy
to maintain the custom.
Ms Walters approached one of the Afghani women and asked, 'Why do you now seem happy
with an custom that you once tried so desperately to change?'
The woman looked Ms Walters straight in the eyes, and without hesitation said, "Land mines."
Moral of the story is (no matter what language you speak or where you go):
BEHIND EVERY MAN, THERE'S A SMART WOMAN Courtesy of Erica Ring
Pg 16 14
Humour Finding a woman sobbing that she had locked her keys in her car, a passing soldier assures her that he can help. She looks on amazed as he removes his trousers, rolls them into a tight ball and rubs them against the car door. Magically it opens. "That's so clever," the woman gasps. "How did you do it?" "Easy," replies the man. "These are my khakis". Jane and Arlene are outside their nursing home, having a drink and a smoke, when it starts to rain. Jane pulls out a condom, cuts off the end, puts it over her cigarette, and continues smoking. Arlene: What in the hell is that? Jane: A condom. This way my cigarette doesn't get wet. Arlene: Where did you get it? Jane: You can get them at any pharmacy. The next day, Arlene hobbles herself into the local pharmacy and announces to the pharmacist that she wants a box of condoms. The pharmacist, obviously embarrassed, looks at her kind of strangely (she is, after all, over 80 years of age), but very delicately asks what size, texture, brand of condom she prefers. 'Doesn't matter Sonny, as long as it fits on a Camel.' "Would you mind telling me, Doctor," Bob asked, "how you detect a mental deficiency in somebody who appears completely normal?" (courtesy of Ray "Nothing is easier," he replied. "You ask him a simple question which everyone should answer with no trouble. If he hesitates, that puts you on the track." "What sort of question?" "Well, you might ask him, 'Captain Cook made three voyages around the world and died during one of them. Which one?' Bob thought for a moment, and then said with a nervous laugh, "You wouldn't happen to have another example would you? I must confess I don't know much about history." A third grade teacher asked her students to, one by one, stand in front of the class and tell what their Daddy's do. Little Mary went first, "My daddy is a doctor
and he saves people's lives." "That's wonderful Mary. Now how about you Jane, what does your daddy do?" "My daddy is a lawyer and he puts bad people in jail," says Jane. "Very good Jane. Ok Johnny, what does your daddy do?" "My daddy is dead," says Johnny. "Oh, I'm very sorry to hear that Johnny," said the teacher, "what did he do before he died?" "He turned blue and shat on the carpet." There was a husband and his wife sitting next to a drunk in a bar. Suddenly the drunk stands up and yells, "Attention all!!" and farts loudly. The wife is extremely embarrassed, and the husband looks at the drunk and says, "Excuse me, you just farted before my wife." The drunks replies, "I'm sorry I didn't know it was her turn." A penguin walks into a bar, goes to the counter, and asks the bartender, "Have you seen my brother?" The bartender says, "I don't know. What does he look like?" A tornado hit a farmhouse just before dawn. It lifted the roof off, picked up the beds on which the farmer and his wife slept, and set them down gently in the next county. The wife began to cry. "Don't be scared, Susan," her husband said. "We are not hurt." Susan continued to cry. "I'm not scared," she said between sobs. "I'm happy because this is the first time in 15 years we've been out together." Politicians and diapers have one thing in common. They should both be changed regularly, and for the same reason. I changed my password to " incorrect" . So whenever I forget what it is the computer will say "Your password is incorrect". I bought a vacuum cleaner six months ago and so far all it's been doing is gathering dust. If you're not supposed to eat at night, why is there a light bulb in the refrigerator? Waking up this morning was an eye-opening experience.
