Surgery with Dr. Haben in two days

[kwala]

Hello, everyone!  I'm nervous, but mostly excited as I am now packing for my trip to Rochester tomorrow.  I have to say another  big THANK YOU to everyone who has been a patient of Dr. Haben and Dr. Kim for being so generous in sharing their stories and answering questions which have helped people like me make the decision to go forward with vocal surgery. You are all doing a wonderful service for the community!

My plan for now is to go with the glottoplasty alone, and not do a trach shave or CTA because, 1)I think my voice is already on the high male/gender ambiguous side so I don't anticipate needing the extra pitch gain and 2)I play a wind instrument professionally so I want to be conservative with that area and go with the least invasive option.  If during the pre-op exam, he uncovers some reason that the CTA is necessary I will consider it, but it would have to be something pretty major for me to consider it, even though I've heard some stellar results from so many of you.

I took the pre-screening phone survey from the hospital today and hadn't considered that I won't be allowed to wear make-up, etc when they operate (duh) so I had to repack everything and I'll basically be traveling in boy-mode.  Felt a little strange at first but, I'm not 100% full-time (this is a big step in getting there!) and if it means I won't have to carry a bunch of extra stuff and deal with airline security I guess it's worth it.  But if anyone sees me there, I apologize for my appearance lol!

I plan to take the post operative instructions very seriously and I've spent the last week practicing being silent for hours at a time and how to clear phlegm without coughing.  I did catch a cold about 6 days ago but it seems to have subsided (phew) so everything feels normal at the moment.

I'll be more than happy to post updates as soon as I'm healthy enough to make a recording worth listening to.  In the meantime, here are two samples from today of my untrained and trained voices for later comparison.

Trained: http://vocaroo.com/i/s0UQxDlOHdgJ

Untrained: http://vocaroo.com/i/s1Gdr8bvFqdA

Thanks again for all the support, and if you have any last minute tips I'd love to hear them

[Dena]

I wore makeup there and to Dr Haben's office pre surgical but didn't wear it the day of the surgery or for the flight back because I didn't have time to apply it. Should you have any more questions, let me know.

[kwala]

I wore makeup there and to Dr Haben's office pre surgical but didn't wear it the day of the surgery or for the flight back because I didn't have time to apply it. Should you have any more questions, let me know.

Thanks!

[Elaine S]

Kwala:

Best wishes on your VFS. The best advise I can offer is to go way beyond the recommended "no talking" time. A month if possible to give things time to really bond and heal. you could ask for a slightly heavier gauge suture for additional resistance to fluids and whatnot. When you do start talking do start gently and short duration. Listen to what your body is telling you if your voice tires. It will give you the best possible outcome.

Hug's and happiness
Elaine

[kwala]

Kwala:

Best wishes on your VFS. The best advise I can offer is to go way beyond the recommended "no talking" time. A month if possible to give things time to really bond and heal. you could ask for a slightly heavier gauge suture for additional resistance to fluids and whatnot. When you do start talking do start gently and short duration. Listen to what your body is telling you if your voice tires. It will give you the best possible outcome.

Hug's and happiness
Elaine

Thanks, I'll do my best to go above and beyond the after care protocol!

[Roni]

Good luck on your procedure! I too wore makeup during my consultation, and not going to lie, I definitely wore makeup during the actual surgery itself LOL (quite a bit of it). I just cannot go out in public in front of strangers without makeup, and that includes being in front of doctors/surgeons at a hospital. Either the staff did not mind my makeup or they didn't notice it.

Also your pre-op voice sounds really good! I have no doubt that the surgery will only benefit you.

[kwala]

Good luck on your procedure! I too wore makeup during my consultation, and not going to lie, I definitely wore makeup during the actual surgery itself LOL (quite a bit of it). I just cannot go out in public in front of strangers without makeup, and that includes being in front of doctors/surgeons at a hospital. Either the staff did not mind my makeup or they didn't notice it.

Also your pre-op voice sounds really good! I have no doubt that the surgery will only benefit you.

Well, I'm at the airport already and while it felt a little strange because I'm usually only in boy mode at work. I do have to say it's nice to be traveling so lightly and not get any strange looks at security.  I was able to fit everything into one small back pack.  Thanks for the compliment.

[Roni]

Well, I'm at the airport already and while it felt a little strange because I'm usually only in boy mode at work. I do have to say it's nice to be traveling so lightly and not get any strange looks at security.  I was able to fit everything into one small back pack.  Thanks for the compliment.

Have a safe trip! Beware of the TSA at the airport in Rochester.. they gave me a hard time on the way back home because I had "anomalies" with my body and was detained for 20 minutes. They pulled me aside and had me open all my luggage, as well as scan my body and hands to see if I had laced myself with anything... needless to say my mom was pissed. She was constantly telling them I was transgender but that didn't stop them from giving us a hard time. After it was clear that we weren't breaching anything security wise and were given the green light to enter the terminal, the TSA employees and the head of management still gave me dirty looks, probably because they weren't used to seeing trans people.

[kwala]

Have a safe trip! Beware of the TSA at the airport in Rochester.. they gave me a hard time on the way back home because I had "anomalies" with my body and was detained for 20 minutes. They pulled me aside and had me open all my luggage, as well as scan my body and hands to see if I had laced myself with anything... needless to say my mom was pissed. She was constantly telling them I was transgender but that didn't stop them from giving us a hard time. After it was clear that we weren't breaching anything security wise and were given the green light to enter the terminal, the TSA employees and the head of management still gave me dirty looks, probably because they weren't used to seeing trans people.

I'm so sorry that happened!  Well, I am presenting as male on this trip so maybe it's for the best afterall that my appearance matched my ID.  Pre-op check is in a few hours so I'll post an update afterwards.

[Dena]

When I returned from Rochester the scanner was broken so they ran us through the old fashion metal detector and unlike the trip out, it was happy with my tummy and back. As far as I know, no airplanes fell out of the sky as the result of it.

[Jessirules]

Hello, everyone!  I'm nervous, but mostly excited as I am now packing for my trip to Rochester tomorrow.  I have to say another  big THANK YOU to everyone who has been a patient of Dr. Haben and Dr. Kim for being so generous in sharing their stories and answering questions which have helped people like me make the decision to go forward with vocal surgery. You are all doing a wonderful service for the community!

My plan for now is to go with the glottoplasty alone, and not do a trach shave or CTA because, 1)I think my voice is already on the high male/gender ambiguous side so I don't anticipate needing the extra pitch gain and 2)I play a wind instrument professionally so I want to be conservative with that area and go with the least invasive option.  If during the pre-op exam, he uncovers some reason that the CTA is necessary I will consider it, but it would have to be something pretty major for me to consider it, even though I've heard some stellar results from so many of you.

I took the pre-screening phone survey from the hospital today and hadn't considered that I won't be allowed to wear make-up, etc when they operate (duh) so I had to repack everything and I'll basically be traveling in boy-mode.  Felt a little strange at first but, I'm not 100% full-time (this is a big step in getting there!) and if it means I won't have to carry a bunch of extra stuff and deal with airline security I guess it's worth it.  But if anyone sees me there, I apologize for my appearance lol!

I plan to take the post operative instructions very seriously and I've spent the last week practicing being silent for hours at a time and how to clear phlegm without coughing.  I did catch a cold about 6 days ago but it seems to have subsided (phew) so everything feels normal at the moment.

I'll be more than happy to post updates as soon as I'm healthy enough to make a recording worth listening to.  In the meantime, here are two samples from today of my untrained and trained voices for later comparison.

Trained: http://vocaroo.com/i/s0UQxDlOHdgJ

Untrained: http://vocaroo.com/i/s1Gdr8bvFqdA

Thanks again for all the support, and if you have any last minute tips I'd love to hear them

I think you trained voice sounds great as is!
Good luck with the VFS

Jessi

[kwala]

Well, I am happy to report that I just underwent surgery with Dr. Haben.  I opted for the glottoplasty alone, he didn't think I needed the CTA and neither did I so we barely even discussed it.  I'm hoping to get the typical 7 half step increase which would put my mean speaking pitch right around middle C or the B just below it.

Surgery was pretty easy, woke up with a slight pain in my throat just as others have reported, but even though I was a bit loopy from the anesthesia I was able to remember to not talk.  I haven't made a sound all morning and the only little slip so far is I accidentally started to clear my throat while eating jell-o but I caught it right away so it was at least a small quiet one.  So far no coughing  *knocks on wood*

I have found Dr. Haben to be friendly and professional.  He explained in great detail how the procedure works, what to do for aftercare, and the risks.   He mentioned to me that although it is extremely rare, there have been times when sutures dissolve and the folds have not fused together and one is basically back to where they started from.  We've come a long way from some of the barbaric practices of the past to get to these new methods but even they are not 100% guaranteed to have a successful outcome.  I really feel for anyone who has not had their desired result due to a malfunction.  *Hugs*

[Elaine S]

Kwala:

I am so happy to hear that your surgery was smooth and uneventful. No one likes surgery but getting this done will likely remove stresses from your mind, either known or unperceived. I hope your recuperation goes smoothly and quickly.

The advice given here by so many regarding the recovery period is very good and if possible waiting an extended period of time before using your voice will help give your vocal cords more time to heal without the increased stress from use at the same time as healing in the early stage of your recuperation. 

Do not hesitate to call Dr Haben for a refill of the narcotic cough medicine before you run out. Some are more prone to coughing that others but it is better to have a bottle left over and unneeded after your recovery than needing it in the middle of the night and not being able to get a prescription called in.

Sleeping with your head elevated will definitely help keep your throat more clear of mucous and phlegm than lying flat or side sleeping. Getting a tickle at night might produce a cough that doesn't awake you but doing everything possible to minimize the chance is worth the hassle of any small discomfort. It will also minimize the possibility of acid reflux too. Breathing through your nose as much as possible will help keep your throat from drying out as much as breathing by mouth.

You may have read about the stitch from my surgery coming out at the 5 week +2 day mark. I still haven't been able to pinpoint any reason. It was even very early in the morning, about 1 am and I was up and tapping out a letter on the computer to a friend. It was a prickly tickle and I breathed the "H" sound and out came a bit of phlegm with the top knot of the stitch inside it. I just happened to look at it as it felt a little spikey so I look at it. The knot was not untied, the suture material seemed to have dissolved on the ends.

Anyway, I am going back on the 8th of Dec for a pre op consult and the following day for surgery. Depending on the outcome of the consult, I may well need to do have CTA to get the result I wish. Though I hope to avoid another scar and my thyroid bone is not prominent, it is a small thing to have to deal with to get the result I want. The scar will fade to nothing in a fairly short time if indeed a CTA is deemed necessary. Regardless, a heavier, longer lasting suture will be used this time.

With reasonable care taken during your recovery, I doubt you will have any issues at all. It is very easy to be anxious about things, I am really bad about things sometimes, but just keep in the front of your mind that your convalescence will be but a short time compared to having a lifetime of a nice voice.

On my pre-op visit, I'm going to take a comprehensive list of my typical diet as it is pretty predictable, outside of the occasional lunch or dinner out, for a line by line yes or no from Dr Haben. Probably an overkill, but in an effort to help the healing process it is a small sacrifice. But, as before, spicy and ascitic food and drinks are out for a few months at the very least. Avoiding alcohol would probably be a wise thing too and of course smoking of any sort is completely counterproductive.

One kind of funny thing that did help was when my wife went throughout (seriously, everywhere, in closets, the laundry room, both sides of the door to the garage, etc) the house and put up pieces of paper saying in big letters "DO NOT TALK". Perhaps silly sounding they were everywhere and they were a constant visual reminder to keep quiet. It did help.

Talking is something we take for granted and it is automatic and mindless done every day for all of us that are able speak. It is difficult to break the habit of simply answering any query but anything you can do to give yourself as much time to heal as possible will ensure the best possible outcome for you. It will also give you some insight into how those that are unable to speak live their lives. It is a consciousness raising experience. 

I guess having to go through the recovery after the surgery is yet another of the things we have to just deal with to get ourselves like we should have been from the start. Perhaps catching up on some reading or reacquainting your self with a hobby or musical instrument if you played something like guitar to piano may help pass the time creatively and productively.

Again, my most sincere best wishes to you and also any others that have already gone through or those that are going through VFS. I hope your goals are exceeded by your final results.

Be safe. Hug's and Happiness
Elaine 

[kwala]

Kwala:

I am so happy to hear that your surgery was smooth and uneventful...

Thank you for the wise words, Elaine.  I really hope the second time around goes much better for you. 

[Roni]

If you wanted to get another bottle of the cough medicine, be sure to do it before leaving the state of New York. I had emailed Dr Haben to ask for a refill but he said he was not able to send prescriptions across different states as it is federally illegal to do so. I had no choice but to settle for over-the-counter Robitussin, which in my opinion is not as effective as pharmacy prescribed cough medicine.

[Roni]

Anyway, I am going back on the 8th of Dec for a pre op consult and the following day for surgery. Depending on the outcome of the consult, I may well need to do have CTA to get the result I wish. Though I hope to avoid another scar and my thyroid bone is not prominent, it is a small thing to have to deal with to get the result I want. The scar will fade to nothing in a fairly short time if indeed a CTA is deemed necessary. Regardless, a heavier, longer lasting suture will be used this time.

I am a bit confused at this point. So did your vocal folds not fuse together despite part of the sutures coming off later in the healing process, at the 5 week mark? I was under the impression that past a certain point in healing, it did not matter whether some of the stitches came off because the chords would have already conjoined?

[Dena]

If you wanted to get another bottle of the cough medicine, be sure to do it before leaving the state of New York. I had emailed Dr Haben to ask for a refill but he said he was not able to send prescriptions across different states as it is federally illegal to do so. I had no choice but to settle for over-the-counter Robitussin, which in my opinion is not as effective as pharmacy prescribed cough medicine.

Might not be able to do it with the cough medicine because it's a narcotic but my roommate was on a number of medications and once they were in the Walmart computer, we could fill them anywhere in the United States.

[Elaine S]

Roni:
Good point about the prescriptions across state lines. I forgot my GP, in a midwestern state won't refill me on pain meds for my back and. I will get a refill from Dr Haben while there but before I leave as I will likely have to have a follow up visit in 8 days post-op if a CTA is done. Have to wait and see about that.

I too thought that the vocal folds were pretty much adhered by the 4 week mark and when the stitch popped out at 5 weeks and 2 days, there was a pain of perhaps 2.5-3 out of 10 and it lasted for a few days. The immediate effect was a loss of a measurable amount of pitch (and regrettably my giggle was gone(:-<). Dr Haben said to relax as it takes at least 3 months to be able to see a real result. So I did.

When I sent him my recording at the 3 month (actually 13 weeks) mark he said i was (direct quote here): "You are at B3, or around 240 hertz, dead center in the average female range!  Yes, it is certainly hoarse, likely from persisting inflammation from the suture, which may take 6+ months to resolve.  Patience!.. If you are concerned, have a local ENT who can scope AND send me a picture to confirm what is going on, versus waiting, or coming back here for the follow-up.  The voice should come.  Patience, patience, patience!  B3 !!!".

I am not sure how that the level of pitch is measured from the recording of the rainbow passage and the sustained EEEEEE. When I did both they were in as normal a voice as I could, neither adding or subtracting and for the EEEE thing I did not go for a super effort as I have really tried to not hurt things. I know that I am my own worst critic, by far, but I have lost some, though not all of the pitch gain from when the stitch came out and a good deal of hoarseness has returned so it may have something to do with the asymmetry thing. it proved all but impossible to get an ENT here in SW FL to scope and take a pix to send to Dr Haben. The only one that had the capability to do so SPECIFICALLY said he would not forward it. Medical care here is crap. I am on Medicare from a career ending bizarre injury and just pay out of pocket as I think medicare is pretty much "DEADNOCARE" for the good it does me.

In another response I mentioned that my hoarseness was related to an asymmetry in my vocal cords, something he addressed in surgery and as previously mentioned at the 9 day mark, talking in a calm and normal voice, it was a marked improvement over my previous one. I haven't measured my voice in a month or more as it hasn't changed. When I used PRAAT I used the AVERAGE (drawing a line between the middle of the highs and lows) for my analysis and then of course the EEEE or other steady state vowel or consonant sounds are easy to suss out.

Again, the 9 day post-op clip from early June, not great but 9 days? I'll take it... Dr Haben said my everyday voice was about 160htz pre-op, to start with but I thought my voice was really poor sounding and got sired about 50% of the time on the phone.

http://vocaroo.com/i/s1BBzLgrTIJ1

Be safe and my very best wishes to you.
Elaine

[Elaine S]

Dena:

Your point about Walmart is excellent and is how I am able to get my Rx's done here rather than travel back to see my GP for every little thing. Dr. Haben may or may not be able/want to do that with a narcotic.

Be safe and enjoy the day.
Elaine

[iKate]

If you wanted to get another bottle of the cough medicine, be sure to do it before leaving the state of New York. I had emailed Dr Haben to ask for a refill but he said he was not able to send prescriptions across different states as it is federally illegal to do so. I had no choice but to settle for over-the-counter Robitussin, which in my opinion is not as effective as pharmacy prescribed cough medicine.

Yeah that's controlled substances only I think.

However regular scrips go across state lines all the time. I go to my endo in NY and get my hormones filled in NJ.

For refills for controlled substances in NY you need to get a dr visit because of state law. I would imagine that's probably why Dr H had that stipulation.