Throat Blog — Operation Voice Restore, Part I

Finally, back to a Throat Blog post that is actually about my throat. We’ve been all over the body…lungs, kidneys, gallbladder, and now circling back around to where this all started, my throat.

To refresh, my original tumor was in my throat…it invaded and destroyed most of my thyroid cartilage and, at its peak, went nearly from cricoid to hyoid vertically, and wider than my larynx laterally. It was big. Treatment was loads of radiation over a 12-week period, which successfully destroyed the tumor, however a lot of damage was left behind.

Notably, my thyroid cartilage was almost totally obliterated and my vocal cords were welded together…an effect of the inflammation and damage from the radiation therapy. My cartilage has surprisingly restored, somewhat. The last good image I had of it, it was about half as tall and twice as thick as a normal thyroid cartilage, and it was still reforming.

However, my vocal cords needed more intervention. I’ve been stuck between a whisper and a rasp, now, for over a year. While that works kind of OK in quiet rooms, anywhere there is any ambient noise, I really cannot participate in conversations (or order food). I’ve adjusted a lot, but actually being able to project some volume would really be great. Whispering at idiot drivers just doesn’t have the same effect as yelling.

So, Tuesday I went in for Operation Voice Restore, Part I. This part consisted of a day surgery where my vocal cords were cut apart with a CO2 laser, then a plastic keel was put in place to hold them apart while they heal. Technically, I had “laryngoplasty” which is the same procedure they use when going through gender reassignment surgery to raise or lower ones voice. Keeping my current gender, thank you, just give me a voice (preferrably more on the Isaac Hayes end of the spectrum). My sister went with me and spent what I’m sure was a wonderful morning drinking coffee while I slept.

Step 1 was to get me intubated and to block my airway so that I wouldn’t aspirate anything during the procedure. (This was all done under complete sedation…I knew none of what was happening at the time.) Here’s a shot of what things looked like just before the cut. The metal tube (blocking my airway and also providing me with oxygen) is actually pulling my vocal cords apart, some. Normally I would not have this large of an opening (pre-procedure).

Next, the surgeon used a laser (insert air quotes if desired) to separate my vocal folds. The laser was able to cut and cauterize at the same time, so not really any bleeding.

Finally (for this stage), a plastic keel was secured in place to hold my vocal cords apart during healing. There is another plastic piece attached to the outside of my throat and the two pieces are sutured together to hold it in place.

When I woke up from the procedure (and I wake up very quickly from these modern anesthetics), I was still on the procedure table, in the process of being moved over to a gurney. They wheeled me into post-op for about 30 minutes, then back to the prep room where I’d left my clothes. Pain was moderate, but building, so I made the first of two mistakes of the entire procedure. I took a 10mg Vicodin. On an empty stomach.

I’ve done that before, but then immediately slept for several hours. This time, I had to get up, get dressed, and get out. I was fine while I was in the hospital bed, but as soon as I got up to get dressed, nausea hit me. I actually allowed them to wheel me to the bathroom (where mistake two happened…no, not what you are thinking), then down to the curb where my brother-in-law was waiting to drive me back to their place for recuperation.

We got about 10 minutes away when I started looking for my phone. Nowhere to be found. We called it, and couldn’t hear it ring, so was certain it was back at the hospital. But, where? Find My Phone said it was out on the front lawn of the hospital. I’ve generally found that app to be exceptionally accurate (identifying which room in my house the phone has hidden itself in), but the hospital pretty much whacked all the GPS signals, so in addition to the spot on the lawn that was the most probable location, it also had a circle of doubt that ranged 1/4 mile to 2 miles, depending on when I looked.

Eventually, we tracked it down to the bathroom on the 3rd floor, where the staff had just found it. Between turning around, stopping before driving back to the hospital to give the truck a good search just to be sure it wasn’t there with the ringer turned off, stopping again so that I could empty what little had been in my stomach (and was entirely water) onto some poor businesses parking lot, in and out of the hospital a few times trying to figure out where it was…a 20-minute drive back to their house turned into a nearly 2-hour fiasco…all on me. And the Vicodin, which I should have passed up.

When we got to their house, I found the first horizontal and relatively comfortable surface I could find (couch), covered my head with a pillow, and passed out until early evening.

Now, it has been a couple of days, and my lingering aftereffects are a sore throat (duh!), a slightly numb tongue (just the right half…I suspect a nerve was compressed when they dammed my mouth open), and a need for a nap (didn’t really sleep well due to the nagging pain which, while not agony by any means, was enough to prevent deep slumber). I am also having a bit of trouble swallowing, as my throat is pretty swollen, right now, but that should get better pretty quickly.

I am back to a whisper only. And, too many people are whispering back to me. I did not realize I was such a trend setter.

On 12/11 I’ll have a much shorter procedure where they’ll knock me out, again, take out the keel, then wake me up. Should be quick, and I should be able to get some sort of voice going after that. Not getting my hopes up that it will be my old voice (doubtful) or even that it will be a full voice. But, if it is better than what I’ve had for the past year, that will be enough, for now.

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