Nevels completed the LSVT Loud program with Johnson at Regional One Health’s Center for Rehabilitative Medicine. Johnson is one of six LSVT LOUD-certified clinicians in Shelby County. LSVT LOUD is a speech treatment that improves vocal loudness by stimulating the muscles of the larynx and speech mechanism through a range of exercises.
Patients work with Johnson four days a week for one hour at a time over the course of one month. But the work continues at home; Johnson goes over daily homework assignments that help patients improve and maintain their speech. That constant maintenance is followed up three months later.
Like many Parkinson’s patients, it was a slow process to realize what was going on for Nevels. He began noticing tremors in his hands and a general achiness in his arms. He traveled a lot, which made it worse.
“The tremors were the worst thing,” he said. “I couldn’t figure out why my hands were shaking. My doctor said I had a Parkinson’s walk. I’ll always remember that. It’s like if you ever get stopped by the highway patrol and asked to walk a straight line. You can’t do it.”
A decline in his speech came later. Johnson said people with Parkinson’s experience a hearing loss of two to four decibels. So when they’re told to speak louder they often believe they’re screaming. When a new patient comes in she records their voice and plays it back to them so they begin to understand the difference between their perception and reality of their voice. Getting someone to speak louder also forces them to speak slower, making their speech easier to understand.
That’s where the LSVT LOUD program does its magic. But it also helps strengthen the tongue and throat muscles, which benefit more than speech. Long term, Parkinson’s patients can experience problems swallowing or have the need to cough when they eat. The No. 1 cause of death for Parkinson’s patients is aspiration pneumonia, and LSVT LOUD helps patients keep that at bay.
“The program is designed so they will calibrate themselves and they can determine if they have a loud voice,” Johnson said.
The LSVT LOUD program also can work for people with multiple sclerosis and cerebral palsy.
Johnson said if someone notices a problem swallowing or coughing while eating that’s when they need to tell their physician who can make a referral to Johnson and Regional One Health.
“Every Friday for 20 years I’ve had lunch with the same golf buddies. I started working with Johnna and now every Friday they help me, too,” Nevels said. “And every Friday they tell me, ‘You’re getting better. You’re getting better.’ It has been a great barometer. I also have friends with Parkinson’s in other cities I chat with a couple of times a week. They say they don’t have a speech therapist in their city who can do the things that have allowed me to do what I’m doing. I’m totally dedicated to the support Johnna has provided.”