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Hello, Marc -- Welcome to the list. I trust you will find useful information here for your friend. It's very important for PD patients to see doctors who are knowledgeable about PD; it's a very complicated disease with many individual quirks. Generally, people recommend a "movement disorder specialist" or a neurologist who specializes in PD. If neither is available locally, periodic travel for consultation is a consideration. (My midwest geography is kinda fuzzy, being an east coast transplant -- is your friend able to go to Chicago or Kansas City?? I know it wouldn't be easy, but would it be possible?) There are actually a number of surgeries available, and a specialist would know about them and whether your friend would be a good candidate for any. My mother also has trouble speaking and got some benefit from speech therapy. There's also a procedure for injecting collagen into the vocal cords. If you give us more details, I'm sure you'll get more suggestions! Mary Rack cg for Mom, Louise, 76 today, diagnosed 6ish years ago (76/6) Overland Park, KS [log in to unmask] PS What kinda music? My brother teaches percusssion/music ed at UNC Wilmington. My daughter's a performance major at Duquesne (Pittsburgh, PA) (violin).