And I'm Back: The Post I Never Wanted to Make

Hey Everyone,

6 years ago, I had a successful operation to remove cysts from both of my vocal cords. I documented the recovery process on this blog and found it a great way to share with people what I had gone through and give a good first person account of what the process is like.

After recovering from the surgery, I lived abroad, finished college, spent two years living and performing in Jackson, MS (true story), and even gained a fan following in Jackson, MS as a singer. My voice performed beautifully. When I moved back to the Bay Area and switched career paths, singing continued to play a vital role - songwriting helped me get my first job, and I've written many a joke song since joining Reddit as an engineer.

I didn't think much about my voice, because I haven't had to. But for the past few months, something has been off. Singing was pained (if possible), my high range basically disappeared, I lost my ability to sustain notes for more than 4-6 seconds, and I started losing my voice very quickly.

I went to the doctor about a month ago, and he initially thought I had nodes. Because Kaiser is not UCSF, I had to wait another month to see their only decent speech pathologist. She did a stroboscopy this week, and it turns out that I have a polyp. It may be surgical, it may not be, but I'm back on vocal rest, and I'm not happy.

Apparently, the polyp is more influenced by food/diet habits than the cysts were, so for the foreseeable future, foods I need to avoid include:

• alcohol
• coffee/black tea/caffeine
• chocolate
• citrus
• spicy food
• anything within three hours of going to sleep

Did I mention that I'm not happy?

Last time I dealt with this, I was in college, and it was pretty easy for me to be alone/silent. I had surgery over summer break when I was living with my parents and doing very minimal work. This time, it's different. I work a highly collaborative job where I am very social. The various forums that exist to get help are often in loud rooms, and though there are lots of folks who do the majority of their communication in writing, my brain doesn't really work that way.

I sent this letter to a large group of my colleagues this week as a way to warn them about the massive personality change they are going to see from me. The reaction was overwhelming and positive, with lots of support and encouragement. Pro tip: if you are going to need to go on vocal rest at work, sending this type of information up front and in an easily digestible format will help you get the support you need at the office. And if it doesn't, you work with assholes.

Why I am positing this?

As I've been frantically researching polyps to try to come to terms with my new diagnosis, I've been reminded how few resources exist about vocal injuries from the perspective of people going through the process. I'm reviving this blog so that other folks with vocal injuries can have it as a resource and know they aren't alone, because I know first hand how isolating being suddenly put on vocal rest feels.

I'm hoping that this recovery will also be successful, but who knows. The good folks at UCSF told me that I would likely have a lifelong battle with my vocal cords, and I guess that this is just the start of chapter 2.

Thanks for reading, and I hope to come at you with better news soon!

A Final Post

Hey Everyone,

I want to start off this post with a huge thank you to everyone that read this blog, sent me a text to see how I was doing, sent their thoughts/prayers my way, and kept me positive during this very difficult summer. Friends and family, thank you. I hope that you all learned something about vocal chords and that you appreciate your ability to use your voice more now.

Since my last post, a bunch of really interesting things have happened. First, Youth Radio did a podcast about my story that features me and my mom. If you haven't yet heard it, check it out.

I also wrote a new song about this summer. It's called Tears and Time. I've already posted a version to my sound cloud, but listen to this one anyways. It has piano, background vocals, and some lead guitar over it. I did all of the production and recording on an iPad, so I'm sorry if the levels are weird.


This week, I had my three-month post-op check up, and my doctors told me what I already knew--my voice is doing really well. The surgeon did not expect my recovery to be as successful as it was, and he even called my voice soulful! My singing range is now a full 2 octaves, and my speaking voice doesn't crack like a pre-pubescent boy. I'm super proud.

Here are a few things that I have learned both about myself and the world in the three-year process of losing and regaining my voice (in no particular order). Read them if you want. I won't be offended if you don't. 

• ·      People take the ability to communicate with sound and language for granted, especially in terms of singing.
• ·      Singing = joy. Even people with terrible singing voices can let loose and go to a club and sing their heart out with friends. When I went out to a club before I was cleared to sing, people asked me why I was in such a crappy mood. Granted, that was in the Castro the night that DOMA was repealed...and it was guilty pleasures night.
• ·      The world is super loud. Having conversations in cars, restaurants (especially bars), and anywhere with traffic requires us to raise our voices far more than we realize. People joke about noise pollution, but in reality, our world is far louder than our voices want it to be. 
• ·      Younger people tend to cut each other off much more than older people, and conversations with older people tend to progress more slowly with older people than younger ones. I spent a lot of time this summer with my parents and their friends (the non-bar crowd), and noticed that they on average take more time between comments to let ideas sink in. We young folk constantly cut people off and are thinking about what we want to say while other people are talking. We talk over each other instead of with each other. In doing so, we miss the great points that our quieter friends make.
• ·      There is a massive difference between hearing and listening. Listening does not merely mean sitting silently—listening requires paying actual attention. While we may delude ourselves and say we can listen while texting, really, we cannot; we can only hear while our fingers are twiddling away playing Candy Crush on our phones.   
• ·      I’ve never liked having “real” conversations over text messaging; after the NSA programs were revealed this summer, I like them even less. By communicating online/over texting, we put everything in writing; because of screenshot technology, everything we convey electronically could be public information. Yes, it’s easy to send a text message, but nothing can beat an in person conversation or a phone call/skype date.
• ·      A sarcastic inside joke often carries the same words as a violent threat, and is (almost) always unnecessary. I’m a super sarcastic person, but when limited to just 5 or 10 minutes an hour of vocal use, it’s not worth wasting precious words on mean ones.
• ·      We (but especially young people) take our bodies for granted, and someone ALWAYS has it worse than us. A friend of mine had his 4^th wrist surgery this summer and is hoping to have mobility in his writing hand; my worst-case scenario was a hoarse voice. Boo hoo. 
• ·      Everyone’s voice is super different, and everyone uses their voice really differently. Think about a metal singer that screams at the top of his lungs with a huge amount of rasp, then a musical theater singer with crazy vibrato, then your favorite artist, and then your average friend that sings in the shower. Just as some body types are better for some sports, some vocal tracts are better inclined to sing different types of music. Some people can do things with their voices that would damage mine. There is no correct way to sing or speak, only a way that is most efficient for your specific anatomy.
• ·      If something is wrong with your voice, I can’t diagnose you. The UCSF Voice and Swallowing Center can.
• ·      I’m lucky that I recovered. Julie Andrews had vocal surgery too, but she cannot sing. My doctors have consistently told me that my recovery has progressed further than they ever imagined, and just listening to what my voice can do this summer vs. last summer exemplifies this change. Having said that, I’d be OK being Julie Andrews.

That's all for this blog, and if you read this much, thank you. Now I'm off to the Middle East for an Adventure, and I wish you all the best!

10 Weeks Post-Op: Hear Me Sing!

Hey Everyone,

It has been 10 weeks since I had surgery to remove the cysts on my vocal cords (check out the last post if you want pics/videos of the medical stuff). A lot has happened since I last checked in. I was cleared to sing a few weeks ago, and just yesterday, I sang a full 5 minute song with a guitar for the first time in over a year. It was a terrifying experience, but I thought it sounded pretty good. For the record, it was a song that I posted on this blog already, called "The Plan". Then, today, I recorded myself singing a different one of my songs, "My Goodbye Song." There's more info on both of the songs below.

In this post, I've put those two recordings, plus older recordings of myself singing the same songs with just me and a guitar. My voice has changed in a lot of ways over the last few, and honestly, my favorite version of it is the voice I have right now.

As you listen, notice how the new voice is higher and less raspy, and see if you can hear how much less strained my voice sounds now vs. before. It sounds like I'm pushing way less.

My Goodbye Song







The Plan

I wasn't going to post this one because my voice cracks really badly during the bridge (I chose too high of a key), but I figured letting you in on my first full song would balance out the videos of vibrating vaginas I posted last time.



The Plan was the first song I wrote after my diagnosis. At the time, I thought my voice sounded incredible, and I was proud of the high notes I hit. It felt right to make it the first song I sang after surgery. It took me a few weeks of singing a little bit to build up the courage to sing a whole song through. No, I'm not kidding.

I hope you enjoyed this post as much as I enjoyed singing these songs in the last few days. I'm so happy to be a singer again!

Becca

My Vocal Cords: Before and After Surgery

Hey Everyone,

It's been six weeks since surgery and four since I last checked in--so I have a lot to catch you all up on.  This post is going to be split into two parts. It will start with an update on how my voice has been doing in the last month since I checked in, and then I will show you pictures of my vocal cords from different stages of my recovery, starting at my diagnosis in May of 2012, continuing to now. The transformation is truly amazing.

Disclaimer: vocal cords look like a vagina. If you don't believe me, scroll down. I promise, there are no pictures of actual vaginas on this blog.

If you just want to know what my voice sounds like now, go down to the very bottom of the post.

How my voice is doing now and what I have been doing to get it there

It has been over six weeks since surgery, and my voice is doing incredibly well. It's been really hard to physically and emotionally get to there. Here are some notable things about this process.

1) I have learned how to talk completely differently. This doesn't seem like that big of a deal, but realize that no one ever taught you how to speak--you just do it. The way I naturally spoke, however, trashed my vocal cords, so I had to learn a whole new technique. Instead of putting pressure in my throat, I have been taught to put the vibrations of my speech into the roof of my mouth right behind my front teeth. If you want to know what I mean, hum on a comfortable pitch and really try to feel the vibration caused by the sound. Then, sing an ahhh or ohhh sound on a comfortable pitch and try to move around where you feel that vibration. It's really freaking hard. Now think about doing that every single time you open up your mouth to speak.

2) As a result of this new technique, my voice is higher. For a while, I would make sound and not recognize my voice as my own, almost as though I was looking into the mirror and seeing a 75 year old man staring back at me. Over time, I have come to embrace my higher voice, but it has taken a while.

3) I have been given the green light to start singing again, a little bit. I cannot yet sing in the car or other places with loud ambient noise, but I'm OK with that. For now, I'm singing mostly to help reenforce the sensation of having the vibration in the right part of my mouth.

4) I no longer am restricted to a certain number of minutes of vocal use an hour, but rather, I can rely on the way my throat feels to dictate what I can and cannot do.

5) I believe wholeheartedly that I will sing and write music again; I believe I will be able to perform again as myself with my own voice, not with a voice I am ashamed of. This is huge.

Vocal Cords Before an After

Vocal cords (or vocal folds) are what allows us to make sound. When you breath in, they spread apart, and when you send breath through them, they come together and vibrate at very high speeds (hundreds of times per second). The following video shows what normal, healthy vocal cords (not mine) look like when in action. If you want the scientific terms/explanations for how all of this stuff works, Google it.

Now, on to the good stuff:

May 10, 2012: I went to the Voice and Swallowing Center at UCSF and they took a video of my vocal cords. It looks and sounds quite a bit different. Your speakers are about to sound like they broke in half. Sadly, they are working correctly--my voice sounded that bad.

My vocal cords were not healthy, but rather, had cysts. Cysts are basically large puss filled blisters/callouses inside the tissue. I should mention that vocal cords should be around an inch tall by a quarter inch wide--mine were WAY bigger. It took far more energy to move them than it does for people with normal vocal cords, leading to the strained sound; the cysts prevented them from vibrating normally, leading to the raspy sound I had. My doctors told me that my cysts were among the biggest they had ever seen. I guess that makes me special?

The traditional protocol with cysts is to remove them and then do speech pathology work during recovery. My doctors decided to take a different route with me, realizing that if they took out the cysts before my behavioral patterns had changed, they would have come back again. Consequently, I spent the summer working with an incredible speech pathologist, Soha Al-Jurf, and three months later (August 2012), my vocal cords looked visibly better, albeit still very unhealthy. Notice how much higher my range can go without cracking:

Even though they look healthier, my cysts were still HUGE. At the time, though, I thought my voice was in the best shape possible. I went back to school for my Sophomore year at Claremont McKenna, and during winter break (January 2013), they took more pictures, showing even more improvement:

In March, I met with the surgeon, Dr. Mark Courey, and we took some more video. He decided that
I would be able to have surgery in the summer.

I had surgery on May 29, 2013, and Dr. Courey was able to remove the Cysts and much of the scar tissue that had accumulated in my vocal folds. The following video and pictures are from the day I was taken off voice rest (June 2013), meaning that the muscles responsible for moving my vocal cords had basically not moved in a week and were stiff as can be. This was among the most frustrating days of the summer, because it was like moving back to square one, unable to get sound out.

Even so, my vocal cords look healthier.

This last video, taken six weeks after surgery shows a completely different set of vocal cords. They come together like normal vocal cords, produce clear sound, and are not incredibly swollen, but rather flexible. Yes, it still sounds breathy (notice the hissing quality to it), but this is because I am still learning the technique that my vocal cords are only now small enough to handle.

I'm in a good place right now. My voice has been my focus for so long, and now I see the light at the end of the tunnel. I hear the light at the end of the tunnel--in my own, new, voice.

If you've read this whole post, give yourself a huge pat on the back, because it was quite long. I hope you learned something about vocal cords and what it takes to fix them when they get damaged. If you have any questions about any of this stuff, feel free to ask!

Best,
Becca

Two Weeks After Surgery

Hey Everyone,

It's been exactly two weeks since having surgery, and my voice is well on it's way to recovery. Here's a recording: https://soundcloud.com/beccarosenthal/two-weeks-after-surgery.

Last week, I was able to talk for about five minutes an hour, which interestingly, is way harder than being a total mute. Going cold turkey on vocal use is way easier than trying to use my voice in a very minimal fashion. Think about it in terms of food, going from one of those crazy vegan only juice cleanses to weight watchers. I only drank fruit juice for a week--now I have access to an entire chocolate cake--but my voice could only handle a tiny crumb an hour.

I'm now up to 10-15 minutes of vocal use an hour. Because my vocal cords are still stiff from surgery, this week is about continuing to find the balance between using my voice (move my vocal cords) enough to help them loosen up and not too much swell and stiffen.

In my diet analogy, it means I can have a small slice of cake every hour, and since I can go to the gym again, I'm all for it!

I Have A Voice!

Hey Everyone!

I am excited to tell you all that as of today (June 4), I am allowed to speak again. It sounds like death, but don't let me tell you - check it out for yourself.

https://soundcloud.com/beccarosenthal/my-voice-june-4-2013*

Here's why it sounds so bad: it's been a week since my vocal cords have moved, and just as any other muscle would be, they are quite stiff. Consequently, starting slowly, my goal for the next week or two is to loosen up my vocal cords, primarily by singing sustained ooooos, eeeeeeees, and mmmmms on the few notes at which my vocal cords vibrate properly. Because my voice hasn't been used in a week (not to mention my vocal cords were chopped up in a surgery a week ago), it gets tired very quickly, so I can't do this for more than 5ish minutes an hour.

I still can't do phone calls or talk over anything that makes pretty much any noise (noise pollution is a very real thing), but I can make short little recordings of me rambling, so I guess I'm making progress.

Til next time,
Becca

*I have a way funnier recording of my voice too, and if you text me, I'll send it to you.

Things That Hurt A Mute's Ego

Hey Everyone,

I want to shed some light on the hardest part of this journey: my severely bruised ego. For those of you who know me, my ego can get pretty big, and I agree that it needs to be put in check. But this process is cruel.

1) Every time the phone rings, I want to cry. 

I don't have to explain why this is depressing. You should know.

2) I can't breathe hard, so I can't work out.

A few weeks ago, I was in Vallejo, trying out for the Collegiate All American Rugby Team. Now, I can't walk for more than 15 minutes on a treadmill at 2.0 without my throat being aggravated. This should change in a few weeks, but in the meantime, I'm going crazy.

3) Typing/handwriting do not accommodate the speed of conversation.

I've given up on communicating complex ideas. it is too complicated, and typing or writing pronouns takes too long. Whatever I write will not be interpreted correctly, so I may as well not write it.


Luckily, today is my last full day of being a mute, and starting tomorrow, I get to speak for roughly 5 minutes per hour. This will be more difficult than this week, seeing as going cold turkey is easier than moderation. Progress is progress, though, and I have to try to stay positive.

Thanks for the support, and anything you got that can help unbruise my very bruised ego would be awesome (desserts delivered to my house always work).

Becca