Jan. 8 at the NYU Voice Center

First, I had vocal therapy with Dr. Lazarus. It was my first "official" therapy session, since our first meeting was an evaluation. I had been practicing some sounds (like hums) since our December appointment, but it turns out I was doing the wrong sounds.

Our visit consisted of me learning to make the right humming sound, then practicing it over and over. Sounds pretty simple, but I can only seem to get it right about half the time. It's amazing how much I have to concentrate to make this one simple sound come out of my mouth. Now I know what I put my Presentation Skills students through when they're speaking in front of the group! "So much to think about!!!" I have to practice this one sound several times a day until my next visit. That's it.

After therapy, I went down the hall for Dr. Amin. One thing I have to say about this place...I've never waited for anything more than 3 or 4 minutes in their waiting room. And I was even about 40 minutes early for my appointment!! Regardless, he took me right away. (One other aside...I've had to call the office on three or four occasions with questions. Each time, I'd start to leave a detailed explanation with the receptionist and each time she either a) put me right through to speak directly with Dr. Amin, or b) had him call me right back. And he did! I find this mind-boggling in this day-and-age of impersonal health care.)

We went right into the laryngoscopy (see my earlier post) with the tube through my nose. This time, instead of improvement, we saw the opposite. The swelling had gone down significantly, but the cyst had at least doubled in size. The reduced swelling is likely explained because I haven't been teaching for several weeks. In fact, I haven't worked at all since the last week of November, except for one 5-hour class on Dec. 11th. So it has been almost a month of rest and my voice is sounding worse than ever. Now we can see why. The cyst is now almost constantly bumping against the right vocal chord, causing irritation and making it even more difficult than ever for me to produce sound. The right vocal chord is irritated and is in danger of being damaged due to the size of the cyst on the other side. Here's the video from the laryngoscopy:



Side Comment: OK. I'm sharing this in case anyone out there stumbles upon this blog and wants more information about problems like mine. It's how I got the help I got...by reading about others' experiences on the internet. That said, these pictures ain't so pretty.

What you'll see here, if you're brave enough to click the video, is a picture of my vocal cords from early January...the day that Dr. Amin told me the cyst had doubled in size. You can see it VERY clearly (I didn't try to add red arrows to show you). And you can hear in the audio exactly where the cyst would interrupt my ability to produce sound. It's pretty cool, if not too gross for you to take in. It's a great demonstration of my lack of range, and how the cyst was causing it. Also, in these pictures, you should be able to see some swelling on the right cord (on your left) that came about because of the size of the cyst. This condition is different from "nodules" another common voice problem that comes from overuse/abuse and is common in performers. Nodules are bilateral (on both sides) and symmetrical. They also impact the sound of the voice, but differently. Treatment options are different, too. That's the extent of my expertise, but this page offers a simplistic distinction between the conditions.

Just to remind you, this is done with a tiny scope that's on the end of a very narrow tube that's inserted through the nasal passages. The procedure is called an laryngoscopy. They spray a numbing agent into your nostrils before getting underway. It doesn't hurt if you don't think too much about it. And what you get to see afterward makes it worthwhile. If you like that kind of stuff...

Dr. Amin is acutely aware that I depend on my voice for my profession, as do a large percentage of the patients he sees due to his NYC location--singers, performers, etc. So he is sensitive to the fact that I need a solution. He told me that considering all of the changes since our last visit, and considering that I need my voice to earn a paycheck, he would lean more toward treating me with surgery than he did in our initial consult.

He spent about 20 minutes with me, answering questions and explaining my options. I continue to be impressed with his availability and personal interest in my case, despite the fact that he told me he sees numerous patients with the same problems on a day-to-day basis.
My choices are to continue with vocal therapy for several weeks, and then check to see how the cyst is behaving. Dr. Lazarus has already assured me that I have several vocal issues to work through and that she can help improve the quality of my voice through therapy. And I trust that she can. If I can learn to "talk around" the cyst (and it doesn't grow any more), we might not need to do surgery at all. The other choice is to operate now (an out-patient procedure) and pick up with the therapy later, after I have healed from surgery.

Other than stopping the annoyance in my throat, my biggest concern is my schedule and my business. If I wait until March or April and the problem persists, I will have to do some serious juggling to move the multiple jobs that I already have booked. I'll lose a lot of work and potentially damage relationships with clients who are depending on me. In the mean time, I'll have to keep working extra hard to produce sound and I'll have a constant sore throat. On the other hand, I can do the surgery now and take the next few weeks off, then hit the ground running in March.

I sat down with my calendar and pondered the options. The schedule was very light in January and February. I have a few meetings and only two scheduled days of teaching. To me is just made sense to squeeze it in now, since I knew that I wouldn't be "losing" any work...I just won't take any new work on for this period.

So surgery is scheduled for Jan. 22 (Hogan's birthday and the day after my birthday) at the NYU Medical Center in Manhattan. Coincidentally, Todd is in court that date, so I am flying my dad in from Erie. He'll take me to the hospital and then stay at home with me for a few days. He likes doing that kind of stuff. Plus, I did it for him when he went to UPMC for his prostate cancer surgery in 2000!

More to follow...