{"version":"1.0.0","segments":[{"speaker":"Jeremy","startTime":11.669,"endTime":15.029,"body":"this is a voice podcast with Dr."},{"speaker":"Jeremy","startTime":15.029,"endTime":17.189,"body":"Gillyanne Kayes and Jeremy Fisher."},{"speaker":"Jeremy","startTime":21.677,"endTime":25.827,"body":"Hello and welcome to this is a"},{"speaker":"Jeremy","startTime":21.677,"endTime":25.827,"body":"voice series five episode four."},{"speaker":"Gillyanne","startTime":26.147,"endTime":28.907,"body":"The podcast where"},{"speaker":"Gillyanne","startTime":26.147,"endTime":28.907,"body":"we get Vocal about voice."},{"speaker":"Jeremy","startTime":28.937,"endTime":30.527,"body":"And she's back!"},{"speaker":"Jeremy","startTime":30.767,"endTime":35.207,"body":"There was so much that we wanted to"},{"speaker":"Jeremy","startTime":30.767,"endTime":35.207,"body":"talk about with Tor about voice, so"},{"speaker":"Jeremy","startTime":35.217,"endTime":37.277,"body":"we brought her back for a second week."},{"speaker":"Gillyanne","startTime":37.767,"endTime":38.757,"body":"Okay."},{"speaker":"Gillyanne","startTime":38.784,"endTime":47.844,"body":"I am going to do a link to acid reflux by"},{"speaker":"Gillyanne","startTime":38.784,"endTime":47.844,"body":"asking you what about people who cough at"},{"speaker":"Gillyanne","startTime":47.844,"endTime":50.964,"body":"night in their sleep and wake up coughing?"},{"speaker":"Tor","startTime":51.089,"endTime":51.389,"body":"Yeah."},{"speaker":"Tor","startTime":51.389,"endTime":56.579,"body":"So the nocturnal cough, the true"},{"speaker":"Tor","startTime":51.389,"endTime":56.579,"body":"nocturnal cough that wakes somebody up."},{"speaker":"Tor","startTime":57.539,"endTime":62.449,"body":"And I differentiate between that and a"},{"speaker":"Tor","startTime":57.539,"endTime":62.449,"body":"cough where somebody wakes up feels a"},{"speaker":"Tor","startTime":62.449,"endTime":64.519,"body":"tickle or a need to cough and then coughs."},{"speaker":"Tor","startTime":64.949,"endTime":68.969,"body":"So the true nocturnal cough may be"},{"speaker":"Tor","startTime":64.949,"endTime":68.969,"body":"set off by a little spasm in the"},{"speaker":"Tor","startTime":68.969,"endTime":72.719,"body":"larynx or something that's happened"},{"speaker":"Tor","startTime":68.969,"endTime":72.719,"body":"to cause that cough when someone's"},{"speaker":"Tor","startTime":72.719,"endTime":74.609,"body":"been asleep and then it wakes them up."},{"speaker":"Tor","startTime":75.329,"endTime":79.082,"body":"And the cause of that can be acid reflux."},{"speaker":"Tor","startTime":79.149,"endTime":83.102,"body":"Usually laryngo pharyngeal reflux,"},{"speaker":"Tor","startTime":79.149,"endTime":83.102,"body":"that's coming up to the top of"},{"speaker":"Tor","startTime":83.102,"endTime":87.992,"body":"the esophagus and into the area"},{"speaker":"Tor","startTime":83.102,"endTime":87.992,"body":"around the larynx and the pharynx."},{"speaker":"Tor","startTime":88.08,"endTime":92.07,"body":"And it can cause the vocal cords"},{"speaker":"Tor","startTime":88.08,"endTime":92.07,"body":"to go into slight spasm and"},{"speaker":"Tor","startTime":92.07,"endTime":93.565,"body":"that wake someone up coughing."},{"speaker":"Tor","startTime":93.565,"endTime":97.571,"body":"Now how that's treated and"},{"speaker":"Tor","startTime":93.565,"endTime":97.571,"body":"whether we can actually prove it's"},{"speaker":"Tor","startTime":97.571,"endTime":99.845,"body":"reflux, that's causing that cough."},{"speaker":"Tor","startTime":99.869,"endTime":100.919,"body":"It's quite tricky."},{"speaker":"Tor","startTime":101.006,"endTime":104.311,"body":"And the way we talk about laryngo"},{"speaker":"Tor","startTime":101.006,"endTime":104.311,"body":"pharyngeal reflux and the way"},{"speaker":"Tor","startTime":104.311,"endTime":108.334,"body":"it's diagnosed, it's It's a"},{"speaker":"Tor","startTime":104.311,"endTime":108.334,"body":"difficult thing to diagnose."},{"speaker":"Tor","startTime":108.364,"endTime":111.064,"body":"And I think it's probably a little"},{"speaker":"Tor","startTime":108.364,"endTime":111.064,"body":"bit over-diagnosed based on what"},{"speaker":"Tor","startTime":111.064,"endTime":112.504,"body":"we're looking at in the larynx."},{"speaker":"Tor","startTime":112.538,"endTime":116.588,"body":"So if we look at the larynx and we"},{"speaker":"Tor","startTime":112.538,"endTime":116.588,"body":"think this person might have some"},{"speaker":"Tor","startTime":116.588,"endTime":120.788,"body":"laryngo pharyngeal reflux, we're often"},{"speaker":"Tor","startTime":116.588,"endTime":120.788,"body":"saying that because we're seeing some"},{"speaker":"Tor","startTime":120.788,"endTime":124.695,"body":"swelling in the posterior part of the"},{"speaker":"Tor","startTime":120.788,"endTime":124.695,"body":"larynx or we're seeing some inflammation"},{"speaker":"Tor","startTime":124.695,"endTime":129.876,"body":"between the arytenoid cartilages or some"},{"speaker":"Tor","startTime":124.695,"endTime":129.876,"body":"redness along the  of the vocal cords,"},{"speaker":"Tor","startTime":130.566,"endTime":133.806,"body":"and that's causing that maybe causing"},{"speaker":"Tor","startTime":130.566,"endTime":133.806,"body":"someone persistent throat symptoms."},{"speaker":"Tor","startTime":133.806,"endTime":137.254,"body":"But how can we prove by looking"},{"speaker":"Tor","startTime":133.806,"endTime":137.254,"body":"at the larynx that's because of"},{"speaker":"Tor","startTime":137.254,"endTime":138.764,"body":"reflux, it's quite a hard one."},{"speaker":"Gillyanne","startTime":138.803,"endTime":142.528,"body":"I heard that in fact and"},{"speaker":"Gillyanne","startTime":138.803,"endTime":142.528,"body":"I'm guessing often it's diagnosed"},{"speaker":"Gillyanne","startTime":142.528,"endTime":146.46,"body":"based on experience and again,"},{"speaker":"Gillyanne","startTime":142.528,"endTime":146.46,"body":"talking with the patient about."},{"speaker":"Gillyanne","startTime":146.527,"endTime":147.691,"body":"What's going on for them."},{"speaker":"Gillyanne","startTime":148.081,"endTime":151.981,"body":"I've got a bit of personal stuff to"},{"speaker":"Gillyanne","startTime":148.081,"endTime":151.981,"body":"share, which I did warn you about, or"},{"speaker":"Gillyanne","startTime":151.981,"endTime":156.901,"body":"which is, I first found out that I had"},{"speaker":"Gillyanne","startTime":151.981,"endTime":156.901,"body":"acid reflux because what used to happen"},{"speaker":"Gillyanne","startTime":156.901,"endTime":161.254,"body":"was I'd start to drop off at night,"},{"speaker":"Gillyanne","startTime":156.901,"endTime":161.254,"body":"when you first begin to drift off and"},{"speaker":"Gillyanne","startTime":161.254,"endTime":163.294,"body":"then I'd have this weird dry cough."},{"speaker":"Gillyanne","startTime":163.654,"endTime":167.224,"body":"And I remember saying to Jeremy, oh,"},{"speaker":"Gillyanne","startTime":163.654,"endTime":167.224,"body":"I feel I got asthma or something."},{"speaker":"Gillyanne","startTime":167.224,"endTime":167.854,"body":"What's going on."},{"speaker":"Gillyanne","startTime":167.854,"endTime":170.524,"body":"I'd have this little cough,"},{"speaker":"Gillyanne","startTime":167.854,"endTime":170.524,"body":"then I'd drop off again."},{"speaker":"Gillyanne","startTime":170.584,"endTime":171.574,"body":"Then it would happen again."},{"speaker":"Gillyanne","startTime":173.074,"endTime":174.934,"body":"And eventually of course, I'd go to sleep."},{"speaker":"Gillyanne","startTime":174.964,"endTime":181.912,"body":"Now across time, what happened was I"},{"speaker":"Gillyanne","startTime":174.964,"endTime":181.912,"body":"got a, you know a full on LPR event,"},{"speaker":"Gillyanne","startTime":182.182,"endTime":187.252,"body":"which is, I woke up feeling like I'd"},{"speaker":"Gillyanne","startTime":182.182,"endTime":187.252,"body":"got a swarm of bees in my larynx."},{"speaker":"Gillyanne","startTime":187.762,"endTime":191.632,"body":"It's so painful when that"},{"speaker":"Gillyanne","startTime":187.762,"endTime":191.632,"body":"you get the spurt of acid."},{"speaker":"Gillyanne","startTime":192.022,"endTime":193.582,"body":"And of course you're in danger of."},{"speaker":"Gillyanne","startTime":193.582,"endTime":194.202,"body":"choking."},{"speaker":"Gillyanne","startTime":195.062,"endTime":197.752,"body":"And it's really unpleasant."},{"speaker":"Gillyanne","startTime":197.813,"endTime":200.393,"body":"And that's when I first"},{"speaker":"Gillyanne","startTime":197.813,"endTime":200.393,"body":"realized, oh my goodness."},{"speaker":"Gillyanne","startTime":200.422,"endTime":202.852,"body":"I didn't know acid reflux could do that."},{"speaker":"Gillyanne","startTime":202.912,"endTime":206.362,"body":"And then I started reading about"},{"speaker":"Gillyanne","startTime":202.912,"endTime":206.362,"body":"the different types of acid reflux,"},{"speaker":"Gillyanne","startTime":206.46,"endTime":210.639,"body":"the lower esophageal sphincter"},{"speaker":"Gillyanne","startTime":206.46,"endTime":210.639,"body":"and they the upper and would you"},{"speaker":"Gillyanne","startTime":210.639,"endTime":212.439,"body":"like to talk more about that?"},{"speaker":"Gillyanne","startTime":212.439,"endTime":216.299,"body":"Because many singers don't know the"},{"speaker":"Gillyanne","startTime":212.439,"endTime":216.299,"body":"difference, well, any professional"},{"speaker":"Gillyanne","startTime":216.299,"endTime":221.499,"body":"voice users, to be honest, and they also"},{"speaker":"Gillyanne","startTime":216.299,"endTime":221.499,"body":"have some very weird ideas about what"},{"speaker":"Gillyanne","startTime":221.499,"endTime":227.739,"body":"to do about it, including things that"},{"speaker":"Gillyanne","startTime":221.499,"endTime":227.739,"body":"introduce acid into the larynx, because"},{"speaker":"Gillyanne","startTime":227.739,"endTime":232.447,"body":"they'd been told you your stomach,"},{"speaker":"Gillyanne","startTime":227.739,"endTime":232.447,"body":"obviously isn't making enough acid, true."},{"speaker":"Gillyanne","startTime":232.597,"endTime":236.527,"body":"So therefore you need"},{"speaker":"Gillyanne","startTime":232.597,"endTime":236.527,"body":"lemon juice inside of it."},{"speaker":"Tor","startTime":236.597,"endTime":237.497,"body":"Interesting."},{"speaker":"Tor","startTime":237.527,"endTime":238.097,"body":"Yeah."},{"speaker":"Jeremy","startTime":238.877,"endTime":239.747,"body":"Unpack that please Tor."},{"speaker":"Gillyanne","startTime":239.747,"endTime":243.327,"body":"That's a lovely,"},{"speaker":"Gillyanne","startTime":239.747,"endTime":243.327,"body":"lovely little rabbithole."},{"speaker":"Tor","startTime":243.767,"endTime":248.507,"body":"So gastroesophageal reflux"},{"speaker":"Tor","startTime":243.767,"endTime":248.507,"body":"is when stomach acid flows back"},{"speaker":"Tor","startTime":248.507,"endTime":252.197,"body":"into the esophagus, connect, which"},{"speaker":"Tor","startTime":248.507,"endTime":252.197,"body":"connects your mouth and your stomach."},{"speaker":"Tor","startTime":252.527,"endTime":255.677,"body":"So that backwash irritates the"},{"speaker":"Tor","startTime":252.527,"endTime":255.677,"body":"lining of the esophagus, and that"},{"speaker":"Tor","startTime":255.677,"endTime":260.057,"body":"causes quite typical symptoms of"},{"speaker":"Tor","startTime":255.677,"endTime":260.057,"body":"heartburn, indigestion, chest pain"},{"speaker":"Tor","startTime":260.124,"endTime":263.812,"body":"which is quite different sometimes"},{"speaker":"Tor","startTime":260.124,"endTime":263.812,"body":"to the symptoms that people get"},{"speaker":"Tor","startTime":263.812,"endTime":266.692,"body":"when they get reflux further up."},{"speaker":"Tor","startTime":267.082,"endTime":270.785,"body":"So laryngo pharyngeal reflux comes"},{"speaker":"Tor","startTime":267.082,"endTime":270.785,"body":"up to the top of the esophagus."},{"speaker":"Tor","startTime":271.011,"endTime":271.941,"body":"Now that can be silent."},{"speaker":"Tor","startTime":272.781,"endTime":275.43,"body":"So you deleted, it sounds"},{"speaker":"Tor","startTime":272.781,"endTime":275.43,"body":"like you've had very, clear"},{"speaker":"Tor","startTime":275.43,"endTime":277.08,"body":"symptoms at night, particularly."},{"speaker":"Tor","startTime":277.088,"endTime":281.198,"body":"A lot of people, we term call it"},{"speaker":"Tor","startTime":277.088,"endTime":281.198,"body":"silent reflux because it's not what"},{"speaker":"Tor","startTime":281.198,"endTime":282.878,"body":"people are expecting of reflux."},{"speaker":"Tor","startTime":282.878,"endTime":287.348,"body":"People are thinking or whatever, any"},{"speaker":"Tor","startTime":282.878,"endTime":287.348,"body":"heartburn or indigestion, it can't be"},{"speaker":"Tor","startTime":287.348,"endTime":291.848,"body":"reflux, yet they're waking up, they're"},{"speaker":"Tor","startTime":287.348,"endTime":291.848,"body":"being woken up in the night by a cough."},{"speaker":"Tor","startTime":292.118,"endTime":296.468,"body":"They've got sticky throat and sticky"},{"speaker":"Tor","startTime":292.118,"endTime":296.468,"body":"mucus around that part in the morning."},{"speaker":"Tor","startTime":296.468,"endTime":299.018,"body":"And they're having to cough"},{"speaker":"Tor","startTime":296.468,"endTime":299.018,"body":"their voices fluctuating."},{"speaker":"Tor","startTime":299.378,"endTime":301.838,"body":"They're noticing a cough or"},{"speaker":"Tor","startTime":299.378,"endTime":301.838,"body":"having to throat clear a lot."},{"speaker":"Tor","startTime":301.939,"endTime":306.902,"body":"And then they end up coming to see ENT"},{"speaker":"Tor","startTime":301.939,"endTime":306.902,"body":"who might have a look at the larynx and"},{"speaker":"Tor","startTime":306.902,"endTime":310.755,"body":"either say, oh no, it all looks absolutely"},{"speaker":"Tor","startTime":306.902,"endTime":310.755,"body":"fine or no, there is some inflammation."},{"speaker":"Tor","startTime":310.845,"endTime":312.165,"body":"And then what do you do?"},{"speaker":"Tor","startTime":313.348,"endTime":315.807,"body":"Um And it's a difficult thing."},{"speaker":"Tor","startTime":315.807,"endTime":319.337,"body":"There's no sort of blanket"},{"speaker":"Tor","startTime":315.807,"endTime":319.337,"body":"treatment or advice that we"},{"speaker":"Tor","startTime":319.337,"endTime":321.047,"body":"can give that suits everyone."},{"speaker":"Tor","startTime":321.137,"endTime":326.267,"body":"It has to be holistic and we have to"},{"speaker":"Tor","startTime":321.137,"endTime":326.267,"body":"take a really detailed history and"},{"speaker":"Tor","startTime":326.627,"endTime":331.803,"body":"work out what is in this person's"},{"speaker":"Tor","startTime":326.627,"endTime":331.803,"body":"medical history, lifestyle, even the"},{"speaker":"Tor","startTime":331.803,"endTime":336.813,"body":"sort of psychosocial elements of it and"},{"speaker":"Tor","startTime":331.803,"endTime":336.813,"body":"what could be exacerbating reflux and"},{"speaker":"Tor","startTime":336.813,"endTime":341.043,"body":"what other causes of inflammation or"},{"speaker":"Tor","startTime":336.813,"endTime":341.043,"body":"cough at night there could be as well."},{"speaker":"Tor","startTime":341.043,"endTime":346.99,"body":"So when it comes to the treatment of"},{"speaker":"Tor","startTime":341.043,"endTime":346.99,"body":"LPR, or we could call it persistent"},{"speaker":"Tor","startTime":347.05,"endTime":350.71,"body":"these persistent throat symptoms,"},{"speaker":"Tor","startTime":347.05,"endTime":350.71,"body":"or perhaps some inflammation that"},{"speaker":"Tor","startTime":350.71,"endTime":356.121,"body":"someone's got in their larynx,"},{"speaker":"Tor","startTime":350.71,"endTime":356.121,"body":"lifestyle management is very important."},{"speaker":"Tor","startTime":356.181,"endTime":360.909,"body":"And I'll talk through realistic"},{"speaker":"Tor","startTime":356.181,"endTime":360.909,"body":"modifications that people can make."},{"speaker":"Tor","startTime":360.909,"endTime":364.119,"body":"So if I'm working with a singer,"},{"speaker":"Tor","startTime":360.909,"endTime":364.119,"body":"for example, we'd talk a lot"},{"speaker":"Tor","startTime":364.119,"endTime":369.019,"body":"about kind of patterns and in"},{"speaker":"Tor","startTime":364.119,"endTime":369.019,"body":"sort of eating and meal times."},{"speaker":"Tor","startTime":369.439,"endTime":372.649,"body":"We'll talk about that when someone's"},{"speaker":"Tor","startTime":369.439,"endTime":372.649,"body":"eating, perhaps in relation"},{"speaker":"Tor","startTime":372.649,"endTime":376.272,"body":"to when they go into bed we'll"},{"speaker":"Tor","startTime":372.649,"endTime":376.272,"body":"talk about, even things, diet."},{"speaker":"Tor","startTime":376.32,"endTime":379.42,"body":"What they're eating that may be"},{"speaker":"Tor","startTime":376.32,"endTime":379.42,"body":"specifically triggering the symptoms"},{"speaker":"Tor","startTime":379.45,"endTime":383.208,"body":"or, you know keeping food diaries"},{"speaker":"Tor","startTime":379.45,"endTime":383.208,"body":"is sometimes a vital part of that to"},{"speaker":"Tor","startTime":383.208,"endTime":387.888,"body":"recognize the patterns between what they"},{"speaker":"Tor","startTime":383.208,"endTime":387.888,"body":"might eat on a certain day or in the"},{"speaker":"Tor","startTime":387.888,"endTime":389.958,"body":"evening, and then how their symptoms are."},{"speaker":"Tor","startTime":390.438,"endTime":393.288,"body":"So again, it's that awareness,"},{"speaker":"Tor","startTime":390.438,"endTime":393.288,"body":"it's that sort of mindfulness of"},{"speaker":"Tor","startTime":393.288,"endTime":396.288,"body":"the sort of lifestyle issues that"},{"speaker":"Tor","startTime":393.288,"endTime":396.288,"body":"might be contributing to things."},{"speaker":"Tor","startTime":396.355,"endTime":399.561,"body":"And then of course there's"},{"speaker":"Tor","startTime":396.355,"endTime":399.561,"body":"the medication side of things."},{"speaker":"Tor","startTime":400.251,"endTime":406.311,"body":"So we know now that for the treatment of"},{"speaker":"Tor","startTime":400.251,"endTime":406.311,"body":"LPR or persistent throat symptoms caused"},{"speaker":"Tor","startTime":406.311,"endTime":411.891,"body":"by laryngo pharyngeal reflux, that proton"},{"speaker":"Tor","startTime":406.311,"endTime":411.891,"body":"pump inhibitors, those medications that"},{"speaker":"Tor","startTime":412.131,"endTime":417.651,"body":"are used to suppress acid production, they"},{"speaker":"Tor","startTime":412.131,"endTime":417.651,"body":"don't work for persistent throat symptoms."},{"speaker":"Tor","startTime":417.681,"endTime":422.789,"body":"There's some really clear evidence"},{"speaker":"Tor","startTime":417.681,"endTime":422.789,"body":"now that we, these patients who have"},{"speaker":"Tor","startTime":422.819,"endTime":429.172,"body":"historically been quite blanketly"},{"speaker":"Tor","startTime":422.819,"endTime":429.172,"body":"prescribed PPIs when they've presented"},{"speaker":"Tor","startTime":429.172,"endTime":433.455,"body":"to primary care with such symptoms"},{"speaker":"Tor","startTime":429.172,"endTime":433.455,"body":"we don't want to do that anymore."},{"speaker":"Tor","startTime":433.485,"endTime":435.825,"body":"We really want to move away"},{"speaker":"Tor","startTime":433.485,"endTime":435.825,"body":"from that because we know they"},{"speaker":"Tor","startTime":435.825,"endTime":437.497,"body":"don't work for throat symptoms."},{"speaker":"Tor","startTime":437.532,"endTime":438.882,"body":"So interesting too."},{"speaker":"Tor","startTime":438.882,"endTime":443.911,"body":"I knew you weren't a fan of PPIs, but I"},{"speaker":"Tor","startTime":438.882,"endTime":443.911,"body":"didn't know that evidence-base existed."},{"speaker":"Tor","startTime":443.971,"endTime":446.911,"body":"If there are any papers or"},{"speaker":"Tor","startTime":443.971,"endTime":446.911,"body":"anything that you want to share"},{"speaker":"Tor","startTime":446.911,"endTime":448.681,"body":"with us at the end, you've"},{"speaker":"Tor","startTime":448.681,"endTime":450.511,"body":"read we'll put them in the show notes."},{"speaker":"Tor","startTime":450.511,"endTime":451.131,"body":"Absolutely."},{"speaker":"Gillyanne","startTime":451.201,"endTime":454.981,"body":"Luckily my laryngologist"},{"speaker":"Gillyanne","startTime":451.201,"endTime":454.981,"body":"did not prescribe PPIs."},{"speaker":"Gillyanne","startTime":455.631,"endTime":458.556,"body":"I'm sure you're going to move on"},{"speaker":"Gillyanne","startTime":455.631,"endTime":458.556,"body":"to something that you can take"},{"speaker":"Gillyanne","startTime":458.556,"endTime":460.686,"body":"that is in fact not a chemical."},{"speaker":"Tor","startTime":460.936,"endTime":461.256,"body":"Yes."},{"speaker":"Tor","startTime":461.556,"endTime":461.996,"body":"Exactly."},{"speaker":"Tor","startTime":462.021,"endTime":463.521,"body":"So we're moving away from..."},{"speaker":"Tor","startTime":463.701,"endTime":467.617,"body":"obviously, if there is a clear"},{"speaker":"Tor","startTime":463.701,"endTime":467.617,"body":"signs of heartburn and indigestion"},{"speaker":"Tor","startTime":467.707,"endTime":471.517,"body":"and gastroesophageal reflux"},{"speaker":"Tor","startTime":467.707,"endTime":471.517,"body":"and PPIs are very important."},{"speaker":"Tor","startTime":472.027,"endTime":476.497,"body":"But when it's throat symptoms and"},{"speaker":"Tor","startTime":472.027,"endTime":476.497,"body":"laryngo pharyngeal reflux, what works"},{"speaker":"Tor","startTime":476.497,"endTime":478.767,"body":"better, but what's also under trial."},{"speaker":"Tor","startTime":478.767,"endTime":484.66,"body":"There is a randomized control trial going"},{"speaker":"Tor","startTime":478.767,"endTime":484.66,"body":"on as we speak or that they're finding"},{"speaker":"Tor","startTime":484.99,"endTime":489.55,"body":"people to take part in this randomized"},{"speaker":"Tor","startTime":484.99,"endTime":489.55,"body":"controlled trial to look at the use of"},{"speaker":"Tor","startTime":489.58,"endTime":492.46,"body":"alginates in persistent throat symptoms."},{"speaker":"Tor","startTime":492.88,"endTime":496.69,"body":"And this is the same team of people"},{"speaker":"Tor","startTime":492.88,"endTime":496.69,"body":"up in Newcastle, carrying out this"},{"speaker":"Tor","startTime":496.69,"endTime":501.825,"body":"research and alginates form a raft"},{"speaker":"Tor","startTime":496.69,"endTime":501.825,"body":"over the contents of the stomach."},{"speaker":"Tor","startTime":501.855,"endTime":506.475,"body":"So the most common one we'll hear"},{"speaker":"Tor","startTime":501.855,"endTime":506.475,"body":"about in the UK is Gaviscon Advance or"},{"speaker":"Tor","startTime":506.475,"endTime":511.005,"body":"Gaviscon generally, but the advanced"},{"speaker":"Tor","startTime":506.475,"endTime":511.005,"body":"version of Gaviscon forms a barrier for"},{"speaker":"Tor","startTime":511.005,"endTime":513.375,"body":"much longer than the regular Gaviscons."},{"speaker":"Tor","startTime":513.885,"endTime":518.115,"body":"So if you are eating something, after"},{"speaker":"Tor","startTime":513.885,"endTime":518.115,"body":"you've eaten or drunk something,"},{"speaker":"Tor","startTime":518.325,"endTime":522.285,"body":"if you put a thin layer of Gaviscon"},{"speaker":"Tor","startTime":518.325,"endTime":522.285,"body":"Advance over the contents of your"},{"speaker":"Tor","startTime":522.285,"endTime":526.035,"body":"stomach, that will prevent against"},{"speaker":"Tor","startTime":522.285,"endTime":526.035,"body":"that backflow or that reflux"},{"speaker":"Tor","startTime":526.095,"endTime":527.775,"body":"certainly really minimize the risk of."},{"speaker":"Tor","startTime":528.835,"endTime":531.175,"body":"So it's really effective taken before bed."},{"speaker":"Tor","startTime":531.595,"endTime":535.375,"body":"If you've eaten earlier in the evening,"},{"speaker":"Tor","startTime":531.595,"endTime":535.375,"body":"you've left a few hours between going"},{"speaker":"Tor","startTime":535.375,"endTime":538.865,"body":"to bed, you're taking a spoonful"},{"speaker":"Tor","startTime":535.375,"endTime":538.865,"body":"of Gaviscon and it's protecting"},{"speaker":"Tor","startTime":538.865,"endTime":542.487,"body":"your esophagus and particularly"},{"speaker":"Tor","startTime":538.865,"endTime":542.487,"body":"your larynx against the backflow."},{"speaker":"Tor","startTime":542.487,"endTime":542.885,"body":"What about the Gaviscon and"},{"speaker":"Tor","startTime":542.487,"endTime":542.885,"body":"taking alginates like this."},{"speaker":"Jeremy","startTime":542.983,"endTime":549.583,"body":"That I didn't know,"},{"speaker":"Jeremy","startTime":542.983,"endTime":549.583,"body":"which is once you've taken it to"},{"speaker":"Jeremy","startTime":549.583,"endTime":551.953,"body":"don't eat or drink anything else."},{"speaker":"Gillyanne","startTime":551.953,"endTime":553.223,"body":"Because you'll breach the raft."},{"speaker":"Jeremy","startTime":553.223,"endTime":555.673,"body":"Because then you"},{"speaker":"Jeremy","startTime":553.223,"endTime":555.673,"body":"basically, you sink the raft."},{"speaker":"Gillyanne","startTime":555.943,"endTime":558.994,"body":"And people might think that,"},{"speaker":"Gillyanne","startTime":555.943,"endTime":558.994,"body":"even if they're brushing their teeth,"},{"speaker":"Gillyanne","startTime":558.994,"endTime":563.267,"body":"before they go to bed, they then might"},{"speaker":"Gillyanne","startTime":558.994,"endTime":563.267,"body":"think, oh, they normally swallow water."},{"speaker":"Gillyanne","startTime":564.027,"endTime":565.467,"body":"But that's not the plan, is it?"},{"speaker":"Tor","startTime":565.817,"endTime":566.147,"body":"No."},{"speaker":"Tor","startTime":566.147,"endTime":567.497,"body":"So the timing is everything."},{"speaker":"Tor","startTime":567.497,"endTime":570.287,"body":"And that's another thing I'll spend"},{"speaker":"Tor","startTime":567.497,"endTime":570.287,"body":"time with people on, let's say if"},{"speaker":"Tor","startTime":570.287,"endTime":573.539,"body":"they've been on PPIs as well, post"},{"speaker":"Tor","startTime":570.287,"endTime":573.539,"body":"the proton pump inhibitors, and"},{"speaker":"Tor","startTime":573.539,"endTime":576.869,"body":"Gaviscon, sometimes people are on"},{"speaker":"Tor","startTime":573.539,"endTime":576.869,"body":"those two things together, particularly"},{"speaker":"Tor","startTime":576.869,"endTime":580.079,"body":"if they've got gastroesophageal"},{"speaker":"Tor","startTime":576.869,"endTime":580.079,"body":"reflux and throat symptoms."},{"speaker":"Tor","startTime":580.379,"endTime":582.906,"body":"And the timing of both is really crucial."},{"speaker":"Tor","startTime":583.266,"endTime":586.26,"body":"And I S water is absorbed quite quickly."},{"speaker":"Tor","startTime":586.775,"endTime":590.225,"body":"And if someone wakes up two hours after"},{"speaker":"Tor","startTime":586.775,"endTime":590.225,"body":"going to sleep and they've taken some"},{"speaker":"Tor","startTime":590.225,"endTime":594.6,"body":"Gaviscon two hours ago, I'll say, if"},{"speaker":"Tor","startTime":590.225,"endTime":594.6,"body":"you're really thirsty, have a small"},{"speaker":"Tor","startTime":594.6,"endTime":596.73,"body":"sip of water, but just one at a time."},{"speaker":"Tor","startTime":596.73,"endTime":598.17,"body":"Definitely don't gulp it down."},{"speaker":"Tor","startTime":598.44,"endTime":601.92,"body":"Think of anything, that barrier"},{"speaker":"Tor","startTime":598.44,"endTime":601.92,"body":"lasting about four hours and anything"},{"speaker":"Tor","startTime":601.92,"endTime":605.666,"body":"that sits on top of it could just"},{"speaker":"Tor","startTime":601.92,"endTime":605.666,"body":"be reflux or sink the barrier."},{"speaker":"Tor","startTime":605.721,"endTime":606.831,"body":"Yeah, that's important."},{"speaker":"Tor","startTime":607.071,"endTime":610.062,"body":"And it's not just about"},{"speaker":"Tor","startTime":607.071,"endTime":610.062,"body":"medications or alginates."},{"speaker":"Tor","startTime":610.152,"endTime":613.002,"body":"I want to really make that clear"},{"speaker":"Tor","startTime":610.152,"endTime":613.002,"body":"because a lot of people will contact"},{"speaker":"Tor","startTime":613.002,"endTime":616.501,"body":"me when I talk about this and say,"},{"speaker":"Tor","startTime":613.002,"endTime":616.501,"body":"I don't want to take any of this."},{"speaker":"Tor","startTime":616.501,"endTime":619.861,"body":"Surely there are lifestyle"},{"speaker":"Tor","startTime":616.501,"endTime":619.861,"body":"modifications I can make."},{"speaker":"Tor","startTime":619.871,"endTime":625.165,"body":"And there are, you know we've talked about"},{"speaker":"Tor","startTime":619.871,"endTime":625.165,"body":"some it's again, very holistic and looking"},{"speaker":"Tor","startTime":625.165,"endTime":629.977,"body":"at everything to do with what you eat,"},{"speaker":"Tor","startTime":625.165,"endTime":629.977,"body":"but also general health taking exercise"},{"speaker":"Tor","startTime":630.125,"endTime":635.729,"body":"um stress management or the things that"},{"speaker":"Tor","startTime":630.125,"endTime":635.729,"body":"could be exacerbating the reflux, but."},{"speaker":"Tor","startTime":636.614,"endTime":641.204,"body":"An algenate is not a systemic medication,"},{"speaker":"Tor","startTime":636.614,"endTime":641.204,"body":"so it's not absorbed into the body."},{"speaker":"Tor","startTime":641.204,"endTime":645.504,"body":"There are minimal side effects,"},{"speaker":"Tor","startTime":641.204,"endTime":645.504,"body":"Gaviscon Advance is a soluble fibre."},{"speaker":"Tor","startTime":645.554,"endTime":648.464,"body":"So once it's done its job,"},{"speaker":"Tor","startTime":645.554,"endTime":648.464,"body":"it just moves through us."},{"speaker":"Tor","startTime":648.644,"endTime":651.584,"body":"So it should create minimal"},{"speaker":"Tor","startTime":648.644,"endTime":651.584,"body":"problems for someone."},{"speaker":"Tor","startTime":651.794,"endTime":655.124,"body":"Obviously you do want to check with"},{"speaker":"Tor","startTime":651.794,"endTime":655.124,"body":"a pharmacist or with your doctor"},{"speaker":"Tor","startTime":655.124,"endTime":658.904,"body":"before you start guzzling Gaviscon"},{"speaker":"Tor","startTime":655.124,"endTime":658.904,"body":"that it doesn't interfere with any"},{"speaker":"Tor","startTime":658.904,"endTime":661.184,"body":"of your other routine medications."},{"speaker":"Gillyanne","startTime":661.236,"endTime":663.684,"body":"And what about sleeping habits?"},{"speaker":"Gillyanne","startTime":663.714,"endTime":667.164,"body":"Cause I know you've spoken about"},{"speaker":"Gillyanne","startTime":663.714,"endTime":667.164,"body":"this on Instagram and things that"},{"speaker":"Gillyanne","startTime":667.164,"endTime":669.684,"body":"you can do actually with your bed."},{"speaker":"Tor","startTime":670.924,"endTime":671.344,"body":"Yeah."},{"speaker":"Tor","startTime":671.374,"endTime":676.019,"body":"So there's some evidence that by raising"},{"speaker":"Tor","startTime":671.374,"endTime":676.019,"body":"the head of the bed by at least six inches"},{"speaker":"Tor","startTime":676.139,"endTime":678.99,"body":"that you will reduce the risk of reflux."},{"speaker":"Tor","startTime":678.99,"endTime":682.753,"body":"So And again, lots of this advice"},{"speaker":"Tor","startTime":678.99,"endTime":682.753,"body":"should be used in conjunction with"},{"speaker":"Tor","startTime":682.803,"endTime":684.733,"body":"other pieces of advice as well."},{"speaker":"Tor","startTime":684.738,"endTime":689.443,"body":"It's not to say that, just that will"},{"speaker":"Tor","startTime":684.738,"endTime":689.443,"body":"stop you from getting laryngo pharyngeal"},{"speaker":"Tor","startTime":689.463,"endTime":692.493,"body":"reflux, but it is useful to know about."},{"speaker":"Tor","startTime":692.523,"endTime":696.173,"body":"And a lot of people will say, I can't"},{"speaker":"Tor","startTime":692.523,"endTime":696.173,"body":"do that because my partner won't sleep."},{"speaker":"Tor","startTime":696.183,"endTime":699.273,"body":"If one side of the beds raised,"},{"speaker":"Tor","startTime":696.183,"endTime":699.273,"body":"there's quite clever ways to raise"},{"speaker":"Tor","startTime":699.273,"endTime":702.433,"body":"and think about raising the whole"},{"speaker":"Tor","startTime":699.273,"endTime":702.433,"body":"mattress, the head of the mattress up."},{"speaker":"Tor","startTime":702.913,"endTime":703.903,"body":"Extra pillows..."},{"speaker":"Tor","startTime":704.323,"endTime":707.143,"body":"if nothing else, if you can't do"},{"speaker":"Tor","startTime":704.323,"endTime":707.143,"body":"anything else and perhaps an extra"},{"speaker":"Tor","startTime":707.143,"endTime":710.683,"body":"pillow might be helpful, but you've"},{"speaker":"Tor","startTime":707.143,"endTime":710.683,"body":"got to get the body tilted rather"},{"speaker":"Tor","startTime":710.683,"endTime":712.183,"body":"than just the head and the neck."},{"speaker":"Tor","startTime":712.543,"endTime":714.823,"body":"And then you might wake up in"},{"speaker":"Tor","startTime":712.543,"endTime":714.823,"body":"the morning with all sorts of"},{"speaker":"Tor","startTime":715.903,"endTime":717.953,"body":"pains and difficulties as well."},{"speaker":"Tor","startTime":717.953,"endTime":719.931,"body":"So yeah, raising the"},{"speaker":"Tor","startTime":717.953,"endTime":719.931,"body":"whole head of the bed."},{"speaker":"Gillyanne","startTime":721.626,"endTime":722.366,"body":"We did it didn't we?"},{"speaker":"Jeremy","startTime":722.396,"endTime":723.336,"body":"We did, yes."},{"speaker":"Gillyanne","startTime":723.486,"endTime":724.056,"body":"Bricks."},{"speaker":"Gillyanne","startTime":724.326,"endTime":724.716,"body":"Yes."},{"speaker":"Gillyanne","startTime":724.776,"endTime":726.156,"body":"Just put house bricks underneath."},{"speaker":"Gillyanne","startTime":726.186,"endTime":726.426,"body":"Yeah."},{"speaker":"Tor","startTime":726.786,"endTime":727.026,"body":"Brilliant."},{"speaker":"Gillyanne","startTime":727.098,"endTime":731.224,"body":"And what about, cause"},{"speaker":"Gillyanne","startTime":727.098,"endTime":731.224,"body":"I'm I'm drawing from Sue Jones, who"},{"speaker":"Gillyanne","startTime":731.224,"endTime":735.754,"body":"was at the Wythenshaw for 30 years"},{"speaker":"Gillyanne","startTime":731.224,"endTime":735.754,"body":"and she always recommended, if you"},{"speaker":"Gillyanne","startTime":735.754,"endTime":741.334,"body":"can, sleeping on your left side, I"},{"speaker":"Gillyanne","startTime":735.754,"endTime":741.334,"body":"always start off on my left side."},{"speaker":"Gillyanne","startTime":741.334,"endTime":743.571,"body":"Now, of course it, you get a"},{"speaker":"Gillyanne","startTime":741.334,"endTime":743.571,"body":"bit bored when you're sleeping."},{"speaker":"Gillyanne","startTime":743.571,"endTime":747.321,"body":"Sometimes you want to move around,"},{"speaker":"Gillyanne","startTime":743.571,"endTime":747.321,"body":"but it does seem to make a difference."},{"speaker":"Gillyanne","startTime":747.351,"endTime":748.101,"body":"Why is that?"},{"speaker":"Tor","startTime":748.431,"endTime":751.551,"body":"It's all to do with the"},{"speaker":"Tor","startTime":748.431,"endTime":751.551,"body":"anatomy of the stomach and where the"},{"speaker":"Tor","startTime":751.551,"endTime":754.071,"body":"stomach opens up into the esophagus."},{"speaker":"Tor","startTime":754.761,"endTime":760.016,"body":"So if you lie on the side where above,"},{"speaker":"Tor","startTime":754.761,"endTime":760.016,"body":"where the acid will sit in the part of"},{"speaker":"Tor","startTime":760.016,"endTime":764.907,"body":"the stomach but not near the opening into"},{"speaker":"Tor","startTime":760.016,"endTime":764.907,"body":"the esophagus, then you'll be better and"},{"speaker":"Tor","startTime":764.917,"endTime":768.127,"body":"safer and less likely to reflux in that."},{"speaker":"Tor","startTime":769.027,"endTime":769.327,"body":"Hmm"},{"speaker":"Gillyanne","startTime":769.593,"endTime":774.264,"body":"Oh actually, can I"},{"speaker":"Gillyanne","startTime":769.593,"endTime":774.264,"body":"ask, can you talk to us please"},{"speaker":"Gillyanne","startTime":774.594,"endTime":778.074,"body":"about Pepsin and why it matters."},{"speaker":"Tor","startTime":778.974,"endTime":781.614,"body":"Yeah, I should have"},{"speaker":"Tor","startTime":778.974,"endTime":781.614,"body":"mentioned that before, actually."},{"speaker":"Tor","startTime":781.854,"endTime":787.566,"body":"So pepsin is an enzyme that"},{"speaker":"Tor","startTime":781.854,"endTime":787.566,"body":"is within the stomach that we"},{"speaker":"Tor","startTime":787.566,"endTime":790.086,"body":"use to digest, help us digest."},{"speaker":"Tor","startTime":791.766,"endTime":793.896,"body":"These good old PPIs we were talking about."},{"speaker":"Tor","startTime":793.926,"endTime":796.806,"body":"Certainly they will suppress"},{"speaker":"Tor","startTime":793.926,"endTime":796.806,"body":"acid production, but they"},{"speaker":"Tor","startTime":796.806,"endTime":798.186,"body":"won't stop the pepsin."},{"speaker":"Tor","startTime":798.756,"endTime":799.176,"body":"Okay."},{"speaker":"Tor","startTime":799.566,"endTime":805.086,"body":"So pepsin is one of the contributors to"},{"speaker":"Tor","startTime":799.566,"endTime":805.086,"body":"the irritation and oedema or swelling"},{"speaker":"Tor","startTime":805.086,"endTime":808.896,"body":"that might occur in the larynx if"},{"speaker":"Tor","startTime":805.086,"endTime":808.896,"body":"people have laryngo pharyngeal reflux."},{"speaker":"Tor","startTime":809.346,"endTime":813.606,"body":"That's where the role of alginates"},{"speaker":"Tor","startTime":809.346,"endTime":813.606,"body":"comes in, particularly to be very"},{"speaker":"Tor","startTime":813.606,"endTime":816.066,"body":"relevant at stopping the pepsin."},{"speaker":"Tor","startTime":816.306,"endTime":822.006,"body":"Cause pepsin can sit in the throat and"},{"speaker":"Tor","startTime":816.306,"endTime":822.006,"body":"wait for us to eat something acidic,"},{"speaker":"Tor","startTime":822.006,"endTime":823.916,"body":"which can then activate the pepsin."},{"speaker":"Tor","startTime":823.986,"endTime":830.086,"body":"So that's why dietary modifications and"},{"speaker":"Tor","startTime":823.986,"endTime":830.086,"body":"things are particularly relevant as well."},{"speaker":"Gillyanne","startTime":830.586,"endTime":833.916,"body":"That was a game changer for"},{"speaker":"Gillyanne","startTime":830.586,"endTime":833.916,"body":"me, finding that out from a speech and"},{"speaker":"Gillyanne","startTime":833.916,"endTime":839.317,"body":"language therapist, friend who sent to"},{"speaker":"Gillyanne","startTime":833.916,"endTime":839.317,"body":"me Jamie Cooperman's dropping acid book."},{"speaker":"Gillyanne","startTime":839.887,"endTime":844.377,"body":"And then I realized that unfortunately,"},{"speaker":"Gillyanne","startTime":839.887,"endTime":844.377,"body":"I've got to stop drinking Sauvignon"},{"speaker":"Gillyanne","startTime":844.517,"endTime":847.997,"body":"Blanc, which is my favourite"},{"speaker":"Gillyanne","startTime":844.517,"endTime":847.997,"body":"wine because although it tastes"},{"speaker":"Gillyanne","startTime":847.997,"endTime":851.417,"body":"really sweet, it's actually the"},{"speaker":"Gillyanne","startTime":847.997,"endTime":851.417,"body":"most acidic of the white wine."},{"speaker":"Gillyanne","startTime":852.107,"endTime":855.71,"body":"I was happily quaffing, you know, a"},{"speaker":"Gillyanne","startTime":852.107,"endTime":855.71,"body":"glass of that every night before my"},{"speaker":"Gillyanne","startTime":855.71,"endTime":860.901,"body":"meal and introducing acid into the"},{"speaker":"Gillyanne","startTime":855.71,"endTime":860.901,"body":"throat, but we need the pepsin don't"},{"speaker":"Gillyanne","startTime":860.901,"endTime":863.751,"body":"we, because we can't digest without it."},{"speaker":"Gillyanne","startTime":864.271,"endTime":870.441,"body":"What we don't want is to get it up here,"},{"speaker":"Gillyanne","startTime":864.271,"endTime":870.441,"body":"because we've got lots of tissue there."},{"speaker":"Gillyanne","startTime":870.441,"endTime":874.177,"body":"That is we don't want the pepsin"},{"speaker":"Gillyanne","startTime":870.441,"endTime":874.177,"body":"digesting our larynx, so to speak."},{"speaker":"Jeremy","startTime":874.177,"endTime":875.317,"body":"So the tissue is edible."},{"speaker":"Gillyanne","startTime":875.317,"endTime":879.327,"body":"It sounds horrible,"},{"speaker":"Gillyanne","startTime":875.317,"endTime":879.327,"body":"but it needs acid, doesn't it."},{"speaker":"Gillyanne","startTime":879.387,"endTime":880.607,"body":"In order to operate."},{"speaker":"Gillyanne","startTime":881.607,"endTime":886.227,"body":"That's why we don't introduce"},{"speaker":"Gillyanne","startTime":881.607,"endTime":886.227,"body":"acid into the throat if we've got"},{"speaker":"Tor","startTime":888.177,"endTime":889.107,"body":"yes, absolutely."},{"speaker":"Tor","startTime":889.107,"endTime":889.407,"body":"Yes."},{"speaker":"Tor","startTime":889.417,"endTime":893.266,"body":"If you think about it in that sense that,"},{"speaker":"Tor","startTime":889.417,"endTime":893.266,"body":"every time you eat something acidic,"},{"speaker":"Tor","startTime":893.346,"endTime":897.846,"body":"if you're getting laryngo pharyngeal"},{"speaker":"Tor","startTime":893.346,"endTime":897.846,"body":"reflux and pepsin is in the top part"},{"speaker":"Tor","startTime":897.846,"endTime":901.724,"body":"of the esophagus or up into the larynx"},{"speaker":"Tor","startTime":897.846,"endTime":901.724,"body":"it could then be activated and start"},{"speaker":"Tor","startTime":901.784,"endTime":906.014,"body":"essentially digesting the tissue there,"},{"speaker":"Tor","startTime":901.784,"endTime":906.014,"body":"and certainly causing irritation and"},{"speaker":"Tor","startTime":906.014,"endTime":907.544,"body":"these persistent throat symptoms."},{"speaker":"Tor","startTime":907.611,"endTime":907.772,"body":"Yeah."},{"speaker":"Tor","startTime":907.772,"endTime":911.329,"body":"And that's where, the carefully"},{"speaker":"Tor","startTime":907.772,"endTime":911.329,"body":"thinking about your diet and particular"},{"speaker":"Tor","startTime":911.329,"endTime":913.943,"body":"triggers and, it's going to be"},{"speaker":"Tor","startTime":911.329,"endTime":913.943,"body":"slightly different for everyone."},{"speaker":"Tor","startTime":913.982,"endTime":916.336,"body":"But it's important to"},{"speaker":"Tor","startTime":913.982,"endTime":916.336,"body":"have support to do that."},{"speaker":"Jeremy","startTime":916.956,"endTime":920.246,"body":"Is there anything"},{"speaker":"Jeremy","startTime":916.956,"endTime":920.246,"body":"in timing of eating?"},{"speaker":"Tor","startTime":920.816,"endTime":927.711,"body":"I say to people too, Whatever"},{"speaker":"Tor","startTime":920.816,"endTime":927.711,"body":"that routine is, try and stick with the"},{"speaker":"Tor","startTime":927.711,"endTime":929.841,"body":"routine because the body is such a clock."},{"speaker":"Tor","startTime":929.871,"endTime":935.481,"body":"So the body will expect food when"},{"speaker":"Tor","startTime":929.871,"endTime":935.481,"body":"it expects it, it will have secreted"},{"speaker":"Tor","startTime":935.481,"endTime":939.351,"body":"the acids and prepared all the"},{"speaker":"Tor","startTime":935.481,"endTime":939.351,"body":"enzymes and everything for digestion."},{"speaker":"Tor","startTime":939.711,"endTime":942.549,"body":"If you don't eat when your"},{"speaker":"Tor","startTime":939.711,"endTime":942.549,"body":"body's expecting it you may"},{"speaker":"Tor","startTime":942.549,"endTime":944.589,"body":"be more likely to reflux."},{"speaker":"Tor","startTime":944.919,"endTime":948.924,"body":"Skipping meals for that reason,"},{"speaker":"Tor","startTime":944.919,"endTime":948.924,"body":"eating late at night, things like"},{"speaker":"Tor","startTime":948.924,"endTime":950.344,"body":"that are probably to be avoided."},{"speaker":"Tor","startTime":950.364,"endTime":954.798,"body":"But, some so often I'm working with people"},{"speaker":"Tor","startTime":950.364,"endTime":954.798,"body":"where we'd just need to look at all those"},{"speaker":"Tor","startTime":954.798,"endTime":956.928,"body":"factors and work out what's realistic."},{"speaker":"Tor","startTime":956.928,"endTime":960.831,"body":"If someone's working late shifts"},{"speaker":"Tor","startTime":956.928,"endTime":960.831,"body":"or performing in the evening and"},{"speaker":"Tor","startTime":960.831,"endTime":964.161,"body":"needed to eat something afterwards,"},{"speaker":"Tor","startTime":960.831,"endTime":964.161,"body":"it would just have to try and get"},{"speaker":"Tor","startTime":964.161,"endTime":967.063,"body":"a balance for different individuals"},{"speaker":"Tor","startTime":964.161,"endTime":967.063,"body":"and work out what's important."},{"speaker":"Jeremy","startTime":967.093,"endTime":969.353,"body":"It's very much like"},{"speaker":"Jeremy","startTime":967.093,"endTime":969.353,"body":"having your own jigsaw."},{"speaker":"Jeremy","startTime":969.373,"endTime":972.253,"body":"You have all of these pieces and"},{"speaker":"Jeremy","startTime":969.373,"endTime":972.253,"body":"you have all of these behaviors that"},{"speaker":"Jeremy","startTime":972.253,"endTime":973.663,"body":"you do that are part of your life."},{"speaker":"Jeremy","startTime":973.693,"endTime":977.051,"body":"And you rearrange the jigsaw to"},{"speaker":"Jeremy","startTime":973.693,"endTime":977.051,"body":"make sure that you don't get certain"},{"speaker":"Jeremy","startTime":977.051,"endTime":978.431,"body":"things and you do get others."},{"speaker":"Gillyanne","startTime":978.521,"endTime":981.611,"body":"Do you know what you brought"},{"speaker":"Gillyanne","startTime":978.521,"endTime":981.611,"body":"joy to my heart because I'm a little"},{"speaker":"Gillyanne","startTime":981.611,"endTime":983.861,"body":"bit food police these days aren't I?"},{"speaker":"Gillyanne","startTime":984.731,"endTime":988.544,"body":"Once, once I started to get to"},{"speaker":"Gillyanne","startTime":984.731,"endTime":988.544,"body":"grips with what was going on,"},{"speaker":"Gillyanne","startTime":988.544,"endTime":989.924,"body":"I actually changed my diet."},{"speaker":"Gillyanne","startTime":989.924,"endTime":993.026,"body":"I read another book called the"},{"speaker":"Gillyanne","startTime":989.924,"endTime":993.026,"body":"acid reflux diet, which I'll"},{"speaker":"Gillyanne","startTime":993.026,"endTime":994.991,"body":"share written by a nutritionist."},{"speaker":"Gillyanne","startTime":995.049,"endTime":998.409,"body":"First of all, what I did was I"},{"speaker":"Gillyanne","startTime":995.049,"endTime":998.409,"body":"eliminated acid, for anything"},{"speaker":"Gillyanne","startTime":998.409,"endTime":1001.595,"body":"acidic from my diet, but you don't"},{"speaker":"Gillyanne","startTime":998.409,"endTime":1001.595,"body":"need to do that for very long."},{"speaker":"Gillyanne","startTime":1001.985,"endTime":1004.685,"body":"And then you gradually"},{"speaker":"Gillyanne","startTime":1001.985,"endTime":1004.685,"body":"introduce more stuff."},{"speaker":"Gillyanne","startTime":1004.791,"endTime":1008.904,"body":"And what I found was that the"},{"speaker":"Gillyanne","startTime":1004.791,"endTime":1008.904,"body":"timing of food was really important."},{"speaker":"Gillyanne","startTime":1008.904,"endTime":1012.654,"body":"And what you're saying is the"},{"speaker":"Gillyanne","startTime":1008.904,"endTime":1012.654,"body":"body gets used to preparing itself"},{"speaker":"Gillyanne","startTime":1012.654,"endTime":1014.784,"body":"for food at a particular time."},{"speaker":"Gillyanne","startTime":1015.774,"endTime":1019.404,"body":"And I think in modern life, we"},{"speaker":"Gillyanne","startTime":1015.774,"endTime":1019.404,"body":"just completely override this."},{"speaker":"Jeremy","startTime":1019.964,"endTime":1021.464,"body":"I love that piece of information."},{"speaker":"Jeremy","startTime":1021.494,"endTime":1022.554,"body":"I think it's really fascinating."},{"speaker":"Gillyanne","startTime":1022.554,"endTime":1022.994,"body":"Oh, you're thrilled."},{"speaker":"Jeremy","startTime":1022.994,"endTime":1023.624,"body":"And I didn't know that."},{"speaker":"Jeremy","startTime":1024.354,"endTime":1028.754,"body":"So the idea that if you're missing"},{"speaker":"Jeremy","startTime":1024.354,"endTime":1028.754,"body":"meals, you're actually messing with the"},{"speaker":"Jeremy","startTime":1028.754,"endTime":1032.684,"body":"preparation that your body's made, let"},{"speaker":"Jeremy","startTime":1028.754,"endTime":1032.684,"body":"alone any nutrition that's going in."},{"speaker":"Jeremy","startTime":1032.774,"endTime":1033.284,"body":"I love that."},{"speaker":"Gillyanne","startTime":1033.324,"endTime":1035.814,"body":"Your body clock, fascinating."},{"speaker":"Jeremy","startTime":1035.854,"endTime":1041.264,"body":"And of course we work with so many"},{"speaker":"Jeremy","startTime":1035.854,"endTime":1041.264,"body":"performers who eat either before the show"},{"speaker":"Jeremy","startTime":1041.264,"endTime":1043.664,"body":"and then go and work or after the show."},{"speaker":"Jeremy","startTime":1043.934,"endTime":1044.384,"body":"And."},{"speaker":"Jeremy","startTime":1047.244,"endTime":1051.474,"body":"This may not even be a question that"},{"speaker":"Jeremy","startTime":1047.244,"endTime":1051.474,"body":"you can answer, but is there a period"},{"speaker":"Jeremy","startTime":1051.474,"endTime":1055.404,"body":"of time after you've eaten that you"},{"speaker":"Jeremy","startTime":1051.474,"endTime":1055.404,"body":"should take before you go to sleep?"},{"speaker":"Tor","startTime":1055.442,"endTime":1059.342,"body":"I generally say"},{"speaker":"Tor","startTime":1055.442,"endTime":1059.342,"body":"three to four hours now."},{"speaker":"Tor","startTime":1059.342,"endTime":1063.062,"body":"I don't particularly, I can't"},{"speaker":"Tor","startTime":1059.342,"endTime":1063.062,"body":"think of that being written or"},{"speaker":"Tor","startTime":1063.152,"endTime":1064.895,"body":"research, you know, proper..."},{"speaker":"Tor","startTime":1065.225,"endTime":1068.195,"body":"I don't, I can't give you a reference"},{"speaker":"Tor","startTime":1065.225,"endTime":1068.195,"body":"for that, that it does tend to be what"},{"speaker":"Tor","startTime":1068.195,"endTime":1072.887,"body":"we recognize what we recommend from a"},{"speaker":"Tor","startTime":1068.195,"endTime":1072.887,"body":"medical point of view, but, you have"},{"speaker":"Tor","startTime":1072.887,"endTime":1076.757,"body":"to be realistic and not everyone's"},{"speaker":"Tor","startTime":1072.887,"endTime":1076.757,"body":"lifestyle is going to suit that."},{"speaker":"Tor","startTime":1076.804,"endTime":1081.473,"body":"So I think, ideally an hour, a"},{"speaker":"Tor","startTime":1076.804,"endTime":1081.473,"body":"couple of hours, at least I would"},{"speaker":"Tor","startTime":1081.473,"endTime":1085.67,"body":"say between eating particularly"},{"speaker":"Tor","startTime":1081.473,"endTime":1085.67,"body":"have a good, a full, proper meal,"},{"speaker":"Gillyanne","startTime":1086.02,"endTime":1089.11,"body":"If I can't do three"},{"speaker":"Gillyanne","startTime":1086.02,"endTime":1089.11,"body":"hours, out comes the Gaviscon."},{"speaker":"Jeremy","startTime":1089.19,"endTime":1089.33,"body":"Yeah."},{"speaker":"Jeremy","startTime":1089.339,"endTime":1093.281,"body":"And in performance terms, that's"},{"speaker":"Jeremy","startTime":1089.339,"endTime":1093.281,"body":"okay if you're in performance week,"},{"speaker":"Jeremy","startTime":1093.611,"endTime":1097.115,"body":"but if you're in performance and"},{"speaker":"Jeremy","startTime":1093.611,"endTime":1097.115,"body":"rehearsal week, that's a killer."},{"speaker":"Gillyanne","startTime":1097.655,"endTime":1099.055,"body":"Yeah, it's hard, isn't it?"},{"speaker":"Gillyanne","startTime":1099.085,"endTime":1099.205,"body":"Yeah."},{"speaker":"Gillyanne","startTime":1099.505,"endTime":1102.355,"body":"And also, if you think about it,"},{"speaker":"Gillyanne","startTime":1099.505,"endTime":1102.355,"body":"Jeremy, the way that singers work,"},{"speaker":"Gillyanne","startTime":1102.355,"endTime":1105.895,"body":"particularly with the abdominal wall,"},{"speaker":"Gillyanne","startTime":1102.355,"endTime":1105.895,"body":"it obviously they're going to be"},{"speaker":"Gillyanne","startTime":1105.895,"endTime":1108.235,"body":"using that abdominal wall quite a lot."},{"speaker":"Gillyanne","startTime":1108.235,"endTime":1112.198,"body":"So that's going to be putting"},{"speaker":"Gillyanne","startTime":1108.235,"endTime":1112.198,"body":"pressure right on the area where"},{"speaker":"Gillyanne","startTime":1112.249,"endTime":1115.609,"body":"we might stimulate a reflux anyway."},{"speaker":"Jeremy","startTime":1115.969,"endTime":1119.155,"body":"It's it makes sense why singers"},{"speaker":"Jeremy","startTime":1115.969,"endTime":1119.155,"body":"in particular can be picky about food."},{"speaker":"Gillyanne","startTime":1119.215,"endTime":1120.085,"body":"Absolutely."},{"speaker":"Jeremy","startTime":1120.205,"endTime":1122.305,"body":"And when they eat,"},{"speaker":"Jeremy","startTime":1120.205,"endTime":1122.305,"body":"because there's a lot of things"},{"speaker":"Jeremy","startTime":1122.305,"endTime":1123.295,"body":"that they have to deal with."},{"speaker":"Gillyanne","startTime":1123.355,"endTime":1124.795,"body":"We understand, friends."},{"speaker":"Jeremy","startTime":1125.285,"endTime":1125.915,"body":"We do."},{"speaker":"Tor","startTime":1125.935,"endTime":1129.412,"body":"It's a very complex"},{"speaker":"Tor","startTime":1125.935,"endTime":1129.412,"body":"routine to have to get sorted."},{"speaker":"Tor","startTime":1129.412,"endTime":1132.502,"body":"And then so many elements, if"},{"speaker":"Tor","startTime":1129.412,"endTime":1132.502,"body":"something knocks off our routine"},{"speaker":"Tor","startTime":1132.502,"endTime":1135.592,"body":"of any reason, which of course"},{"speaker":"Tor","startTime":1132.502,"endTime":1135.592,"body":"it's going to, particularly for a"},{"speaker":"Tor","startTime":1135.592,"endTime":1137.632,"body":"performer where things are just right."},{"speaker":"Tor","startTime":1137.632,"endTime":1140.574,"body":"But if they're knocked off in some"},{"speaker":"Tor","startTime":1137.632,"endTime":1140.574,"body":"way people do worry that it's gonna"},{"speaker":"Tor","startTime":1140.784,"endTime":1142.836,"body":"impact on their voice and their throat."},{"speaker":"Tor","startTime":1142.836,"endTime":1143.506,"body":"And yeah."},{"speaker":"Gillyanne","startTime":1143.556,"endTime":1148.236,"body":"And you are actually"},{"speaker":"Gillyanne","startTime":1143.556,"endTime":1148.236,"body":"setting up your own courses now"},{"speaker":"Gillyanne","startTime":1148.236,"endTime":1152.986,"body":"aren't you to guide other SLTs"},{"speaker":"Gillyanne","startTime":1148.236,"endTime":1152.986,"body":"who might be interested in voice."},{"speaker":"Jeremy","startTime":1152.986,"endTime":1154.176,"body":"You're already a mentor."},{"speaker":"Tor","startTime":1154.236,"endTime":1154.656,"body":"Yeah."},{"speaker":"Tor","startTime":1155.076,"endTime":1155.376,"body":"Yeah."},{"speaker":"Tor","startTime":1155.376,"endTime":1157.056,"body":"So I love being a mentor."},{"speaker":"Tor","startTime":1157.176,"endTime":1166.886,"body":"I, over the past eight years, Supervised"},{"speaker":"Tor","startTime":1157.176,"endTime":1166.886,"body":"and trained sort of generalists therapists"},{"speaker":"Tor","startTime":1166.916,"endTime":1171.806,"body":"who see some voice patients, but it's"},{"speaker":"Tor","startTime":1166.916,"endTime":1171.806,"body":"not the majority of their caseload, but"},{"speaker":"Tor","startTime":1171.806,"endTime":1173.696,"body":"they've wanted to build their skills."},{"speaker":"Tor","startTime":1173.696,"endTime":1177.056,"body":"And I've done that on the"},{"speaker":"Tor","startTime":1173.696,"endTime":1177.056,"body":"NHS and in private practice."},{"speaker":"Tor","startTime":1177.086,"endTime":1182.006,"body":"But last year or the year before"},{"speaker":"Tor","startTime":1177.086,"endTime":1182.006,"body":"I thought to myself, how can I put"},{"speaker":"Tor","startTime":1182.006,"endTime":1186.066,"body":"all this experience and knowledge of"},{"speaker":"Tor","startTime":1182.006,"endTime":1186.066,"body":"what the developing voice therapists"},{"speaker":"Tor","startTime":1186.066,"endTime":1188.496,"body":"needs into an online course."},{"speaker":"Tor","startTime":1188.496,"endTime":1191.316,"body":"And of course at that"},{"speaker":"Tor","startTime":1188.496,"endTime":1191.316,"body":"time, everyone was online."},{"speaker":"Tor","startTime":1191.316,"endTime":1195.546,"body":"Everyone was wanting and finding"},{"speaker":"Tor","startTime":1191.316,"endTime":1195.546,"body":"it easier to learn online and the"},{"speaker":"Tor","startTime":1195.546,"endTime":1197.469,"body":"flexibility that brought to people."},{"speaker":"Tor","startTime":1197.799,"endTime":1202.394,"body":"So I ended up developing VoiceFit to"},{"speaker":"Tor","startTime":1197.799,"endTime":1202.394,"body":"Practise, which is for a developing"},{"speaker":"Tor","startTime":1202.394,"endTime":1206.264,"body":"voice therapist, whether that's therapist"},{"speaker":"Tor","startTime":1202.394,"endTime":1206.264,"body":"at the beginning of their career, or"},{"speaker":"Tor","startTime":1206.504,"endTime":1210.644,"body":"a few years down the line, or any time"},{"speaker":"Tor","startTime":1206.504,"endTime":1210.644,"body":"what they want to specialize in voice."},{"speaker":"Tor","startTime":1211.034,"endTime":1214.124,"body":"So it really covers what's"},{"speaker":"Tor","startTime":1211.034,"endTime":1214.124,"body":"essential learning and"},{"speaker":"Tor","startTime":1214.124,"endTime":1216.164,"body":"development that first 12 months."},{"speaker":"Tor","startTime":1216.554,"endTime":1218.834,"body":"And I provide supervision"},{"speaker":"Tor","startTime":1216.554,"endTime":1218.834,"body":"within the course."},{"speaker":"Tor","startTime":1218.834,"endTime":1222.88,"body":"It's all online, very flexible"},{"speaker":"Tor","startTime":1218.834,"endTime":1222.88,"body":"and ideally studied alongside"},{"speaker":"Tor","startTime":1222.88,"endTime":1225.22,"body":"a caseload with supervision."},{"speaker":"Tor","startTime":1225.25,"endTime":1227.59,"body":"So people hopefully"},{"speaker":"Tor","startTime":1225.25,"endTime":1227.59,"body":"get the most out of it."},{"speaker":"Tor","startTime":1227.59,"endTime":1231.81,"body":"Yeah, that's one of my favorite things"},{"speaker":"Tor","startTime":1227.59,"endTime":1231.81,"body":"and really is supporting people with that."},{"speaker":"Jeremy","startTime":1232.65,"endTime":1234.72,"body":"And we will put"},{"speaker":"Jeremy","startTime":1232.65,"endTime":1234.72,"body":"a link to your course."},{"speaker":"Gillyanne","startTime":1234.816,"endTime":1239.256,"body":"Have you got time"},{"speaker":"Gillyanne","startTime":1234.816,"endTime":1239.256,"body":"to talk about nasal breathing?"},{"speaker":"Gillyanne","startTime":1241.056,"endTime":1245.646,"body":"I know you're a fan and it's sometimes"},{"speaker":"Gillyanne","startTime":1241.056,"endTime":1245.646,"body":"it's a bit of a moot point sometimes"},{"speaker":"Gillyanne","startTime":1245.646,"endTime":1250.536,"body":"for singers because of course,"},{"speaker":"Gillyanne","startTime":1245.646,"endTime":1250.536,"body":"singers tend to need quite high lung"},{"speaker":"Gillyanne","startTime":1250.536,"endTime":1254.286,"body":"volumes in order to sing long phrases."},{"speaker":"Gillyanne","startTime":1254.286,"endTime":1258.244,"body":"And particularly if they need to"},{"speaker":"Gillyanne","startTime":1254.286,"endTime":1258.244,"body":"project acoustically we often feel"},{"speaker":"Gillyanne","startTime":1258.27,"endTime":1261.518,"body":"actually, we can't get enough air"},{"speaker":"Gillyanne","startTime":1258.27,"endTime":1261.518,"body":"in when breathing through the nose."},{"speaker":"Gillyanne","startTime":1261.938,"endTime":1265.524,"body":"But recently there's been a lot"},{"speaker":"Gillyanne","startTime":1261.938,"endTime":1265.524,"body":"of interest in nasal breathing,"},{"speaker":"Gillyanne","startTime":1265.572,"endTime":1270.672,"body":"in terms of downregulation of the"},{"speaker":"Gillyanne","startTime":1265.572,"endTime":1270.672,"body":"sympathetic nervous system, which"},{"speaker":"Gillyanne","startTime":1270.672,"endTime":1275.082,"body":"let's face it, we've all needed to do"},{"speaker":"Gillyanne","startTime":1270.672,"endTime":1275.082,"body":"over the last two and a half years."},{"speaker":"Gillyanne","startTime":1275.772,"endTime":1279.913,"body":"And people are very interested in it"},{"speaker":"Gillyanne","startTime":1275.772,"endTime":1279.913,"body":"from that, holistic point of view."},{"speaker":"Gillyanne","startTime":1280.363,"endTime":1285.073,"body":"But from your perspective as a speech"},{"speaker":"Gillyanne","startTime":1280.363,"endTime":1285.073,"body":"and language therapist, why do you"},{"speaker":"Gillyanne","startTime":1285.073,"endTime":1287.323,"body":"think nasal breathing is beneficial?"},{"speaker":"Tor","startTime":1288.703,"endTime":1292.483,"body":"So my interest in this has come"},{"speaker":"Tor","startTime":1288.703,"endTime":1292.483,"body":"from working with an asthma service"},{"speaker":"Tor","startTime":1292.583,"endTime":1296.243,"body":"with obviously patients with the"},{"speaker":"Tor","startTime":1292.583,"endTime":1296.243,"body":"laryngeal component to their symptoms."},{"speaker":"Tor","startTime":1296.243,"endTime":1302.483,"body":"But a lot of these patients have breathing"},{"speaker":"Tor","startTime":1296.243,"endTime":1302.483,"body":"pattern disorders or dysfunctional"},{"speaker":"Tor","startTime":1302.483,"endTime":1304.403,"body":"breathing, whatever you want to call it."},{"speaker":"Tor","startTime":1304.433,"endTime":1308.153,"body":"This is based on observations"},{"speaker":"Tor","startTime":1304.433,"endTime":1308.153,"body":"of someone's breathing patterns."},{"speaker":"Tor","startTime":1308.603,"endTime":1311.093,"body":"That does include the channel"},{"speaker":"Tor","startTime":1308.603,"endTime":1311.093,"body":"which they're breathing through,"},{"speaker":"Tor","startTime":1311.093,"endTime":1314.853,"body":"the mouth or the nose, but also"},{"speaker":"Tor","startTime":1311.093,"endTime":1314.853,"body":"talks about and observes things"},{"speaker":"Tor","startTime":1314.853,"endTime":1316.913,"body":"like  where's the air going?"},{"speaker":"Tor","startTime":1316.973,"endTime":1320.213,"body":"Is it apical or thoracic,"},{"speaker":"Tor","startTime":1316.973,"endTime":1320.213,"body":"or is it diaphragmatic?"},{"speaker":"Tor","startTime":1320.603,"endTime":1323.483,"body":"It looks at the speed with"},{"speaker":"Tor","startTime":1320.603,"endTime":1323.483,"body":"which someone's breathing."},{"speaker":"Tor","startTime":1323.783,"endTime":1326.708,"body":"It looks at whether it's audible"},{"speaker":"Tor","startTime":1323.783,"endTime":1326.708,"body":"or silent as it should be."},{"speaker":"Tor","startTime":1326.752,"endTime":1330.03,"body":"And it looks at the rhythm or whether"},{"speaker":"Tor","startTime":1326.752,"endTime":1330.03,"body":"someone's breathing patterns are erratic."},{"speaker":"Tor","startTime":1330.03,"endTime":1333.446,"body":"So there's lots that goes into breathing"},{"speaker":"Tor","startTime":1330.03,"endTime":1333.446,"body":"patterns and there's a lot of reasons"},{"speaker":"Tor","startTime":1333.446,"endTime":1339.356,"body":"why they can be knocked off, but it made"},{"speaker":"Tor","startTime":1333.446,"endTime":1339.356,"body":"me really aware of my own breathing."},{"speaker":"Tor","startTime":1339.476,"endTime":1343.061,"body":"It made me really aware of just"},{"speaker":"Tor","startTime":1339.476,"endTime":1343.061,"body":"generally other people's, and"},{"speaker":"Tor","startTime":1343.391,"endTime":1345.041,"body":"how people are breathing and why."},{"speaker":"Tor","startTime":1345.641,"endTime":1350.599,"body":"And when we're born, we're breathing"},{"speaker":"Tor","startTime":1345.641,"endTime":1350.599,"body":"completely spontaneously, automatically,"},{"speaker":"Tor","startTime":1350.599,"endTime":1354.463,"body":"beautiful involvement with the"},{"speaker":"Tor","startTime":1350.599,"endTime":1354.463,"body":"abdominals and the diaphragm."},{"speaker":"Tor","startTime":1354.483,"endTime":1355.529,"body":"It's quiet."},{"speaker":"Tor","startTime":1355.575,"endTime":1357.925,"body":"It's slow, it's through the nose usually."},{"speaker":"Tor","startTime":1357.961,"endTime":1363.295,"body":"And like with other things in life posture"},{"speaker":"Tor","startTime":1357.961,"endTime":1363.295,"body":"and whatnot, life has a huge impact"},{"speaker":"Tor","startTime":1363.295,"endTime":1365.7,"body":"on how we do these bodily functions."},{"speaker":"Tor","startTime":1365.7,"endTime":1370.35,"body":"So breathing is an essential"},{"speaker":"Tor","startTime":1365.7,"endTime":1370.35,"body":"part of voice, obviously, and an"},{"speaker":"Tor","startTime":1370.35,"endTime":1374.46,"body":"essential part of the, of how and"},{"speaker":"Tor","startTime":1370.35,"endTime":1374.46,"body":"why the upper airway functions."},{"speaker":"Tor","startTime":1374.88,"endTime":1378.27,"body":"Nose breathing, if we isolate"},{"speaker":"Tor","startTime":1374.88,"endTime":1378.27,"body":"that for a minute, the nose."},{"speaker":"Tor","startTime":1379.56,"endTime":1381.06,"body":"It's how we should breathe."},{"speaker":"Tor","startTime":1381.12,"endTime":1382.62,"body":"And those is designed for breathing."},{"speaker":"Tor","startTime":1382.65,"endTime":1386.61,"body":"I say to people, nose for breathing"},{"speaker":"Tor","startTime":1382.65,"endTime":1386.61,"body":"mouth, for eating or talking"},{"speaker":"Tor","startTime":1386.88,"endTime":1389.09,"body":"the nose keeps the air warm."},{"speaker":"Tor","startTime":1389.24,"endTime":1390.5,"body":"It keeps it wet."},{"speaker":"Tor","startTime":1391.34,"endTime":1397.022,"body":"And it allows for the production of"},{"speaker":"Tor","startTime":1391.34,"endTime":1397.022,"body":"nitric oxide in the parasinuses, which"},{"speaker":"Tor","startTime":1397.022,"endTime":1401.387,"body":"helps for the absorption of oxygen and"},{"speaker":"Tor","startTime":1397.022,"endTime":1401.387,"body":"for using the oxygen more efficiently."},{"speaker":"Tor","startTime":1401.448,"endTime":1405.228,"body":"Um So there's lots of benefits of"},{"speaker":"Tor","startTime":1401.448,"endTime":1405.228,"body":"nose breathing and it's difficult."},{"speaker":"Tor","startTime":1405.258,"endTime":1407.658,"body":"I see lots of people who"},{"speaker":"Tor","startTime":1405.258,"endTime":1407.658,"body":"will say, I just can't do it."},{"speaker":"Tor","startTime":1407.778,"endTime":1408.768,"body":"I can't nose breathe."},{"speaker":"Tor","startTime":1409.368,"endTime":1410.748,"body":"It doesn't feel comfortable."},{"speaker":"Tor","startTime":1411.588,"endTime":1412.638,"body":"I can't do it when I'm talking."},{"speaker":"Tor","startTime":1412.638,"endTime":1413.598,"body":"I can't do it at rest."},{"speaker":"Tor","startTime":1413.598,"endTime":1415.278,"body":"I certainly can't do"},{"speaker":"Tor","startTime":1413.598,"endTime":1415.278,"body":"it when I'm exercising."},{"speaker":"Tor","startTime":1415.788,"endTime":1418.188,"body":"And I say to people, it will feel strange."},{"speaker":"Tor","startTime":1418.188,"endTime":1423.413,"body":"It will feel really strange if you're"},{"speaker":"Tor","startTime":1418.188,"endTime":1423.413,"body":"not used to it, but with practice and"},{"speaker":"Tor","startTime":1423.413,"endTime":1427.26,"body":"with educating people on the benefits of"},{"speaker":"Tor","startTime":1423.413,"endTime":1427.26,"body":"it it's really worth persevering with."},{"speaker":"Gillyanne","startTime":1427.26,"endTime":1428.174,"body":"That's very interesting."},{"speaker":"Gillyanne","startTime":1428.774,"endTime":1433.994,"body":"Since reading some of your Instagram"},{"speaker":"Gillyanne","startTime":1428.774,"endTime":1433.994,"body":"posts, I have started noticing that,"},{"speaker":"Gillyanne","startTime":1434.037,"endTime":1438.49,"body":"sometimes if I'm just walking up to the"},{"speaker":"Gillyanne","startTime":1434.037,"endTime":1438.49,"body":"shops around here and I'm speeding along,"},{"speaker":"Gillyanne","startTime":1438.91,"endTime":1440.38,"body":"I tend to breathe through my mouth."},{"speaker":"Gillyanne","startTime":1440.44,"endTime":1444.55,"body":"I actually think I got into a pattern of"},{"speaker":"Gillyanne","startTime":1440.44,"endTime":1444.55,"body":"doing that because I developed a heart"},{"speaker":"Gillyanne","startTime":1444.64,"endTime":1446.723,"body":"arrhythmia um about three years ago."},{"speaker":"Gillyanne","startTime":1447.143,"endTime":1451.861,"body":"So I thought, okay I'll just try"},{"speaker":"Gillyanne","startTime":1447.143,"endTime":1451.861,"body":"breathing through my nose every so"},{"speaker":"Gillyanne","startTime":1451.861,"endTime":1456.751,"body":"often while I'm doing the walk and"},{"speaker":"Gillyanne","startTime":1451.861,"endTime":1456.751,"body":"actually I found I could do it."},{"speaker":"Gillyanne","startTime":1458.161,"endTime":1460.592,"body":"And so I'm very curious about it."},{"speaker":"Gillyanne","startTime":1460.592,"endTime":1465.464,"body":"I've also invested in some of those"},{"speaker":"Gillyanne","startTime":1460.592,"endTime":1465.464,"body":"tapes, around the mouth which are"},{"speaker":"Gillyanne","startTime":1465.464,"endTime":1468.828,"body":"recommended by actually they recommended"},{"speaker":"Gillyanne","startTime":1465.464,"endTime":1468.828,"body":"for asthma people aren't they."},{"speaker":"Gillyanne","startTime":1468.888,"endTime":1472.738,"body":"But I found that it's very helpful at"},{"speaker":"Gillyanne","startTime":1468.888,"endTime":1472.738,"body":"night, so that I don't breathe through"},{"speaker":"Gillyanne","startTime":1472.758,"endTime":1475.398,"body":"my mouth at night, less snoring."},{"speaker":"Gillyanne","startTime":1476.418,"endTime":1480.658,"body":"So I just think it's very interesting,"},{"speaker":"Gillyanne","startTime":1476.418,"endTime":1480.658,"body":"not only about the nitrous oxide,"},{"speaker":"Gillyanne","startTime":1480.658,"endTime":1485.957,"body":"but you're talking really about"},{"speaker":"Gillyanne","startTime":1480.658,"endTime":1485.957,"body":"the patterning of nasal breathing."},{"speaker":"Jeremy","startTime":1485.973,"endTime":1489.021,"body":"I'm going to I'm not"},{"speaker":"Jeremy","startTime":1485.973,"endTime":1489.021,"body":"going to gently disagree, but I"},{"speaker":"Jeremy","startTime":1489.021,"endTime":1490.971,"body":"am going to do a contextual thing."},{"speaker":"Jeremy","startTime":1491.018,"endTime":1495.24,"body":"Because it's only in fairly recent years"},{"speaker":"Jeremy","startTime":1491.018,"endTime":1495.24,"body":"that I've been able to nose breathe."},{"speaker":"Jeremy","startTime":1495.39,"endTime":1499.335,"body":"I have very narrow passages, so I just"},{"speaker":"Jeremy","startTime":1495.39,"endTime":1499.335,"body":"literally can't get enough oxygen in,"},{"speaker":"Jeremy","startTime":1499.725,"endTime":1501.265,"body":"but that's changed over the years."},{"speaker":"Gillyanne","startTime":1501.265,"endTime":1503.355,"body":"We're sharing a lot"},{"speaker":"Gillyanne","startTime":1501.265,"endTime":1503.355,"body":"of information on this podcast."},{"speaker":"Jeremy","startTime":1503.409,"endTime":1507.169,"body":"When I was 20 years ago,"},{"speaker":"Jeremy","startTime":1503.409,"endTime":1507.169,"body":"there was only one of the conchae that"},{"speaker":"Jeremy","startTime":1507.169,"endTime":1508.379,"body":"was wide enough to take the camera."},{"speaker":"Jeremy","startTime":1508.379,"endTime":1513.897,"body":"So I really do have my narrow passages,"},{"speaker":"Jeremy","startTime":1508.379,"endTime":1513.897,"body":"but contextual thing that I want to talk"},{"speaker":"Jeremy","startTime":1513.897,"endTime":1516.077,"body":"about is actually the act of singing."},{"speaker":"Jeremy","startTime":1516.381,"endTime":1518.901,"body":"And the reason why I want to talk"},{"speaker":"Jeremy","startTime":1516.381,"endTime":1518.901,"body":"about it is because of the breathing"},{"speaker":"Jeremy","startTime":1518.901,"endTime":1523.658,"body":"patterns for singing in general,"},{"speaker":"Jeremy","startTime":1518.901,"endTime":1523.658,"body":"which is very fast intake in a very"},{"speaker":"Jeremy","startTime":1523.718,"endTime":1528.278,"body":"short space of time and then long ex"},{"speaker":"Jeremy","startTime":1523.718,"endTime":1528.278,"body":"exhale as it were when you're singing."},{"speaker":"Jeremy","startTime":1528.488,"endTime":1532.179,"body":"And it's almost any singing"},{"speaker":"Jeremy","startTime":1528.488,"endTime":1532.179,"body":"style that interrupted pattern"},{"speaker":"Jeremy","startTime":1532.179,"endTime":1533.589,"body":"of standard breathing is there."},{"speaker":"Jeremy","startTime":1533.889,"endTime":1538.809,"body":"So you breathe in very fast and then"},{"speaker":"Jeremy","startTime":1533.889,"endTime":1538.809,"body":"you use the breath for medium phrases"},{"speaker":"Jeremy","startTime":1538.809,"endTime":1540.189,"body":"or long phrases or very long phrases."},{"speaker":"Gillyanne","startTime":1540.201,"endTime":1542.227,"body":"It's also about"},{"speaker":"Gillyanne","startTime":1540.201,"endTime":1542.227,"body":"sustaining the sub glottal"},{"speaker":"Gillyanne","startTime":1542.227,"endTime":1543.827,"body":"pressure for particular pitches."},{"speaker":"Gillyanne","startTime":1543.847,"endTime":1544.117,"body":"Isn't it?"},{"speaker":"Jeremy","startTime":1544.687,"endTime":1548.903,"body":"And so I'm perfectly happy"},{"speaker":"Jeremy","startTime":1544.687,"endTime":1548.903,"body":"with the idea that you can in real"},{"speaker":"Jeremy","startTime":1548.903,"endTime":1553.851,"body":"life nasal breathe, but I'm, I just"},{"speaker":"Jeremy","startTime":1548.903,"endTime":1553.851,"body":"don't get that you could do that when"},{"speaker":"Jeremy","startTime":1553.851,"endTime":1555.451,"body":"you're singing pretty much anything."},{"speaker":"Jeremy","startTime":1555.919,"endTime":1561.091,"body":"Um Partly because I'm noisy if"},{"speaker":"Jeremy","startTime":1555.919,"endTime":1561.091,"body":"I breathe in nasally Uh at speed"},{"speaker":"Jeremy","startTime":1561.241,"endTime":1564.415,"body":"and I can't afford to do that as a"},{"speaker":"Jeremy","startTime":1561.241,"endTime":1564.415,"body":"singer I just don't get enough in."},{"speaker":"Jeremy","startTime":1564.685,"endTime":1567.685,"body":"So not that I'm suggesting that"},{"speaker":"Jeremy","startTime":1564.685,"endTime":1567.685,"body":"everybody takes deep breaths all the"},{"speaker":"Jeremy","startTime":1567.685,"endTime":1569.005,"body":"time when they sing, they don't need to."},{"speaker":"Jeremy","startTime":1569.575,"endTime":1573.414,"body":"But it is interesting that's the"},{"speaker":"Jeremy","startTime":1569.575,"endTime":1573.414,"body":"one area that I would say that"},{"speaker":"Jeremy","startTime":1573.444,"endTime":1577.457,"body":"it does not work for me, but the"},{"speaker":"Jeremy","startTime":1573.444,"endTime":1577.457,"body":"nasal breathing in general life."},{"speaker":"Jeremy","startTime":1577.517,"endTime":1578.357,"body":"Yes, absolutely."},{"speaker":"Tor","startTime":1578.627,"endTime":1579.347,"body":"Yeah, no."},{"speaker":"Tor","startTime":1579.347,"endTime":1581.253,"body":"And I completely get your point."},{"speaker":"Tor","startTime":1581.253,"endTime":1585.093,"body":"And I think the majority of people"},{"speaker":"Tor","startTime":1581.253,"endTime":1585.093,"body":"when they're singing will probably"},{"speaker":"Tor","startTime":1585.093,"endTime":1588.964,"body":"breathe in through the mouth and"},{"speaker":"Tor","startTime":1585.093,"endTime":1588.964,"body":"that's not necessarily a bad thing."},{"speaker":"Tor","startTime":1588.969,"endTime":1592.355,"body":"That's not going to turn everyone into"},{"speaker":"Tor","startTime":1588.969,"endTime":1592.355,"body":"mouth breathers at rest and chronic"},{"speaker":"Tor","startTime":1592.355,"endTime":1593.915,"body":"mouth breathers at night, for example."},{"speaker":"Tor","startTime":1593.915,"endTime":1595.087,"body":"It's, you can be both."},{"speaker":"Tor","startTime":1595.117,"endTime":1599.315,"body":"You can use your mouth when breathing"},{"speaker":"Tor","startTime":1595.117,"endTime":1599.315,"body":"in when you're singing, but you can also"},{"speaker":"Tor","startTime":1599.345,"endTime":1602.825,"body":"be a healthy nasal breather at rest."},{"speaker":"Jeremy","startTime":1603.725,"endTime":1607.128,"body":"I think it's, I feel quite"},{"speaker":"Jeremy","startTime":1603.725,"endTime":1607.128,"body":"strongly that it's important to say that"},{"speaker":"Jeremy","startTime":1607.158,"endTime":1612.454,"body":"because we are so much now bombarded"},{"speaker":"Jeremy","startTime":1607.158,"endTime":1612.454,"body":"with you must you must you must you must."},{"speaker":"Jeremy","startTime":1612.454,"endTime":1615.184,"body":"And there's a whole list of you"},{"speaker":"Jeremy","startTime":1612.454,"endTime":1615.184,"body":"musts, and then you're trying to"},{"speaker":"Jeremy","startTime":1615.184,"endTime":1617.054,"body":"live your life with these you musts."},{"speaker":"Gillyanne","startTime":1617.074,"endTime":1617.364,"body":"Yeah."},{"speaker":"Gillyanne","startTime":1617.434,"endTime":1621.677,"body":"Particularly on social media posts,"},{"speaker":"Gillyanne","startTime":1617.434,"endTime":1621.677,"body":"we're being advocated to do this"},{"speaker":"Gillyanne","startTime":1621.677,"endTime":1623.435,"body":"and that and people pick things up."},{"speaker":"Gillyanne","startTime":1623.475,"endTime":1627.74,"body":"But I'm going to say from my point of"},{"speaker":"Gillyanne","startTime":1623.475,"endTime":1627.74,"body":"view, that it was, it's an interesting"},{"speaker":"Gillyanne","startTime":1627.74,"endTime":1631.85,"body":"exercise for me to breathe through"},{"speaker":"Gillyanne","startTime":1627.74,"endTime":1631.85,"body":"my nose while I'm walking along."},{"speaker":"Gillyanne","startTime":1631.85,"endTime":1636.356,"body":"I wouldn't do it if I was running"},{"speaker":"Gillyanne","startTime":1631.85,"endTime":1636.356,"body":"or probably wouldn't do it if I was"},{"speaker":"Gillyanne","startTime":1636.356,"endTime":1638.126,"body":"mowing the lawn or anything like that."},{"speaker":"Gillyanne","startTime":1638.786,"endTime":1641.936,"body":"But I just noticed I'd fallen"},{"speaker":"Gillyanne","startTime":1638.786,"endTime":1641.936,"body":"into this other pattern and"},{"speaker":"Gillyanne","startTime":1641.936,"endTime":1643.076,"body":"I thought, hang on a minute."},{"speaker":"Gillyanne","startTime":1643.706,"endTime":1645.806,"body":"I don't think I really need to do this."},{"speaker":"Jeremy","startTime":1646.556,"endTime":1647.036,"body":"I agree with that."},{"speaker":"Jeremy","startTime":1647.126,"endTime":1647.336,"body":"Yeah."},{"speaker":"Gillyanne","startTime":1647.336,"endTime":1651.266,"body":"And so it's another one of"},{"speaker":"Gillyanne","startTime":1647.336,"endTime":1651.266,"body":"those you can intervene with that pattern."},{"speaker":"Gillyanne","startTime":1651.266,"endTime":1653.036,"body":"You don't have to get caught up in it."},{"speaker":"Gillyanne","startTime":1653.066,"endTime":1653.156,"body":"Yeah."},{"speaker":"Tor","startTime":1654.521,"endTime":1654.731,"body":"Yeah."},{"speaker":"Tor","startTime":1654.761,"endTime":1659.291,"body":"So I worked very closely with the"},{"speaker":"Tor","startTime":1654.761,"endTime":1659.291,"body":"physiotherapists who work really"},{"speaker":"Tor","startTime":1659.307,"endTime":1661.09,"body":"with breathing pattern disorders."},{"speaker":"Tor","startTime":1661.09,"endTime":1665.86,"body":"And a lot of our work now crosses over,"},{"speaker":"Tor","startTime":1661.09,"endTime":1665.86,"body":"particularly with the respiratory services"},{"speaker":"Tor","startTime":1665.86,"endTime":1670.026,"body":"and the NHS and that we re you know,"},{"speaker":"Tor","startTime":1665.86,"endTime":1670.026,"body":"again, really holistically at the whole"},{"speaker":"Tor","startTime":1670.026,"endTime":1673.086,"body":"body and what the whole body's doing"},{"speaker":"Tor","startTime":1670.026,"endTime":1673.086,"body":"when we're breathing and when we're"},{"speaker":"Tor","startTime":1673.086,"endTime":1678.006,"body":"exercising and how we can just optimize"},{"speaker":"Tor","startTime":1673.086,"endTime":1678.006,"body":"breathing patterns that we're never"},{"speaker":"Tor","startTime":1678.006,"endTime":1679.756,"body":"going to breathe perfectly all the time."},{"speaker":"Tor","startTime":1679.786,"endTime":1683.568,"body":"You know We'd have uh uh you know"},{"speaker":"Tor","startTime":1679.786,"endTime":1683.568,"body":"things, so many factors, lots of"},{"speaker":"Tor","startTime":1683.568,"endTime":1687.799,"body":"variables, but there's lots of"},{"speaker":"Tor","startTime":1683.568,"endTime":1687.799,"body":"benefits for health, for voice"},{"speaker":"Jeremy","startTime":1687.899,"endTime":1690.083,"body":"So, Tor, what's coming up for you."},{"speaker":"Gillyanne","startTime":1690.083,"endTime":1690.353,"body":"Yeah."},{"speaker":"Jeremy","startTime":1691.053,"endTime":1691.683,"body":"What's in the future?"},{"speaker":"Gillyanne","startTime":1691.683,"endTime":1694.573,"body":"Yes, because there's a"},{"speaker":"Gillyanne","startTime":1691.683,"endTime":1694.573,"body":"change in your life, isn't there,"},{"speaker":"Gillyanne","startTime":1694.603,"endTime":1696.753,"body":"coming up right now or very soon."},{"speaker":"Gillyanne","startTime":1697.083,"endTime":1697.533,"body":"Tell us about it."},{"speaker":"Tor","startTime":1697.533,"endTime":1698.859,"body":"Yes, there is a change."},{"speaker":"Tor","startTime":1698.859,"endTime":1704.019,"body":"So I've worked in the NHS for"},{"speaker":"Tor","startTime":1698.859,"endTime":1704.019,"body":"15 years, I think, around that."},{"speaker":"Tor","startTime":1704.079,"endTime":1708.009,"body":"And I've decided for various reasons,"},{"speaker":"Tor","startTime":1704.079,"endTime":1708.009,"body":"I'm just going to take a little break"},{"speaker":"Tor","startTime":1708.033,"endTime":1713.103,"body":"which is a huge sort of sacrifice in many"},{"speaker":"Tor","startTime":1708.033,"endTime":1713.103,"body":"respects, I comes saying goodbye to a job"},{"speaker":"Tor","startTime":1713.103,"endTime":1715.721,"body":"that I absolutely love in, in the NHS."},{"speaker":"Tor","startTime":1715.841,"endTime":1719.651,"body":"But I may be back, but I'm just"},{"speaker":"Tor","startTime":1715.841,"endTime":1719.651,"body":"decided what's best for me at"},{"speaker":"Tor","startTime":1719.651,"endTime":1721.202,"body":"this minute is to take a break."},{"speaker":"Tor","startTime":1721.202,"endTime":1725.565,"body":"And I'm going to focus on building"},{"speaker":"Tor","startTime":1721.202,"endTime":1725.565,"body":"my private practice and do more"},{"speaker":"Tor","startTime":1725.565,"endTime":1730.515,"body":"teaching and training and work on"},{"speaker":"Tor","startTime":1725.565,"endTime":1730.515,"body":"these, on developing these courses"},{"speaker":"Tor","startTime":1730.543,"endTime":1732.157,"body":"for voice and upper airway therapists."},{"speaker":"Tor","startTime":1732.847,"endTime":1734.377,"body":"So yeah, I'm excited."},{"speaker":"Tor","startTime":1734.377,"endTime":1739.013,"body":"It's it's going to be different more,"},{"speaker":"Tor","startTime":1734.377,"endTime":1739.013,"body":"I'll need more discipline to work under"},{"speaker":"Tor","startTime":1739.013,"endTime":1741.171,"body":"my own steam and keep that going, but..."},{"speaker":"Jeremy","startTime":1741.891,"endTime":1743.617,"body":"Welcome to the"},{"speaker":"Jeremy","startTime":1741.891,"endTime":1743.617,"body":"world of the freelancer."},{"speaker":"Jeremy","startTime":1743.617,"endTime":1744.903,"body":"So how can we find you?"},{"speaker":"Jeremy","startTime":1744.903,"endTime":1745.773,"body":"How can we contact you?"},{"speaker":"Jeremy","startTime":1745.773,"endTime":1746.703,"body":"What's your social media?"},{"speaker":"Jeremy","startTime":1746.703,"endTime":1747.843,"body":"What's your handles?"},{"speaker":"Tor","startTime":1748.293,"endTime":1754.038,"body":"So I'm @VoiceFitUK on Twitter"},{"speaker":"Tor","startTime":1748.293,"endTime":1754.038,"body":"and Instagram and Facebook."},{"speaker":"Tor","startTime":1754.085,"endTime":1759.915,"body":"So yes, I'm a big fan of social media, and"},{"speaker":"Tor","startTime":1754.085,"endTime":1759.915,"body":"Instagram, particularly for making ama..."},{"speaker":"Tor","startTime":1760.085,"endTime":1761.795,"body":"Like I met you guys on Instagram."},{"speaker":"Tor","startTime":1762.349,"endTime":1764.989,"body":"For networking, for meeting,"},{"speaker":"Tor","startTime":1762.349,"endTime":1764.989,"body":"amazing people in this"},{"speaker":"Tor","startTime":1765.409,"endTime":1766.459,"body":"profession, in the world of voice."},{"speaker":"Tor","startTime":1766.459,"endTime":1766.949,"body":"And what's your website?"},{"speaker":"Tor","startTime":1769.346,"endTime":1771.246,"body":"Um voice set.co.uk."},{"speaker":"Tor","startTime":1771.846,"endTime":1772.206,"body":"Excellent."},{"speaker":"Gillyanne","startTime":1772.296,"endTime":1772.806,"body":"It's easy."},{"speaker":"Gillyanne","startTime":1772.806,"endTime":1775.416,"body":"It's just all about VoiceFit UK."},{"speaker":"Jeremy","startTime":1775.446,"endTime":1775.596,"body":"Yeah."},{"speaker":"Jeremy","startTime":1775.652,"endTime":1776.569,"body":"Tor, it's been a pleasure."},{"speaker":"Gillyanne","startTime":1776.639,"endTime":1777.789,"body":"Yes, very much so."},{"speaker":"Jeremy","startTime":1777.789,"endTime":1778.919,"body":"Thank you so much for coming."},{"speaker":"Tor","startTime":1778.939,"endTime":1780.559,"body":"Oh, thank you so much for having me."},{"speaker":"Tor","startTime":1780.559,"endTime":1781.129,"body":"I've loved it."},{"speaker":"Jeremy","startTime":1781.889,"endTime":1784.579,"body":"Everything that Tor has"},{"speaker":"Jeremy","startTime":1781.889,"endTime":1784.579,"body":"been describing, we'll have a huge"},{"speaker":"Jeremy","startTime":1784.579,"endTime":1787.489,"body":"list of show notes that people"},{"speaker":"Jeremy","startTime":1784.579,"endTime":1787.489,"body":"can find all of those links."},{"speaker":"Jeremy","startTime":1787.519,"endTime":1788.179,"body":"So Thank you."},{"speaker":"Jeremy","startTime":1788.179,"endTime":1788.539,"body":"Tor."},{"speaker":"Jeremy","startTime":1789.179,"endTime":1799.339,"body":"It's been a pleasure."},{"speaker":"Tor","startTime":1799.369,"endTime":1800.869,"body":"Thank you!"},{"speaker":"Jeremy","startTime":1802.399,"endTime":1804.649,"body":"This is a voice uh"},{"speaker":"Jeremy","startTime":1804.649,"endTime":1808.009,"body":"podcast with Dr Gillyanne"},{"speaker":"Jeremy","startTime":1804.649,"endTime":1808.009,"body":"Kayes and Jeremy Fisher"}]}