Susan's Place Transgender Resources

Hello again.

As I am just starting to get my things in order for another try at VFS with Dr Haben, I thought I would post a new thread as a lead up and follow after. Also, I have made several posts on other VFS threads but want to try and not hijack others experiences and comments.

My previous VFS comments are here:

https://www.susans.org/forums/index.php/topic,189945.msg1756215.html#msg1756215

Monday and again today I made recordings that are similar in content but I am posting both due to the one from today being wildly different in measurement on PRAAT when compared to the ones made 2 days ago. Both are longish to give a sense of how I sound on a daily basis without artificially adding or subtracting anything and also serve as a vocal chronicle of my previous VFS and thoughts rather than just doing the rainbow passage thing.

This past Monday, I made many attempts due to silly content and wording errors, trying to be coherent and focused rather than rambling but resolutely showed right at 180-183 htz. Today, Wednesday 4.Nov.2015, I was satisfied, content and word wise, on the 2nd go but did another when the reading was 262 htz "plateau" on the sustained sound and if anything, today I was not as forceful (never REALLY going for higher as I do not want to abuse my voice).

But if you asked me today what my voice was, I would have to default to Mondays 180 number. As another reference, Dr haven stated my voice was 160 htz in our pre-op meeting the first time. Before the stitch popped out I was very consistently at 230-235 and not at all pushing things hard and had a MUCH more clear and pleasing, somewhat musical, bell like character to it if that makes sense.

Those recordings are below. Youmay want to reduce the volume on your computer's sound output as they may possibly be loud due to me using a laptop on my breakfast bar and sitting somewhat close to the computer:

Monday 2.Nov.2015 10am voice 182 htz on "E" sound, up for about 3 hours prior to recording, about 14 shorter, partial takes after trying to get wording and content in some semblance of order
http://vocaroo.com/i/s0kfrMX1PChO

Wednesday 4.Nov.2015 6:45am voice, 262 htz on "E" sound, 2nd take just after getting up this morning
http://vocaroo.com/i/s1h4j7ituGFE

(please note: If these don't show up initially as an easily accessed hyperlink, I apologize in advance and will try and make it happen, but computers are not my strongest talent by any means)

Audio wise, to my ear they sounded fairly similar, but when todays recording is analyzed on PRAAT I got a 80 htz increase for the same reference "E" sound as compared to Monday's recording, which consistently was at 180 htz. I am recording simultaniously on PRAAT and Vocaroo to be able to refer to hertz and specific word groupings, overall trend and measuring the plateau one gets when making a constant sound like a vowel/E for a full breath.

The program parameters were not changed at all as PRAAT has been running in the background of my laptop since Monday and I always use a horizontal line the lowest side of the plateau (underside of the juddery tight squiggles in the plateau you get on a sustained sound) and the approximate average between the highs and lows for a reference hertz reading. When doing these estimates I will always err to the loser side rather than to a higher artificial number.

Ones voice and vocal characteristics is a result so much more than just a hertz number but for right now this is what I am measuring for a something to refer to for directly comparable, subjective results to my past post-op recording and also in any future results.

I will send these results for Dr Haben so he has an out of office voice record to compare to what ever comes of my upcoming pre-op and eventual post-op results. During my recovery and when finally able to use my voice again after a strictly enforced 1+ month silent period, I will make my observations and some recordings available for anyone interested.

This opening post is a "living document" type of thing for today as I may need to tweak wording today if things there are questions or comments pointing out silly mistakes or stupid wording blunders I might make. Sometimes the auto fill settings/feature on my macbook can make words COMPLETELY different to my intent by adding or dropping even just 1 letter. My apologies in advance if that happens and I will try to remember to preview my words prior to posting.

In closing, I wish to be very clear, that thread is NOT about me pointing any fingers about the previous surgery and the suture coming out when it did. I am the one responsible for my recovery and while I followed the post-op instructions, it is surgery and we are all told about risks and potential outcomes in ANY surgery we may undertake, win, lose or draw results wise. I have not and will not ever refer to my previous VFS as being "botched", as it wasn't. Stuff happens and it it would be so very nice to not have to do VFS again, the result I had for 5 weeks or so was WELL worth it then and worth it too me to try again. 

Be safe
Elaine 

Sounds like the thread dissolved prematurely. Hence the intact knot.

I think your recording of the e sound may not be good for analysis in PRAAT because you are hitting the maximum capacity of the microphone. Maybe go away to some distance before doing this.

Can you tell me what the purpose of this sound is and what you are doing to get it?

You can record something on PRAAT by the way, analyze it, even cut out some parts and then save out as wav file, and then upload it to vocaroo. Remember however that vocaroo saves the audio only for some days or weeks, if you want a permanent audio here, you need to either use something else like soundcloud or upload the audio file as an attachment to the post.

Good luck with your second surgery.

anjaq:

I appreciate the recording/analyzing tips. Definitely not technically proficient in PRAAT, just using the record and analyze function so far. As discussed elsewhere pitch is not nearly everything in a voice but it is an easily quantifiable quality.

Thank you for the advise about saving the previous sound clips knowing that vocaroo has a shelf life of sorts on recordings before disappearing.

The "e" sound thing seems to be a reference  for Dr Haben uses so I used it as well as a longer recording. It also gives anyone listening a way to see how rapidly my lung capacity is depleted with the asymmetry in my vocal folds just letting a lot air blow uselessly. That is the biggest cause of my hoarseness.

Be safe
Elaine

Ah, I use mostly the pitch analysis of PRAAT too, not sure what to do with the other tools.

But I try to make the recording softer so it does not "hit the roof" as this causes some frequencies to appear from the microphone resonance and such, which will distort the readings.

The hoarseness often comes from incomplete glottal closure - I have that issue too - had it before the surgery and still have it, but after the surgery it became more pronounced because the gap now covers a bigger percentage of the active focal folds, I presume. But its a matter of voice therapy to get this fixed for me. In your case maybe it is caused by scarring at the commissure. If it is confirmed that a part of the suture opened, it may be you have scarring at that section, which definitely would make your voice hoarse.

anjaq

I will have to pay attention to the 'hitting the roof' (like driving an amplifier into clipping/distortion) by backing away from the computer. Also, it occurred to me that the room I use is large and has a high, vaulted ceiling causing its own resonance and acoustic properties to color sounds. Getting a really accurate reading will only be had when in Dr Habens office using his equipment to analyze things and try to emulate his standard methods of determining speaking fundamental frequency.

Thanks again
Elaine

Please note these are my observations and opinions. I AM NOT a Doctor nor have I played on on TV (though I did stay at a Holliday Inn Express once...). None of my comments or opinions are to be considered medical advise.(//)

Well, I made it through surgery yesterday ok and wanted to put some thoughts down as the anesthesia fog for has mostly worn off...

The pre-op consult on Tuesday afternoon was quite similar as the first one back in May 2015. I didn't get my hertz results (forgot to ask, will be sure to get next week) but the final result was a firm recommendation for a CTA this time to get the results I had hoped for. I was emphatically offered to just do another larengioplasty alone and was told it would likely result in approximately 200 HTZ after all was healed. But, Dr Haben's strong articulation regarding his belief that the CTA was in order, so that was that.

I was more nervous for this surgery than ANY in the past. His calm and soothing assurances of "don't worry we will take good care of you" helped but still my use was definitely elevated. My wife agreed with his assessment and that helped too.

Surgery yesterday was around 12:30 or so. We were picked up at 10:30 at the Merriott and swiftly delivered to Unity Hospital. Sign in was notably quicker having been there before and I was immediately whisked back to pre-op. Quickly into the unflattering yellow johnnie, and wifey was back much quicker this time. Lots of questions and of course the obligatory "what procedure are you having done?" being asked at least 6 times. I had an 20 gauge iv cath inserted (hate those) in my right back of hand.

The anesthesiologist was a different one this time and older and much less personable. Not bad, just really detached and not very animated. When it was time to be wheeled back to the OR, I had but time for a quick smooch to my wife and he hit me hard with his velvet hammer of IV med's and I awoke seemingly seconds later in recovery.

I woke without incident to a VERY sore throat (6/10) and a nurse (male) that was indifferent and downright insensitive. As I woke he machine gunned me with questions seemingly expecting me to vocally answer, before I had any chance to write a wobbly answer. He sent my wife on a wild med hunt for my RX's with out giving the right (any) paperwork so she had to do it 2 times.

I took about 2 hours of his horrible clueless attitude (actually wandering in circles seemingly trying to get out of doing anything and was successful in that respect, appearing to all the world as if completely lost, much loopier acting than I was with all med's on board) and eventually had quite enough and wrote him a note saying quote: "You are an insensitive Alpha Hotel" (you probably suss what the actual words I used were.)

I won't use his name or physical description but if you see him you will know the kind.  Ask for another, it is your right and you are paying a not inconsiderable amount for your short stay. I hope his supervisor were to know of his ineptitude displayed yesterday afternoon. I have no problem with someone like this being reprimanded or more.

BTW, ALL the other nurses and hospital staff I dealt with were very nice, helpful and skilled in there approach to patient wellbeing.

Anyway, I had another nurse to finish up my paperwork as both my wife and I were steamed and do not put up with pissy attitudes, condescention and passive aggressive BS. Hope someone there sees this post and passes it along to this. He desperately needs a "tune up" and a reevaluation of being a nurse. I could go on but will stop now as I was REALLY aggravated with him.

Dr. Haben came back by 3 hours later as he had another case to do, so I went in at 11am and left about 7pm. As always he was pleasant and informative, assuring he was very satisfied with the result. 7 more days and the post op consult...

After sign out and being wheeled to the Merriott Van under the portico, we got in and waited for the driver. I mean we waited long enough for me to play several games of Mah-jong before I was getting pissed at the driver fro abandoning the van and making us wait.

We went in the lobby of the hospital and he was very animatedly chatting up a woman. I rapped my nails on the counter to get his attention and pointed at the van. The stated he had been there for an hour waiting on us, yet he was NOT there when I was wheeled out nearly 3 minutes before. Go figure. Got to chalk as a poor timing/stuff happens moment. I still had residual anger from the post-op debacle. No hard feelings.

It was nearly impossible to swallow pills of the tiniest size last night and I had to put some in water to dissolve them as just sipping was also near impossible. First I had to get down was the first round of the Medrol dose pac, then the Prilosec softened in water and the Cephelexin follower by some pain med. I did not talk at all, nor did I cough, remembering to breath in and "huff" out then "reverse swallow" to bring up post surgical phlegm of which there was a massive amount.

Sleep was totally elusive last night until about 4 am when I took a hydrocodone and valium I use for my back and neck as necessary (but not very frequently). Finally I snatched about an hour and a half. Tonight will be a good night's sleep with a full belly.

It is 2:40 pm and we are in another hotel that is very pleasant and at an excellent rate. Please feel free to pm me for the info if you like. It is but a long golf shot from the Airport Merriott. The hotel bonus points are pouring in from a branded credit card and will be piled into my frequent flyer miles will come in handy against a trip to Spain mid spring next year. You do get points don't you? If not start, it is simple and free.

About an hour and a half ago I was relieved that I was able to eat a half a sandwich as my wife did some grocery shopping to hold us over. I asked Dr Haben specifics regarding diet and the caution regarding juices was more from a perspective of sugars rather than premature dissolving of the sutures. Interestingly, Dr Haben said the juices were a problem from the sugar aspect for him and being somewhat junk food in nature but cleared me for ALL berries and fruits. I LOVE a nice bowl of frozen mangos, blueberries, bananas (try them ripe then frozen, WOW delicious), peaches and pineapple. I was a bit surprised as many would be considered citrus but Dr Haben was emphatic about any and all whole fruit. Life is good at least for my diet. There is no prohibition beyond spicy foods and that is to guard against reflux. I will none the less hold off on the Jalapeno's and salsa for a few months in deference to taking care of my newly tuned instrument.

Ah, yes, about my last surgery and the stitches coming out. He said 5 weeks was normal and upon examination the web had formed but just not as much as hoped for. That is why when the stitch pressure was relieved by coming out, I perceived a pitch loss and the silly giggle I liked so much.

Before we left for the hospital yesterday I had a chance to do a quick, off the cuff recording and it is here for any interested:

http://vocaroo.com/i/s1lbcFfDDDyo

I will be on a 1 month voice rest at the MAXIMUM. Dr Haben was very specific on that. The month following is unrestricted, just listen to your body. When we return home, we will be 1/4 of the way done with the quiet period so lots of reading, studying American Sign Language and Spanish grammar and some binge watching shows and movies in the DVR quest will pass the time.

All exercise and cycling will be curtailed for more than a month. He also reiterated that 6 months was needed before elective surgery requiring intubation. This is what I had planned when doing the ground work for the planned upcoming trip to FT next year. Need to allow enough time but sooner is better than later. Life is for living, not waiting.

I will post a selfie of the CTA incision once I sort out how to do that here. Not willing to directly link to my personal accounts so thoughts and ideas are welcome. I figured I was asking for them from others prior to surgery so I feel obligated to provide the same. I will shoot another late next week or in the weekend after the stitch is out and also as healing goes on. BTW, twice Dr Haben mentioned " I defy anyone to find the scar at 6 months. A bold claim I am interested and hoping to see come to fruition. As my body heals incredibly fast, I have some hopes for that.

As others have noted, keep dry till the suture comes out and a month wait till any scar treatments are to be used. Keeping it out of the sun and also using SPF is highly recommended. I will follow all post op recommendations EXACTLY.

Be safe and enjoy the day
Elaine

P.S. Questions and comments are welcome but please try to avoid thread drift.

Quote from: Elaine S on December 10, 2015, 02:43:59 PM
...P.S. Questions and comments are welcome but please try to avoid thread drift.

Glad everything went okay other than the "Alpha Hotel" nurse.  Wishing you much success in your recovery this time around. 

P.S. My stitch also popped out a few days ago, at 7 weeks.  I posted a picture in the thread- just curious if it looked like yours.  There wasn't any pain, and my voice (which is still super swollen and almost unusable) had no noticeable change.

Sorry to hear about the awful nurse you had, what a douche. You should have your wife call to file a complaint. Just make sure you don't put any scar gel on the incision until one month has passed. Wish you a speedy recovery!

Kwala,
That pix looked much like the topknot I had come up at the 5 week and 2 day mark. Dr Haben said that time line for it coming out was fine.me to the fold area just didn't take as well. The webbing was in his words good and he added a bit more tie off, length wise. He was emphatic about a certain point just a tiny bit beyond 45% relative closure will lead to the minie mouse voice. Not my desires. What I had before was nice and I asked about any benefit of aiming a bit high (I am talking a tiny amount now) to help account for any inevitable "sag" in pitch after things settle.

As I sit now, I am at 0 pain though I had some Hydrocodone a bit ago and am getting bleary eyed so I am off to sleep.

Yes that nurse was a real piece of work and I had contemplated on having my wife speak with a supervisor. I hesitate because of others going through after me and the possibility of others being treated poorly due to an any complaint I would make. I have been in well over 50 different ER's working with literally hundreds of Doctors and nurses during massively frantic efforts were underway to stabilize a patient for transport and have never seen anything like this. It wasn't someone "having an off day". I just edited out a short reminiscence that could possibly construed as a reason for his behavior. It is over and I am healing. Being able to swallow is something we take for granted and the frozen fruit bowl cools and soothed the throat and issues much fiber in the diet.

There is starting to be a bigger database for Dr Haben now. I harbor NO animosity for my having to go back and he repeatedly stated that I did not have a part in the stitch having came out. While I really had that $$ earmarked for a rework on my jawline and contouring, it is just a hassle I have to deal with. Nothing good will come from pointing fingers. Just looking forward to day 30!.

FWIW My surgical charley hoarse in my tongue quite nearly gone.

Please feel free to ask questions as I want to help others as I have been helped. I would just prefer questions be respectful towards others feelings and in a manner that helps put out concise data as I have it. Being highly empathetic toward others is my reason of contributing in hopes of others being able to make more informed decisions...

Please excus me as I am dead tired and need sleep badly. Happiness to all!




 

Hi Elaine! I am super happy for you that you were able to get another surgery to fix things up. And I wish you the best in recovery! : )

I did have a question in regards to the previous suture you popped. I had the triple with Haben just over a week ago and am still following his advice for strict voice rest. I have no reason to believe that anything went wrong with my procedure, this is totally just a curiosity thing to satisfy my own paranoia - but how noticeable is it to have the suture come undone? Is there any pain or discomfort when that happens? Any sort of sensation? Or can you only tell from drop in pitch, or part of the string in your mouth?

Thanks! The first couple days of swallowing were really rough with the CTA, but that struggle goes away fast. I have zero issues swallowing at this point. Hang in there.

Andromeda:

As I mentioned a while back, when the stitch came out, it was immediately apparent I lost some of my high end pitch also with my giggle being gone. Pain was immediate but really not really a lot, maybe 2.5 or so out of 10 for a few days.

Dr Haben stressed in my pro-op consult last Tuesday that nothing I did had anything to do with it coming out and not to "beat my self up" for doing anything wrong. Nor do I fault him. We sign papers knowing fully well that stuff happens and to me I ALWAYS plan for the worst knowing things usually never are. The stitches were "due" at somewhere about 5 weeks to dissolve and most simply swallow the suture remains. I just happened to "huff" it up. My larengioplasty just didn't fuse quite as completely as hoped.

My pain now isn't bad but as you note, swallowing is very difficult for the first day post CTA. For me the first priority RX was the steroid as it can be life threatening to not have the swelling to subside. That happened with in about 6 hours. He said if I couldn't or wouldn't swallow pills, I had to spend the night and be on IV meds.

I wanted out of the recovery room ASAP as explained in my post last night.

Slept in the last 2 mornings and will do so again tomorrow as my wife was so kind as to bring me back a very nice, easy to eat breakfast.

So far no talking but I had to ask my wife for yes or no questions only and face to face to avoid the natural tendency to speak even though we know it is verboten for now. 28 days to go...   

My very best wishes to you for a rapid and complete recovery. Hug's and happiness to all this holiday season.

Be safe
Elaine

Nothing really new to report today, 7 days post-op. Have a consult tomorrow morning. Providing things look good, then onward towards home. Things are kind of at a basic functional pattern now in communicating with pen, pad and some signs. My wife is much less prone to exasperation with me as I pre loaded MANY I'm sorrys in advance. That and we have our own interests that keep us occupied. Getting cabin fever for sure without exercise or a demanding physical outlet for pent up energy.

So far, NO coughing, none at all. Opening the throat/vocal folds and exhaling then expelling any nastiness is working well. Staying well away from others in an effort to stay healthy. So far so good.

The accommodations we are currently in are excellent with a very good breakfast offering. If one has a Govvie ID then the rate is a downright deal (or get a AAA or AARP to save). The rooms are all very nicely equipped efficiencies. Recently remodeled, clean and the bedroom is a separate room as opposed to a typical all in one arrangement. Zero icky factor. Much nicer than a place I stayed in BH a couple of times and of course for much less than 1/2 the price.

I have been playing mental gymnastics adapting a similar floorpan layout with the king bedroom and a bigger shower being upsized some . Having 2-4 of these co-located on a multifamily lot would be a excellent rental business for long term renters over transients as mostly seen here. A quadraplex is an intriguing investment idea...

Placed in our home town area, one could EASILY live mortgage free and have a tidy sum left over after the tenants rents much more than pay the freight, mortgage wise. Most of the condo commando's are in stupidly high HOA fee'd places that could be subverted by making it a pay-go situation rather all inclusive (basic cable, internet phone, H2O, etc.) Not everyone needs or wants a prepackaged deal. Especially older folks with fixed incomes.
 
Been eating a very light diet for the last week with fruit at night as a treat and eggs for breakfast and dressing minimally with the heat cut back for a bit of caloric burn from that. Kind of different for me as I typically only eat one meal a day around 4pm and have done so for years. No juices as per Dr Haben's recommendations, though my usual diet includes, Orange, Prune and Cranberry juice plus V8 from time to time and a LOT of frozen fruits as my late afternoon snacks. It will be a nice gift to be able to roll out some easy miles on the Kinetic trainer when permitted. I know this is more than a month off now. Just something to look forward to. When I return home i will be doing a full on refurbish of my bike and perhaps getting a second one as well.

An interesting note I mentioned before about Dr Haben saying a MAXIMUM of 1 month of silence, then speak as possible while "listening to your body" regarding over use. 

Pain level is really mostly non existent with occasional discomfort rather than pain both in my larynx and at the CTA incision site.

He reiterated a safe 6 month minimum interval for any elective surgery requiring intubation. Anything involving local anesthetic or field blocks are unrestricted after a couple weeks. Works for me with plans underway for late spring 2016...

Best wishes to all in the holiday season where ever you may be.

Elaine

The $50 question everybody has is what caused the other surgery not to take or did it partially work? It's a little hard to understand why the cords didn't fuse properly before.

I am glad that your recovery is uneventful. The steroids were something else for me. I spent the night in the hospital and they left the IV in my hand. Every few hours they would shot a fresh batch of steroids in me it it would hurt when they did it. I was really glad when they pulled the IV out and I could start using the tapering off kit.

Dena:

Hi. I made a reply to your message before we left but somehow it didn't post. Likely operator error. Sorry.

The $50 answer, I think, is: stuff happens... When one signs up for ANY surgery we know there are possibilities of positive, negative or in some cases, something in between results. Consider the FFS forum where revisions are not even close to rare.

The post op followup on the 17th was pretty unremarkable. Dr Haben, was able to find a tiny spot with his scope that triggered my gag reflex. Usually not susceptible to that, I was at the edge of dry heaving as I skipped breakfast.

I took pix of his scope screen and have the before and after pix from the OR. In a few days after this road weariness leaves, I will find another pix hosting site for a shot of the CTA post op and now that it de stitched.

My throat feels reasonably good today though there is a bit of discomfort as opposed to pain when swallowing. Swallowing was extremely difficult at first. I have not coughed at all. No speaking at all and that is almost easy to do now. This is day 10 of 30 and the days seem to be really passing fast.

Please note: I mentioned to Dr Haben about exhaling phlegm and not coughing. He said that was not the thing to do. He preferred a very gentle throat clearing, mmmm, mm type of thing, to the "HHH" exhalation. Seems counter intuitive and also counter to what I was told before. Not positive on that. I kept all my previous paperwork and notes and will have to look that up when I am not so bleary eyed. Can't seem to win sometimes. Anyway, the pix of the stitch look pretty substantial and heres hoping it does the trick.

We both mentioned the problem child male nurse (my wife brought it up at the consult in a most animated way) and I specifically mentioned (on paper of course) how literally lost he looked and his inept, inappropriate methodology at administering IV pain meds also with his insensitive treatment. I had to write quickly and scribbled quickly trying to articulate my thoughts. From what he said, that nurse will not likely be in the recovery area again...

The trip home was long and we power drove it again. I am used to massively long drives and a thousand miles is not that big of a deal. 1500+ miles, however is a different thing all together. Funny, I was sleeping during the passing of one certain road turn as during the first trip and the sudden braking woke me to see the same turn that startled me during the first trip. Deja vu. The time, I instantly registered the memory and was back to sleep for my "shift" in the right seat. We both love driving and listening to audiobooks passes is something we both very much enjoy. It does feel good to be home though.

Be safe
Elaine

Glad you had a safe trip home, Elaine.  Very impressed with your diligence in following the aftercare instructions.   

Elaine! The attention to detail in your notes is astounding. Your methodology is almost clinical. Very good and insightful stuff here, thank you :)

Sorry to hear about the nurse, and I'm glad that it sounds like they're moving him out of there. He may have been the same nurse that I had when i woke up. I feel like my experience was quite similar, but I was so groggy and confused myself I hardly remember the trouble. My friend found his way around just fine while getting the meds... and I think in between I probably knocked out again before I could experience any more unpleasantness.

This time around, I'm sure everything will stick! Cheers and I wish you a speedy recovery!

Audree

Now, at day 13 of enforced silence, it can seem surprisingly easy to be quiet for much of the time. Though I had to remind my wife this morning to not ask me questions, especially in the dark, out of fear of replying. Previously, when I could still talk, a stockpile of pre apologies were laid in as against eventual dumb moves on my part or frustrations I cause.

Yesterday, I had the great idea of Skyping with dear friends and grandly figured I could tap out replies after the initial preface from my wife to him about my inability to speak for a while. He was aware that at some point I would be incommunicado, but didn't realize the time started recently. How hard could it be? What could possibly go wrong?

Well, with the best of intentions... He was not available after 2 tries and then I completely spaced out about making the call until Skype trilled its tone during the early evening hours, shocking me a bit into action from other online housekeeping.

Frantically running to the other room and gesticulating wildly for my wife to come and deliver her "canned" preface to him when we answered.

The call was nice after struggling to find the text pull down tab on the lower right hand side of the screen (not a Skype pro by the longest of shots) and being a barely mediocre typist, it was difficult keeping up. Kind of like a movie reel with the sound track slightly out of synch. Retrospectively, in the theatre of my mind it looked so completely and utterly comical... Who's on first? type comical moments at times... It makes me smile now just thinking about it. Surely we will laugh about that call in the future.

For others with significant others/spouses, etc... have you noticed how utterly unfair ANY conflict can be when the ability to speak is gone? The can seem to be escalated by not having the ability to instantly reply to whatever. Fancifully akin to showing up to a sword fight armed with a but pencil.

Being half way in the doghouse as I write due to, as I saw it complete kindly thoughtfulness, led to a bit of a row over something as simple as trying to be quiet and start the day in another room doing online chores and planning to catch up on a show whilst listening through earphones. It just takes SOOOO long to first form a thought, then write or type it, wait for (mis) interpretation and then response. Just frikkin AARGH!

I MUST try to become adept at ASL if for no other reason than to remind me that how different and difficult life is when something which most take completely for granted, like speech. One's world view is so different when one is unable to effectively communicate. Be it voluntary as with situations like undergoing voice surgery or for those unable to speak it gives one a wholly different perspective on life and is a thoroughly humbling and consciousness raising experience.   

Be safe and Happy Solstice...

Elaine

"Face piles of trials with smiles. It riles them to believe that you perceive the web they weave" Moody Blues

Quote from: Elaine S on December 22, 2015, 08:33:16 AM

I MUST try to become adept at ASL if for no other reason than to remind me that how different and difficult life is when something which most take completely for granted, like speech. One's world view is so different when one is unable to effectively communicate. Be it voluntary as with situations like undergoing voice surgery or for those unable to speak it gives one a wholly different perspective on life and is a thoroughly humbling and consciousness raising experience.   

It definitely is. I dont want to repeat it, but it was a very interesting experience that I dont want to miss ;) - glad it was time limited though... it is quite easy for people to ignore you and just move on to the next topic while you are still typing a reply to the previous one

anjaq:

That is something that is likely overlooked by almost everyone that can speak. It was really a problem this time in the recovery room and ,surprisingly to me anyway, even at Dr Habens office. I was feeling rushed to express all I needed to at my post of appointment this time. The follow up appointment had an air of accelerated time. He has schedules but I think he is a lot more busy. At least around the time of my last visit.

There are personal limitations that require I keep copious quantities of notes or thoughts are gone, often forever. Perhaps having to do this a second time has sensitized me more to your point.

Be safe and my best wishes for a happy holiday season to you.

Be safe
Elaine

And now for my next trick...

Finally, @ the confluence of time, energy and just getting off my sofa, here are pix of VFS 1 & VFS 2. It took a while to get my computer to give up and let me win so I could post the pre & post-op pix from both of the ER pix rounds 1 and 2. Comments to follow on this as I have not really looked and compared the before and after and after before and after (eye roll) pix before. I saw some things worth noting.

Note: Perhaps of interest to some, the errant stitch came out at 6 weeks and 2 days not 5 weeks +2 as I have previously been posting. While checking through stuff today, I found the message I sent to Dr Haben early in the morning when it came out. Just saying I was wrong about the time frame. Maybe Santa will bring me a new abacus if I'm good. Sorry about that.

As follows:

Pix 1 - The stitch that popped out at 6 weeks and 2 days from VFS #1. 10.Jul.2015


(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1382.photobucket.com%2Falbums%2Fah249%2Felainespix%2FIMG_1590_zpsezpwjfr3.jpg&hash=5c17d5f4705285c267865c445dda83c814fb77fc) (http://s1382.photobucket.com/user/elainespix/media/IMG_1590_zpsezpwjfr3.jpg.html)


Pix 2 - VFS # 1 (top 4 pix 27.May.2015) & #2 (bottom 2 pix 09.Dec.2015) OR pix showing before and afters. Surgeries 1 & 2 were 7 months apart to the day. Photo bucket kicked back the pix but I re did it with a title denoting throat surgery...


(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1382.photobucket.com%2Falbums%2Fah249%2Felainespix%2FVS_zpsib0axpmp.jpeg&hash=12a0eac0d3b9e86b021357b9eddab09fe319063d) (http://s1382.photobucket.com/user/elainespix/media/VS_zpsib0axpmp.jpeg.html)


Pix 3 - Nothing much to see but a purple x marks the spot (Q-tips and Dove white soap VERY CAREFULLY applied got the purple off) and a bandaged CTA on my swollen larynx.  09.Dec.2015


(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1382.photobucket.com%2Falbums%2Fah249%2Felainespix%2FIMG_2021_zps8vv8rmyz.jpg&hash=15fb6e19a7af5baf65d71f8529556eddc9a042d2) (http://s1382.photobucket.com/user/elainespix/media/IMG_2021_zps8vv8rmyz.jpg.html)


Pix 4 - Kind of a grotty looking screen grab from my iPhone of the post-op follow up in Dr. Habens office (he encouraged it if we wanted one). He was using the scope as he had ahold of my tongue and telling me to "imagine saying E but don't make the sound". This was a few seconds before my gag reflex kicked in pretty badly. It was a good day to skip breakfast. The tissues in my throat look angry and pissed off. Pain was minimal, maybe 1.5 - 2 out of 10 though at the time. 17.Dec.2015


(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1382.photobucket.com%2Falbums%2Fah249%2Felainespix%2FIMG_2057_zpsuv9ugeeg.jpg&hash=b08b89d97de2e540dae427a298ca079fcfed332d) (http://s1382.photobucket.com/user/elainespix/media/IMG_2057_zpsuv9ugeeg.jpg.html)


Pix 5 - Selfie on the sofa the after the 1500+ mile trip home. 19.Dec.2015


(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1382.photobucket.com%2Falbums%2Fah249%2Felainespix%2FIMG_2074_zpsk9jtnnrj.jpg&hash=1530835b841bc88ad743022cb38c872aada019f8) (http://s1382.photobucket.com/user/elainespix/media/IMG_2074_zpsk9jtnnrj.jpg.html)


Pix 6 - Close up of CTA scar today. Not bad, but not as smooth as I had hoped for to be honest as it a bit of a puckery look to it if I tilt my head back some. Pain is pretty much nonexistent at most times. Swallowing is also mostly pain free but pills require careful effort and a good deal of water. 22.Dec.2015


(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1382.photobucket.com%2Falbums%2Fah249%2Felainespix%2FIMG_2085_zpsnzbusaiu.jpg&hash=bc8701a04139420d71a2cff92cd6a409d7a73aa9) (http://s1382.photobucket.com/user/elainespix/media/IMG_2085_zpsnzbusaiu.jpg.html)


In the comfort of my home, literally using a magnifying glass and my bi-focals to compare surgeries 1 and 2 before shots. My vocal folds look to me to be thicker in the pre-op pix for round 2 perhaps due to residual swelling. How ever, look at the area where there should be closure. I see NONE at all. Zero. Zip. Nada. How there was any residual increase in pitch is beyond me. I would expect thicker (or swollen if they were) folds to vibrate at a slower rate = less pitch...

Regarding post-op shots of surgery 1 & 2 it actually appears that the first time around he tied more of the vocal fold off though in the second the suture appears to be possibly heavier or different. This could be related to angle, focal distance or different equipment but that is how it appears to me.

I do not know if he varies the amount tied off depending on whether a CTA is employed or not. Having the CTA was done as an added bit of help to assure a successful outcome. I would have definitely preferred to not have it, but when having to decide after 1 failed attempt, it was decided to try and do whatever could be done to try and ensure success this time.

Nothing will be known with any kind of certainty for months to come. Seventeen days to go till I will try and speak at all. I was told SPECIFICALLY to not and wait longer than 1 month (4 weeks actually). Also, I believe I mentioned that Dr Haben said to NOT minimize use of my voice after that but to, as we have all likely heard before, "listen to your body" and not overdo things.

Makes me think of the old saw of: "Dr, my thumb hurts 'cuz I hit it with a hammer". The Doctor, sagely furrowed brow replies "Don't hit your hand with a hammer, pay the cashier please on the way out".

I question that a bit, but it might be moot depending how things heal and whether I can make intelligible sounds at the 30 day mark. Just because the first time around I could speak remarkably well at the 9 day mark (1 more day than recommended), does not imply that the same will happen this time. Hope that is the case, but just have to wait till it is time. I figure January 9th or 10th.

For me, not being able to speak for a month or so is secondary to not being able to exercise. Now that is tough to take!

Sorry it took so long to post the first set of pix. I will make a couple more of the CTA scar in the months to come as it matures and post recordings when appropriate and possible.

Thanks to all before that have taken the time to post regarding their VFS experiences. No one wants to have to go through any invasive proceedures but the fact that they are available now provides the possibility of an increase in the quality of one's life. Two years ago I was completely unaware there was any help of this sort...

My warmest wishes to all where ever you may be this holiday season and may health & happiness be your constant companions in the coming New Year.

Be safe

Elaine

Typing speed can be fixed. I make 13 post a day as well as PMs and I am finding my typing speed is improving. Another issue is my keyboard is about a year old and I am wearing the letters off it. Most noticeable is the "E" key is getting really faded. A month without voice may improve your typing speed. I know Susan sure improved mine  ;D

It looks like when the surgery came undone it it didn't fail all the way. It looks like maybe you still had about a 10% tie in place. You seem to heal pretty well because there isn't any signs of the surgery on the cords where they opened up.

Take care of yourself and keep us posted.

Thanks for the comprehensive update, Elaine.  It's interesting that in the second set of photos (surgery #2) there is almost no web present before surgery. I'm no expert, so this is total speculation, but I'm thinking that the web never formed or it was so small that your cords were still able to come together even at 9 days.  With the stitches still in place, the bottom third of your vocal cords were artificially pinched together, resulting in a higher pitched voice.  However, when the stitches were undone there was nothing to hold things in place and the bottom third was active again. 

My stitches also came out (at 7 weeks) but in my recent scope there is a visible web, albeit covered in granulation tissue.  Hopefully the tissue will disappear in the coming weeks and the web will remain strong and permanent.  All I can do is hope for the best.

Sending all the good healing vibes I can your way! Thanks as always for the detailed updates.

Hey Elaine!

Just a comment regarding the gauge of the suture: in my Pre-Op consult I did ask Dr. Haben if he could use a thicker gauge with me since I read so many nightmare stories about it coming out early. He did say that a thicker suture would cause the voice to be altered in a negative way and said that the suture he uses is the best for the procedure--this leads me to believe that he only uses one suture, though I could be wrong. Might just be easier to ask him.

Hope the healing continues :)

<3
Audree

Dena:

I have increased my speed but sometimes going fast is really slow. Certain spell checkers predictive programming make a hash of things, sometimes a single replaced letter can change the whole complexion of a sentence of make something seem as a slight to someone. I HAVE to proofread everything carefully and still the occasional slip-ups occur. I stroke out over stuff like that...

kwala:

Finger tapping my nose vigorously in agreement. So it isn't just me that saw that anomaly... There was only a bit of pain and no blood or the like.  Still don't get though how there was still 20 - 25 hertz improvement in virtually all recordings made after the event. How would swollen vocal folds help as they are thicker therefore one could logically deduce they would vibrate at a lower frequency.

I don't know how Dr Haben could say there was a big improvement, I forget the number, have to see if I can find that message. His measurement methodology is somewhat enigmatic in that comparing to what I have to use for pitch measurement (PRAAT, tone generators, guitar tone tuners, etc...) don't necessarily directly translate. Not trying to paint him into a corner, BUT it was instantly obvious that my voice lost pitch (my wife noticed it right away) and he still was sending what I thought was overly encouraging words. 

To put a different way as I am not a physician, if a person using one of my machines called and said "listen, it is making very markedly different sounds" I would not say, "yeah, it is getting better, sounds great, check back in 6 weeks."

It could certainly have saved me around 5 months of my life waiting and eventually having surgery #2 which was so obviously needed. I would be skiing this year rather than having to push things to next season. It probably sounds to some like slagging somebody but I am offering my subjective opinion based on objective evidence.

Nothing to do about it now but take care of round 2.

Audree:

That is an interesting comment as I was specifically told the opposite when I re-booked with him for round 2 and asked about how to help ensure a permanent, successful outcome.

Have to see if that was in a message or it was verbal as I don't recall that detail. (Note/update: I do have a email specifically referencing using "a slightly heavier gauge suture" sent by Dr. Haben)

Thank you all very much of you for your thoughts and observations, I really do appreciate them. Please do feel free to ask me anything and ideas and comments are welcome.
 
I hope the holiday season is a happy time for all.

Be safe

Elaine

I have the impression that he relies more on the CTA part of the surgery now than on the glottoplasty, since that is maybe a 20% suture at best... thats a bit odd, but I guess he has to balance it out, otherwise you end up with a voice that is too high when combining both methods.
You are right, there is NO visible leftover of the first surgery, fascinating...

I believe all these issues with the thread - it coming out too early, not being tight enough, the need for it to be very thin to not affect the voice negatively - all of this is probably why Dr Kim uses permant threads...

First day with the new voice... Again...

http://vocaroo.com/i/s0WdHpWmRCMn

Here's a clip from today in the first half hour of speaking again. A bit surprised is anywhere close to usable, though not powerful. Enough to be heard in the same or an adjacent room without difficulty. Now the don't talk notices can come down. Yea!!!

Quite obviously, I need to explore things. This time around I had been silent for the past 31 days. Dr. Haben was specific about NOT going beyond a month. For most days to that time I have been taking Ibuprophen. They were quite difficult to swallow at first as they are the industrial size. Got pill swallowing 101 down now for the most part. 

Note: I would emphatically recommend against using gel type ibuprofen caps. If they dissolve quickly and if they get stuck, they start do release their contents in your throat, which can burn.

So far, it has been more difficult not exercising than not talking.

One gets to notice things when going longer periods of time as opposed to a 8-9 day period. It teaches how utterly unprepared you are to deal with life. It demonstrates how unprepared others are to dealing with muteness. There is a definite marginalization that happens when trying to conduct day to day chores. Another thing is when people realize you are functionally mute, is a lot of sorry and apologies and... PITY. I really don't care for that part at all. Others seem to want to try and be done with you as fast as they can. Between gesticulating and writing, there is a genuine sense that people want to get past you and on to someone else. Didn't get the sense of that last time around as it was a quick 9 days spent mostly at home. I seriously considered the possibility of what would happen if I got pulled over for a traffic stop. Having to reach for a pad and pen could be misinterpreted.

Anyway, thats all for now. Time to go play with the shiny new voice a bit more. While it will be interesting to see over time how things progress it is something I'd rather be done with now. Things could definitely be worse, I do realize...

Be safe
Elaine

Sounds very good for only 1 month!!

I think it sounds good because the timbre changed. The pitch is better, too. There is roughness and vocal fry of course, but behind that one can hear a well hiegher pitched voice that has that female ring to it. especially in the second half of the recording. Congrats and good healing.

Today is 1 week since I started speaking again after VFS. I made a clip if anyone is interested...

http://vocaroo.com/i/s1RaqOPUFkjy

Last Sunday I had resumed an online Italian language program. It is a really basic from the start sort of course. Anyway, Sunday through Tuesday I was doing about 30 - 45 minutes a day, speaking gently and using earbuds to hear the fine details in the speakers voice.

Wednesday, 13.Jan.2016, my voice was getting tired so I stopped around 25-30 minutes in. Shortly afterward I felt a soreness that wasn't there when I was speaking. I very gently cleared my throat and had a small, about 1/3 the size of my pinkie nail small, bit of phlegm come up that was tinged pink.

Of course I was freaking out but that was the only phlegm that came up. I was producing copious quantities of saliva (gross, I know, just want to try and be accurate) that was clear save for a micro fine, vellus hair thin, line of red in a few of the saliva samples I looked at. The red line things were definitely not stitch material. The salivary out put diminished about as quick as it came on.

I weighed sending Dr. Haben a message and eventually dithered enough that the day was gone and would decide Thursday. When I got up Thursday, my throat was much more sore, about a 4 of 10, than the day before and I composed a message to Dr. Haben, still haven't heard back (:-<). Here is a copy of the message FWIW:

snip>
"Addressed to:Dr. Michael Haben Dear Dr Haben: Hello again. I started speaking on Saturday as that was the 31 day mark and was surprised to have any sort of usable voice, albeit, weak and a bit unstable. I am still off of ANY exercise of any sort. Of course I am still on the omeprezole and am being careful with my acreage very careful diet. I have not spoke at all prior to Saturday, day 31. Surprisingly to me, I have totally avoided any coughing by drinking a lot of water especially if there is a tickle in my throat and with meals. During the day I have restarted my online Italian language course since Sunday through Wednesday 13.Jan.2016, speaking gently into the computer direct in front of me. Yesterday, I felt my voice getting tired and stopped. A bit of soreness developed in a short time, about a 2 or so on a scale of 1-10. I had a small bit (about 1/2 the size of my little fingernail) of mucus come up when I very, very gently cleared my throat and it was tinged pinkish. It was not lumpy at all. I did produce more mucus for a while though it was completely clear but for a single micro fine (vellus hair type thin) hairlike line of red in a few of them. It was not suture as it was truly micro thin. The mucus itself was clear though. I immediately went into voice conservation mode. This morning I have not spoke save for making a short rainbow passage recording I can send if you like. During the recording, my voice sounded pretty much the same as yesterday, though a little weaker. I wasn't pushing my voice at all however. Shortly after waking this morning, I noted my throat was sore to about a 4 out of 10. It feels like the soreness is more to the left side rather than it being more to right side yesterday. Prior to yesterday I have had NO pain at all for the last 2 weeks. Do you think I should do a round of antibiotics? Voice rest for a few days? Do you think the 1 pink tinged mucus from yesterday was from the suture dissolving (5 weeks exactly tot eh hour, 3pm)? Or what else could I be doing to help during my recovery process? The recording I made today sounded pretty much like my voice the last few days but there is the sudden soreness that has me scared. This time HAS to work out and I want to take no chances. I am not a baby about the soreness and can deal with that. I give the pain level as a point of reference not me being a whiney baby. It is the THOUGHT of what could be going on and how to ensure things don't break down like last time. I know you get many panic messages from other girls that have had VFS and do perfectly understand that it is very early on in the recovery and plan on taking it easy for the coming month. I understand patience, I live patience, I AM patience incarnate(:->) having got through this for the second time 7 months after the first. Please advise at your earliest convenience. Thank you in advance for your thoughts and help. Be safe" <snip


But I did stop talking until this morning and will minimize usage for a few days to come. Not fully stop, just cut back on usage till I hear back. The soreness is mostly gone and I compared this recording with others I made on a daily basis during the Italian course. To me it sounds pretty much the same and on PRATT the numbers confirm what I hear.

My guess is that the stitch has dissolved (EXACTLY 5 weeks to the hour!) and that was the cause of the soreness and red tinged sputum. Of note on Wednesday, was the fact the soreness was to the right side of midline and on Thursday morning it was definitely to the left of midline. Now it is not very sore, 1-10 maybe, especially compared to Thursday morning.

I know things could be MUCH worse and still am a bit surprised my voice was usable though not very strong. Even if I get an all clear from Dr Haben, I am still going to reign in things a bit for a little while.

Random thought while composing message to Dr Haben... I have seen a few of the replies that others have C&P'ed to a post and they are, to me anyway, almost form letter the same. Does he write them, I wondered???

Going to make a few more posts here over the coming weeks and will give a review opinion around 3 months possibly longer. I feel semi obligated to do so as much of my research to VFS was from here or linked to post from here. Same for FFS, but that is a completely different story...

Be safe and heres hoping you all have a pleasant weekend.

Elaine

Your voice clip sounds very good and clear compared to my voice that that stage. I'm 1 week away from 4 months, and my voice still gets tired/strained pretty easily. I do notice some rare moments without hoarseness which gets me very excited, but the majority of the time the voice still sounds hoarse and a bit strained. I am hopeful that I will fully heal, it's just a matter of time I think, and I've already mentally prepared myself that it could take longer than 6 months for me. Because you said your voice is sore, I think you should try to rest your voice as much as possible these days until the soreness is gone.

A language course at 5 weeks? I think you are still early for heavy voice usage and it will take time for the strength to return to you vocal cords. If you overuse your voice at this stage, I would expect this to happen. I would use the voice but take it easy on it for now.

The voice sample sounds very good with both pitch and inflection. You even have the little noises of expression taking advantage of the higher pitch which yells female.

Hello again to all who may be looking and listening.

I made another recording today as it is now 2 months plus a couple days post VFS with Dr Haben. I will let the recording be pretty much all of my post. It is longish at around 9 minutes. If you are interested, try a set of earbuds and closing your eyes to focus on the voice. I try to do that with all the clips I see here and it does help.

Also, if you or some you know is considering VFS in general and a CTA in particular, especially with Dr Haben, take the time and listen and add it as a data point in your research. It is nothing special and I guess that is my point.

Just a thought...

http://vocaroo.com/i/s0EpZYrsniRN

Be safe and enjoy the upcoming weekend.

Elaine

Quote from: Elaine S on February 11, 2016, 04:52:15 PM
Hello again to all who may be looking and listening.

I made another recording today as it is now 2 months plus a couple days post VFS with Dr Haben. I will let the recording be pretty much all of my post. It is longish at around 9 minutes. If you are interested, try a set of earbuds and closing your eyes to focus on the voice. I try to do that with all the clips I see here and it does help.

Also, if you or some you know is considering VFS in general and a CTA in particular, especially with Dr Haben, take the time and listen and add it as a data point in your research. It is nothing special and I guess that is my point.

Just a thought...

http://vocaroo.com/i/s0EpZYrsniRN

Be safe and enjoy the upcoming weekend.

Elaine

Elaine, I just listened to your message and here are a few thoughts.   Throughout your two surgeries you have provided some really wonderful, useful information for those in the community who are considering surgery and that is to be commended a thousand times over!

I especially appreciated your demonstration of the "cut off point" where your range bottoms out.  I don't know that anyone has demonstrated that so clearly before.

I think your voice sounds great.  It's hard to be completely unbiased after hearing it so many times, but I believe that if I didn't know you and I heard you on the phone, I would assume I was speaking with a woman.  An intelligent, thoughtful, and sweet woman at that!  I do disagree with your wife on one point in that I would not use the adjective "harsh" to describe the tonal color of your voice at all.  I think I would choose "mellow."

That being said, I do agree with you that your voice does not sound very different at all from the results of the first surgery.  While that must be a little disappointing, the good news is that you have a wonderful voice and, after getting to know you a little bit, I think it suits your warm and caring personality.   :)

Elaine, yours is unmistakably female. I don't think you have any problem with your voice, other than your own criticisms. I imagine that at six months when it's expected to fully recover will you see even higher magnitudes of improvement!! Just something to look forward to (:

Audree

Yes, Elaine, your sound very feminine. People also told me my voice sounded strained at the two months  mark. My voice has since improved, but the hoarseness is not completely gone yet. Hopefully you can have a quicker recovery than me!

So after listening to the voices of a number of folks here, I can somewhat conclude that age might have a factor in how our voices turn out in the end. I know that might be obvious, but the older we are, the longer we will heal so it'll take quite a while longer for some of us to achieve the end result. Also, the older we are, perhaps the less likely our voices will change all that much. Going into this surgery the first time I was prepared for this. Dr. Haben said that he could raise my voice 7 semitones and, using my pitch-formant software, I was able to hear an approximation of what my voice might sound like. I thought to myself, "Wow, that'd be great if I sounded like that." But then I thought realistically and said to myself, "Well, I'm 45 (at the time I was back in 2013), so if I end up with 4 or 5 semitones higher, let's see what that sounds like" and the result was still pretty good. Going into any surgery, I think in this way: what is the best scenario? What is the worst? What is the middle? Am I prepared for the worst if it happens? Unfortunately, I wasn't prepared for the worst when I did my VFS the first time. The worst was no real change at all. With every other surgery, there were good, even great results, so VFS was frustrating for me. Anyways, I'd be glad if I got decent results of 4 or 5 semitones. I just have to be patient with my downtime. I'm thankful for reading all of your stories and experiences. I didn't have a forum like this to learn from at the time of my VFS.

Geekgirl, it's funny how everyone has different expectations going in.  I will say that like you, I tried to simulate what my results would be in terms of best, average, and worst (no change).  What I didn't account for, and wasnt warned about, was an extremely exaggerated healing time.  It's been so long since I've been able to go out in public without fear that I won't be heard or understood that pitch has been the least of my worries these days.  Recent progress suggests that my pitch has gone up quite a bit, but after 4+ months of anxiety, having no social life, awkward conversations, etc it feels like much of the joy I should be experiencing has been taken away.  I'm just ready to have a working voice in any shape or form and leave this period behind.

I'm glad that there is so much information here and I hope that continues as more and more surgeons start helping the trans community with these types of procedures.  Keep us posted if you decide to have a second surgery.

I was 63 years old when I had my surgery and Dr Haben has put me on his web page as a 64 year old example. Different vocal cord lengths limited my tie but I am seeing a 70-80 Hz improvement over my pre surgical voice. Note that my before and after voice is a trained voce because the surgery alone isn't enough to push my original voice into the feminine range. It would take about 130 Hz if I were to use surgery alone. This isn't a big deal for me because I have used a trained voice for so long that it's hard for me not to use it. Dr Haben is pretty good at hitting target voices now except he undershot mine and it's  a bit higher than his initial estimate.