“Long time no see.” A smile and a shake of hands. He runs through the procedure again, “any questions?” “No.” I pause – “ I’ll speak to you later.” He laughs – and he’s off.
It’s around midday. There is just me and one other man in the ward. A room full of empty beds – all made up and waiting. It’s bizarre – like a scene from a disaster movie, when no one else is left alive. This used to be Men’s Surgical – it’s now an admission ward for people being treated elsewhere. So a short stay?
The man in the next bed is fairly affable. And talkative. It turns out I will spend the next 4 hours listening to him – well – I try to join in, but speaking is difficult. My mouth is dry as parchment from fasting since 7.00am.
Around 1.00pm the anaesthetist arrives. That anaesthetist; “Oh it’s you again – you got in quick”. I explain that after seeing her last week I called the admissions office and was lucky enough to get a cancellation. “Anything changed since I saw you?” I’m tempted to say that that my pension fund has probably fallen in value by 10% and my lawn has grown another 6 inches. But I don’t. “No”. A nod, paperwork ticked and she’s gone.
In between hearing about my neighbour’s impending operation – which I’m quite happy to do – he’s extremely anxious about it, I try and relax. I’m not at all apprehensive – nervous perhaps, about the outcome. I realise that this is one procedure I am actually looking forward to.
Around 2.0pm Mr ENT comes dashing back, dragging the curtain as he passes; “Change of plan.” My heart sinks. Please don’t tell me you’re going to cancel. “No general – local – and we’ll go in through the front”. He points to his throat. What? There may have been a couple more words in there than the few I recall, but not many. I certainly don’t hear them. It sounds like some sort of ill-fated military campaign. We’ve lost our General and the troops have all run away so we’re going to have to rely on local peasants and attempt a frontal assault, which is bound to end in failure because we’re going to get our throats cut. Note to self; stop reading historical fiction.
He realises his hurried announcement needs some sort of qualification and further explanation. “This has nothing to do with your heart”. He’s decided to do the procedure under a local anaesthetic and inject the collagen from the base of my throat. This means no tubes, giving him more room to manoeuvre. He’ll be guided by a camera down my nose. “You’ll be sedated and have IV pain relief”. “So I’ll be awake?” “Yes – but you shouldn’t feel anything – just a bit of pressure as I insert the needle. And I can hear you speak as I do it.”
So let me get this straight; I’ll be awake while he sticks the needle in my throat – right in front of my eyes – but I’ll be too dozy to do anything about it. Great. No – really – I mean it – great. The wretched tube is painful and there’s the after effect of all that wrestling to put up with. This sounds quite good in comparison.
It’s only after he’s gone that I think – hang on – why didn’t we do this before? All that time lost waiting because of concerns about general anaesthetic and heart arrhythmia. As it turns out, it is not quite as simple as that. It never is.
It’s around 4.30pm by the time I’m finally called. My neighbour went about an hour ago. Another long day.
I’m prepped by the anaesthetics team; first a cannula and then my nostrils are sprayed with a numbing agent. I’m wheeled into the operating theatre, fully awake and sitting upright. Now I get to see the bits that usually take place while I’m out of it.
Ms Anaesthetist and Mr ENT fight over my nostrils; “I need to feed him oxygen.” “But I’m going in there with the camera”. “I need to make sure he’s breathing”. Can’t wait to tell Annie – it really is like Holby City. Eventually an assistant suggests just using one nostril for the oxygen feed. I was going to say that. And then it begins.
The camera is fed down to my voice box and Mr ENT paints my throat with iodine. The sedation is turned on and I’m away with the fairies. My, but it feels good. Think how many Global conflicts could be sorted out if we just gave everyone a quick squirt of this; “Hey Mr (insert enemy of choice) – you’re my best mate you are”. I smile a lot and want to chat to everyone but realise that that’s the last thing they need. Then the needle. I don’t feel it but someone calls out for pain relief. Perhaps he missed me and stuck them.
He asks me to say ‘E’ loudly and then ‘e’ softly. “I think that’ll do for today”. He asks me to cough. To my surprise the projectile is a gobbet of blood. Another cough – more of the same. Not the thin red stuff you see when you cut your finger, but the thick black stuff, the dark matter. Now I understand about his reluctance to do this while I was on warfarin. The neck is more than just a convenient support for the head – there’s a lot of serious vascular traffic around – as any cheap and nasty horror film will confirm.
I’m in recovery for about an hour then go back to the ward. I stay in overnight – sedation is not as serious as a GA but they like to be sure things are OK. It takes around 3 hours for the effect to wear off. I have no pain in the back of my throat and all my teeth are intact. But the voice?
It’s hard to tell. It’s not the deep, mellifluous, but short-lived, impression of Richard Burton that I managed last time. That was a consequence of the procedure – the swelling enabled the dormant cord to meet its active partner more than halfway. As the swelling diminished, so did the voice. The new voice doesn’t sound very different to me right now, but time will tell. The days when people tell me that my old voice sounds stronger are days when my lungs are working more efficiently. So lying in a hospital bed is not a fair test. But one thing I do know – I won’t be singing yet.
Next morning Mr ENT comes to see me very early, before rounds. “I’m very impressed – you were flying blind”. He acknowledges the compliment. “I can see the tip as it emerges but once it disappears under the cord, I am, as you put it, flying blind. It takes a bit of practice, but you get used to it after a while.” I don’t ask on whom he practiced.
He explains that the injection has enabled the dormant cord to move about halfway across my voice box, but I won’t know for a few days if that’s going to be enough. There will be some swelling and soreness from bleeding (which I have to say, I’m not aware of). “I didn’t want to put too much in – once it’s in I can’t take it out. I’ll see you in about 4-6 weeks and if necessary I’ll do it again”. He tells me to rest the voice for a few days; “no singing”. Ha – no chance of that.
I’m not bothered if I have to go through this again – especially if we can do it under a local anaesthetic. Much less intrusive and painful than the other way. And, presumably, much more quickly organised as there will be no hanging around waiting for the heart to resolve itself.
‘Not bothered’ is an overstatement – I mean I’m resigned to it. A quick Google reveals many people having 2 or 3 – sometimes more – sessions before getting some semblance of a voice back. That’s life I guess. And there are times when flying blind is the only way to go.