Why can’t my voice be as easy to fix as my nose was?

I’ve had two injections, an implant, and speech therapy.  It still sucks.  An incredibly uncomfortable laryngeal EMG test, and a couple weeks later, today was the day that Dr. Hillel and I were going to decide on the next surgery.  I’m fairly hopeful and even excited that I’ll get what I want out of the appointment.

That didn’t happen.

I’m going back to the operating room once again next Wednesday.  Not for something that I was expecting, but instead for another test or experiment or a way to try something and see what happens.  Damn.  Why does my case have to be so damn difficult and complicated?
When we did the first injection, I knew what was going to happen before I got there.  I heard my original voice when the needle was in my neck and I had to make sounds, this happened in the clinic and I drove home with a different voice than what I got there with.  It wasn’t my voice, but it was better than before.  A month later, I had a follow up with Dr. Short.  Neither of us were all that happy with the results, so we do another injection.  This time he couldn’t get the needle through my neck.  He gets a different, curved needle and goes through my mouth.  I wasn’t mentally prepared for another injection, let alone the process of doing it through my mouth.  Once again, I left with a slightly different voice than the one I arrived with.

A couple months later I had to switch insurance and with that came new doctors.  Numerous scopes down my nose to see my vocal cords, and a surgery to mess with a muscle in the back of my throat and pop in implant in the cartilage to move to the right vocal cord over all while being awake and talking to the team.

We wait several months to see if there’s a big improvement after enough time for healing, I don’t feel like it’s where it needs to be, but there’s a slight improvement anyway. I start speech therapy to see if there’s just something mentally that I’m not doing right now that I have to be conscious of everything I do from swallowing to talking. Things that just happen without thinking no longer work that way for me.  Speech therapy helped me to realize I was breathing incorrectly, which in turn helped my voice ever so slightly.

Dr. Merati decided it would be best if I start seeing his colleague at UWMC. With the hope that we’d be able to get the voice back more. Dr. Hillel doesn’t have the personality that Merati has. I miss that. However, I do get to see him and my speech therapist Jan just about every time I’m there, I look forward to it. They make me feel comfortable and give the impression that they really care and want to see me get to where I should be. It’s different with Hillel.  It’s almost like this is all business and that’s it.

As I mentioned in my last post, today I wanted to be able to schedule the nerve-muscle pedicle surgery which is a type of reinnervation.  Hillel informs me that be just doesn’t think it’s a viable option for me because of the lack of nerves and muscles on the right side of my neck. He would have to move the laryngeal nerve so that it would go across my neck from left to right. This means that in the situation where I would need more surgery to my neck in the future this would likely get cut.  Damn. The disappointment sets in.

His fellow or student or whatever he is gives him the idea of doing another injection but this time we’ll do it on the left vocal cord.  Uh. What?  Hillel goes on to tell me this would be a temporary short term material that would last about 6-8 weeks instead of the 9-12 months of the previous material.  He wants to do this in the operating room while I’m put under instead of doing it in the clinic like my previous injections.  He says this will also give him the opportunity to poke around and do some investigation without me being aware of it. He tells me that this will help to determine if there’s any benefit to bulking up that side.  It will help to determine what exactly we’re going to do with the implant or maybe implants.  Once we hear how my voice changes to this injection it will help them determine if we’re going to put an implant in on the left side, re-do the right side implant AND put one in on the left side, or just re-do the right side only.  This surgery will happen in about 3 months, hopefully this year for insurance reasons.

I wasn’t expecting to have to go to the operating room two more times for my voice.  I was expecting one more surgery and we’re done.  The flipside is that I don’t do anything and continue to have a barely audible voice when I’m looking to the left and a slightly better one when I strain and look straight or to the right. This really isn’t a viable long term option.  So off I go once again to the operating room next Wednesday, I wonder what my voice will be like when I leave later that day?