Speech therapy: When silence is not golden
Published on 24 October 2022
We find out how two patients who lost the power of speech were finally able to find their voices once again.
Ms Belinda Lee began to lose her hearing when she was in her 30s.
It was a gradual process, but one that was nonetheless terrifying. When she first realised that her hearing was beginning to fail, she visited the polyclinic – but ended up defaulting on her referral appointment due to fear.
But her condition began to worsen. As the years went by, she lost all the hearing in her right ear, and eventually, in her left ear as well. “The sound I heard became softer and softer until I lost my hearing completely,” she said, adding that she relied heavily on lip reading to understand others. “I had to frequently borrow a listening ear from other people, as I could not hear…even so, I felt stressed as not everyone was keen and available to help me communicate.”
Her struggles made it difficult to find a job, and Ms Lee ended up working as a part-time cleaner for seven years. And as her hearing deteriorated further, her social life suffered – to the point where even the prospect of communicating with other people became frightening. She soon began cutting down on her communication with others, only speaking if it was necessary.
One of the most depressing periods in her life came when she just gave birth to her child. Without her hearing, Ms Lee found it challenging to take care of her newborn daughter as she would not know if she was crying. “I had to constantly watch over her facial cues and guess if my baby needed me,” she shared. “I felt very angry yet helpless…I was very depressed, and worried that I would live without hearing forever.”
In Ms Lee’s case, her eventual diagnosis was of sensorineural hearing loss, a condition caused by a damaged cochlear (inner ear). But problems with communication can emerge even in unexpected situations.
Musician and producer Mr Tony Goh never expected to lose his voice – until he did, and nearly lost his life as well. Part of local music trio Tony, Terry & Spencer, he tested positive for COVID-19 in October 2021.
“I still could walk, and I didn’t feel anything serious,” he shared. “When I went to the hospital, I didn’t know what was happening…but they put me straight on oxygen.”
Although he was quickly admitted into the Intensive Care Unit (ICU), his condition rapidly deteriorated. Within a week, he was sedated and put on a breathing tube through his mouth – by mid-November, the damage was so severe that doctors told his wife that he would need “a miracle to get well”.
In a last-ditch attempt to save his life, Mr Goh was recommended a tracheostomy to help him breathe. This is a procedure that involves creating an opening in the front of the neck so a tube can be inserted directly into the windpipe. But such a process leaves a patient unable to speak or sing, possibly for the rest of their lives – a decision that his wife was left to make.
Thankfully, he survived the procedure. But when he regained full consciousness two weeks later, he was unable to speak at all, and instead had to communicate through writing and text messaging. “My throat was in bad shape,” he shared, adding that he had to be on a feeding tube because he couldn’t swallow.
Although he was subsequently able to tolerate the capping of his tube with a speaking valve – a device that helps a person on tracheostomy speak – “my voice was still very weak and soft,” he said. “Like a whisper.”
Turning point for Ms Lee
For Ms Lee, the turning point came when her daughter entered primary school.
With no one available to watch her after school, Ms Lee’s daughter began to accompany her mother at work. Seeing Ms Lee being worked to the bone, however, upset her daughter, who urged her to find another job.
She added, “She disliked the working environment and kept asking me to quit, until I couldn’t take it anymore and promised to seek help for my hearing and source for a better job.”
She finally made the decision to go back to Ng Teng Fong General Hospital (NTFGH), where she was originally referred to. After a cochlear implant in 2019 and two years of aural rehabilitation with her Audiologist and Speech Therapist, Ms Lee now feels more confident, is able to communicate freely, and has even found a new job.
“Following the surgery, I made sure that I did all the homework given by my speech therapist. It was a long process,” she shared, adding that her rapid progress “exceeded everyone’s expectations”. As sound is perceived differently with cochlear implant, she had to relearn and gradually identify sounds, words, and sentences. Eventually, she was even able to hear and communicate on the phone. Despite her initial anxiety, she diligently pushed herself to communicate with other people as much as possible to improve her hearing, and practised listening to music in her free time.
“I am finally independent and lead a normal life now,” she said. “I did not have many friends in the past as I dared not, and could not, talk to others – but now, I take initiative to continue conversations with other people, and enjoy making new friends.”
Mr Goh’s story has a happy ending too
After many sessions with his speech therapist, during which he practised vocalising and did neck exercises to strengthen the muscles around his throat, he was able to eat and drink again, and his voice improved nearly to the point of what it was prior to his hospitalisation.
And it was a huge relief to him when he first realised he could sing again. “I finally found something that I was still capable of doing even though my lungs were still weak,” he said. “And [eventually]…I was discharged a day or two earlier than expected.”
Mr Goh still heads back to Alexandra Hospital (AH) for follow-up speech therapy appointments with Senior Speech Therapist Jaymie Chai every few months to continue strengthening his voice. Today, he can sing songs in full, swallow large pills, and is back to jamming in the studio with his band. He even sang in his first live performance in August 2022, in a tribute concert for the late pianist Jimmy Chan – nearly a full year after being hospitalised for COVID-19.
“So it is possible to recover,” he said. “I could have ended up being hooked to the ventilator for the rest of my life…but I went home, and my voice came back.”
For Ms Lee and Mr Goh, the road to recovery required hard work, courage, and patience. But it was also the guidance of their respective speech therapists that proved crucial in their recovery.
From providing patients like Ms Lee and Mr Goh with the right treatment plan, to supporting them through their exercises and rehabilitation, speech therapists play an important role in helping those who have difficulty speaking find their voices - and that really is something to shout about.