Tuesday, September 3, 2019

Documentation of a broken voice

Part I: 2013
I do not have good notes from 2013, so after checking in with several people who had to spend a lot of time dealing with me, I have a clearer picture of how things happened. I woke up from surgery with the ability to push out three words at a time before completely running out of breath. The surgeon was mortified at how I sounded when I spoke to him over the phone. Over the course of five weeks, my voice did not apparently improve much at all; I had 'a few words' of barking and then apparently I got very good at loud whispers. When my voice returned, it was sudden and a more or less complete recovery, save for a lot of range.

Part II: Six intervening years
The only things I had to say after my range recovered from not being used at all for over a month was that if I talked and walked at the same time, I ran out of breath a lot. I have it on good authority from a speech therapist that this is a fairly common long-term impact people in my situation notice and report if they put the pieces together. It probably comes from one side of the larynx not coming in to the center and, in exertion, a wider aperture for speaking than one would normally have, and the subsequent more rapid loss of air.

Part III: 2019
IIIa: Pre-surgery, I was asked to participate in an evaluation to know how gentle the surgeon needed to be with my nerves. I had apparently made a full recovery; both flaps were flapping and moving all the way in to the center. Evidently, the left side was visibly more muscular than the right, likely from years of compensation. Both meeting in the center likely explains why the "talking while exercising" problem got better over the years. I was also informed that I am "very protective" of my vocal cords, as I don't tolerate being scoped very well at all. Fun fact to file away for 'weird things to be self-conscious about.'
IIIb: Immediately post-surgery, I had intermittent fits of voice. I have come to understand that this was the result of mucus I couldn't clear from my throat while I still lacked the ability to cough. As time went by and I could clear more and more, I arrived at the point where I could summon perhaps four or five words, then I'd need to take a breath, and after a while, my voice would die to a whisper. As time has progressed, this has actually gotten better... I still run out of air, but what I have of a voice has been getting steadily stronger (while still very weak) with the passage of time, and I tend to have more of it at the end of the day than I did last week or the week before. I am one day shy of five weeks out, with follow-ups for post-op and speech therapy next week. It's going to be a fascinating visit, as I will find out whether or not the sensations I feel and the hypothesis I've developed correspond to reality: I think the right side vocal cord is in a paralysis partially closed, and the reason I've been improving is that as the left starts to compensate, as it did last time, it's got less and less distance to cover. I also know that clearing the consequences of seasonal allergies causes the strength of my voice to collapse pretty quickly in the morning, but most mornings, I do wake up with a sound recognizably mine.

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