From the beginning through today

1 September - I checked into Piedmont Hospital for surgery to fuse C5, C6, and C7. The doctor and his PA had discussed it with me individually regarding safety. As always with surgery, particularly using general anaesthesia, there is always some risk. The surgeon has a great deal of experience in this particular procedure and all others prior to me had successful outcomes. I just want to get rid of this feeling in my right arm that feels as if I grabbed a live electrical wire. Since it first appeared about three months or more, ago, it has become worse and reached a point where I rarely go more than 10 or 15 minutes without experiencing it. It is forcing me to become left-handed.

Anyway, back to the narrative. I checked in and since this is not first time at the surgical dance, I am not nervous. I know what to expect and this is one of the best hospitals around and the staff is supremely well-trained. Everything flowed smoothly until all the preparation was done. My blood sugar was high despite fasting so I was given a dose of insulin. The nurse who started my IV in my forearm did an outstanding job, and I barely felt the needle slide into my vein. That is one of those little signs. If the IV is started with little pain and fuss, then it boosts the evidence of good staff especially for someone like me who has big, juicy veins that even a blind person could hit.

Nancy came in around this time. She is always there for me. I could not have a better partner in my life. We chat a little while waiting, then the surgical people come for me, and we are off. After I move to the surgical table, the nurse anaesthetist tells me it is time to go to sleep. She administered the drug(s). In seconds, I felt a growing sense of peace, and then I woke up. My throat was sore as if I had the worse case of tonsillitis in the history of tonsils. My mouth felt how I imagine a dried out pig lot might feel in the middle of the Arizona desert. I remember taking a sip of water through a straw and realizing just how painful it was to swallow. I persevered and managed to get a piece of ice in my mouth to melt it.

My neck was in a collar, I think, but I cannot swear to it. Things were quite blurred and my memory was jumbled. I must have drifted off, again. When I woke up, Nancy was talking to me, at least, I think she was. We chatted, but I can remember little or nothing of the conversation. Nurses came in every so often, whether every five minutes or every hour, I cannot say. So far so good. Surgery was successful, and I was on track to go home the next day.

Nancy went home to take care of things and get some rest. Did I mention how fortunate I am to have someone like her? Very fortunate, indeed.

I slept off and on into the night but around 0300 or 0400, I woke for good. Now, not only was my throat still really hurting, but I was bored. So I watched television. I had already been up a couple of times to go to restroom when it became clear I could not piss in a urinal under the sheet with people standing around. I did ask before my first trip to the toilet. Standing up was actually a relief. I definitely had a collar around my neck so my earlier jumbled memory of one was probably real and not just a figment of my imagination.

As the night turned into Thursday morning of 2 September, I was brought pills. This is my only quibble. I made sure I provided a list of all my ongoing medications, their doses, and their schedules. My HIV medications were there, but one of them, either Ziagen or Isentress, should have provided two pills instead of one. Anyway, I set it straight and the nurse was not difficult about it. She realized I knew my medications. My throat was no better, perhaps, even a little worse. I was also having trouble swallowing especially on the right. Swelling must be increasing. It felt as if my throat had a racquetball in place of my right tonsil. I had trouble swallowing my pills and got choked. I coughed and coughed, which was agonizing. Finally, I swallowed the last pill. When my breakfast arrived, I was surprised since I had not ordered any, but once again, Nancy had taken care of it the night before. Eggs, bacon, grits, fruit (?), tomato juice, and hot tea. It seemed delicious, but I had to eat slowly and carefully to avoid choking.

Nancy arrived and the preparations to depart commenced. First, I had to see various and sundry people with various and sundry instructions and questions; however, it wasn't bad, and everyone was just so damn nice. Dr. Wray's PA was the first and arrived just at dawn. He is a nice, young (by my standards), gay man. He checked that everything was looking good. He started to remove my IV, but thought better of it when he realized there was a lot of tape and it was stuck to the hair on my arm. My day duty nurse came in eventually and removed the IV with no trouble. Then it was time to remove the tube draining from my neck into the little bulb. I was a man about it, but damn, that hurt. I'm glad the nurse got it done quickly. Get through pain quickly is my preference.

Someone arrived to replace my dressing with a waterproof bandage, which I was to wear for seven days. I could shower, which I needed. My voice was gravelly, but that was expected. My throat pain was still really bad, but had stopped getting worse. Finally, I was ready to leave. I am sure I looked a fright, but I was on my way home.

Nancy got a milkshake for me from somewhere. Strawberry. I sipped carefully because I was having trouble swallowing, but the cold felt so good in my throat. I spent the rest of the day sitting around the house, watching television. My voice was still very gravelly. As the evening progressed, it seemed to me, my hoarseness was worse. By the time I went to bed, my voice was down to a whisper, and swallowing was a chore. The pain seemed to be subsiding, but when I took my pills, ate, or drank, every swallow was a challenge because of choking. I began to wonder if I sustained some injury from the intubation during surgery but decided it was too early to think there might be a problem.

3 September - I awoke with no voice to speak of, but I really slept well. I spent the day sitting around. My mum called, but my voice was definitely not making an appearance. Talking on the telephone was a chore. I decided that I sounded like a Komodo dragon hissing. I did notice that when I talked, I would run out of breath too quickly. Swallowing and pills were a problem. I felt a little like a cow chewing a cud. If any food started down from the right side of my mouth it was getting caught. I learned just to blow it back into my mouth, reposition it to the left side, and go again. Taking my fistful of pills at night use to be one toss followed by two or three swigs of water. Now, I must take each pill individually with small sips of water. The big pills are the most difficult. It seems to take four or five attempts to swallow the capsules and larger, oblong pills.

4 September - My voice doesn't exist. Something was wrong definitely, but I was managing so decided to wait until Tuesday to raise an alarm. It was Labour Day weekend, and I was not in a life-threatening situation.

7 September - Nancy called Dr. Kingsley Chin an otorhinolaryngologist who saw me in the past for nosebleeds and sinus infection. She got an appointment for me at 1400 on 8 September.

8 September - My first trip outside the house since coming home from surgery. Nancy drove me to my appointment. I appeared calm, but on the inside, I was worried. I hoped that he would tell me it was just swelling that will reduce soon and allow me to speak, but in my head, I knew something else was wrong. Dr. Chin used a laryngoscope to look at my vocal cords. It is an odd sensation akin to sucking something up your nose into your nasal cavity. Anyway, the procedure went quickly, and he made some pictures. The right vocal cord is paralyzed. This indicates some degree of trauma to the nerve controlling it. It might be permanent or not, but it will likely be months before that can be determined. I felt a sense of bewilderment. Dr. Chin referred me to speech therapy at Piedmont hospital and to his partner who specializes in laryngology specifically.

9 September - I spoke to Dr. Wray's P.A., Scott. He said this had not happened in his four years with Dr. Wray and numerous, identical cases. He seemed to want this to disappear. He called me, again, and talked about how this was unlikely to be as serious as I thought. I finally interrupted him and asked if he realized that Dr. Chin had scoped my vocal cords and took photographs to document the paralysis? That appeared to slow down Scott. These two calls are the first contacts from Dr. Wray's office since the day of discharge.

10 September - Dr. Wray called Nancy. He stated that he was sure my voice would return. How can he be sure? Does he know something about the future that is not known to mere mortals? I think he is concerned more about a possible malpractice suit. It might come to that, but even I know that talk of suing is premature. Besides, how would I pay for a lawyer? Remember, I am unemployed.

How can this be? I need to talk. My livelihood has always depended in large part on my ability to communicate with speech. How can I go to interviews? No one will be impressed by my Komodo hiss. I have a deep, well modulated voice. It makes people stop and listen. It made my babies smile. I used it to make different voices while reading to them. It is the one attribute, I liked about myself. I not only have a face for radio, I had a great voice for it too. Monsignor Regan used to ask me to read at mass because he said I sounded like Lawrence Olivier. On the drive home, Nancy tried to bolster me, but it didn't work. I had to hide my fear as much as I could, because she was getting upset with me. She is scared I will give up. I won't give up, but I need to come to grips with this and quickly. I am still unemployed and the need for a job is increasingly urgent. No one seems to want to hire me, these days, but I have to try. Hell, I can't even be a greeter at Walmart without a voice.

Nancy keeps telling me that she is sure it will come back. I cannot say with certainty that my voice will not return; neither, can I say it will. I am to start speech therapy on 30 September to help me speak better. I don't need to speak better. I need to speak PERIOD!!!! Why can't anyone get that notion through their heads? I am crippled by this. How do I get good jobs? How do I even find out where to look for a decent job where my voice won't matter come what may? Why do I have to pretend this is alright all of the time? Do I always have to keep my feelings to myself about this? Christ, it is not as if I am making a lot of noise. It simply sounds like a FUCKING KOMODO DRAGON is belching in the house. If I speak slowly and carefully, I can make myself understood on the telephone. Forget McDonald's. I ordered a tea and had to get my face within inches of the order taker to be understood. I had to write my order down for Chik-Fil-A. I cannot use a drive through window. It would be problematic, if I was alone and needed to call 911.

I have noticed how people respond when it dawns that I cannot make normal speech. The lady at McDonald's looked a little spooked as if I might be a vague threat. When my grandchildren came for a visit last weekend, I couldn't talk to them. They are too young and verbally inexperienced to process my well-enunciated hisses. I don't think I was this unnerved when I found out I was HIV+ fifteen years ago or diabetic thirteen years ago.

I don't know how to cope with this. I must cope with it, but it will take me a little time. In the meantime, Nancy, demands that I carry on business-as-usual in hunting for a job, completing the application for PMP certification. Pretend nothing is out of the ordinary. Show no fear or worry. Easier said than done.