THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: January 22, 2013 09:15 AM Tuesday; Rod Welch

VA SF Medical Center ENT meeting voice therapy.

1...Summary/Objective
2...Vocal Chords Weak Schedule Voice Therapy Correct Disorder


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CONTACTS 

SUBJECTS
Voice Disorder Correct Speech Therapy Exercises Training Weak Vocal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2403 -    ..
2404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
240501 - Follow up ref SDS 23 0000. ref SDS 21 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
240502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240507 -  ..
2406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
240901 -  ..
240902 - Vocal Chords Weak Schedule Voice Therapy Correct Disorder                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
240903 - 
240904 - Follow up ref SDS 23 LS6W.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
240905 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240906 - Meeting changed from 130114 to 130122 in call with Trish on 121226                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
240907 - 0742. ref SDS 24 0I4G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
240909 -  ..
240910 - Meeting changed again from 130122 0800 to 0915. 130114 1619,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
240911 - ref SDS 26 GJ52                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240913 -  ..
240914 - Background patient history on voice disorder reported on 121221 0830.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240915 - ref SDS 23 3X6L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240917 -  ..
240918 - Trish submitted voice exercises...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
240919 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240920 -        San Francisco VA Medical Center                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
240921 -        Vocal Function Exercises                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240922 -        (2 Repetitions 2 Times Daily)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
240923 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240924 -        1.  Warm Up - Hold the sound "e" as long as you can on one                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
240925 -            breath.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
240927 -             ..
240928 -            As softly as possibly but not a whisper                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
240929 -            Forward focus slightly nasal sounding                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
240930 -            Smooth voice                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
240931 -            Continue until out of breath even if voice fades out                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240933 -             ..
240934 -            Goal....... 20 seconds                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
240936 -             ..
240937 -        2.  Stretching - Glide up from your lowest to your highest                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
240938 -            pitch on "OOOH"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
240940 -             ..
240941 -            As softly as possibly                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
240942 -            Keep gliding even if your voice fades out until you are                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
240943 -            out of breath                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
240945 -             ..
240946 -            Goal... Continuous smooth sound without voice breaks                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240948 -             ..
240949 -        3.  Contracting - Glide down from your highest to your lowest                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
240950 -            pitch on "OOOH"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
240952 -             ..
240953 -            As softly as possibly                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
240954 -            Do not growl when you get to the lowest pitch                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
240955 -            Keep gliding down until you are out of breath                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
240957 -             ..
240958 -            Goal... Continuous smooth sound without voice breaks                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240960 -             ..
240961 -        4.  Power - Hold "oh" as long as possible on one breath on C D                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240962 -            E F G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
240964 -             ..
240965 -            For men, begin begin at the 3rd octave, for women begin at                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240966 -            the 4th octave                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
240968 -             ..
240969 -            As softly as possible                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
240971 -             ..
240972 -            Goal... Longest output with minimum effort                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240973 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240975 -  ..
240976 - Trish demonstrated performing these 4 exercises.   Explained not sure                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240977 - about difference between soft and whisper, and not sure what "Forward                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240978 - focus slightly nasal sounding" means.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
240980 -  ..
240981 - Trish requested the customer try each voice exercise.  This was poorly                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
240982 - performed.  Trish was helpful further demonstrating each exercise, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
240983 - indicated the customer eventually came closer to performing the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240984 - exercises as intended and in a way that may yield results.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
240986 -  ..
240987 - Trish scheduled meeting on Monday 130225 0800.  She will evaluate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
240988 - progress resolving voice disorder and adjust voice training.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
240989 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240990 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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240997 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
240998 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2410 -