3 Second delay in VoIP calls and 30%+ packet loss and cannot turn off SIP Helper

Hey Guys,
I have a RB750Gl in front of a Sangoma Vega 100 VoIP gateway. These are the only two devices on the network and they have a dedicated internet connection. I setup a DMZ of sorts with

/ip firewall nat



add chain=dst-nat action=dst-nat in-interface=ether1-gateway to-addresses=192.168.5.10

so I did not have to worry about opening and closing ports. I forgot when I was setting everything up to disable SIP Helper so when they reported problems I went in and turned it off. As soon as I turn it off I lose all audio on incoming and outgoing calls. I have always disabled SIP Helper with no issue but this is my first install with a gateway instead of SIP phones. Anyone have any ideas about this delay/packet loss and why I cannot turn off SIP Helper?

Have you referenced the Vega manual? http://wiki.sangoma.com/How-to-configure-a-Vega-gateway-to-operate-behind-a-NAT