This script begins with Herbert and Wanda Mae getting ready to attend their first support group meeting.

Wanda Mae: Herbert, its 6:00, when are you going to get dressed, so we can leave for the support group meeting? And why do you already have on your pajamas?

Herbert: 6:00, huh, I thought it was bedtime.

Wanda Mae: You ole fox, you know exactly what time it is. Stop playing around and get dressed we don’t want to be late.

Herbert: Who says we don’t want to be late. I’ve changed my mind, I don’t want to go.

Wanda Mae: Now Herbert, I e-mailed Ms. Skeens earlier in the week and asked her for the name of the support group leader and her e-mail address. You know that she responded with that information and I also e-mailed Ms. Scott, telling her to expect us. Now get up and get ready.

Herbert: No!

Wanda Mae: Are you trying to make a liar out of me?

Herbert: No,…..You should have asked me first.

Wanda Mae: Herbert, don’t sit there and act like you didn’t agree to this. Are you going crazy or just being contrary?

Herbert: I’m going crazy.

Wanda Mae: Herbert,…I feel like this support group can help us adjust to your swallowing disorder in a healthy way.

Herbert: Wonderful, now you’re a health fanatic. All right, I’ll get ready. You know, when I married you 40 years ago, I never thought you turn into such a nag.

Wanda Mae: Uh huh. Let’s go.

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Scene 2 Fade in

Herbert and Wanda Mae arrive at the library.

Herbert: Wanda Mae, I’m nervous about talking in front of all those people.

Wanda Mae: Herbert, I’m sure you don’t have to talk if you don’t want to. If you feel uncomfortable, just listen. Although, I’ve never seen a day go by where you were at a loss for words.

Herbert: First you’re a health fanatic, now you’re a comedian.

Wanda Mae: If you're nervous about talking in front of everyone, why don't you pretend like you're making an entry into your private journal. That way it should be easier for you to talk. Just pretend.

Herbert: Maybe....

Wanda Mae: You have already written your thoughts and feelings in your journal, now just pretend that you're reading them out loud.

Herbert: Maybe I will, if I get nervous.

Wanda Mae: Here it is, 2nd floor, Preston room. Come on Herbert, lets find a seat. Oh, this is a tiny room.

Herbert: Lets sit near the door just in case we need to leave early.

Wanda Mae: Herbert.

Imogene Scott: Good evening folks, I’m Imogene Scott (extending her hand).

Herbert: Hello Ms. Scott, my name is Herbert Calhoun and this is my lovely, healthy and funny wife, Wanda Mae. (Shaking hands with Ms. Scott)

Wanda Mae: Good evening Ms. Scott. It’s so nice to meet you. (Shaking hands with Ms. Scott).

Imogene: (Looking at Herbert a little strangely because of the way he introduced his wife) Thank you both for your interest in our group, we’re just about ready to get started, it won’t be long. Would you like something to drink or munch on?

Herbert: No, I can’t eat or drink right now.

(Herbert's thoughts are heard over the speaker: Ain’t that a kick in the head, asking a man who is starving to death if he wants something to eat or drink, when he can’t swallow)

Wanda Mae: Nothing for me.

Imogene: Well, like I said we’ll get started in a few minutes, we still have a couple of members who aren’t here.

Herbert: Real considerate woman.

Wanda Mae: Shhhh... Herbert, you’re not the only person here. Other people can eat and drink. Stop being so childish and difficult.

Herbert: If I didn’t love you so much…

Wanda Mae: I know, "POW" right in the kisser. Ha! Ha! Crazy ole man.

Imogene: Well, it looks like we’re all here, so let’s get a seat and get started. Tonight we have a couple of guests. Their names are Herbert and Wanda Mae Calhoun.

Group: Good evening.

Herbert: (Stands) Hello.

Wanda Mae: (Stands) Hello everyone.

Imogene: Now, the first thing we are going to do tonight is watch a powerpoint presentation. It was developed by a friend of mine, who happens to be a speech therapist, and actually I think she has or is working with many of you. Her name is Geneva Skeens and her presentation talks about swallowing disorders and how it can affect your self-image. I feel like everyone in this room can personally relate to this topic.

Group member Larry: Sounds good to me, lets get this show on the road.

Imogene: Okay. It won't take but about 5 minutes and then we'll get into our group discussion. Herbert and Wanda Mae, I'm so glad you're here tonight, I feel the presentation will reflect a lot of your personal thoughts.

Herbert: She's my speech therapist right now.

***************Powerpoint Presentation******

Group: Oh, that was really good.

Marvin: You know the part about men having a difficult time adjusting or should I say coping with swallowing disorders, is true on my part. I felt worthless and useless but I don't any more. (Gergen & Davis, 1997).

Imogene: Do you think that has anything to do with your being able to swallow now?

Marvin: No, because I'm still working exercises to improve muscle strength. My SLP is also using thermal stimulation since I have a delayed swallow reflex. (Searle, 2002).

Herbert: What's thermal stimulation?

Marvin: Its where my SLP rubs something hot in the back of my throat, so I'll know when to swallow. It helps to trigger my swallow reflex. Cold things also work for me. (Searle, 2002).

Herbert: I never heard of that before.

Imogene: Probably because you don't have a delayed swallow reflex.

Imogene: Herbert, if I remember correctly from Wanda Mae’s e-mail, you have a swallowing disorder as the result of a stroke around 2 months ago.

Herbert: Yeah, that’s right.

Group Member Thomas: I had a stroke 6 months ago and I’m almost back to normal. Whatever that is. Anyways, I’m able to eat solid foods, but I have to be extremely careful with liquids. I haven’t choked but there’s this feeling that I might and sometimes I feel like my swallowing mechanism doesn’t work when I take a sip of water. (Klugman & Ross, 1994).

Wanda Mae: See Herbert, it just takes time.

Group Member Lewis: I have to be careful when I drink because I often choke. It’s like my throat forgets to swallow. (Klugman & Ross, 1994).

Herbert: I know what you mean. A sip of water can choke me. I can’t even swallow my pills. They have to be crushed and fed into my gastric tube. (Finney & Gettig, 2002).

Group member Sally: I was lucky I didn’t need a gastric tube. I worked with my speech therapist doing exercises to strengthen my laryngeal muscles, so swallowing wouldn’t be so difficult. At first the doctor was afraid I would aspirate and didn’t want me to eat, but now my speech therapist says I have made tremendous progress. (Searle, 2002).

Wanda Mae: Yes, Sally, it sounds like you’re extremely blessed.

Imogene: Let’s not forget to mention postural changes when we eat. Marvin, would you like to help us out here.

Marvin: Be happy to. Because I have a delayed swallowing reflex, this means when the food is moved to the back of my throat by my tongue, the trigger point at the facial arches is delayed, causing some of the food to spill over into the back of my throat, which can cause me to aspirate. So my speech therapist has recommended posture changes when I’m eating. When I swallow I tilt my head forward and this chin tuck prevents me from getting choked. (Searle, 2002).

Herbert: It’s not just the eating that I miss, but also the socializing with my family and friends. When we have family or church socials I feel like I can’t participate like I used to. I don’t want to grill out because the smell of steaks on the grill drives me crazy. I get so hateful, that I don’t know why my family would come around me. I’m constantly depressed and angry. And I don’t always know why. I feel isolated, hopeless, and worthless. I had to quit my job at the airport and even though money isn’t a problem I still feel useless. (Nagler, 1990).

Imogene: Herbert, as I told Wanda Mae a loss of any kind whether its due to death, illness or a disability is a significant event in a person’s life. It takes time to adjust or learn how to cope with the differences in our lives. The best strategy is understanding what is happening to you. The more you learn about swallowing disorders and the compensatory strategies such as postural changes, indirect treatment techniques, such as exercises to improve muscle coordination, and direct treatment strategies, such as the use of swallowing maneuvers to apply voluntary control of components of the swallow, which your speech therapist will teach you, the sooner you will come to terms with your disorder and learns ways to help yourself. It’s so important that we all learn how to cope. (Klugman & Ross, 1994).

Thomas: I have to say she’s right about that. At first, I was always so mad about what happened to me, I totally lost sight of what I had going for me. I mean, once I started thinking about it, I could walk, my speech wasn’t too bad, and I had my memory. Not everyone is that blessed. So, I started becoming more involved in my therapy, not just going to my regular sessions but I practiced my exercises and speech techniques at home and well I’ve come a long way.

Herbert: Well, our granddaughter, Amy, did find this site on the Internet, that talks about some of the things you’re talking about, it also had links to other sites, that talk about swallowing disorders. She said it was really interesting and helpful. Amy said the site belongs to a student in the communication disorder department at Marshall University. She called it a webliography or something like that. She said its got a lot of good information on what happens to a person who has a swallowing disorder.

Marvin: Man its all part of the grieving process. It’s normal to grieve for a life, that we feel like we’ve lost. I say this because some of the things I did in the past, I can no longer do. But should I view my life as hopeless now? No, I don’t want to spend the rest of my days here feeling hopeless. I’m 65, single, and ready for action. (Nagler, 1990).

Sally: (Rolling her eyes) Marvin, we’re all married here.

Marvin: (Huge grin on his face) Nothing wrong with a little advertising. Who knows, someone here may have a single friend.

Wanda Mae: No, we don’t have any single friends, that I can think of. Anyways Herbert got so upset when he would try to eat or drink and food starting coming out of his mouth and then would get chocked. And that's when the doctor and speech therapist told Herbert it would be best if he didn’t eat or drink liquids by mouth, that a feeding tube would be the best thing for him, it really sent him around the bend. (Finney & Gettig, 2002).

Herbert: Its embarrassing not to be able to eat when you’re out with a crowd. I feel so left out. And my mother-in-law doesn’t help. After my stroke, when I started getting choked, she would scream “Wanda Mae look he’s getting choked again” that old hag doesn’t know the meaning of embarassment. Her mother is 85 and has reverted back to her childhood.

Wanda Mae: Herbert, she has not! You two just fight like children all the time. You should see them, our house is like a mad house.

Imogene: That’s okay Wanda Mae, I’m sure we've all have encountered relatives who mean well. Herbert, I know it’s really embarrassing to be out in public or just around your family and begin choking and spluttering with food coming out of your nose and mouth. And its equally frustrating, when instead of joining the crowd at your favorite restaurant, you have to go home and hook up this little bag filled with Ensure (Vitamin and protein enriched drink) so you won’t become malnourished and dehydrated. Unfortunately that’s all part of the learning process. (Finney & Gettig, 2002).

Herbert: You got that right. Who would have ever thought a swallowing disorder could be so stressful. Total frustration. Try having an old hag for a mother-in-law who says, "I hope your vitamin bag gets a leak."

Group: (Laughs)

Thomas: Sounds like she's a pistol.

Marvin: Too bad she's 85, instead of 50.

Sally: Let's get back on the subject. Well, if you don’t know anyone with a swallowing disorder, its not something you think about.

Imogene: (Passing out brochures to the group provided by Geneva Skeens) I almost forgot to hand these out. Ms. Skeens has composed an excellent brochure on swallowing disorders. The format is pretty basis, it doesn't contain a lot of professional jargon, its actually very helpful. After you're read it, pass it along to others who may be interested.

Group: Okay.

Imogene: Well, gang I’m sorry to put an end to our meeting, but it’s already 9:00 and we’ve run 30 minutes over our scheduled time. Herbert and Wanda Mae, I hope you’ll consider joining us again next week.

Group: Yes, please come back.

Herbert: Well, I must confess, that I didn’t want to come tonight, but I’m glad that I did. I can see, there is hope for me. It's been really helpful for me to talk about how lonely and isolated I feel because of my swallowing disorder. (Nagler, 1990).

Wanda Mae: Yes, we’ll be back, I can already see a difference in the way Herbert talks about his swallowing disorder. He’s much more open, which is a very difficult thing for him. Herbert, maybe you can bring the poem you wrote to next week’s session. Herbert wrote a very emotionally moving poem about what its like to have a swallowing disorder. Thank you all so much.

Imogene: Herbert, thank you for sharing so much with us. It’s always good to realize there are others out there with the same problems, and its even better when they are willing to share their experiences with us.

Sally: Herbert, please bring your poem, I'd love to hear it.

Marvin: She's a very emotional person.

Sally: (Glares at Marvin).

*********Group members exit***************

Herbert and Wanda Mae on the drive home.

Herbert: Wanda Mae, I’m so glad you talked me into going to the support meeting. I feel a lot better just getting some of those bad feelings off my chest.

Wanda Mae: I know sweetheart, but I feel like everything is gonna be all right.

Herbert: I love you.

Wanda Mae: Ditto.