My Vocal Chord Function was tested this morning and the Doctor said that my function was completely normal. Here is a quick recap of why it was necessary. In my surgery to remove part of my thyroid, my Laryngeal nerve was stretched so one of my two vocal cords was not working properly. Here is an image I found that shows what your cords are supposed to do when they work normally:
Pretty simple, right? They separate when you breathe and they open and close and vibrate and do all sorts of things when you talk. There are two nerves that run behind the thyroid that make the vocal cord work. One of the nerves is under the thyroid on the right side and the other is under the thyroid on the left. My surgery was to remove only the right side of my thyroid and when that nerve was stretched in surgery, the result was that the vocal cord on the right side did not move. It just stayed in the closed position. Since the nerve on the left was not damaged, that side worked fine. My voice sounded pretty strange (very weak) and my breathing was very shallow but at least I could talk and breathe. It took about 5 or 6 weeks for my nerve to heal on its own. The doctor told me that there is nothing that you can do to hurry up the healing process and I asked if my bike ride (when I felt like I was having an asthma attack) made my recovery slower, he said no.
Anyway, the procedure to check the function was really interesting though I almost passed out when I saw the tool that he was going to use to test the function.
This instrument of terror is called a 70 degree rigid endoscope. Before the procedure, the nice Dr Fink asked if I was in any pain and I told him no asked if that was about to change. He said no but I wasn't sure that I believed him so I asked "what are we about to do and what are you going to do with that thing?" He said that he would examine my ears which have no connection to the vocal cord but that is part of their basic exam since they are part of the Ear, Nose, Throat group at UCSF. Then he used the popsicle stick to make me say "ahhhh" and then he recorded me reading a few pre-written sentences. Now they will have a record of my voice when it is healthy. Before we did that, I let him listen to the recording I made of my voice a few days after surgery. Now it was time for that scary tool. The Doctor was really nice and he put me at ease pretty quickly when he said that he would insert the tool into my mouth until he reached where my back teeth are and the tool has a high resolution camera in the tip which is angled at 70 degrees and would let him see my vocal cords. He said he was going to have me say the letter "e" a few different ways and he would film the cords doing their "e" thing and then we would be done. That didn't sound terrible and it wasn't. Before he put that thing in my mouth, he dipped the tip into a cup of hot water and quickly told me that the instrument of terror was sterilized and that the hot water had nothing to do with cleaning it but rather, they warm it up so that the camera does not fog when it is put in your mouth. His gloved hands picked up a piece of gauze and he used that to hold my tongue and stuck that thing in my mouth and started telling me how he wanted me to pronounce my "eees": regular, high pitched, low pitched, high to low, low to high, high low high low, fast, slow and that was about it. It lasted no more than a minute, probably more like 40 seconds. He told me that some people have a very strong gag reflex so for those who can't handle having that thing in their mouth, they have to take a little camera and stick it down their nose for the test. Thank goodness I could do this one.
The Doctor let me see the video of my cords in action and I will say it was really cool to see. He said that the function was completely normal so that means that I can schedule my next surgery to have the rest of my cancerous thyroid removed. Yay!
On a related note, my Mom has a friend who had a total thyroidectomy and she suffered damage to both of her laryngeal nerves during the surgery and that was a pretty terrible outcome - it has been a few years and she is still not 100% back to where she was before the surgery. My humble advice is that if you have to have this surgery, make sure your surgeon is a thyroid specialist and does hundreds of these surgeries each year. My surgeon fits that criteria and I still had damage to mine. I also recognize how important the breathing tube is for this surgery. The one that they used for my surgery had feelers/sensors on the outside which constantly monitor the laryngeal nerve function throughout surgery. The second mine was damaged they doctors knew it had happened and if I had been in there for a total thyroidectomy instead of a partial, they would have stopped the surgery after they had finished removing the thyroid tissue from the damaged side. They would not have continued with the total. I think about Mom's friend who had this surgery a few years ago and I assume that this specialized breathing tube was probably not invented yet or maybe it was not in widespread use because had they had one, the minute they knew that one side of her nerve was damaged, they could have finished removing the thyroid on the damaged side and stopped the surgery. She could have recovered from the damage and then go back in for round 2 when everything was better. Of course I do not know the circumstances for her - maybe they HAD to remove both sides immediately no matter what and maybe rather than just stretching her nerve they actually cut it and it would not have healed so there are certainly many things that I don't know about this but what I will say is:
1. Make sure your surgeon is a thyroid surgery specialist who performs 100+ of these surgeries each year (I got this number from thyca.org)
2. Make sure your surgeon will use the breathing tube that monitors laryngeal nerve changes during the surgery.
I hope this helps!
Pretty simple, right? They separate when you breathe and they open and close and vibrate and do all sorts of things when you talk. There are two nerves that run behind the thyroid that make the vocal cord work. One of the nerves is under the thyroid on the right side and the other is under the thyroid on the left. My surgery was to remove only the right side of my thyroid and when that nerve was stretched in surgery, the result was that the vocal cord on the right side did not move. It just stayed in the closed position. Since the nerve on the left was not damaged, that side worked fine. My voice sounded pretty strange (very weak) and my breathing was very shallow but at least I could talk and breathe. It took about 5 or 6 weeks for my nerve to heal on its own. The doctor told me that there is nothing that you can do to hurry up the healing process and I asked if my bike ride (when I felt like I was having an asthma attack) made my recovery slower, he said no.
Anyway, the procedure to check the function was really interesting though I almost passed out when I saw the tool that he was going to use to test the function. 
This instrument of terror is called a 70 degree rigid endoscope. Before the procedure, the nice Dr Fink asked if I was in any pain and I told him no asked if that was about to change. He said no but I wasn't sure that I believed him so I asked "what are we about to do and what are you going to do with that thing?" He said that he would examine my ears which have no connection to the vocal cord but that is part of their basic exam since they are part of the Ear, Nose, Throat group at UCSF. Then he used the popsicle stick to make me say "ahhhh" and then he recorded me reading a few pre-written sentences. Now they will have a record of my voice when it is healthy. Before we did that, I let him listen to the recording I made of my voice a few days after surgery. Now it was time for that scary tool. The Doctor was really nice and he put me at ease pretty quickly when he said that he would insert the tool into my mouth until he reached where my back teeth are and the tool has a high resolution camera in the tip which is angled at 70 degrees and would let him see my vocal cords. He said he was going to have me say the letter "e" a few different ways and he would film the cords doing their "e" thing and then we would be done. That didn't sound terrible and it wasn't. Before he put that thing in my mouth, he dipped the tip into a cup of hot water and quickly told me that the instrument of terror was sterilized and that the hot water had nothing to do with cleaning it but rather, they warm it up so that the camera does not fog when it is put in your mouth. His gloved hands picked up a piece of gauze and he used that to hold my tongue and stuck that thing in my mouth and started telling me how he wanted me to pronounce my "eees": regular, high pitched, low pitched, high to low, low to high, high low high low, fast, slow and that was about it. It lasted no more than a minute, probably more like 40 seconds. He told me that some people have a very strong gag reflex so for those who can't handle having that thing in their mouth, they have to take a little camera and stick it down their nose for the test. Thank goodness I could do this one.
The Doctor let me see the video of my cords in action and I will say it was really cool to see. He said that the function was completely normal so that means that I can schedule my next surgery to have the rest of my cancerous thyroid removed. Yay!
On a related note, my Mom has a friend who had a total thyroidectomy and she suffered damage to both of her laryngeal nerves during the surgery and that was a pretty terrible outcome - it has been a few years and she is still not 100% back to where she was before the surgery. My humble advice is that if you have to have this surgery, make sure your surgeon is a thyroid specialist and does hundreds of these surgeries each year. My surgeon fits that criteria and I still had damage to mine. I also recognize how important the breathing tube is for this surgery. The one that they used for my surgery had feelers/sensors on the outside which constantly monitor the laryngeal nerve function throughout surgery. The second mine was damaged they doctors knew it had happened and if I had been in there for a total thyroidectomy instead of a partial, they would have stopped the surgery after they had finished removing the thyroid tissue from the damaged side. They would not have continued with the total. I think about Mom's friend who had this surgery a few years ago and I assume that this specialized breathing tube was probably not invented yet or maybe it was not in widespread use because had they had one, the minute they knew that one side of her nerve was damaged, they could have finished removing the thyroid on the damaged side and stopped the surgery. She could have recovered from the damage and then go back in for round 2 when everything was better. Of course I do not know the circumstances for her - maybe they HAD to remove both sides immediately no matter what and maybe rather than just stretching her nerve they actually cut it and it would not have healed so there are certainly many things that I don't know about this but what I will say is:
1. Make sure your surgeon is a thyroid surgery specialist who performs 100+ of these surgeries each year (I got this number from thyca.org)
2. Make sure your surgeon will use the breathing tube that monitors laryngeal nerve changes during the surgery.
I hope this helps!
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