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Dr. Haben and Dena's broken voice

Started by Dena, July 18, 2015, 01:38:35 PM

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Dena

This is the tale of my trip to Dr Haben for voice surgery. I am still in my first week of not speaking after surgery and I already know my voice will not turn out to be one of the shining examples already posted on this site. I will go into the details latter but the rules for this thread include no criticism of Dr Haben because he has done everything possible for me. Criticism of my voice should be very carefully made because while my voice will end up in the female range, it will never become one of the beautiful one that have been posted here. If the criticism is out of line and the mods don't catch it, I will personally flag it for their attention.

I picked July 15th as my surgical date because I thought I would have guest early in September and I knew I would need a voice when they visited. I figured that should give me time to have a workable but not great voice. Waiting until after their visit just pushed the window out to far. I was very surprised that July 15th was open because I had seen on the web site to expect a month and a half wait for an appointment. As it was I put my money down on 6/23 for an appointment three weeks off. After I committed, my guest changed their plans to visit me the 4 days BEFORE I was to leave for New York. Getting everything ready for the visit was exhausting but I made the window and enjoyed my visit. Sunday night the 12th after delivering them to the airport, I finished packing my bag and got some sleep.

Monday the 13th I was up at 3am in order to be ready for the Super Shuttle ride to the airport. I made the flight with plenty of time to spare and the first leg was from Phoenix to Chicago. I enjoyed a pleasant conversation with a gentleman about 12 years older than me (I get motion sick if I read while in motion) and everything went fine until we approached the Chicago airport. The pilot cut way back on the engines was we were just kind of hanging out in the air. We touched down about 15 minutes late and the pilot did a hard stop and once he killed the speed, he stopped on the runway. After a few minutes he explained that they shut down the airport due to bad weather and everything was stopped up. Our gate was available but there were so many planes on the runway that he couldn't get to it. My next connection flight was a about an hour off and this was starting to worry me a bit. Over the next hour, the pilot shut down the engines and restarted them three times with much of the time the plane was powered off the APU. The problem with the APU is while it will keep all systems powered, it's not powerful enough to keep the Air-conditioning running at full blast so we had to close all the window shields to help control the temperature. Finally we were able to get off the plane so I located a flight board and discovered where my connecting flight was. I headed in the correct direction but my bladder was sending me a message I couldn't ignore. I saw a restroom and then the line of people waiting to use it. I stepped into line and looked to the other side of the walk way and saw my gate so one worry out of the way. In about 7 minutes I was back in business and found it would be about half an hour before my plane boarded. The flight to New York was short but bumpy because we flew over the storm that shut down the airport. After landing I took a cab to the hotel, checking in and then entering my room. My first thought was this place is a meat locker. I quickly found the temperature set to 68 degrees where as most people in the phoenix area keep a much warmer house temperature. For the comfort of the hotel staff, I only bumped it up to 78 degree but it still took most of the night for the room to warm up enough for me to be comfortable without blankets. Dinner was in the hotel and consisted of fresh salmon and apple pie. I hadn't had anything to eat for 24 hours and I figured I would need fuel. The people were very nice and the room comfortable but my pre surgical nerves were already kicking in so I didn't get much sleep.

Next morning I had a late breakfast knowing I wouldn't eat lunch. I killed time in the room waiting until I could make my 1pm call to find my surgical time. When I got through I found I needed to be at the hospital by 6am. The less time with my nerves the better. About 15 minutes before 2 I went to the lobby to wait for the cab I had reserved the night before. The cab driver was already waiting for me so we took off. He was a really great guy and has been driving for over 50 years and yes, he knew ALL about Dr Haben's work for us and others. On the trip to Dr Haben we discussed me and he was completely comfortable with trans. He didn't have another call so he said he would wait for me. As I didn't have anything else planed for the afternoon, I gave him permission to pick up another call if he had one and I would wait for his return.

Once in the office there was the paper work but it was small compared to what other doctor offices give give you. Upon meeting the doctor I found he is a very likable person and loves his work. Any questions I had were given a complete answer. The first possible problem was my mouth. My lower teeth are crowded in and not lined up. It should have been taken care of when I was young but I am to old now for teeth to be moved around in my mouth so I live with it. Finding my voice proved my voice was every bit as low as I stated and my have been even a bit lower. The real problem came when he looked at my vocal cords. One vocal cord is longer than the other. He called it Superior Laryngeal Nerve Paresis. He thought I developed it latter in life and it results in a hoarse or raspy voice. There is noting that can be done to correct it and because the affected vocal cord is the pitch limiting one, the degree he could help me might be limited.

I also explained to the doctors about my surgical jitters without explaining the source and told him in detail how my nerves were made far worst by studying my brothers death through malpractice.

Now I understand he is the doctor and knows far more about this than I do, but I have another theory. I have one brown eye and one blue eye. The blue is from my fathers side of the family and on the left side where as the brown eye is on the right side and from my mothers side of the family. Before puberty my father side I had a great voice and should consider singing. I suspect this was because my father had shallow Mob contact in Wisconsin and they wanted to to use him for an act in their night clubs. His voice was male but soft, much like Perry Como. After puberty my voice was destroyed and my father never made the suggestion again. My mothers father had a very deep voice and was among one of the lowest male voice I have ever heard. Because the longer cord is on the right, the same side as my mothers side of the family, I suspect this is something as the result of puberty and has always been with me. That combined with the fact there have been no other changes in my voice after puberty.

I was pretty disappointed at this point because I understood my voice will not be beautiful and may take much more work to get a usable speaking voice going. At this point I was only promised a 60hz push because the pitch would be determined off the longer cord but it was the best and only deal in town so I was a go for surgery.

My cab driver was waiting and the conversation centered around his family, and his interest in the arts and theater with my appointment results running around in the back of my mind. By dinner time my nerves were really kicking up so I decide what the blank, you only live once so for my last meal I would order the most expensive thing on the menu, the Filet mignon and apple pie again for dessert. To be honest, I think I should have had the salmon again. In any case, I made it back to my bedroom and figured I needed to get up at 4:30 to get cleaned up and ready in time. I was really tired after several days of little sleep so fully dressed I pulled the covers over me to warm up a little and drifted off for about half an hour only to be waken my by phone. It was my neighbor and she for the first time hear a noise from my irrigation system. I knew what she heard and it was normal. After getting her off the phone I took off my clothes and slid into bed laying there away until 2:30 when I finally fell asleep. I woke up before the alarm at 4:20 and started to get ready for surgery.

My guts were churning all the time I was getting ready but nothing came out so I went out for my ride. The ride to the hospital was short and I was about 3rd in line for processing. After a few question and paying up I was brought to the back where I was to change. I decided to use the toilet once more and everything including last nights dinner came out. One problem solve. After changing and securing all my valuables. I saw the anesthesiologist first. He only talked with me about my brothers death and said he had something special in his pocket for me and would be back after I saw Dr Haben. After he left, Dr. Haben came in and discussed a few things. After that I was laying there watching the curtains waiting for the anesthesiologist to return and then I was waking up from the surgery. Once my head cleared, I knew what happened. The special thing was a drug that prevents short term memories from becoming long term memories. I knew about the drug for several years but I never expected it to be used on me. They were kind enough to prevent one more painful memory from being added to my collection. I now need to write a letter thanking them for this bit of extra thoughtfulness.

I pretty quickly had my first round of coughs getting the accumulation from surgery out but it took a second round to get the remainder out. Neither were bad so I didn't damage anything. I didn't find any damaged teeth but my mouth felt like I went 10 round with a professional boxer and lost. My lower teeth hurt and I had sore spots all over the inside of my mouth. The pain started out at around a 4 or 5 but quickly dropped to 3 or below without pain medication. After I was delivered to a room, Dr Haben delivered my before and after pictures and explained that my neck was very stiff. This made it very hard for him to get the correct working angle and my mouth paid the price for this. The remainder of the day was spent making trips to the bathroom as I found water the best way to prevent coughing and after a few trips, the nurses decided it was time for me to get my walking uniform. Out of surgery you are given a yellow gown which means when on your feet, you must be in arms reach of help. Blue means you are safe to walk by yourself. I covered the entire floor earning my walking gown with flying colors.

I didn't receive any lunch and 3 times they ask me if I had any nausea. On the third time it flagged something in my mind but it wasn't ready to come out yet so I let it pass. My first food came for dinner and what a problem.

Fruit Cup
Wheat Dinner roll
Stuffed Chicken with gravy
While Rice
Baby carrots

Under normal conditions I would down this with no problems but my mouth was still in bad shape. The carrots where a bit raw, the wild Rice had to be chewed fine so it wouldn't stick and cause a cough and the chicken was rubbery. It took me 2.5 hour to get this simple dinner down. Everything had to be cut into small bites and I need to rest my mouth often.

Again, never try sleeping in a hospital because I totaled around 3 hours of sleep between bathroom breaks and all the racket going on.
The next morning not much happened until 7am when breakfast was served. At first I was fearful of the french toast but it was soft and went down pretty fast. It only took half an hour to finish the meal. They reviewed my drugs and got all the other paper work done. Next I used the bathroom sink to clean up for travel and time was so tight I didn't have time to put on a face or comb out my hair. I walked out the door and the cab wasn't there so I used a window to work on my hair while I waited.

In the final visit with Dr Haben, he took one more look at the surgery and reviewed the follow up information. We also talked a bit more about my cord problem and he told me he took out 40% of the cord. Depending on healing that should give be between a 60 and 80 hz bump in pitch depending on healing. I want the extra 20 hz so I am going to be very careful giving my body a crack at the higher number.

My final thought about Dr Haben is that you don't buy his time, you buy a voice from him. Any support you need in the future for your voice will come at no additional charge so you will never be left without support from him.

The doctor told me to take the first round of cough medicine before boarding the flight and checking in my baggage. BIG MISTAKE. Codeine hits me pretty hard and with the lack of sleep and center seating I needed to to everything I could to stay awake.
The trip home was not as eventful as I was seated between two women. The one to my right next to the window put a real scare in me. She started coughing and I though just what I need, a case of the flu. As the plane was packed, I didn't have any options. The one to my left I bribe with my snacks as I didn't want to risk coughing with them and we chatted all the way to Orlando. Yes, all of my responses were on paper. We reached Orlando half an hour early. I had about a 3 hour layover so I attempted to find some food. I wanted soup but couldn't find it. I ended up doing something I would normally never do and had a chicken Mc Nugget meal. It was tender enough that I could eat it but it wasn't the best dining experience I have ever had. While waiting to board the plane for the final leg, I saw the woman who sat next to me in a wheel chair and it hit me. The coughs she had were from MS and not the flu. I felt bad for thinking that on the other flight. On the last leg I was seated between two men. One was into movies and didn't talk at all. The other was using all the WIFI he could to do business. We chatted a bit but mostly for me it was working at staying awake.
The airport was a maze seeing this was the first time I used it for more than a transfer but I found my luggage and a ride home making it by 10pm. With the time zone changes my body said it was 1am or latter so I dropped everything, spent a few minutes soaking up water and went to bed getting about 7 hours of rest for the first time in days.

Friday was a slow start but I visited with my mom to let her know I was fine then went home for rest, and a bit of susan's. That was when it hit me. After the anesthesiologist gave me the medication, he started talking to me about my fear of doctors. I told him about my eye surgery at age 4 and all the fear and nausea I felt at the time. Being a responsible person he noted it in my charts and it may be the reason I didn't receive any lunch. As he was young and I didn't appear to tell him, he didn't understand my first two surgeries were with ether and I am one of the few who react very badly to it. All my surgeries after that were with injectable drugs that I never reacted to. I don't have a direct memory of our conversation but I do have a good idea of what it was about and what was said. I hope he finds it useful in helping other from developing surgical nerves like I have.

In closing there is a terrible irony about this whole thing. My mom didn't tell my sister about the surgery and I thought my mom did so I didn't say anything. I pounded off an email to her last nigh explaining it and she was interested in hearing my new voice. She may be in for a surprise.
When I was in college I had late classes and often would attempt to sleep in late. Far to often my sister would crank up her record player with her favorite artist and I came to despise that voice. Now it appears I may end up with a voice that resembles that of her favorite artist - Janis Joplin.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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iKate

Hey Dena,

That's quite a story!

However, even with Dr Kim's patients, including myself, he has found vocal fold asymmetry and he corrects it. Was that the case with Dr Haben?
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Dena

Quote from: iKate on July 18, 2015, 02:02:16 PM
Hey Dena,

That's quite a story!

However, even with Dr Kim's patients, including myself, he has found vocal fold asymmetry and he corrects it. Was that the case with Dr Haben?
One cord is longer that the other and paralyzed somewhat. Because the cord is a nerve there is not way to adjust the length or restore the connection. Because of this by best voice will be defined by the worst cord of the pair. It isn't a problem with the folds themselves. Dr Haben indicated this normally occurs in older people and is why old people sometime talk with a hoarse voice.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
If you are helped by this site, consider leaving a tip in the jar at the bottom of the page or become a subscriber
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iKate

Ah I got it. I got confused with cords and folds
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Laura_7

Congratulations on your journey  :)

And Janice sounds sexy  :)


hugs
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Katie

Well I am still going to take a crack at his work in four more days!!!!!! Cant wait!
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Dena

Quote from: Katie on July 18, 2015, 03:48:18 PM
Well I am still going to take a crack at his work in four more days!!!!!! Cant wait!
If I knew what I know now before I went, I would do the same. I hope your voice turns out far better than mine and I suspect it will. My advice you you is enjoy the people while you are there. I found them all to be very nice and made the stay that much more enjoyable. If you need anything just ask at the front desk and they will go out of their way to get it for you. Far better that the motel 6s that I would normally stay at. I now understand why when people have the money, they stay in places like that.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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Katie

Its been just a few days. KIND of hard to determine how it will turn out in such a short period of time.
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Dena

Quote from: Katie on July 18, 2015, 10:03:56 PM
Its been just a few days. KIND of hard to determine how it will turn out in such a short period of time.
That is correct. I am still in the no speak period and it will be 2.5 weeks before I can use it much. The doctor said for me it might take as much as 3 to 6 months before I know what I will sound like. I do know with unequal cord length it will not be a smooth rich tone and there will always be a trace of hoarseness to it. I heard a raspy sound in the male voice but I always though that was my ear incorrectly interpreting my recorded voice. I was wrong and there will be some of that in the new voice.
What I have learned so far about this problem is that in a normal voice the cords come together producing a regular stream of air pulses. These pulses are rich in harmonics that are filtered by the passages. In my voice, the cords product a few pulses of air and then there is a break in the pulse stream until the cords get synced up again. This happens so fast it can happen many times a second. The ear will know there is something wrong with the tone but won't really understand what it is.
I had only two options, stick with the male voice or go with the new one. The new one, even with the problems is still going to be better than the old one. It's just a little disappointing after all effort over years I have put into voices to discover a limit that can't be overcome.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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Laura_7

Here are two resources that might help:

lena.kiev.ua/voice/

This resource shows that there might be some improvements possible:

zvuk.hamu.cz/vyzkum/dokumenty/Poster_navrh6_EDV_vM.pdf


hugs
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Promethea

Dena, if you end up sounding like Janis, you WILL be amongst the most beautiful results posted here.

I would be very happy if I could get to sound like her.

Hers was a sweet-ass voice. Unlike mine, which has a different hyphenation.
Life is a dream we wake from.



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Dena

Quote from: Promethea on July 19, 2015, 11:15:15 AM
Dena, if you end up sounding like Janis, you WILL be amongst the most beautiful results posted here.

I would be very happy if I could get to sound like her.

Hers was a sweet-ass voice. Unlike mine, which has a different hyphenation.
I am starting to wonder just how many people really listened to her voice. This was what after many late nights at school I woke up to with only about 6 hours of sleep. If you listen carefully you will hear a very raspy voice. By the way, it will also be at a lower pitch though after surgery I might be able to hit those notes.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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  •  

Promethea

I listen to her voice quite often, I'm a big fan of hers. Of course I get the negative emotional response you have to it because of how your sister annoyed you with it, but not all beautiful voices are smooth. And there's a lot of dull smooth voices out there.

Anyway, if your voice used to be just a bit raspy, it's very very unlikely it will get raspier now, unless Dr. Haben screwed up real badly and you didn't follow your recovery plan and exercises.
Life is a dream we wake from.



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Dena

Quote from: Promethea on July 19, 2015, 02:06:46 PM
I listen to her voice quite often, I'm a big fan of hers. Of course I get the negative emotional response you have to it because of how your sister annoyed you with it, but not all beautiful voices are smooth. And there's a lot of dull smooth voices out there.

Anyway, if your voice used to be just a bit raspy, it's very very unlikely it will get raspier now, unless Dr. Haben screwed up real badly and you didn't follow your recovery plan and exercises.
There are three things that go into Dr Haben's voices that we need to be aware of. The first is the suture he uses to hold the cords in place will dissolve over time but that should be as long as possible. I am currently on Prilosect even though I don't have acid reflux to prevent the suture from dissolving early. I was given a 30 day supply but the Doctor said if I had acid reflux, I would have been on it longer. The time the suture takes to dissolve series on the person but could be less than a month or two or more months. The doctor couldn't give a hard time on that. The next issue is swelling. To reduce that we receive steroids and I am in the tapering off stage which will last two more days. The doctor indicated this could extend from 3 to 6 months. From some of the surgeries I have had, I believe those numbers. Again it is all depending on the person as to how long the swelling will last. The last factor is learning/knowing how to use the voice. Many of us have had a good deal of voice training and that will apply to the new voice.
Dr Haben made one very clear promise to me. He said when I first start using the voice it will be far worst so I shouldn't freak out about it. Recovery will take time.
There are no exercises with this type of surgery as voice therapy if needed will target any problems you have. The thing I like about Dr Haben's work is the procedure is simple, clean and reduces the possibility of damage as much as possible. Your voice can be used in a week though lightly and the real risk is damage to the suture of which Dr Haben has had no failures so far.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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anjaq

Can you tell me the difference between vocal chords and vocal folds? I always assumed it's the same thing. And none of them is a nerve, just tissue and muscles... At least that is how I understood it...

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Dena

Quote from: anjaq on July 19, 2015, 04:32:15 PM
Can you tell me the difference between vocal chords and vocal folds? I always assumed it's the same thing. And none of them is a nerve, just tissue and muscles... At least that is how I understood it...
I am not fully clear on this one myself so if it sounds wrong, it might be. I think the vocal folds are the inter edge of the cords and the cords are the main mass. If Dr kim alters the folds, he must be very careful not to go to far and alter the cord it's self or you end up with a problem much like mine. To better see what I am talking about, go to https://en.wikipedia.org/wiki/Vocal_folds and scan down a screen or two. You will see the folds in action producing the pulses of air that make our voice. I think the red in the image is part of the cord and that could be altered as long as the cut isn't deep enough to reach one of the nerves that run in that area.
In surgery I ask Dr Haben to explain my condition better in the follow up appointment and he did making it very clear that the cords are the nerves and my problem involves getting the signal through the cords. That statement turned my whole image of how the voice works upsides down.

By the way, I do owe you a bit of an apology because you were right about me having a possible voice problem. In the end it made little difference weather I discovered it in my home town or in New York.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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  •  

kwala

Quote from: anjaq on July 19, 2015, 04:32:15 PM
Can you tell me the difference between vocal chords and vocal folds? I always assumed it's the same thing. And none of them is a nerve, just tissue and muscles... At least that is how I understood it...
They are the same thing. We used to call them "cords" because doctors thought they were more string like, but as medical technology improved and we were able to examine them and see their shape and way of movement "folds" was deemed to be a more accurate description.  But old habits are hard to break and most still use both terms interchangeably (myself included).
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Promethea

See? Your voice will be alright, worrybutt!
Life is a dream we wake from.



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Katie

By the way in the consult today doc said I had a vocal cord that didn't vibrate much either. Go figure.
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Dena

Quote from: Katie on July 21, 2015, 03:03:31 PM
By the way in the consult today doc said I had a vocal cord that didn't vibrate much either. Go figure.
That sounds different that what i am dealing with but I still hope the doctor was able to give you a good option. All of a sudden we are learning how many imperfect voices there are out there.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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