DOB: 3/5/41
Sex: M
Post-onset: 3 months
Referral: self
| Pertinent Medical History (PMH): | tonsillectomy 1953
tibia fracture 1960 Type II diabetes (AODM) diagnosed 1994 COPD CAD, s/p MI 5/95 |
| Social history: | Tobacco: 60 pack year, quit 5/95
Alcohol: 2 drinks/week Divorced computer programmer |
| Family history: | father died of heart attack at age 63
mother: AODM |
| Surgical history: | CABG x4 3 months earlier |
| Current complaints: | hoarse voice |
Interview: (Questions quoted from Duffy (1995) Motor Speech
Disorders)
| ONSET & COURSE | |
| 1. Do you have any difficulty with your speech? If not, has anyone else commented on a change or problem with your speech? | Voice is hoarse |
| 2. When did the speech problem begin?
Did it begin suddenly or gradually? Who noticed it first, you or someone else? |
noticed it after heart surgery three months ago |
| 3. Did you develop any other difficulties when your speech problem
began?
Were other problems present before your speech problem began? Did other problems develop after the sppech problem began? |
n/a |
| 4. Has the speech problem changed?
Better, worse, stable, better-than-stable, fluctuating? |
I stayed the same, maybe a little better |
| 5. Has your speech ever returned to normal?
If so, when and for how long? |
no |
| ASSOCIATED DEFICITS | |
| 1. Have you had any difficulty with chewing? drooling? | no |
| 2. Is it difficult to move food around in your mouth? Why? | no |
| 3. Does food get stuck in your cheeks or in the roof of your mouth?
Do you have to remove it with your finger or a fork? |
no |
| 4. Do you have trouble moving food back in your mouth to get a swallow started? | no |
| 5. Do you have trouble with swallowing?
Food or liquid? Do you have trouble getting a swallow started? Do you lose food or liquid out of your mouth? Does food or liquid ever get into or out of yournose when you swallow? Does food or liquid go down before you swallow and cause coughing or choking? Do you gag or choke when swallowing? Do you cough or choke wheen completing a swallow? Have you had to modify your diet because of these problems? Have you lost weight? |
no |
| 6. Have you had any cahnge in your emotional expression?
Do you cry or laugh more easily or less easily than in the past? |
no |
| 7. Are you taking any medications that seem to affect your speech? | no |
| PATIENTS PERCEPTION OF THE PROBLEM: | |
| 1. What did your speech sound like when the problem began?
Did anything feel different when you spoke? |
Quiet, hoarse |
| 2. Describe your current speech difficulty. How does it sound to you?
How does it feel to speak? Is it faster or slower? Louder or slower? Less precise? Is speaking effortful? |
people can’t hear me |
| 3. Have you noticed any change in the appearance or feeling in your face or mouth? | no |
| CONSEQUENCES OF THE DISORDER: | |
| 1. Do people ever have trouble understanding you?
When? What do you do if that happens? |
When they can’t hear me.
Especially in groups. I either try to yell or just shut up. |
| 2. Do you ever have to write to make yourself understood?
Has your speech problem affected your work? Does it prevent you from doing anything? |
no. no. not really—just people can’t hear me. |
| MANAGEMENT | |
| 1. What have you done to compensate for your speech difficulty?
Have you had any help for your speech? When? For how long? What was done? Did it help? |
Just try to talk loudly. No |
| 2. Do you think you need help with your speech now? | I just want to know what’s wrong—Is it going to get worse? |
| AWARENESS OF DIAGNOSIS AND PROGNOSIS: | |
| 1. What have you been told is the cause of this problem? | First time I’ve asked |
| 2. In view of this diagnosis, what is going to happen? | n/a |
| Area | No Impact | Very little impact | Some impact | Significant Impact | Profound (can't perform in this area) |
| Professional | x | ||||
| Social | x | ||||
| Communicative | x | ||||
| Physical | x | ||||
| Emotional | x |