If you’ve been following our story closely you will know that some time ago, Nige lost most of his voice. He completely lost the voice that we knew and loved, what is left is a scratchy croak that to be perfectly honest sounds a little frightening at times. The condition is called Vocal Fold Paralysis. It is probably being caused by one of his lung tumours pushing against the laryngeal nerve. The damage is most likely irreversible. It basically means that instead of both vocal cords moving together and apart during speech, one is immobile. The cords can’t meet in the middle properly, so diminished vocal sound and shortness of breath ensues.
When I first met Nige one of the first things I noticed was how lovely his voice was. I enjoy beautiful sounds and sights, and with its deep richness and melodious quality Nige’s voice certainly fit that criteria. It didn’t hurt that he was seriously cute either (and manly eh Nige :)). He was often told he should be a DJ due to his dulcet tones.
I miss it. Sometimes I ring our home phone just so I can listen to his voice on our message service.
But I bet I don’t miss it as much as Nige.
I know many have probably wished it upon me, but I just can’t imagine how hard it would be not to be able to express yourself vocally. For Nige these days, every word is an effort, and needs its own breath before it can be expelled. He has one tone, with very little volume. People struggle to hear him, so he is often ignored or talked over without anyone even realising. There’s not much Nige enjoys more than shooting the breeze with his mates, but that pleasure, along with many others, has been taken from him. As if he doesn’t have enough to deal with. As if a cancer sufferer hasn’t lost most of the control over and expression of their former lives as it is. Diet, mobility, driving, socialising, medication, work, relationships – everything has changed, and Nige has mostly no governance over any of these changes.
When Nige is frustrated he can’t yell, it is physically impossible. He can only squeak in protest, like an angry mouse. And there’s a lot to be frustrated about when you have cancer. You need a voice. You need to be heard. I have become that voice for Nige, another thing he has had to relinquish, another dependency, for this fiercely independent man who loves nothing more than to ease others burdens.
This Thursday he has a chance to regain some of that lost expression. There is a procedure known as an Injection Laryngoplasty that may help Nige regain some sort of a voice back. Here is a brief description of the procedure:
The injection is carried out with patient sitting upright. The nose is prepared with a combination anaesthetic and decongestant spray. A small amount of local anaesthetic is injected through the skin into the windpipe. This will make the patient cough for a brief time.
A flexible endoscope is placed through the nose and a fine needle is placed through the skin of the neck. A small needle prick is felt when the needle enters the skin. The needle is passed either under the cartilage of the larynx (the thyroid cartilage) to enter the vocal fold from below (the most direct route), or the needle is passed over the top of the cartilage of the larynx to enter the vocal fold from above. There is a mild amount of discomfort as the needle is manipulated into position.
After the needle enters the vocal fold the filler is injected into one (unilateral injection) or both vocal folds (bilateral injection). The amount injected is determined by the appearance of the vocal fold and by the sound quality of the voice.
I love how they talk about “mild discomfort”. I have learnt that doctors always underestimate how a procedure is going to feel for the patient involved. After all how many times have they actually experienced their own procedures? Still I guess it’s a good thing. If the description read “agonisingly painful with extreme discomfort and unrest” I doubt many would go ahead!
If after examination Nige is able to go ahead with this procedure, he will be able to both speak and breathe easier. He will probably never sound like the Nige we once knew – another loss to grieve – but at least he will have a voice. We all deserve to be heard.