Microlaryngoscopy
"Microlaryngoscopy is a procedure that means the vocal folds are looked at in great detail with magnification. The magnification may be with a microscope, endoscope or by video enlargement. It is often accompanied by some additional procedure such as removal of a mass, swelling or tumor. Long delicate instruments or a laser may be utilized. It is sometimes performed in the office, though more typically it is performed in the operating room."
Sounds like fun...
For several years now I have been having trouble with my vocal cords. Whenever I get a cold, or have a big night, or yell too much, I lose my voice.
I think part of it is just genetic bad luck - my grandmother has a very scratchy voice and my auntie (her daughter) is practically hoarse. My sister also suffers from the same problem, you can tell when she's had a great weekend by how her voice sounds on Monday morning.
This wouldn't be much of a problem for me, except that I sing. I'm not an amazing singer or anything, but I love to sing, and have done so for many years, mostly in choirs and bands. I love harmonising and have always taken the alto part, as it's lower so easier for someone who loses her top register all the time, and also more interesting because it's hardly ever the melody. Which is why singing backing vocals in a band suits me, I love doing all those harmony parts. Except that my voice is so weak and unreliable that it has become a bit of a stressful thing.
About four years ago I went to see an ear nose and throat specialist, who stuck a tube with a tiny camera on it up my nose and down my throat to have a look at my vocal cords. He showed me where the nodules had formed, like callouses, from the cords banging together too much in the wrong way. When you speak and sing, the cords are supposed to come together in a wavelike motion to form the sound. When you yell and cough, the cords bang together harshly, and if this happens frequently nodules form. When nodules start to form, the cords try to come together when you speak, but can't close completely because of the lumps. This means more air gets through than usual, giving you a breathy, husky voice. Because it's now more effort to get the sound out, most people find themselves trying to force the sound out. This causes more banging and more breathiness and it's a vicious cycle.
So, I was referred to a speech therapist to teach me how to use my voice correctly and avoid this happening.
The problem was that while I understood what I was doing wrong, I was not prepared to change my lifestyle to fix it. I did the exercises I was given, sporadically, I admit, but having a job where I was on the phone all day, and going out a lot and yelling over loud music in smoky pubs & having no sleep did nothing to improve the problem. Eventually I stopped seeing the therapist, I was having no improvement and I hated feeling like crap every time I turned up for an appointment with no voice.
So, four years later, I still have nodules, only now it's more of a problem because it's interfering with the band. I want to be a reliable backing singer and I really want to improve my singing and make it more of a feature of the band, but every time I try to have singing lessons the nodules get in the way. My voice gets exhausted before we've even finished the warm up.
My singing teacher, Hayley, who I studied music with at uni and is now a professional singer & teacher, has had a few run-ins with nodules, and encouraged me to try two months of being a hermit - not going out, eating steamed vegetables & salmon for dinner every night to avoid reflux, no alcohol, no smoky places, less talking, etc etc to see if I could make them go away. That was in May. It's now November. I have noticed a little improvement, but as soon as I get a cold, or go somewhere unavoidably smoky, I lose my voice again. Hayley urged me to go back to the specialist and find out how the nodules look now, so I made an appointment.
The specialist kept me waiting for an hour and a half - thank god I wasn't trying to do that in a lunchbreak!! There's one of the many pros for not having a job. Finally my name was called and I was ushered in to a consultation room with about fifteen university degrees, doctorates etc on the wall. This wasn't like last time. I didn't see any cool video thing hooked up to a chair. That must be in an adjacent room.
The specialist finally came in, and while it's irrelevant to the story, I must make mention of his facial features. They were all extremely - big. I don't know how to explain it except that he looked a lot like Willem Dafoe. Not in a good way. In a creepy way. It was quite distracting.
Anyway, he looked at me expectantly and I started telling him why I was there. He cut me off. "So you're doing all the right things and nothing's changed?"
"Yeah, I guess so." I said.
"Let's have a look..."
He took a lighter out of his desk draw and lit a little lamp on his desk. He then produced a little mirror like the ones dentists use and held it over the flame. I guess to sterilise it. I thought this was the 21st century!
He put a tissue between his fingers and grabbed my tongue, squeezing hard. This was painful. Then he checked out my vocal cords with the mirror, getting me to make various sounds while he looked. Eventually the pain in my tongue became too great and I started replacing "ooo" with "OWWW!!". He got the message and let go.
"Well, you've got nodules," he said. "They're not huge, but they're there. I think you should have surgery."
Even though part of me was expecting this, I was a bit shocked. Surgery? I've never had surgery before. I had a burst blood vessel on my chest burned off when I was in primary school; it barely even left a scar. I didn't even go to hospital to have my wisdom teeth out, I had them yanked out one by one in the chair. Surgery on my voice sounded so scary - what if his hand slipped while he was cutting and I was left with no voice at all?? What if I never woke up from the general anaesthetic???
When I enquired about the chances of these things occurring he laughed and said there's no chance. I don't know how I'm supposed to believe that. He said the biggest risk is that they might chip a tooth because of all the stuff in my mouth.
I asked as many questions as I could think of, which wasn't many since I wasn't really prepared for this. He gave brief answers and volunteered very little information about the procedure. He did recommend I speak to Debbie Phyland, one of the leading speech pathologists in Australia, who has lots of experience with singers, to find out more. But he really didn't offer very much at all. I left feeling slightly baffled and nervous. I made a tentative appointment for the surgery, figuring if I spoke to Debbie and decided to go ahead, it would be good to have it all booked in already and not have to wait until next year. The surgeon said I would be singing three weeks after the operation. That to me seemed a little bit ambitious.
I went home & spent the rest of the day researching the procedure. Googling microlaryngoscopy gave me a world of information that my doctor couldn't be bothered to provide. The best website was here. By the end of the day I'd decided that the procedure was a pretty safe one, and that it might just be best to have the nodules removed and get on with the rest of my life, but I wasn't too keen on having someone operate on me who kept me waiting for an hour and a half, for five minutes of his time, and couldn't even produce a leaflet or website or anything about a routine procedure he performs all the time.
I spoke to Hayley and asked what she thought about it all, and she suggested I go to the place she normally goes to for her nodules. This is where Debbie Phyland works, and they have different surgeons there who do the same thing as Willem Dafoe, but she said they are much more sensitive about singers. She said she would come with me and ask lots of questions and remember the answers with me.
I made an appointment for two and a half weeks' time, but couldn't coordinate one at a time when Hayley was available. She promised to write down some questions for me before the day. I ended up organising Paris, our manager, to come with me, partly for moral support and partly because if I was going to make a decision about when to be out of action for 3-4 weeks, I was less likely to cop flack later if she was involved in the decision-making. Also she's smart and I knew she'd ask good questions.
The next few weeks positively flew by, and soon the day of the appointment approached. The situation was not ideal, it turned out I had a graveyard shift at 3RRR the night before the appointment. So I would be broadcasting from 2-6am, and then the appointment was at 9.45am. Not really enough time to get a sleep in between, but then what else would I do? I tooke everything I needed for the appointment with me to the station just in case.
THE GRAVEYARD SHIFT
I have been volunteering at RRR for over a year now, and I love it. It started with answering phones for their annual subscription drive, then I started doing the schedule for the weekly IT show, then I learned how to panel for that show (push the buttons to make things go on air) and then I was thrown into doing graveyard shifts. Once a month for the last few months I have been arriving at the station at a ridiculous hour with a huge bag of CDs under each arm, ready to fill four hours with music until the breakfast crew takes over. Fun parts: playing whatever the hell music I want, getting phone calls from random people listening to the station & enjoying, meeting the presenters before & after me. Not so fun parts: staying awake for a ridiculous number of hours and having your body clock fucked for the next 3 days, talking myself in circles so the whole world can hear it, getting phone calls from random loonies/stalkers. But overall I enjoy it and I know it is a stepping stone to something slightly less - inhumane.
THIS graveyard shift was different, I was going to have company.
Back in the uni days, I used to co-present the breakfast show once a week on Monash radio. When I say co-present, I mean I read the news and weather, and generally laughed at the other guys' jokes. The other guys were Disco Don (my boyfriend at the time: a very intelligent, slightly obnoxious guy who had a lot to say about everything) and Maximum Joe (his best mate: ditto). Together, they were Maximum Disco and I was their sidekick. Don and I took great pleasure in scouring op shops and cash converters for music to play on the show. It was a point of pride that we never paid more than a few dollars for anything we played, meaning we ended up with everything from Lionel Ritchie to Louis Prima. Despite the ridiculously early mornings, we used to have a ball.
So, recently I was chatting to Don and mentioned that I was doing some shows at RRR, and he expressed interest in getting back into something like that. So now, here we were, about to do our first radio show together in over five years.
It may sound weird, doing a radio show with your ex-boyfriend. But Don and I have remained friends, and I was hoping there would still be a good on-air chemistry between us. I have been trying to think of a way to sum up our relationship... I think that we were the right people who met at the wrong time, and with the combination of bad timing and even worse judgement, we both hurt each other quite badly. But somehow, that doesn't seem to have destroyed the respect we have for each other. I know I learned a lot from him, about who I was, who I wanted to be, and how to be brave enough to be that person. I guess I've never forgotten that he taught me those things, and the shit that went down between us is less important than that. That's my take, anyway, his may be completely different.
Anyway, I was right about the chemistry, we were great on air together. Once I got past the initial shock of having someone else in the studio with me, I relaxed and began to enjoy myself. Between songs we chatted about lots of random stuff, and it was lots of fun delving into his iPod to mix up the music selection a bit.
Adam listened to the last hour or so of the show, and said I was even funny!! ME!!! Amazing.
I was very happy with how it went and hopefully we can do more together in the future. Unfortunately Don told me he's moving to London next year, so the next few months might be our only chance. Oh well, it was good while it lasted!
After the show I was rather tired. I'd been awake since about 11am Wednesday and it was now 6am Thursday. I went home and hopped into bed for a few hours, before I had to get up for my voice appointment. I sent Paris a text saying I would be up at 8.30 and to call me after that. Then I put my phone on silent, set my alarm for 8.30 and went straight to sleep.
****
I woke with a start. Somehow, I knew immediately that something was wrong. What time is it? Shit!!!! It's 10.30!!! My appointment with the voice people was at 9.45. What happened to my alarm?? Sure enough, I had set it to the right time, but forgotten to switch it on. Dammit!!!
****
I rang the clinic and they were very understanding, and rescheduled me for the following week. Then I rang Paris to apologise for booking her in and then not turning up. We ended up talking for two hours or more, about the band, and life, and the future. It was a really good discussion. The more I get to know her the more glad I am she is involved in the band.
Then I cancelled the appointment I'd made for the surgery with Willem Dafoe. I just couldn't let someone like that cut me up. When the receptionist asked whether I wanted to reschedule the surgery, I said "Can I be honest with you?" and told her all about how I didn't feel comfortable about him and that he hadn't given me enough info etc etc. She was very good, and asked whether I would like to speak to the surgeon about it when he was in next.
"You know what," I said to her, "I think I'll skip the uncomfortable conversation thanks."
"Ok," she said. "We'll pass on your feedback."
I just didn't feel like saying all this all over again to someone who was probably going to get defensive about it and make me feel like shit. I just needed to get it off my chest, to someone.
So, the new appointment is for tomorrow, at 2.30. No-one was available to come with me this time, so I'm on my own. I have a list of questions from Hayley, and a whole lot of print outs from the internet, so I'm already much more prepared than last time. Wish me luck!
Sounds like fun...
For several years now I have been having trouble with my vocal cords. Whenever I get a cold, or have a big night, or yell too much, I lose my voice.
I think part of it is just genetic bad luck - my grandmother has a very scratchy voice and my auntie (her daughter) is practically hoarse. My sister also suffers from the same problem, you can tell when she's had a great weekend by how her voice sounds on Monday morning.
This wouldn't be much of a problem for me, except that I sing. I'm not an amazing singer or anything, but I love to sing, and have done so for many years, mostly in choirs and bands. I love harmonising and have always taken the alto part, as it's lower so easier for someone who loses her top register all the time, and also more interesting because it's hardly ever the melody. Which is why singing backing vocals in a band suits me, I love doing all those harmony parts. Except that my voice is so weak and unreliable that it has become a bit of a stressful thing.
About four years ago I went to see an ear nose and throat specialist, who stuck a tube with a tiny camera on it up my nose and down my throat to have a look at my vocal cords. He showed me where the nodules had formed, like callouses, from the cords banging together too much in the wrong way. When you speak and sing, the cords are supposed to come together in a wavelike motion to form the sound. When you yell and cough, the cords bang together harshly, and if this happens frequently nodules form. When nodules start to form, the cords try to come together when you speak, but can't close completely because of the lumps. This means more air gets through than usual, giving you a breathy, husky voice. Because it's now more effort to get the sound out, most people find themselves trying to force the sound out. This causes more banging and more breathiness and it's a vicious cycle.
So, I was referred to a speech therapist to teach me how to use my voice correctly and avoid this happening.
The problem was that while I understood what I was doing wrong, I was not prepared to change my lifestyle to fix it. I did the exercises I was given, sporadically, I admit, but having a job where I was on the phone all day, and going out a lot and yelling over loud music in smoky pubs & having no sleep did nothing to improve the problem. Eventually I stopped seeing the therapist, I was having no improvement and I hated feeling like crap every time I turned up for an appointment with no voice.
So, four years later, I still have nodules, only now it's more of a problem because it's interfering with the band. I want to be a reliable backing singer and I really want to improve my singing and make it more of a feature of the band, but every time I try to have singing lessons the nodules get in the way. My voice gets exhausted before we've even finished the warm up.
My singing teacher, Hayley, who I studied music with at uni and is now a professional singer & teacher, has had a few run-ins with nodules, and encouraged me to try two months of being a hermit - not going out, eating steamed vegetables & salmon for dinner every night to avoid reflux, no alcohol, no smoky places, less talking, etc etc to see if I could make them go away. That was in May. It's now November. I have noticed a little improvement, but as soon as I get a cold, or go somewhere unavoidably smoky, I lose my voice again. Hayley urged me to go back to the specialist and find out how the nodules look now, so I made an appointment.
The specialist kept me waiting for an hour and a half - thank god I wasn't trying to do that in a lunchbreak!! There's one of the many pros for not having a job. Finally my name was called and I was ushered in to a consultation room with about fifteen university degrees, doctorates etc on the wall. This wasn't like last time. I didn't see any cool video thing hooked up to a chair. That must be in an adjacent room.
The specialist finally came in, and while it's irrelevant to the story, I must make mention of his facial features. They were all extremely - big. I don't know how to explain it except that he looked a lot like Willem Dafoe. Not in a good way. In a creepy way. It was quite distracting.
Anyway, he looked at me expectantly and I started telling him why I was there. He cut me off. "So you're doing all the right things and nothing's changed?"
"Yeah, I guess so." I said.
"Let's have a look..."
He took a lighter out of his desk draw and lit a little lamp on his desk. He then produced a little mirror like the ones dentists use and held it over the flame. I guess to sterilise it. I thought this was the 21st century!
He put a tissue between his fingers and grabbed my tongue, squeezing hard. This was painful. Then he checked out my vocal cords with the mirror, getting me to make various sounds while he looked. Eventually the pain in my tongue became too great and I started replacing "ooo" with "OWWW!!". He got the message and let go.
"Well, you've got nodules," he said. "They're not huge, but they're there. I think you should have surgery."
Even though part of me was expecting this, I was a bit shocked. Surgery? I've never had surgery before. I had a burst blood vessel on my chest burned off when I was in primary school; it barely even left a scar. I didn't even go to hospital to have my wisdom teeth out, I had them yanked out one by one in the chair. Surgery on my voice sounded so scary - what if his hand slipped while he was cutting and I was left with no voice at all?? What if I never woke up from the general anaesthetic???
When I enquired about the chances of these things occurring he laughed and said there's no chance. I don't know how I'm supposed to believe that. He said the biggest risk is that they might chip a tooth because of all the stuff in my mouth.
I asked as many questions as I could think of, which wasn't many since I wasn't really prepared for this. He gave brief answers and volunteered very little information about the procedure. He did recommend I speak to Debbie Phyland, one of the leading speech pathologists in Australia, who has lots of experience with singers, to find out more. But he really didn't offer very much at all. I left feeling slightly baffled and nervous. I made a tentative appointment for the surgery, figuring if I spoke to Debbie and decided to go ahead, it would be good to have it all booked in already and not have to wait until next year. The surgeon said I would be singing three weeks after the operation. That to me seemed a little bit ambitious.
I went home & spent the rest of the day researching the procedure. Googling microlaryngoscopy gave me a world of information that my doctor couldn't be bothered to provide. The best website was here. By the end of the day I'd decided that the procedure was a pretty safe one, and that it might just be best to have the nodules removed and get on with the rest of my life, but I wasn't too keen on having someone operate on me who kept me waiting for an hour and a half, for five minutes of his time, and couldn't even produce a leaflet or website or anything about a routine procedure he performs all the time.
I spoke to Hayley and asked what she thought about it all, and she suggested I go to the place she normally goes to for her nodules. This is where Debbie Phyland works, and they have different surgeons there who do the same thing as Willem Dafoe, but she said they are much more sensitive about singers. She said she would come with me and ask lots of questions and remember the answers with me.
I made an appointment for two and a half weeks' time, but couldn't coordinate one at a time when Hayley was available. She promised to write down some questions for me before the day. I ended up organising Paris, our manager, to come with me, partly for moral support and partly because if I was going to make a decision about when to be out of action for 3-4 weeks, I was less likely to cop flack later if she was involved in the decision-making. Also she's smart and I knew she'd ask good questions.
The next few weeks positively flew by, and soon the day of the appointment approached. The situation was not ideal, it turned out I had a graveyard shift at 3RRR the night before the appointment. So I would be broadcasting from 2-6am, and then the appointment was at 9.45am. Not really enough time to get a sleep in between, but then what else would I do? I tooke everything I needed for the appointment with me to the station just in case.
THE GRAVEYARD SHIFT
I have been volunteering at RRR for over a year now, and I love it. It started with answering phones for their annual subscription drive, then I started doing the schedule for the weekly IT show, then I learned how to panel for that show (push the buttons to make things go on air) and then I was thrown into doing graveyard shifts. Once a month for the last few months I have been arriving at the station at a ridiculous hour with a huge bag of CDs under each arm, ready to fill four hours with music until the breakfast crew takes over. Fun parts: playing whatever the hell music I want, getting phone calls from random people listening to the station & enjoying, meeting the presenters before & after me. Not so fun parts: staying awake for a ridiculous number of hours and having your body clock fucked for the next 3 days, talking myself in circles so the whole world can hear it, getting phone calls from random loonies/stalkers. But overall I enjoy it and I know it is a stepping stone to something slightly less - inhumane.
THIS graveyard shift was different, I was going to have company.
Back in the uni days, I used to co-present the breakfast show once a week on Monash radio. When I say co-present, I mean I read the news and weather, and generally laughed at the other guys' jokes. The other guys were Disco Don (my boyfriend at the time: a very intelligent, slightly obnoxious guy who had a lot to say about everything) and Maximum Joe (his best mate: ditto). Together, they were Maximum Disco and I was their sidekick. Don and I took great pleasure in scouring op shops and cash converters for music to play on the show. It was a point of pride that we never paid more than a few dollars for anything we played, meaning we ended up with everything from Lionel Ritchie to Louis Prima. Despite the ridiculously early mornings, we used to have a ball.
So, recently I was chatting to Don and mentioned that I was doing some shows at RRR, and he expressed interest in getting back into something like that. So now, here we were, about to do our first radio show together in over five years.
It may sound weird, doing a radio show with your ex-boyfriend. But Don and I have remained friends, and I was hoping there would still be a good on-air chemistry between us. I have been trying to think of a way to sum up our relationship... I think that we were the right people who met at the wrong time, and with the combination of bad timing and even worse judgement, we both hurt each other quite badly. But somehow, that doesn't seem to have destroyed the respect we have for each other. I know I learned a lot from him, about who I was, who I wanted to be, and how to be brave enough to be that person. I guess I've never forgotten that he taught me those things, and the shit that went down between us is less important than that. That's my take, anyway, his may be completely different.
Anyway, I was right about the chemistry, we were great on air together. Once I got past the initial shock of having someone else in the studio with me, I relaxed and began to enjoy myself. Between songs we chatted about lots of random stuff, and it was lots of fun delving into his iPod to mix up the music selection a bit.
Adam listened to the last hour or so of the show, and said I was even funny!! ME!!! Amazing.
I was very happy with how it went and hopefully we can do more together in the future. Unfortunately Don told me he's moving to London next year, so the next few months might be our only chance. Oh well, it was good while it lasted!
After the show I was rather tired. I'd been awake since about 11am Wednesday and it was now 6am Thursday. I went home and hopped into bed for a few hours, before I had to get up for my voice appointment. I sent Paris a text saying I would be up at 8.30 and to call me after that. Then I put my phone on silent, set my alarm for 8.30 and went straight to sleep.
****
I woke with a start. Somehow, I knew immediately that something was wrong. What time is it? Shit!!!! It's 10.30!!! My appointment with the voice people was at 9.45. What happened to my alarm?? Sure enough, I had set it to the right time, but forgotten to switch it on. Dammit!!!
****
I rang the clinic and they were very understanding, and rescheduled me for the following week. Then I rang Paris to apologise for booking her in and then not turning up. We ended up talking for two hours or more, about the band, and life, and the future. It was a really good discussion. The more I get to know her the more glad I am she is involved in the band.
Then I cancelled the appointment I'd made for the surgery with Willem Dafoe. I just couldn't let someone like that cut me up. When the receptionist asked whether I wanted to reschedule the surgery, I said "Can I be honest with you?" and told her all about how I didn't feel comfortable about him and that he hadn't given me enough info etc etc. She was very good, and asked whether I would like to speak to the surgeon about it when he was in next.
"You know what," I said to her, "I think I'll skip the uncomfortable conversation thanks."
"Ok," she said. "We'll pass on your feedback."
I just didn't feel like saying all this all over again to someone who was probably going to get defensive about it and make me feel like shit. I just needed to get it off my chest, to someone.
So, the new appointment is for tomorrow, at 2.30. No-one was available to come with me this time, so I'm on my own. I have a list of questions from Hayley, and a whole lot of print outs from the internet, so I'm already much more prepared than last time. Wish me luck!
posted by Aussie Rock Chick at 10:00 PM
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