Friday, September 23, 2011

Funky Sexy Manifesto #83 Get My Voice Back

One of the possible complications of a thyroidectomy (thyroid removal surgery) is damage to the laryngeal nerve which hence impacts the movement of the vocal chords. Unfortunately, I had met one young woman who experienced this complication (representing less than 1% of thyroidectomy patients) with her partial-thyroidectomy. As a result, one of her vocal chords was paralyzed meaning that only one side moved. The downside was that she required a second surgery since the results from the first one revealed that her nodules were malignant.

Paralyzed Vocal Chord

Another extreme case of voice loss after thyroid cancer is in the experience film critic Roger Ebert. I met Ebert years ago when I worked for a well-known film festival but at the time I did not know that it was him. Ebert represents a small percentage of men who get papillary thyroid cancer, the same type that I had. However, for some reason, more men get the serious kind. Although Ebert had the routine treatment of removal of cancer tissue from the thyroid (not clear if he had a total thyroidectomy) and radioactive iodine ablation (RAI) and his thyroid cancer was in remission, he was diagnosed with salivary cancer a year later. Again, a diagnosis of a second cancer after RAI is very uncommon but possible. Over the years, cancer had spread to his jaw and after a series of operations, he had a trachaeotomy which resulted in a total loss of his voice. He now speaks with a computerized voice-system called "Alex".

Roger Ebert: Remaking my voice
A really inspirational talk about how Roger Ebert remade his voice after a lifetime of making his living from his voice.

My case was quite different. My fine needle aspiration (FNA) biopsy revealed that I had thyroid cancer so they were pretty sure about getting it all with a total thyroidectomy. However, one thing has changed for me quite dramatically in fact is... my voice. Now don't get me wrong, I can still speak and most people will tell me that they cannot hear any difference in my voice. However, I can hear the difference.

Before my thyroidectomy, I had a mid-range feminine voice which tended to get hoarse (a possible early symptom that I had some thyroid nodules a-developing.) I loved to sing and sang and hummed constantly. I could sing both soprano and alto ranges. I'd sing in my car, I'd sing in the shower, in the supermarket when I hear my song playing on the speakers, to my kindergarten students, in choirs, and even back-up in reggae bands. I didn't have a gifted voice (a la Mariah or Jill Scott) but I knew how to carry a tune, keep a note, and sing harmony for days.

Mariah Carey (when I liked her songs best)

Jill Scott

So imagine my shock, when the first time I busted open a church hymnal at service time, and out came a squawk. An unrecognizable, ugly sound. I was embarassed. I began to hum the melodies of the hymns and sing out only to the notes I know I could reach.

I began to search online and in my thyroid support group to find out if other singers and music teachers who had thyroidectomies noticed the same thing. I got several replies and recommendations. Many had said that they too experienced what I had: a deepening of their voice, decreased projection, still some hoarseness. However, they said many of these would improve after the surgery. My experience, and that of others, is that the voice could be permanently changed.

I could hear it in my singing voice.

I felt sad about this difference but have accepted that my voice may be permanently different.

I went to my surgeon and asked him about this. He said that after the surgery, scar tissue can form on the laryngeal muscle/nerve (?) causing limitations in the stretching. He sounded pretty nonchalant about it. I was not impressed.

I heard the change on my very first day of teaching a few weeks ago.

I heard the limitations in my vocal projection. My voice would get to a certain volume and then it was inaudible, it wanted to stop. When I sang with my students, my voice would crack and arch in unpredictable ways. It was a bit humbling. Although, I taught for only half the day, my vocal chords felt sore at the end of three hours.

I knew I needed to get some help so I went to google to search me some voice therapy (Funky Sexy Manifesto #83 Get My Voice Back). Twice daily, I have been completing vocal exercises. I have also been recommended for use of voice amplification at work.

So the day before I had my voice therapy session scheduled, ironically, I attended an event in which I got to hear my voice and speak about my experience of going through cancer. I was invited to speak at an event called Satisfying Her Soul. This was fulfilling the first of my Funky Sexy Manifest #57 Do A Speaking Gig.

I was blown away by the sincerity, trust, and openness in the room. The audience, mostly Black women and a few men and other women, was affirming, attentive, and supportive.

I have never experienced anything like that.

I exhaled...

My soul just opened up...

I was loosed...

And every other cliche book title that us Black women love to read.
(Now just throw a Tyler Perry movie in there and we're set!)

I arrived late at Satisfying Her Soul since I needed to nap (I still need my naps!) but I was greeted with beautiful artwork and an attentive audience. Women were sharing their experiences, challenges, and struggles through some pretty tough shit. They explored their concerns and shared their wisdom. What a powerful space!

After hearing stories of how women overcame abuse, teen pregnancies, and relationship break-ups, I wondered what I could contribute. But then as I sat down with my laptop and my journal, I realized that there was a lot to share. Where do I begin? As this was my first official speaking engagement, I wanted to do a great job but not overwhelm the audience.

I found myself wondering about how I did get through some of the tough times. How did I deal with my diagnosis of cancer? How did I last through four days in isolation without going mad? How did I walk into court and challenge a board of three government officials? How dare I be bold enough to challenge my Endo's recommendation? How did I deal with knowing the thyroid cancer spread to my surrounding lymph nodes? How did I deal with the fact that Thyrogen was worth $ 2000 and not only unavailable but my insurance company refused to cover it? How did I decide to go from 100% salary to less than 40% from sick benefits and long-term disability with the cost of increased medical bills, care, and medication? How did these experiences change me?

That's some crazy shit!

Well, I didn't go through it alone. I have my faith, healthcare team, my partner, friends, family, community, therapy, and everything. But after this event, I also realize the importance of inner strength, perseverance, and tenacity (a word that some use to describe me).

And I told my story to an audience-- familiar faces and new ones-- by using my voice as breathy, hoarse, and unpredictable as it may be.

So instead of grossing you out with more thyroidectomy photos, I will show you more highlights from that night.

No comments: