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Mar 19, 2007 Today I went to the Laryngologist to have the procedure done that will somewhat improve my ability to speak louder than a whisper http://www.voicedoctor.net/. The procedure is not too painful, but is pretty nerve racking and anxiety-creating, given you have a 3" needle stuck through your Adam's apple and into your vocal cord for what seems to be an eternity. And the keen part is, you get to see it all on the monitor! I think it might have been tougher on Maria, who watched the whole thing live,  than on me. (Note from Maria: Ye-ea-ah! I had to watch the doctor insert that needle half a dozen times and wiggle it around, trying to break through some cartilage. I honestly don't know how John managed to sit still through the whole thing. He says it didn't hurt too much, but he didn't look at all comfortable at the time!) The idea is to go in with the needle, through the Adam's Apple, and inflate the offending vocal cord with collagen or a synthetic material (I chose the synthetic stuff which may have a slightly lower risk of allergic reaction and is touted as not being reabsorbed as quickly as collagen). This helps close the space between vocal cords off so that the air doesn't just bypass the good vocal cord, causing that wispy sound and using a ton of air to say not very much. So, they deadened my nasal passage to get the scope down to the vocal cords and deadened my throat where the needle goes in. This makes you feel like it's impossible to swallow and that you have a golf ball stuck in your throat. Then in goes the needle and on the monitor you see it finally poke through the voice box and get deftly manipulated into the cord.  Oh, the inhumanity! 

Getting the right amount of filler in seems to be more art than science.  Dr. T. said he likes to over-inflate slightly so that the cord will maintain itself as some of the initial filler is reabsorbed. Unfortunately, he felt he wanted a little more in so he tried to go back in with the needle several times but, due to swelling, couldn't quite get through. He said if it's not enough (too weak a voice?) we can consider a "refill" in a couple of weeks. However, that's not something to take lightly, since it's definitely not a ton of fun.  I think I'd do a lot better after 2-3 good Scotches.

So, right now I'm not in any pain from the procedure, the golf ball seems to be gone, and I can string quite a bit of a sentence together before I run out of air.  I don't know how the final voice might turn out, but the one I'm experiencing right now belongs to someone else - perhaps someone of a different gender?  At least it can be heard a bit and seems to have some strength.  I'm actually having fun just hearing myself blabber a bit.  We will have to see how long it will last.  Dr. T said it will weaken over time (e.g., 6-10 weeks) and then we can decide whether to do another one or go for a more permanent, surgical (minor) fix.  In the meantime, I have been saving up a lot of stuff to say, so call or come by at your own peril.