Dr. Haben and Dena's broken voice

[Dena]

I figured I should give a one week update. I have had a few minor slips with the voice and the sound that comes out is enough to discourage me from testing it until it has had a few more days for the swelling to go down. In the past I have tended to swell a bit more than normal and the steroids given in the hospital and after I was out should have reduced the swelling. Most of the pain was in my mouth from the surgical tool and that has pretty well calmed down. There is a little burning in my throat that I started feeling after the pain in my mouth went away but it's like I have a cold. I have used no pain medication and I have needed a few light coughs to clear the mucus that sometimes accumulates. I am keeping ice or cold water with me at all times to make sure I can stop a cough should one develop.
The biggest pain is carrying on a conversation where half of it is written. I purchased 4 good sized note books and I think before this is over I will go through two of them.
I got off my back side and load the surgical images up to photo bucket so you can have a look at them. You need to be careful in judging size because the camera tended to be off to the side when the pictures were shot. That is the working angle I can still feel in my mouth as Dr Haban had to work off to one side to get access. In the pictures the right cord is the longer of the two and the doctor tied off 40% of the cord. A bit more than 40% may heal together possibly giving me an extra 20Hz which is the other reason I am not in a real hurt to test the new voice. For your viewing displeasure I present the following pictures.

[Dena]

Huston we have two problems - I like that movie

Yesterday was the first day I could use the voice and I couldn't. The pitch was way off and volume little more that a loud whisper. Thanks to a post Lunarain made about her Surgical Laryngitis I was prepared for it. A little bummed out about it but I was prepared. When I had my SRS I spent additional time in the hospital waiting for the swelling to go down so I could pee with out having a tube stuck in me to drain the bladder every 6 hours. I am guessing it may take another week or two in order to have something usable but that's only a guess so stay tuned for additional information as I figure it out. There isn't any reason to contact the doctor yet because there isn't anything he can do other than calm me down and I am not stressed out about this. I know the swelling will go down sooner or latter but I hope it's sooner. I do hope I have a voice by October 24, the day of my High School reunion but as I expected trouble, I took the july 15 surgical date so I would have plenty of time to get my voice back.

I did mention there was a second problem. We have a young guy who works part time assembling the hotrod that was my brother's project before he died. In his full time job, he had come up with the need for a security clearance and he put my mother down as a reference. That wasn't enough people so my mom suggested me as a possible reference completely forgetting my voice is out of order. I got the call Friday and let it go to the message box. My mom said we will worry about it Monday but from where I sit now, it isn't going to happen on Monday either. Why didn't this happen before I had my surgery?

[Rejennyrated]

Dena can I just say how much I appreciate the AWESOME medical photos. You have stimulated a professional interest in this work, in me and I would love to see any other photos that you might have (privately if that is your preference).

[Dena]

Those were all the photos I was given. I scanned them at a much higher resolution but they were far to big to fit on the page so I reduced them before posting them. The size is about .5 mb an image so I can ship them by email if I have an email address.

I don't know if you have looked at it but the reason I picked Dr Haben is because of his detailed web page. With it I knew exactly what to expect. I didn't have the feeling with Dr. Kim. You will find the web page here
http://www.professionalvoice.org/feminization.aspx 🔗

[iKate]

I don't know if you have looked at it but the reason I picked Dr Haben is because of his detailed web page. With it I knew exactly what to expect. I didn't have the feeling with Dr. Kim. You will find the web page here
http://www.professionalvoice.org/feminization.aspx 🔗

His website is indeed very much detailed, however as a patient of Dr Kim, I don't think it is really accurate about him to say that their website is not detailed. The website does have details and pictures here. 🔗 [Link: yesonvc.net/disease/feminization_​surgery.asp/] Also, when I emailed Jessie she explained everything to me and gave me a lot of information. I had to ask about a number of things, namely my low CBC results, diabetes and other stuff, which I had also asked of Dr Haben by the way (and he did answer them to my satisfaction).

Either way I don't think you can go wrong with either surgeon and if you need a trach shave and/or CTA all in one package then Dr Haben may be a better choice. Dr Kim recommends against the trach shave and they used to do it at one time but I believe they stopped doing it. Thankfully my apple is not at all visible and is higher up so I did not need the trach shave.

The biggest stumbling block with Yeson I see is going to Korea and spending 9-10 days there. But I kind of looked forward to that. I had a great time and played tourist extensively. The only bad experience I had was with airport security roughing me up but I would go back, just to visit. However Dr Haben is just a short drive away for me, relatively speaking, so there is that.

Anyway I think it's a great thing we have these choices now. I know people who had voice surgery years ago and their voice is either a fake sounding falsetto or completely damaged beyond repair and all they can manage is a very breathy forced voice.

[Dena]

In the end, selecting a doctor is a personal personal decision and I was more comfortable with Dr Haben. Dr Kim is also doing some impressive work and has turned out good voices as well. We each made our own decision and this very well may be a case of no right and no wrong. I really don't know enough to comment on Dr Kim as I didn't call the office and I have tried not to say anything about Dr Kim other than I didn't have the information on him that I had on Dr Haben. Dr Kim seems to be doing something different with voices in altering the folds. That is something Dr Haven isn't routinely doing but Dr Haben is a very skilled surgeon and sees people for many reasons other than Feminization. He is well known around town and the woman seated next to me knew the name from my hospital arm band(airline restrictions, didn't have anything to cut the @$%$#% thing off).

It's hard to compare two doctors with so little information so as I said, it is a personal decision.

[iKate]

When I was there at Yeson, there were other patients who were there for other stuff, as in male patients who were obviously not there for feminization. Dr Kim also does a fair amount of medical charity work with kids.

I think he is definitely doing something different. The "AAC" portion of VFS-AAC is probably what makes the difference in his procedure. In an old CNN interview it was mentioned that he developed this procedure to treat cis women who had androphonia as a side effect of anemia (which I also suffer from).

Either way, yes, it is a personal choice. I did choose Dr Kim because of more published examples of good results, which is what really mattered to me, and is something Dr Haben explained why he would not provide. I did not find that explanation very comforting, but I can see his point of view.

In the end, we both will likely end up with good voices, no matter who we went to. 🙂

[Dena]

Today is two weeks after surgery. At this point light usage is permitted but damage is still possible so usage has to be watched carefully. When I first tested the voice on Friday, I thought I was in big trouble because the cords wouldn't vibrate at all and the voice was like a loud whisper. My usage monday through today have changed my opinion because the swelling has gone down enough that the cords are now vibrating. I now sound like a woman with a very bad head cold and the voice is all over the place. I am between 150hz and 210hz with limited control on pitch. The volume is above a whisper but no were near normal. I can get through a day pretty much without using the voice so at this point I  giving it more time to heal. When I visit, I use paper and pen because I will be doing far more talking that would be good for the voice. I think I had more swelling that normal and may be a week or more behind the curve. Next Monday most of the restriction come off the voice and I will be allowed to use it more. The question is will it be clear enough that I want to use it more .

[iKate]

Today is two weeks after surgery. At this point light usage is permitted but damage is still possible so usage has to be watched carefully. When I first tested the voice on Friday, I thought I was in big trouble because the cords wouldn't vibrate at all and the voice was like a loud whisper. My usage monday through today have changed my opinion because the swelling has gone down enough that the cords are now vibrating. I now sound like a woman with a very bad head cold and the voice is all over the place. I am between 150hz and 210hz with limited control on pitch. The volume is above a whisper but no were near normal. I can get through a day pretty much without using the voice so at this point I don't giving it more time to heal. When I visit, I use paper and pen because I will be doing far more talking that would be good for the voice. I think I had more swelling that normal and may be a week or more behind the curve. Next Monday most of the restriction come off the voice and I will be allowed to use it more. The question is will it be clear enough that I want to use it more .

I had the same experience with my recovery. I said a few words before the rest period was over and the pitch was all over the place.

Also I could feel an attempt to use the lower pitches and then something like my brain was searching for the ones that would work.

Now I can't use the lower pitches even if I tried. I just sound like a bad imitation of a man by a woman, and my brain doesn't even try the lower ones anymore.

[Dena]

I am at the three week point and as of Monday, I have some of the volume back and can speak on the phone. The down side is if I talk very much, the voice will give out and I am back to a whisper. Some of the control has come back to the voice and I am comfortably able to work with the voice over 200hz. This was the upper region of the falsetto voice but now I can comfortably reach it with the mouth voice. Just for kicks, I dropped into my chest voice and found my lower end of 80hz is now 140hz which is just above where my mouth voice was. I can't wait for more of the swelling to go down so I can see where this voice is going to settle down. As I still have a week of Prilosec left, I am pretty sure the sutures are still in place. As the swelling continues to go down and the numbness leaves there is a small burning sensation but it's no where near bad enough to take pain medication. The voice is changing so fast that there isn't any point in posting a voice sample at this time.

[anjaq]

Now I can't use the lower pitches even if I tried. I just sound like a bad imitation of a man by a woman, and my brain doesn't even try the lower ones anymore.

Thats fascinating - and must be really a cool experience

I funnily have two options when I lower pitch - I can try to sound male and then it usually sounds like a woman faking a male voice - or I can use my voice in a low pitch but just sound low pitched female. I have learned the latter in the past years as I had not choice, so now maybe its a problem, because if I drop in pitch it will not sound fake and my brainw ill not learn that I should stop doing this silly thing 😛 - but instead it will just sound ok and my brain thinks "ah well, thats fine then"... but then its not that problematic either - it will not sound male in any case and even "low pitch" is still usually in the lower female range, which is perfectly ok for Germany with its 20 Hz lower female average speaking pitch

[iKate]

Thats fascinating - and must be really a cool experience

I funnily have two options when I lower pitch - I can try to sound male and then it usually sounds like a woman faking a male voice - or I can use my voice in a low pitch but just sound low pitched female. I have learned the latter in the past years as I had not choice, so now maybe its a problem, because if I drop in pitch it will not sound fake and my brainw ill not learn that I should stop doing this silly thing 😛 - but instead it will just sound ok and my brain thinks "ah well, thats fine then"... but then its not that problematic either - it will not sound male in any case and even "low pitch" is still usually in the lower female range, which is perfectly ok for Germany with its 20 Hz lower female average speaking pitch

J-Mi (lovelyjmi) had that same issue when she got her VFS. She even made a video about it.

[anjaq]

I remember J-Mi making a video about imitating a boy voice by going low in pitch, but her regular speaking pitch was always higher than that. Maybe I missed that video where she uses a low pitch and a feminine resonance? I had the impression unless she really wanted to go low in pitch and do a boy anime voice, her pitch was rather very high - above what Yeson predicts as average increase. If I missed a video, can you point me to it?

[iKate]

I remember J-Mi making a video about imitating a boy voice by going low in pitch, but her regular speaking pitch was always higher than that. Maybe I missed that video where she uses a low pitch and a feminine resonance? I had the impression unless she really wanted to go low in pitch and do a boy anime voice, her pitch was rather very high - above what Yeson predicts as average increase. If I missed a video, can you point me to it?

I can't because she deleted the videos she posted here.

[Dena]

It's Friday and I am two days late posting an update on the surgery. Not much to report yet because the voice starts out good and then after a few minutes of conversation, I lose flexibility and pitch. I can continue the conversation at reasonable volume but it's not really a nice sound voice once it goes down hill. The major improvement is recovery time is much faster. Now an hour or two will bring the voice back enough that can get the pitch back up again. The good thing is the sweet spot for the voice seems to have moved up a bit to just over 200hz. This is a major change because I could hit that with the falsetto voice but that was near the upper limit and I couldn't use it for normal speech, Now it appears I will be able to comfortably use that area of the voice. Maybe next week I will have more to report. One of the last questions I ask Dr Haben was how will I know when the voice is healed. Dr Haben's reply keeps echoing in my head "When your voice goes from very bad to very good". Well my voice isn't so bad any more but it is still a ways from very good.

[iKate]

For me with Dr Kim's procedure I did have the point where it went from very bad to very good. That happened almost exactly at 1 month. I'm above 200Hz on average now and with natural prosody I find myself between 200-270Hz varying like a see-saw.

But you got CTA right? So you did have a change in how your muscles tighten to even go to falsetto?

[anjaq]

I still am not sure about the CTA and falsetto/head voice. Theoretically there should be no more break anymore after this, because one of the two muscles that cause that break is basically disabled by it and the break supposedly comes from the interaction of the two.

For me the voice improved dramatically between week 4 and 6 but then after that I got ups and downs all the time. Good voice days, bad voice days, it never has gotten really worse on average though, except at about 3.5 months when the Botox stopped working, my voice took a dip in quality. After that it is now (with ups and downs) steadily improving. Pitch did not change much since the 6 week point, after the Botox stopped. I think I lost some quality that I have not regained yet or maybe am just now at the 6 month point about to regain. So these things will have to do with the vocal tremor that is now active again . But volume and quality definitely have improved since that 3.5 month point and keep doing so. I guess it will take the full 12 months to really recover though.

[iKate]

I do realize the good/bad days now. My voice is clear as a bell now though and I've never not been outed because of it. But there are some days I notice my pitch lower and some higher. Maybe it's just mental or maybe it's real. I don't obsessively measure it.

[Dena]

No, I had he minimally invasive surgery which is pretty much like your surgery. I needed 40% of the cord tied which I think is 40% of the longer cord. The doctor said he could do what I needed without the triple, I was't happy about getting my neck cut again and I wanted to retain the flexibility in the voice. My male voice was so restricted I didn't want to place any limits on the post surgical voice. The small amount of testing I have done indicates this was wise because I have far more range than before. Post surgically I use the mouth voice to put me in the proper range. The chest voce takes me down to around 140hz to 150hz which is far to low. As far as the falsetto, I don't know where that voice is yet. I don't think I have entered it but my voice has gone over 500hz which indicates the cross over between the mouth and the falsetto may be very easy to make. There are still rough spots in the voice where I may be changing voices or they could be due to needing more healing time
I fully expected that I might need a little longer to reach the final voice because for some reason it takes longer for the swelling after an injury or surgery to go down. 

[Dena]

I still am not sure about the CTA and falsetto/head voice. Theoretically there should be no more break anymore after this, because one of the two muscles that cause that break is basically disabled by it and the break supposedly comes from the interaction of the two.

The whole CTA surgery is a bit confusing. My take on it is you get a bit higher range out of it but you lose a good deal in flexibility. You may lose the breaks but you no longer have the range in the voice to use it for singing. If you are only interested in the speaking voice and you have a very low/smokers voice to start out with, it may be your only option. I may never sing but I do like to keep the options open so I was going with the doctors judgement on this. If he told me CTA was my only option, I had the plastic ready to run through the machine. So far, I think avoiding CTA was a good thing for me.