Here's what I would try if I would in your position. I'd start with Say-Now's interface to Microsoft SAPI (say-now.com) for voice commands and dictation [$14]. It does take a little while (20 minutes for me) to train Windows to recognize your voice. Next, I'd check out RunRevolution Studio (runrev.com) with the Transcript programming language for desktop programming [$399]. Of all the languages I'm (somewhat) familiar with, Transcript is appears to be most similar to English and seems amenable to speech-based input. I'd also look at The Foot/Slipper Mouse (bilila.com) [$199].