My Yeson VFS experience

[Denjin]

I'm glad the information is useful.   You must be getting excited!

On another note, I'll do my three month update tomorrow, or perhaps Thursday.  It depends how much I abuse my voice - insane amounts of talking today and also tomorrow I think.

[Denjin]

Hi   Here is my 12 week post-op reading of the rainbow passage.  Not too bad considering how much I've had to use my voice the last two days. I have a slight speech impediment and since i'm tired you'll notice it slightly more than usual.

Rainbow Passage
http://vocaroo.com/i/s1w2u1Y2qnWp (different mic from recording below).

Oh, here is free speaking
http://vocaroo.com/i/s0PbCdjcyQ5K

[Denjin]

Shared the last clips with Yeson and Dr. Kim thinks my progress is 'very positive'.  At this point they don't want me to start the clonazepam yet but wait another month and see.

My voice is a lot better, most of the time. It still takes a bit more effort to speak loudly, but I can totally do it now and people tell me my voice is clearer than it was before surgery.  I have the cutest giggle, too.  Before surgery I could make sure my laughs, giggles, sneezes, etc., were feminine but I don't need to try now and they sound better.

So, I'm now in the 'happy' camp in terms of results.

[bmiranda]

Hi   Here is my 12 week post-op reading of the rainbow passage.  Not too bad considering how much I've had to use my voice the last two days. I have a slight speech impediment and since i'm tired you'll notice it slightly more than usual.

Rainbow Passage
http://vocaroo.com/i/s1w2u1Y2qnWp (different mic from recording below).

Oh, here is free speaking
http://vocaroo.com/i/s0PbCdjcyQ5K

I hate repeating myself but you sound always good to me and it sounds clearer and better now

Shared the last clips with Yeson and Dr. Kim thinks my progress is 'very positive'.  At this point they don't want me to start the clonazepam yet but wait another month and see.

My voice is a lot better, most of the time. It still takes a bit more effort to speak loudly, but I can totally do it now and people tell me my voice is clearer than it was before surgery.  I have the cutest giggle, too.  Before surgery I could make sure my laughs, giggles, sneezes, etc., were feminine but I don't need to try now and they sound better.

So, I'm now in the 'happy' camp in terms of results.

Youpi! Congrats!!!

I agree that you sound clearer and better! (Oops! Sorry I've just repeated myself again )

What is Clonazepam by the way?

Brenda

[Denjin]

Thanks, Brenda.   It does sound a tiny bit better each week. Which is good since I've been having interviews lately!  I think I finally have my old resonance control mostly back, although the feeling in my face is different. Perhaps that's just due to the higher pitch resonating differently, though.

Clonazepam is a type of anxiolytic medicine I think (anti anxiety), but much more mild than diazepam/valium.  In this case he prescribes it for its muscle relaxing characteristics, which can help with a vocal tremor and other issues.

[bmiranda]

Thanks, Brenda.   It does sound a tiny bit better each week. Which is good since I've been having interviews lately!  I think I finally have my old resonance control mostly back, although the feeling in my face is different. Perhaps that's just due to the higher pitch resonating differently, though.

You're always welcome sweetie and nice to hear that you are getting your old resonance back! Perhaps it's the botox wearing off slowly which is good.

Clonazepam is a type of anxiolytic medicine I think (anti anxiety), but much more mild than diazepam/valium.  In this case he prescribes it for its muscle relaxing characteristics, which can help with a vocal tremor and other issues.

Oh! Ok! Thanks for the info

[Denjin]

I hope it is the botox, Brenda.   Will know within a month, though, I guess.

Tomorrow I'm seeing a ENT who will take a look at my vocal cords.  Doctors seem terrible in the UK, but maybe I'll get lucky and they'll have some useful comment or let me take a picture (or provide one).

[Denjin]

As expected, the ENT was totally useless.  I have no granulation, and it looked 'ok' but she didn't even know what glottoplasty was!!?!?!?  All she could say is that when I phonate (iiiiii sound) the folds aren't closing completely.  Not a tremor (I asked), just that they don't close all the way.  I guess this could explain the volume issues.

Got a referral to yet another doctor...lol

So, anything that can be done or is this just a healing/time thing?  Perhaps it is muscle tension dysphonia or something.  She also said one side is still thicker than the other (was before surgery,too). Passed the information on to Dr. Kim.

[anjaq]

Can you get a copy of the video they did or screenshots? Dr Kim can look at those.
Incomplete closure is very common at this stage and makes the breathiness and lower volume int he first months. It usually passes - more healing, but also adaptation to the new vocal chords are needed. Tremor can cause incomplete closure in that Dr Kim regards it as tremor when muscles tense up and "pull apart" the vocal chords instead of letting them close completely. Botox and Clonazepam are supposed to help relax those muscles. But more importantly are voice exercises and speech therapy. Many women have some incomplete closure at the "back end", its not uncommon, so that would not be to worry about , if it is only that.

[Denjin]

Can you get a copy of the video they did or screenshots? Dr Kim can look at those.
Incomplete closure is very common at this stage and makes the breathiness and lower volume int he first months. It usually passes - more healing, but also adaptation to the new vocal chords are needed. Tremor can cause incomplete closure in that Dr Kim regards it as tremor when muscles tense up and "pull apart" the vocal chords instead of letting them close completely. Botox and Clonazepam are supposed to help relax those muscles. But more importantly are voice exercises and speech therapy. Many women have some incomplete closure at the "back end", its not uncommon, so that would not be to worry about , if it is only that.

Thanks, Anja.  No idea, unfortunately.  The ENT was absolute pants - I've pretty much had it with the NHS.  At least she is referring me to a 'speech clinic' that can do videos.  She did say they won't provide copies, though, so I'll go to go by what they say.

I need a real speech therapist, too, as mine has no clue.  There are just no options up here.

[anjaq]

Sounds even worse than here - at least in Munich and Berlin and some other big cities there seem to be proper speech doctors, although the one I go to has also just an office the size of my bedroom including her examination room. Sigh. But at least she is helpful and gives me copies of the videos. Maybe you can take someone with you who can make a video of what is seen on the screen during the examination?

[gentlebreeze]

As expected, the ENT was totally useless.  I have no granulation, and it looked 'ok' but she didn't even know what glottoplasty was!!?!?!?  All she could say is that when I phonate (iiiiii sound) the folds aren't closing completely.  Not a tremor (I asked), just that they don't close all the way.  I guess this could explain the volume issues.

Got a referral to yet another doctor...lol

So, anything that can be done or is this just a healing/time thing?  Perhaps it is muscle tension dysphonia or something.  She also said one side is still thicker than the other (was before surgery,too). Passed the information on to Dr. Kim.

The problems you describe are usual. I was told by the surgeon that most ENTs would not really know that much about the glottoplasty procedure. The closure problem you describe will effect volume etc, but it can be mostly fixed by exercises. Get a video done and post it off to the surgeon and follow whatever advice they give. Patience is needed, but it will get better.

[Denjin]

Thanks for both of those replies.  It totally explains why it takes more effort to speak loudly.   It is also one of those things that gets a TINY bit better each week, so if that continues, I'll be happy!  On the up side, at least I can speak loudly or even yell if I need to, and it never hurts afterwards.

It will be literally months before I get someone to take a proper examination, though, with video (if I get that at all).

[Denjin]

Sorry for all the 'bumping' of my own thread lately.   I'm just winding back my posting so thought I'd have a few more voice clips due to this.  However, going forward there won't be more until after my botox has completely worn off (in another 3 weeks?) and then the updates will be sparse.  I do monitor the thread via email notifications, though, so just reply if you ever have questions or anything.  Since my voice files do expire eventually, just PM me and I'll share privately.

As we were talking about speaking loudly, here are two clips speaking what seems loud now (but probably just barely above normal those I interact with).  Praat is showing just a bit over 225 average, but that's because when I go above a quieter volume the pitch goes up 10-15 Hz on average. I'm at about 13.5 weeks now.

Rainbow Passage
http://vocaroo.com/i/s04fNeKInF4J

The Caterpillar
http://vocaroo.com/i/s1FvvNruJzPC

And I don't remember 100% what my voice was like before training or anything, but I tried to do the old voice whilst reading the Rainbow Passage, before surgery (just under 160hz):
Old voice?
http://vocaroo.com/i/s0JT9xexzlK7

[bmiranda]

Sorry for all the 'bumping' of my own thread lately.   I'm just winding back my posting so thought I'd have a few more voice clips due to this.  However, going forward there won't be more until after my botox has completely worn off (in another 3 weeks?) and then the updates will be sparse.  I do monitor the thread via email notifications, though, so just reply if you ever have questions or anything.  Since my voice files do expire eventually, just PM me and I'll share privately.

As we were talking about speaking loudly, here are two clips speaking what seems loud now (but probably just barely above normal those I interact with).  Praat is showing just a bit over 225 average, but that's because when I go above a quieter volume the pitch goes up 10-15 Hz on average. I'm at about 13.5 weeks now.

Rainbow Passage
http://vocaroo.com/i/s04fNeKInF4J

The Caterpillar
http://vocaroo.com/i/s1FvvNruJzPC

And I don't remember 100% what my voice was like before training or anything, but I tried to do the old voice whilst reading the Rainbow Passage, before surgery (just under 160hz):
Old voice?
http://vocaroo.com/i/s0JT9xexzlK7

Sounding clearer and better Denjin!

As expected, the ENT was totally useless.  I have no granulation, and it looked 'ok' but she didn't even know what glottoplasty was!!?!?!?  All she could say is that when I phonate (iiiiii sound) the folds aren't closing completely.  Not a tremor (I asked), just that they don't close all the way.  I guess this could explain the volume issues.

Got a referral to yet another doctor...lol

So, anything that can be done or is this just a healing/time thing?  Perhaps it is muscle tension dysphonia or something.  She also said one side is still thicker than the other (was before surgery,too). Passed the information on to Dr. Kim.

LOL! This is why I chose the option to see Professor Remacle for follow-ups

[Ritana]

Try to have an appt with Remacle if you can afford it. He is very good, although a little pricey.

[calicarly]

Denjin, your voice sounds good to me, what I notice is problems with your entonation that can be addressed with speech therapy. You actually have the right idea of the entonation it just seems you go up sometimes in an odd part of a word or sentence rather than where it naturally leads you to go up or down, so a few tiny parts seem forced you could say. But overall I think you are on the right track and addressing those small issues you should be fine in no time. You'll see

I am having to go to an ENT myself, I'm making an apt with the GP tomorrow to get referred for the endoscopy. I'm gonna take my bf with me and have him take the pics . Sadly I developed a strep throat type infection a couple of days ago and it's such early days after my surgery I am very worried about it affecting the correct healing of my vocal folds...  Now I read your experience with nhs ENTs I'm not gonna expect a whole lot ... But I'll try and get those pics for Remacle. Did they allow you to take the pics?? How did you ask for the referral? X

I'm glad I read your thread this is my first time checking it out .

Hugs

[Denjin]

Denjin, your voice sounds good to me, what I notice is problems with your entonation that can be addressed with speech therapy. You actually have the right idea of the entonation it just seems you go up sometimes in an odd part of a word or sentence rather than where it naturally leads you to go up or down, so a few tiny parts seem forced you could say. But overall I think you are on the right track and addressing those small issues you should be fine in no time. You'll see

I am having to go to an ENT myself, I'm making an apt with the GP tomorrow to get referred for the endoscopy. I'm gonna take my bf with me and have him take the pics . Sadly I developed a strep throat type infection a couple of days ago and it's such early days after my surgery I am very worried about it affecting the correct healing of my vocal folds...  Now I read your experience with nhs ENTs I'm not gonna expect a whole lot ... But I'll try and get those pics for Remacle. Did they allow you to take the pics?? How did you ask for the referral? X

I'm glad I read your thread this is my first time checking it out .

Hugs

Thanks, Cali.  I had the intonation fine before surgery, so most of it is due to pitch control still being harder for me at the moment....or at least different.  Also, performance anxiety due to recording perhaps. lol

I imagine strep shouldn't be too much of a problem, just painful of course.  

For the referral, just tell your GP you had some micro laryngeal surgery privately and want to have an examination by a ENT to make sure it's healing fine.  Unfortunately, the ENT I went to was terrible so they are referring me to a voice clinic!?! I think.  I'll know 100% when the referral letter arrives in the post (and will update this thread).  The ENT I saw said she's not sure if a video or photo will be allowed...  Not impressed with the NHS.

And, Ritana - thanks!  I might as well see if the next referral comes through, but if not I'll go see Remacle.  At least it was confirmed that I don't have any granulation or anything, which is a plus.

[anjaq]

I think the pricy part about getting a checkup with Remarcle is the travelling. The examination itself is not that epensive - at least not if you compare it to Yeson. They charge several hundred Dollars for that full voice examination they do before surgery if you opt to only get that done and no surgery...

[calicarly]

Hi Denjin,

Thanks Hun I got the referral with no problem. I printed out Remacle's email and the GP seemed to be pretty agreeable to it and said just snap a pic while the endoscopy is happening and took a copy of the email so just so they know to expect me to want the image.

I hope you're right that the strep won't affect things. Sure makes me feel better to read that.. I got some antibiotics in the meantime... I'm only a week and a day into recovery. When did you start talking? I know yeson has different post op directions...