Appointments with James P. Thomas, MD

Updated: 11:05 a.m. PDT (18:05 GMT), May 2, 2007

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Appointments: What to expect from an appointment with Dr. Thomas
Dr. Thomas in the voice lab reviewing a videotape of the voice box with a patient.
	My area of special interest is voice disorders, both singing & speaking. Disorders of breathing and swallowing are also part of my interests. My qualifications for this subspecialty practice in Ear, Nose & Throat Surgery (Otolaryngology) include a passionate interest in voice disorders, as well as extensive study including and beyond a six year residency training program in Otolaryngology. I have traveled widely, studying under numerous other laryngologists (ENT doctors who specialize in throat disorders) in the US, Canada and in Europe. In addition, I completed a concentrated fellowship at Loyola University in Chicago studying under Robert Bastian, M.D. What to expect during your visit to my office. On average, I spend about one hour with new patients. This varies quite a bit depending on your needs and the complexity of your problem. Return appointments run about a half-hour, again depending on your needs. Since many patients travel a great distance to see me, I do make an effort not to get behind. While I try to spend whatever time necessary with each one of you, if the problem is quite complex we may need to schedule additional visits if it appears we will significantly delay other patient’s appointments. If you are travelling a great distance, we can sometimes preschedule time for a procedure if we are relatively sure you will need one. We do ask for various ways of contacting you at the time of your initial appointment so that we can notify you if I am behind in my appointments.
The exam I use a three part examination which you will likely find different from your past interactions with Ear, Nose & Throat physicians. I start with the usual: a medical history. Likely you will have filled out this form (pdf version) before your arrival and we will review these together focusing on your voice or throat related problem. We will find out what your goals are for the appointment. Listening to your voice The second part of my exam involves listening to your voice. I will be asking you to read aloud, to use your low voice, high voice, a loud and soft voice and perhaps other vocal tasks, as needed. Listening to your voice under different situations allows me to focus on the characteristics of your voice problem. Even if your problem is not “acting up” on the day of your visit, I can almost always determine the problem this way. Many people are afraid they can't sing or they will sound bad in the office. However, that really is the point of coming here, if your voice isn't working well (flutters, fades, goes off pitch, gives out), that is what we both want - to find out what is not working. Looking at your voice box The third part of the exam is looking at your voice box. This may involve looking with a mirror, but will usually involve looking with a video telescope as well. I use a numbing spray medication on the throat and/or nose, if needed, to prevent gagging. I numb the nose if we look with fiberoptic instruments at the voice box to see it close up and in motion. I record your vocal cords and their movement on a digital videotape and with a special strobe light to view the vocal cords in slow motion. This allows you and I to review any problems on videotape, several times if needed. Since the recording is digital we can look at each tiny movement with minimal distortion or streaking on the monitor. Through this comprehensive examination of the problem, including a history, together with how your voice sounds and how the voice box looks, allows for a precise and accurate diagnosis. I attempt to explain your problem in laymen’s terms and show you how to deal with your problem most effectively. The outcome of treatment should be an improvement in your voice. Treatment Options Treatment of voice disorders may at times involve therapy or an office or surgical procedure. Speech Therapy: I have contacts with speech therapists throughout the city, state and region. I can usually arrange for therapy to be obtained locally for you. I will monitor the progress of your therapy with return visits. Office Procedures: I perform many procedures in the office, which is often quicker, more precise and quite a bit more cost effective for you. At times surgical intervention is most appropriate. Surgical Procedures: In order to accommodate the special care needed for the precise treatment of voice disorders, the hospitals I utilize have upgraded to state of the art surgical instruments and lasers. For those of you who travel, I have contacts with laryngologists and speech therapists throughout the country should you desire or need to see a voice specialist while journeying. I am also available by phone (503) 341-2545 or email during your travels. Should you have any questions regarding your treatment, please see our contact page or feel free to contact my nurse Jody who may be reached by phone toll free at (866) 378-4662 or at [email protected] or myself at any time and we would be happy to answer your questions. Sincerely, James P. Thomas, M.D.