Hardly able to walk or speak, unable to eat and facing confinement to a wheelchair just a few short months ago at age 78, Dennis Welch, who has Parkinson’s Disease, felt he wouldn’t be around much longer.
The tall, thin man, who lives south of Garrison with his wife, Maggie, was basically a shut in unable to control his movements and was becoming more and more depressed each day.
“I was going into a shell, things were closing in,” Welch said recently as his hands involuntarily flailed.
Welch was diagnosed with Parkinson's, a chronic, degenerative neurological disorder of the central nervous system that results from the loss of cells in various parts of the brain,affects one in 100 people over age 60, in 2007. He had been to numerous specialists for treatment and recently a speech therapist at the University of Minnesota referred him to Cuyuna Regional Medical Center’s new Lee Silverman Voice Treatment Big and Loud program.
In the four-week program, Welch came to CRMC for appointments four times a week where he was treated by speech, physical and occupational therapists and did a set of exercises to help build his strength. He was also provided recommendations like drinking thickened liquids and modifying his diet to improve the ease and safety of swallowing. His progress has been amazing and life changing. He is now walking just fine, has his balance back, finds it easier to swallow and can talk louder and clearer.
CRMC’s Rehabilitation Services has been offering LSVT Big and Loud for patients with Parkinson’s Disease and other neurological conditions for about a year. The intensive, amplitude focused physical therapy approach was developed from the principles of the effective Parkinson’s specific speech treatment, LSVT LOUD. These programs were scientifically researched over the past 25 years with funding from the National Institutes of Health. The research documented improved ratings by people with Parkinson’s in the following areas: faster walking with bigger steps, improved balance, increased trunk rotation, and improvements in activities of daily living such as bed mobility.
“It was an absolute pleasure for me to have had the opportunity to get to know and introduce the LSVT Big program to Dennis along with my well-trained cohorts,” said Occupational Therapist Laura Amundson.
She explained how the program altered the way Welch lives his life, impacting him positively beyond the program. Her focus for Welch involved taking an Occupational Profile to incorporate involvement in “meaningful activity.” One of the activities involved being able to “mow the lawn again.” Other activities involved feeding himself more efficiently without spills to avoid embarrassment when eating out at a restaurant. Also, speed and efficiency with movement patterns during dressing tasks.
Physical Therapist David Campbell used high amplitude movements and speed to improve Welch’s functional mobility so he could stand from chairs quickly and without using his arms, get in and out of bed quickly and independently, and get in and out of his vehicle independently. “His walking and balance drastically improved to the point where he no longer needed a cane to walk or complete stairs,” Campbell stated.
“Dennis was a joy to work with and a star student,” said Speech-Language Pathologist Kristin Elliott. She explained that Welch improved his vocal loudness by stimulating the muscles of his voice box and speech mechanism through a systematic hierarchy of exercises. Focused on a single goal “speak LOUD!” – the treatment improved respiratory, laryngeal and articulatory function to maximize speech intelligibility.
Elliott further explained that at his initial evaluation, Welch reported that dysarthria (a motor speech disorder) impacted his ability to communicate with family and friends and said he was less likely to participate in conversations out of fear that people couldn’t understand him. His difficulty communicating significantly impacted both his confidence and quality of life.
By actively completing exercises at treatment sessions and at home, Welch not only improved his ability to self-monitor his vocal loudness, but he also consistently completed carryover activities that allowed him to embrace his “new LOUD normal.” He exceeded treatment goals which had a positive real-world impact on his ability to communicate.
Now Welch is leading a fulfilling and productive life. He is able to have a conversation with his 11 children, “too many to count” grandchildren and their friends. He’s enjoying life and able to do ordinary things like writing, driving and helping to cut wood.
His family life has also improved. Before the treatment, he said his wife and children always asked “what?,” “what?,” as he coughed and fought to speak louder. Their conversations were strained and frustrating.
“Now, they can understand me when I speak and we can carry on a conversation,” said Welch adding that he really enjoys visiting with people. “Some days are tough but most days are pretty good.”
Welch, who was raised in Pequot Lakes and graduated from Pine River High School, retired from Brainerd’s paper mill in 1997. He and his wife spent the next 10 years traveling the country in their recreational vehicle until he needed a liver transplant in 2004. Welch received the transplant at the Mayo Clinic in Jacksonville, Florida, where he now annually goes back for follow up appointments.
Today, he continues to do LSVT Big and Loud exercises for about a half hour twice a day and sometimes three times a day because it makes him feel so much better and gives him more energy.
“This is a really fantastic program; I recommend it to anyone who has Parkinson’s,” Welch stated. “Everyone in the therapy department is so knowledgeable and caring.”