LPR

Mmm...laryngopharyngeal reflux (LPR). Apparently, I have it.

I've been learning about it in my voice disorders class. It's when gastroesophageal reflux/acid that causes "heart burn" gets up to the level of the vocal folds and causes irritation. It can cause your voice to go hoarse, it can make you clear your throat a lot, etc. If it's really bad, there are medications that can help control the reflux, but I haven't really been symptomatic, although looking back I can see very subtle symptoms of it (e.g. coughing in the middle of the night, as gastric acid is most likely to go up the esophagus as I'm lying down).

How did I find out that I have LPR?

Earlier this week I decided to calculate my s/z ratio just for fun. This ratio is a test that SLPs can do to screen for a possible vocal fold pathology. The client takes a deep breath and produces the /s/ sound for as long as possible and then does the same thing for /z/. The sounds are the same except that /s/ is voiceless, meaning the vocal folds are apart during production and /z/ is voiced, meaning the vocal folds are together and vibrating. Normal ratios are 1:1. If it's greater than 1.4 it means that /z/ is shorter than /s/ and too much air is escaping between the vocal folds as a result of nodules or polyps or some other pathology. I was shocked to find that my s/z ratio was 1.5. I thought "No way, I don't have nodules or anything, this s/z ratio is bogus". And I kind of dismissed the whole thing.

Then a few days later it my last day at my clinical placement and I finally got a chance to be videostrobed. I was so excited. I couldn't wait to get a picture of my vocal folds. But my supervisor had a hard time getting a clear picture because 1) I was drooling a lot and it was making the picture foggy and blurry, 2) My oropharynx is small so by the time the strobe got past my tongue and epiglottis to see into my airway it was already up against the back of my throat and 3) My vocal folds are pretty far down my airway. Well, anyway, she was still able to get some images and as she was watching them on the monitor she goes "I hate to tell you this, but you have reflux!" What?! Not possible! Reflux is what old people get when they eat spicy food!

So I have LPR. It explains the s/z ratio. When your vocal folds are irritated by the acid they get inflamed and swollen and they may not fully come together during phonation, thereby allowing air to escape. I've had no other symptoms, no "heart burn", no hoarsenes, nothing other than a bit of coughing in the middle of the night, which I have always attributed to dry air.

Here are the pictures. Don't get grossed out. I'm really proud of them : )

Okay, back to studying. I just spent the last hour and a half posting when I should have been spending my limited supply of energy on exam prep and paper writing. Bah.

Haaaaaallelujah

This past weekend was symphonyful. On Friday I used the free tickets I had to go to a Detroit Symphony Orchestra (DSO) performance of The Four Seasons by Vivaldi. The seats were on the main floor and worth $68 each. I didn't care much for the view. We could only see the musicians at the edge of the stage. It was fantastic music, though. I think my favourite seasons/concertos are Spring and Fall.

On Saturday I went to Handel's Messiah by the DSO and Michigan State's Chorale. It was long, but definitely worth hearing in its entirety. The soprano soloist was the best, as she was the only one who didn't use vibrato excessively, and I think I heard her sing a really high D. The conductor was cool--at times he was conducting and playing harpsichord simultaneously! During the Hallelujah chorus everyone in the audience stood up. It's traditional to do that because apparently King George II stood up at that point during a performance, so everyone else in attendance stood as well. Theories as to why he was standing: he was late and walked into the hall at that point in the performance, he needed to stretch or he needed to go to the bathroom. I also found out that the text/libretto is based mostly on Isaiah, Matthew and 1 Corinthians. I just finished reading 1 Corinthians, so it was neat to hear it put to music.

Go to http://www.tsoundcheck.com/ for cheap student tickets to the Toronto Symphony Orchestra. Live classical music is fantastic! I've gotta say, I'm not usually a big fan of it, but when it's live it can be pretty thrilling.

American Thanksgiving

A couple of weekends ago I had my second Thanksgiving of the year. I spent the American holiday with Dawn (a friend from church) and her family. I told her it would be my first ever white people Thanksgiving. Little did I know that white people are the minority in her family! The story is that her parents adopted a bunch of kids, all of whom are ethnic minorities (Korean, African American, Hispanic). Out of 12 kids in the family only 4 are biological. Several years ago Dawn's dad passed away and her mom ended up remarrying a man who also adopted a bunch of kids. Altogether there are 22 kids in the family now! Absolute insanity. But such amazing people. Anyway, it was a fun day...I ate way too much, but that's expected.

The next day I went to the Detroit Institute of Arts for its grand re-opening. Free admission :) My goal is to go to all the museums in the area for free before I graduate. I've already hit up 4 of them on various free admission days, but at least one of them I have to revisit at some point b/c I didn't really get to see everything I wanted to see. Grad school has made me so stingy (let's say...frugal) it's not funny. Not having any income whatsoever after 7 years of holding down multiple part-time and full-time jobs simultaneously will do that to you.

Saturday morning my family came to visit. We went outlet shopping, of course, but we were disappointed that we didn't find any major deals. After Birch Run we went to Chicago Uno Bar and Grill, which is becoming a bit of a tradition now. We always go there for steak after a day of shopping. The next day, after some more shopping, I finally got to take my family to Citadel. The past several times they've come to visit they weren't able to stick around for the service, which is in the afternoon. This time they stayed and I think overall they at least thought it was interesting, but then I didn't feel like the service was representative of Citadel. My parents were also really shocked at the testimonies of youth in the church who had just come back from a purity retreat. A bunch of them stood at the front of the sanctuary and said stuff like "I learned that masturbation is a sin...not that I do it" (haha!) and "After this retreat I've decided not to have sex anymore until I get married" (nearly causing the girl's grandma to have a heart attack at the news that the girl had been having sex at all).

Christmas is three weeks tomorrow! Definitely putting up the tree as soon as I get home. I don't care that it will only get put up a couple of days before the 25th or that it'll probably be ugly since there is no rhyme nor reason to our random collection of decorations. The past three years we've been away during the holidays, but this year we're home and we are having Christmas.