Tips on communicating with an electrolarynx

Jim talks about using an electrolarynx and shares some valuable communication tips for new electrolarynx patients.

How does your device work?

A TEP (Tracheo Esophogeal Prothesis), or an indwelling valve, allows the patient, as they recover, to regain a voice by using the muscles at the back of the neck, that whilst diverting the air. I will show you.

So you would press that, and that would divert the air from the windpipe into the esophagus, and then they form words just by using the tongue and the mouth, so that's a TEP.

Over 90% of laryngectomy patients are fitted with one of them at the point of the operation. It gets changed about once every 6 weeks to 3 months depending on how much you speak and whether the valve starts to leak.

However, the other 10% of us, are given an electrolarynx.  Although, the handing out of an electrolarynx is a bit patchy across the NHS, and some people have to fund them themselves. 

But in most cases, people are given these devices and they learn how to speak by using the vibration which is inserted into the neck and then the same muscles at the back of the throat, and the lips and tongue and then form the words.

What do you think could be improved for patients who are going to have a laryngectomy?

I think that comes back to the diagnosis in the first place. I think what would make it a lot easier for patients is for in between the diagnosis and the actual treatment, is for the patients to meet other laryngectomies who have had the treatment.

You can imagine, that when you’re actually told by a consultant that you have laryngeal cancer, of any type, you may think the usual reaction is; will I live?’  But in fact, that was not my reaction, it was; ‘you can’t possibly take my voice away because my voice is my personality’.  So it is quite a devastating thing to be told, however, if you get the opportunity to meet post-operational laryngectomies they can show you how to regain a voice. 

I, in fact, do that now with laryngectomies who are about to go through the operation. And I also help people who are given electrolarynxes to learn how to voice using this machine.  Getting used to an electrolarynx and being reasonably fluent with it, is not as easy as I may make it look.

So, over the last 5 years, I have developed a method of doing this. That is what I help new electrolarynx users get used to, how to phrase, how to enunciate, how to raise and lower the voice.  And that helps a lot in communication.

What are your top tips for communicating?

One of the key things, with using an electrolarynx, or even a valve, is maintaining eye-to-eye and face-to-face contact with the person you are speaking to.  Because although we don’t realise it, we all have the ability to lip-read. And as someone is talking to you, if you can’t quite make them out, if you look at the lips, then very often, you’ll be able to see a lot clearer.

I had some problems at the front end in making people understand this, and being able to have the confidence to tell them that.  The natural thing that people do when I start to speak to them is they tilt their head towards me, like that.  And I’ve got to say, no no no, look at me, you’ll hear me a lot clearer.

The other thing that I tell new electrolarynx users, is do not be scared to use them. Get out there, get into a Costa coffee shop, and order yourself a coffee.  And that alone is an amazing boost to the ability to communicate as soon as you get out into the open world.