Susan's Place Transgender Resources

Hi everyone,
Surgery went very well. Recovery was great the very sore tongue being the worst part. I'm very very impressed with Dr Kim and with the setup at Yeson. Everything is just so efficient and the staff have been so kind to me. I had meant to write a very detailed report of what happend but there's just been so much to do in Korea I've not had a chance.  ;) I promise to write one when I get back.

At the pre-op consultation I sung my notes dead-straight in the hope I might avoid a tremor diagnosis. What Dr Kim said was "You have a supressed tremor, but because of your vocal technique you are able to completely control it."  So I've got to have the botox, which I hoped I'd avoid.

Also I did have fairly bad asymmetry. That's one of the reasons why it's felt like "playing oboe concertos on a *broken* tuba" over all these years.

On the post-op endoscope video I noticed that on my right hand side there is a wedge of vocal fold that appears to have been 'pinned-up' longitudinally. I'm guessing that's the asymmetry correction, but maybe not? I forgot to ask Dr Kim.

Was there with two other girls.  Both of them had a sore tongue for about a week.  Mine lasted a month and only just now feels normal.  It was also extremely swollen.  Glad to hear you are recovering well!  And yes there is a lot to do in Korea.  I play the Seoul subway interchange tune when I want to think of my time there.  Hearing that on the subway was always a highlight.

Good luck with the recovery girls!

Had my op yesterday...you can look in my thread for my description...my throat was on fiiiiiire for good couple hours after the op...very uncomfortable..but interestingly..not a single bit of pain or strange feeling in my tongue...so I guess it all depends on if it gets trapped or caught by the tube Dr. Kim works through. I guess I was lucky as many seem to mention that!!

Gigi

Is there a way to avoid these tongue issues? I am very easily crippled by pressure on nerves. I lost feeing in a finger just from holing a shopping bag too long. LOL

At the follow up Dr Kim put the endoscope up my nose again. It was less painful than last time because I knew what to expect.
Dr Kim asked if I'd had any pain and I said "no". He said everything had healed well. It looked different from last week. The wedge of tissue I mention in my last post
is actually my right vocal cord. It's just that it was a very swollen/distorted immediately after surgery. He got me to make a high pitched "heee" sound. It felt odd but at least I realised that despite my worries I'd not spoken since surgery. A very girly 'heee' sound come out and I couldn't stop myself grinning. :) :) Dr Kim said "You have good closure of your vocal folds during phonation".
He said you can still see the blue coloured sutures. It was hard to tell because the sutured area is so small. Had to wait 20 minutes before Botox.
Went to a sterile treatment room next to the OR. I had to put special shoes on. It was very quick and almost painless.
"This won't hurt" Dr Kim said. I Felt a slight injection sensation. An electromyograph device was attached to the needle to guide it in. All took about 2 mins.
It looked about a million times scarier than it was. :)

Unfortunately, because I'd got so bothered about the Botox, I was half way through the voice program before I realised I had no idea what was being said.

They only give you 5-10 minutes to explain it and not having had any formal singing training I didn't understand any of it. It all felt very rushed. I just assumed it'd be the
same as the video on the internet, but when I checked later it was different stuff. Also they gave me a piece of paper which didn't seem to have much connection with either the online video or what was said. I remember she said something about 3 and 5 note scales, project from front of mouth, "ng-ah" exercises, glides.
So it's lost forever. :(

Hey Charlotte,

I have a write-up of Dr. Kim's voice training program that I'm supposed to start on Monday. I can send you a copy, just drop me a PM with your email address.

Amy

Had my surgery a month ago, so guess I will be starting the voice exercises soon enough.  But like you said the voice training felt very rushed and would appreciate a copy of your write up too.  As I do not have the necessary amount of posts yet, would it be possible for you to PM it to me?  Thanks!

Quote from: AmyBerlin on June 20, 2014, 04:51:46 PM
Hey Charlotte,

I have a write-up of Dr. Kim's voice training program that I'm supposed to start on Monday. I can send you a copy, just drop me a PM with your email address.

Amy

Amy,
PM on its way   ;)

Hi. What I just wondered again - why do they give you the botox only a week after the surgery and not right away? would it not help the healing in the first week as well? Did anyone ever ask Dr Kim that?

Quote from: anjaq on June 17, 2014, 05:59:51 PM
Is there a way to avoid these tongue issues? I am very easily crippled by pressure on nerves. I lost feeing in a finger just from holing a shopping bag too long. LOL

Hi Anja,
The tongue thing isn't really a big issue. Frankly I've had much worse dental experiences than the surgery (although in fairness I have had some unpleasant dental work done). Tongue is absolutely fine now. Anyway I don't want to be "luring" you into having VFS. LOL  ;D

I don't really understand the whole Botox thing at all. So I'm not sure why he doesn't inject right away. Perhaps the botox might interfere with healing?

Charlotte

At the initial consultation they get you to fill in a self-assessment of your voice. As I was filling it in it suddenly dawned on me how much of a voice disability I had. I was ticking so many 4's (out of 4). I'd not really realised till then how much it has affected my life. The other thing I discovered was that I had physiological issues as well. My right vocal cord was nearly twice as big as my left. Coupled with the tremor and a fairly low natural voice it's not too surprising I had problems. So it's been a vindication for me: it wasn't (entirely!) for lack of practice that I couldn't get a decent voice.

I actually regret not doing this years ago. Dr Kim said he'd been doing it since 1997 (if I heard him right). It seems that he was much better known in Asia than in the West until very recently. But until Jenny went over there was almost nothing on the web about voice surgeries at all. It was just people telling you not to do it.

Quote from: Charlotte on June 25, 2014, 06:16:30 AM
But until Jenny went over there was almost nothing on the web about voice surgeries at all. It was just people telling you not to do it.

That makes me REALLY happy to hear :D :D

Thank you!

And glad to see that things seem to be going well for everyone here! That is so wonderful!!

Yes - I had to do this self assessment at my phoniater too. It was really not a nice result. And it was part of why they got me now the third set of 10 hours at a voice therapist on insurance cost. Dr Kim is doing this since 1997? Then he started at about the same time or even earlier than Dr Gross here in Berlin. Obviously he had much more chances to do this surgery since then though ;) - How many did he now ? Must be over 300 by now, given that it was already well over 200 last year and he got at least 10-15 people just from this forum plus probably a lot more sho do not appear here as posters or do not have any contact to this forum at all.

Quote from: Jennygirl on June 25, 2014, 06:58:31 AM
That makes me REALLY happy to hear :D :D

Thank you!

And glad to see that things seem to be going well for everyone here! That is so wonderful!!

Thank *you* Jenny  ;)  It's just awesome how much you've done for everyone. You have so much generosity! I know if it hadn't been for you I might never have had this life changing surgery.
So thank you again!  :)  :)

Quote from: Charlotte on June 26, 2014, 05:54:17 AM
Thank *you* Jenny  ;)  It's just awesome how much you've done for everyone. You have so much generosity! I know if it hadn't been for you I might never have had this life changing surgery.
So thank you again!  :)  :)

STAHP! ;)

All I did was expose it, the real goodness is in the procedure itself. I'm glad that you think I'm generous, too, but I would not have been able to share it so effortlessly without this site and the community here. If you look back on the original thread, you will see how much support I had going into it.

Without the feedback and connections here, there would have been much less incentive for me to share my experience. That's part of the reason why I donate time and money here, because I want it to keep going- especially for that reason :)

So, thank you again for your kind words. And I wish you the best :D

Updates:
I'm now at the 1~2 words per day stage. I really glad to get back to using my voice. I read some research that absolute voice rest after 2 weeks no longer has any benefit (sorry can't remember the reference). So it's good to start getting my voice going again. I'm also glad that I did a lot of voice strengthening exercises pre-surgery because what comes out is very weak. However, it is intelligible, a bit breathy from the early stage Botox, and most importantly all the heavy male sounding overtones have gone!!! I'm so happy.

Another thing I did pre-surgery was to get a high-end studio condensing microphone; overkill I know and maybe not even the right tool for the job, but you only do this once. I then recorded several 20-30 minute readings, as well as my singing repertoire. I really wanted to have every detail there so I could see what had changed post-surgery. So it's been really interesting to compare the few snatches of my post-op VFS voice that I've recorded with the old one. The fundamental frequency isn't that much higher yet (though it's difficult for praat to work with such short clips), but all the heavy male resonance (overtones) are gone.

I'm a bit confused because I thought the whole thing was that VFS raised the pitch but didn't alter the resonance. Or do different people mean different things by resonance. In the same way people seem to use head voice and falsetto in different ways.   

Quote from: Jennygirl on June 26, 2014, 06:09:01 AM
STAHP! ;)

All I did was expose it, the real goodness is in the procedure itself. I'm glad that you think I'm generous, too, but I would not have been able to share it so effortlessly without this site and the community here. If you look back on the original thread, you will see how much support I had going into it.

Without the feedback and connections here, there would have been much less incentive for me to share my experience. That's part of the reason why I donate time and money here, because I want it to keep going- especially for that reason :)

So, thank you again for your kind words. And I wish you the best :D

;D ;D

I would be careful comparing very softly spoken, low volume sounds with full voice at regular volume recordings. But I am happy that it seems to work and we are all looking forward to hear some of the voice comparisons once you are at the "several sentences a day" stage ;)

Quote from: anjaq on June 26, 2014, 09:20:10 AM
I would be careful comparing very softly spoken, low volume sounds with full voice at regular volume recordings. But I am happy that it seems to work and we are all looking forward to hear some of the voice comparisons once you are at the "several sentences a day" stage ;)

Hi Anja,
You piqued my interest with this comment about low volume sounds  ;) So I decided to measure my voice with a sound meter today. It wasn't a very scientific experiment. First I measured a healthy person's voice at 1m distance from the sound meter (with setting "C weighted/Fast") then I measured my own. I was very careful not to strain my voice or put any pressure on it.  The healthy voice had a maximum of about 57 dB. The two words I'm allowed to speak today came in with a maximum of 39dB for the first word (I fumbled it a bit) and 49dB for the second word.

Just a bit of fun!  :D

I've been saying two words per day and recording them. I've been thinking quite hard of long difficult words; sort of getting maximum syllabic bang for my buck.  :D Then I've compiled a mix of all the various days and put it on a loop.

Some days sound better than others. Like everyone say sleep really does help a lot. Maybe it gives a chance for the vocal muscles to relax?

These few weeks are hard because you have to be so vigilant not to accidentally make a sound. It's easy to forget that you've had surgery. So far I have only once got caught out. I was distracted and replied to a question. The first thing that went through my head was "Why does my voice sound so light and breathy?" the second thought "Oh no! I'm not suppose to be talking!" Couldn't stop grinning for a while after that though.  :) :)

Because I can't speak people have been treating me different. I think I get far fewer odd looks now. (Obviously once they find out I can't speak they usually look a bit scared, but that's a different story). My pre-surgery voice was really bad, and absolutely my weak spot so it's probably not too surprising.

Anyway it's made me definitely decide to sort out my 'M' shaped hairline. The only problem with that is once I have transplants it's going to be very hard to have any work done on my forehead (I'm a type I) if I decide that in fact it does need doing. I was told when I transitioned that I was inside the female range so never bothered having my brow bossing reduced (think it's about 3-4 mm - can't remember).  :-\

I had the surgery for the same reasons as you ~ everything was going great except for my voice.

And you are right: once you even go quiet after having a masculine sounding voice, people start treating you differently. It's certainly the most lifechanging thing I've undergone in transition. I imagine it might even be more lifechanging overall than SRS will be for me because of the level of importance voice plays in everyday interaction ~ and that is where I spend most of my life.

Glad to hear that you are getting smiles out of it :D :D :D Sounds like you are already warming up to the new setup!

Ok so I'm a complete idiot! I was playing around with my email address and managed to get locked out of my account on Susans  :(

I thought I'd post an update. The TL;DR is I'm very happy with the way things are going. In fact more than happy, I can't quite believe that finally after all these years I have a different voice.  :)

I've started speaking! It feels like my brain is trying to play my voice in a way that it no longer wants to be played. Maybe like a cellist trying to play a violin the way they play a cello. So metaphorically I've put the violin between my knees and I'm hunched over trying to play it. What I've been trying to do is let my voice tell me how it wants to be used. So just very gently feeling my way round it - IYSWIM.

It's probably not surpring that I'm confused by it because I had so much done to it. A major asymmetry correction, almost half of the cords sutured together, botoxed, and not allowed to talk for a month. So I don't really know what's what.
There was some diplophonia from the asymmetry before surgery. In other words because of the size difference of the cords they were vibrating at different frequencies. Causing me to have 'two voices', sort of like an overdub. Also getting any kind of sound out before used to be a big effort and I had to force the words out. I can't remember whether this was because of hyperfunction, tremor, or muscle imbalance or a combination. Consequently when the words finally came out they sort of exploded out. For those reasons I think I'd have had this surgery done anyway. The fact they threw in a voice feminization surgery for free was just a bonus.  :D
I measured the loudness of my voice again with a sound meter and the reading was 58dB. That is actually louder than my "reference person's" normal speaking voice. This doesn't surprise me since I've always had a booming voice. However, at just 1 month post-op it was a warning to me not to push it too hard.
The first couple of readings that I recorded did come out to be around 145Hz. I feel quite despondent for a while and then deliberately pulled my voice up and it came out at 180Hz and sounded great. So that's the catch. The fundamental frequency is still low. However, there does feel like there's a lot of swelling. The positives are that it does seem, for me anyway, to be a magic bullet for sounding fem when my voice goes above 165Hz. I think 16 years of living as a woman probably helps with the prosidy etc.

Hi Charlotte,

Quote from: Charlotte2 on July 15, 2014, 12:28:26 PM
The first couple of readings that I recorded did come out to be around 145Hz. I feel quite despondent for a while and then deliberately pulled my voice up and it came out at 180Hz and sounded great.

Don't worry. I can also still hit my current lower limit of 130 Hz, with effort. The first words I spoke also were around 150. But as the swelling goes down, the voice will settle into a higher range, so don't worry and enjoy the ride, it's all gonna be great.

Hugs,

Amy

Not really an update today. Everything is going great. :)

I've been thinking about something I said when I joined susans about why I was doing this now after transitioning 16 years ago. Anyway, I've thought about it a bit more and wanted to expand my reasons.

Public awareness of trans. You just can't move in the media for trans stories. Back in the 1990s many people didn't even know such things existed. Consequenly the cis-population are an order of magnitude better informed than when I started out. I think people now see trans even when it isn't there. In other words I'm sure there are a lot of false-postive clockings. IYSWIM. So people notice things about me that would have gone unheeded before.

Also I realised I've been "sweeping things under the carpet" for years. Things that were too difficult to deal or painful to think about just got ignored. Maybe it's hitting middle age and realising I'm running out of time, or more positively maybe it's that my self-estime has improved.
So finally I've had to deal with these things. So that's why I've had VFS, why I'm off to Belgium to get hair transplants, why I'm looking at my HRT regime. There are other things as well but I've gone quite OT already, and I don't want to be (even more of) a bore! ;)
Just my $0.02.

Charlotte - I hear what you are saying and I think it is about 100% why I am now (also after exactly 16 years :o ) thinking about basically the same things. More public awareness certainly was part of it - there was a stupid reality show in a big TV channel last year and incidentially in that year I got several misgenderings etc. Also things that nag at me forever. Back then there was no viable solution, no VFS existed that was not incredibly risky and bad, FFS was only Dr O... So I tried to make due with it and now am reconsidering. One has to go with the spirit of the time maybe ;) - and since now FFS is done by a significant number of people , maybe its time. I also think maybe its my personal choice of "mid life crisis" :P

Interesting, you mention changing HT - it was a major change for me last winter to revise this.

Quote from: anjaq on July 24, 2014, 06:38:21 AM
Charlotte - I hear what you are saying and I think it is about 100% why I am now (also after exactly 16 years :o ) thinking about basically the same things. More public awareness certainly was part of it - there was a stupid reality show in a big TV channel last year and incidentially in that year I got several misgenderings etc. Also things that nag at me forever. Back then there was no viable solution, no VFS existed that was not incredibly risky and bad, FFS was only Dr O... So I tried to make due with it and now am reconsidering. One has to go with the spirit of the time maybe ;) - and since now FFS is done by a significant number of people , maybe its time. I also think maybe its my personal choice of "mid life crisis" :P

Interesting, you mention changing HT - it was a major change for me last winter to revise this.

I'm not sure if your avatar is a picture of you because if it is then you look rather pretty in it.  :) Do you think you need FFS? I would worry about getting a 'surgery face' which draws more attention to oneself than not having any. Obviously I'm playing devils advocate here a little.  ;) I don't mean to be talking you out of having FFS! It's just so difficult to get objective advice from people isn't it? People either tell you everythings fine (people spent years telling me my voice was fine when it obviously wasn't) or they are trying to sell you a service. Particular at this stage in our lives when you're talking about fairly subtle clues.

What was the catalyst for your change in hormones? Do you think it's made a big difference?

Also another reason for doing all this stuff now is that my life hasn't really ended up quite where I hoped it'd be. Not badly wrong, but I'd just hoped for better.

Quote from: Charlotte2 on July 24, 2014, 10:24:52 AM
I'm not sure if your avatar is a picture of you because if it is then you look rather pretty in it.  :) Do you think you need FFS?

Well. Do I think I need voice surgery? Do you think you need voice surgery?
Its not so much about "need", I guess. I mean, the past 16 years went well enough for me, but some things just bug me . The occasional stare, the remarks one hears just from the distance, an occasional "he" .. it is bugging me a bit, although not devastating usually.
I dont know how much I "need" FFS. People who know me say I dont need either - VFS or FFS. FFS surgeons obviously think I need FFS. People who have dont FFS themselves and have thought about the topic suggest that I really do consider it as it saved them a lot of worries from there on. So I am not sure. I am considering it seriously though, although I would stress that I would not want to overdo it - just more subtle changes.

Oh and yes it is me in the picture but it is a bit distorted and filtered so I hope to not be easily recognizable by chance ;)

QuoteParticular at this stage in our lives when you're talking about fairly subtle clues.

Definitely - this is all not catastrophic. If FFS and VFS was still unavailable like it was 16 years ago, I could probably just keep going as it is and not be depressed about it. Although I can imagine I would have to push more into the direction of not caring so much about being "stealth". Not sure "stealth" is healthy anyways, but I still try.

QuoteWhat was the catalyst for your change in hormones? Do you think it's made a big difference?

Tons of things. its a bit offtopic now, but I had increasing health issues with blood pressure, migraines, skin issues, digestion, hair loss, depression, tiredness, weight, sex drive and a defeminization, particularly in body shape and face. The changed HT corrected some or lessened some others of these symptoms, I got hair regrowth at the temples and my face looks better now among other things. As a Bonus I finally have gotten some more breast development in terms of fullness.

QuoteAlso another reason for doing all this stuff now is that my life hasn't really ended up quite where I hoped it'd be. Not badly wrong, but I'd just hoped for better.

What do you mean by that - what is bugging you that can be blamed on "this stuff"?



[/quote]

Hi Anja,
I'd love to continue this conversation via PM, but I don't have enough post on this account to PM. I managed to get locked out my other account 'Charlotte' because I'm an idiot and had been playing around with my email settings. Is there any way a mod could re-activate the old account with my old email address? I'm very sorry for all the inconvience caused and I promise it wont happen again. Otherwise I'm sure I'll reach the required 15 posts quite soon.

Charlotte

Sorry, I am just Chat Staff, I have noi forum mod powers and dont know if this would be possible at all to reactivate an account if the email adress was changed.

Oh well, I'm up to 5 messages already!  ;)

Yesterday someone showed me a picture of some baby hippos and I went "OMG! Baby hippos!". Only I squealed it. :) I was in shock for like 5 seconds after: in a "What just happend there?" kind of way.  ;D Then today I've been a bit hoarse. So it really is quite a ride at the moment.  ;)