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Scott Adams and Spasmodic Dysphonia

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Dilbert creator Scott Adams was stricken in 2005 with a rare condition called Spasmodic Dysphonia, which prevented him from speaking in a normal voice. The condition is somewhat bizarre, because sufferers can sometimes sing or speak in unusual circumstances, just not with their normal voices. The condition has struck a variety of famous people (according to Wikipedia), including Darryl McDaniels of Run DMC, and Diane Rehm from NPR.

For Adams, the condition meant he could still speak publicly, sing, or speak to himself while alone. But in normal circumstances his vocal cords would seize up and he simply couldn't speak. And to make it worse, Adams reported that no one has ever recovered from the condition. In late 2006, Adams noticed that he could speak perfectly in rhyme. So he repeated a rhyme ("Jack Be Nimble") over and over, and then...something changed. Since then, he has been able to speak semi-normally. It's not perfect, but he reported in January that he is still in a state of partial recovery.

After the jump, read Adams's report of his original recovery. I would just link to it, but his blog entries from that period have disappeared.

Good News Day

As regular readers of my blog know, I lost my voice about 18 months ago. Permanently. It's something exotic called Spasmodic Dysphonia. Essentially a part of the brain that controls speech just shuts down in some people, usually after you strain your voice during a bout with allergies (in my case) or some other sort of normal laryngitis. It happens to people in my age bracket.

I asked my doctor - a specialist for this condition - how many people have ever gotten better. Answer: zero. While there's no cure, painful Botox injections through the front of the neck and into the vocal cords can stop the spasms for a few months. That weakens the muscles that otherwise spasm, but your voice is breathy and weak.

The weirdest part of this phenomenon is that speech is processed in different parts of the brain depending on the context. So people with this problem can often sing but they can't talk. In my case I could do my normal professional speaking to large crowds but I could barely whisper and grunt off stage. And most people with this condition report they have the most trouble talking on the telephone or when there is background noise. I can speak normally alone, but not around others. That makes it sound like a social anxiety problem, but it's really just a different context, because I could easily sing to those same people.

I stopped getting the Botox shots because although they allowed me to talk for a few weeks, my voice was too weak for public speaking. So at least until the fall speaking season ended, I chose to maximize my onstage voice at the expense of being able to speak in person.

My family and friends have been great. They read my lips as best they can. They lean in to hear the whispers. They guess. They put up with my six tries to say one word. And my personality is completely altered. My normal wittiness becomes slow and deliberate. And often, when it takes effort to speak a word intelligibly, the wrong word comes out because too much of my focus is on the effort of talking instead of the thinking of what to say. So a lot of the things that came out of my mouth frankly made no sense.

To state the obvious, much of life's pleasure is diminished when you can't speak. It has been tough.

But have I mentioned I'm an optimist?

Just because no one has ever gotten better from Spasmodic Dysphonia before doesn't mean I can't be the first. So every day for months and months I tried new tricks to regain my voice. I visualized speaking correctly and repeatedly told myself I could (affirmations). I used self hypnosis. I used voice therapy exercises. I spoke in higher pitches, or changing pitches. I observed when my voice worked best and when it was worst and looked for patterns. I tried speaking in foreign accents. I tried "singing" some words that were especially hard.

My theory was that the part of my brain responsible for normal speech was still intact, but for some reason had become disconnected from the neural pathways to my vocal cords. (That's consistent with any expert's best guess of what's happening with Spasmodic Dysphonia. It's somewhat mysterious.) And so I reasoned that there was some way to remap that connection. All I needed to do was find the type of speaking or context most similar - but still different enough - from normal speech that still worked. Once I could speak in that slightly different context, I would continue to close the gap between the different-context speech and normal speech until my neural pathways remapped. Well, that was my theory. But I'm no brain surgeon.

The day before yesterday, while helping on a homework assignment, I noticed I could speak perfectly in rhyme. Rhyme was a context I hadn't considered. A poem isn't singing and it isn't regular talking. But for some reason the context is just different enough from normal speech that my brain handled it fine.

Jack be nimble, Jack be quick.

Jack jumped over the candlestick.

I repeated it dozens of times, partly because I could. It was effortless, even though it was similar to regular speech. I enjoyed repeating it, hearing the sound of my own voice working almost flawlessly. I longed for that sound, and the memory of normal speech. Perhaps the rhyme took me back to my own childhood too. Or maybe it's just plain catchy. I enjoyed repeating it more than I should have. Then something happened.

My brain remapped.

My speech returned.

Not 100%, but close, like a car starting up on a cold winter night. And so I talked that night. A lot. And all the next day. A few times I felt my voice slipping away, so I repeated the nursery rhyme and tuned it back in. By the following night my voice was almost completely normal.

When I say my brain remapped, that's the best description I have. During the worst of my voice problems, I would know in advance that I couldn't get a word out. It was if I could feel the lack of connection between my brain and my vocal cords. But suddenly, yesterday, I felt the connection again. It wasn't just being able to speak, it was KNOWING how. The knowing returned.

I still don't know if this is permanent. But I do know that for one day I got to speak normally. And this is one of the happiest days of my life.

But enough about me. Leave me a comment telling me the happiest moment of YOUR life. Keep it brief. Only good news today. I don't want to hear anything else.

SOURCE: The Dilbert Blog (link currently dead) 10/24/06.

See also: an MSBNC article on the situation.

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Knock-Off Versions of Nerf Ammo Can Cause Serious Eye Injuries
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Mike Mozart, Flickr // CC BY 2.0

Nerf toy guns and their foam projectiles, as marketed and manufactured by Hasbro, are virtually harmless when used as instructed. But, as reported by CNN, a recent paper in the UK medical journal BMJ Case Reports is providing a reality check when it comes to using the mock weapons and off-brand ammo improperly.

Three unrelated patients were treated at Moorfields Eye Hospital in London with ocular injuries that were sustained as a result of being "shot" with Nerf guns. Two adults had bleeding and inflammation in the eye; one 11-year-old had bleeding, inflammation, and damage to the outer retinal layer. All three suffered what the paper described as "significant ocular trauma." Attending doctors treated their swelling, and all symptoms resolved within a few weeks.

So what happened? In the case of one patient, a Nerf play session went awry as a result of using non-licensed ammo that isn't subject to Hasbro's quality control measures and may be made of harder materials as a result. On their Nerf landing page, Hasbro cautions users to "never modify any Nerf blasters or other Nerf products. Use only the darts, water, rounds, and discs designed for specific Nerf blasters."

Pediatric ophthalmologists interviewed by CNN recommend that protective eyewear be used whenever anyone is playing with Nerf weapons. It's also advisable never to aim for the face when shooting and to avoid attempting to modify the weapons to shoot faster or farther.

[h/t CNN]

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Here's What You Need to Know Before Getting Inked or Pierced, According to Doctors
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Getting inked or pierced is a rite of passage for many teens and young adults. But before getting that belly ring or butterfly on your back, experts want you to be aware of the risks, which are reviewed in a new clinical report from the American Academy of Pediatrics (AAP). According to NPR, it's the first set of recommendations the professional association has ever released on the practices.

Forthcoming in the October 2017 issue of Pediatrics and available online, the report provides a general assessment of the types and methods used to perform body modifications, along with potential health and social consequences. Here are a few main takeaways:

—It's unclear how often tattoos cause health complications, but they're generally believed to be rare, with the greatest risk being infection. One recent study found that nanoparticles in ink can travel to and linger in lymph nodes for an extended period. That said, you should check with your doctor to make sure all of your immunizations are up to date before getting either a tattoo or piercing, and that you're not taking any immunity-compromising medicines.

—Before shelling out your hard-earned cash on a tattoo, make sure it's something you'll likely still appreciate in five to 10 years, as it costs anywhere from $49 to $300 per square inch to remove a tattoo with lasers. (This might provide all the more incentive to opt for a small design instead of a full sleeve.)

—About half of people 18 to 29 years of age have some kind of piercing or tattoo, according to Dr. Cora Breuner, who is chair of the AAP committee on adolescence. Many individuals don't regret getting one, with some reporting that tattoos make them feel sexier. But while millennials appear to be cool with metal and ink, hiring managers might not be too pleased: In a 2014 survey of 2700 people, 76 percent said they thought a tattoo or piercing had hindered their chances of getting hired, and nearly 40 percent thought tattooed employees reflected poorly on their employers.

—Not all tattoo parlors are created equal, as each state has different regulations. Keep a close eye on whether your artist uses fresh disposable gloves, fresh needles, and unused ink poured into a new container. This helps prevent infection.

—The advice is similar for getting pierced: Make sure the piercer puts on new, disposable gloves and uses new equipment from a sterile container. Tongue piercings can cause tooth chippings, so be careful of that—and remove any piercings before you play contacts sports.

The full report is available online.

[h/t NPR]

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