Day 249. The Heartbreak of Presbylarnyx.

A few years ago back around 2003, when in an iPod listening frenzy we got rid of our cassette tapes [and our stereos] Margie and I had a listening party. One I played was my college radio show. My radio handle had been Anne Archy—I stole that from a sign in NYC and thought it was super cool, but was so not down with what it really meant.

In fact, I remember a drunken college argument with Greg Hansen in which neither of us could let the issue of anarchy go. He argued that a world without government would be superior to the present one.“Yes, hun,” I disagreed (we called each other hun), “but who would take care of the roads?”I thought myself so superior for taking up something so mundane, but, perhaps I was missing the point? Greg gave up in frustration.

But I digress. So, I’m playing this tape of my radio show, and the break between the songs comes up, and on comes my voice: “That was UB40’s ‘Red, Red Wine’ going out to Megan Hudson….”

Margie is stunned.“That’s you?”

My voice had already changed a great deal by then.Granted, we all sound a bit different after twenty years, to be sure, but this difference was between, say, Debra Messing and Brenda Vaccaro. Either voice would be a vast improvement on mine, granted, but my point is the vast difference in range.

My voice felt gravelly almost all the time, as though I had swallowed a handful of asphalt.And if I didn’t bring my customary cup of tea, speaking to my students for three hours could be pure hell. It felt like a perpetual frog in the throat. I assumed the cause was post nasal drip, from allergies and chronic sinusitis. When I resolved those problems to some extent, my allergist said that sometimes the medications for asthma could cause one’s voice to be hoarse.

Indeed, I learned the hard way one day way back in 1999 giving a lecture to the whole Physical Therapy Assistants Program, that asthma could interfere with one’s ability to complete a full sentence (I still get that some days).The first day it happened, though, my lips turned blue, and I had to go in for an emergency breathing treatment.

These days I’m such an old pro at not breathing, I have a nebulizer under my bed so that I can use it without fully waking up if things get really awful (though I proudly will say I haven’t used the thing since early 2011, long enough ago that I should probably refill the meds in case of a midnight emergency because they may be expired; having them is a helluva lot better than awakening an allergist and then having to go to extract my wheezing self on a midnight jaunt to Walgreens. Ugh.).

Anyway (how I do digress), once I realized it wasn’t my sinuses or my asthma, my allergist (the amazing Henry Fishman, a doctor I can recommend as one of the good guys in the business, incredibly smart, and very kind as well).He sent me to a voice specialist, after ruling out any of the major issues. Maybe this guy can help by doing some voice work with you, he told me.

By this time, ten years had passed since my original voice problem: it was summer 2009. So the ENT, “Dr. Quacker,” a voice specialist I went to at a major University Hospital named after a dead president, was a disappointment to say the least.

My first appointment was very exciting. Apart from the singularly unpleasant experience of the scope shoved up my nose and down my throat, it was pretty cool to see my vocal cords projected on a 48” screen so close I could touch it. He asked me to phonate various sounds: /ee/, /ay/, /i/, etc. The evaluation continued at great length with a speech therapist who I never saw again (nor was speech therapy ever suggested or discussed with me).

Dr. Quacker finally went over the results of my exam, saying that my vocal cords do not meet, which causes a gravelly, breathless sound, and that the fix for that would be to inject them with fat (unfortunately, not four or five pounds from my gut). As a member of PeTA, I don’t want to think about the lab rodent who sacrificed his or her life for my vocal vanity. I agreed to do something flatly against my beliefs hoping fiercely to be normal.

I should say this was only eight months after my aneurysm, so I was prepared to do anything to return to normal. I still thought I could do some procedure, somehow and be normal again. Sometimes I still do. I still think that this is all a joke and all this foolishness will stop and there will be a surprise party for me one day and I will get to go back to work and everyone will have a big laugh about what a nutty rib-tickler all of this foolishness has been.

So when I wrote a check for $800 for the part of the procedure that wasn’t covered by insurance (namely, the fat from the poor creature—a considerable sum for me) and the result was that my voice sounded WORSE, I was livid.

It goes without saying that I returned to Dr. Quacker to let him know how upset I was. It was one of those days when I could do nothing but be polite, and in my most humiliating 1950s June Cleaver way, say, “Well, Dr. Quacker, I’m not very happy with these results, I can tell you. And I’d like to have some restitution, or else”

This is one of many times in my life when I have cried tears of rage…on the way out the door…because was I born a sorry bird from the suburbs with no street savvy, no moxie to stand up for herself and tell someone to go straight to hell. This is where it would have been immeasurably helpful to break nasty and say, “Look fatface. You fix this or I’ll….._________” You fill in the blank there. Any number of threats or pseudo-threats would have sufficed. Instead, I had to bite the insides of my cheeks so that the humiliation didn’t extend beyond his having to extend the tissue box to me.

His response was predictable: “Oh, I guess I should have told you. I mean, what you have is a Connective Tissue Disorder and the Vocal Cords are Connective Tissue. So, you know, the fat might not work on them at all. There’s no way of knowing what might happen with your disease. You understand. It’s the fault of the genetic disorder.

Um. I should have told you?

You understand? I really love that one. No, I don’t understand, lunkhead, or I wouldn’t be sitting here boohooing in your chair.

“I’d like to have a refund,” I blurted out, like some sort of a sick cartoon character at negotiation remediation school.

“Oh no.” He actually laughed. “Refunds are impossible! We have to pay for the fat. It comes from a lab.”

So I had no idea what to do, other than to review him honestly (read: scathingly) on the web—and right here on this blog—I mean, it wouldn’t take a detective to determine his identity, based on the information I have given.

So that was the end of voice work for me forever, until I had to visit an endocrinologist for my Adrenal Insufficiency. (My endocrinologist is another fantastic doctor, Jason Wexler at Washington Hospital Center. He gives the finest thyroid palpation on the planet; I give him my highest recommendation. He sorted out my complex case with thyroid and adrenal gland issues, which was tall order. Endocrinology is such a difficult specialty, and Dr. Wexler is outstanding). Dr. Wexler strongly suggested that I give the voice work another try. He knows of another ENT who has a good track record with helping people with unique and challenging voice problems. Because he is such a good doctor, I thought I should follow his advice.

What was interesting about Dr. Nazaneen Grant at Georgetown University was that she performed the same exam with the scope down the nose and saw the same problem with the vocal cords not closing as the previous doctor had seen almost a decade  before. However, her conclusion was entirely different.

She prescribed a short course of speech therapy, shrugging her shoulders about why anyone would ever have wanted to do fat injections. Possibly he might have thought that fat would have made the vocal cords connect, she surmised, but she explained why (without voice therapy) that would never have worked.

“Presbylarnyx is my diagnosis,” she explained, which is understandable, as Greek roots in words make sense. Here, the Greek word presbys (πρέσβυς), refers to “old man,” and larynx (voice) is clear all by itself. Thus, she called me an old-voicer. Thanks ever so, young whippersnapper! Nice as she was, I felt like telling her to go straight to hell. But seriously, the age that “presby” refers to might be premature aging thanks to my Connective Tissue Disorder.

Lucky me! That is what makes me sound like crap, along with Breath Control issues (which make me run out of steam in the middle of a sentence, and sometimes in the middle of a word—particularly when I am excited, walking, running, or tired). This is complicated by what seem to be my Chiari Malformation issues that I am just learning about. Whatever the cause, speech therapy is already helping.

That is good news for me, but maybe not so good for my neighbors. Speech exercises didn’t seem to be bringing about any improvement for the first two weeks, not until we started working on volume. These are exercises that really force the vocal cords together.

For example, I say /ee/ /ee/ /ee/ (loudly) then breathe, ten times. The phonation has to be done at between 80 and 90 decibels—that’s quite loud. To the neighbors, it must sound like I have captured a baby seal and am keeping her as a pet in my living room.

The next exercise is even funnier. It reminds me unfailingly of my friend E-beth, who has always adopted a joking voice at about 100 decibels; this volume would thrill my sweet speech clinician on Tuesday mornings, but it is not an inside voice. Still, just for giggles in a restaurant or something, E-beth’ll just shout out, “It’s fat free half-and-half” or something. It’s funny, but you have to be there, I guess, to appreciate it.

So as I do my exercises, I am channeling E-beth. My second exercise, at 80-90 dbs, is to read a list of words:“Good Morning! Thank you! Happy Birthday! How are you! Ouch! No, thank you! Not today! Yes, Please! Let’s Go! Help!” and so on. Most of the phrases are positive, but others are not. I envision that the neighbors hear me shouting “Ouch!” and “Help!” and worry that I have fallen, or worse. Or maybe they think E-beth is visiting, and we’re playing with the baby seal in the living room.

The good news is that, while I don’t have back my singing voice, I do notice a change, my speech therapist gave me a great response today–and even my physical therapist noticed the difference.

So, here’s one cool exercise to help bring vocal cords together, in case your voice is froggy (clearing the throat is a less than ideal method).Take a swallow of straight bourbon (or whatever it is you’re drinking) and immediately out of that swallow, make the /ee/ sound and hold it as long as you can.The sound should be a kind of gulp-eeeeeee.That forces you to start phonating with your vocal cords together. I tried it the other day on the phone when I had such a gruff voice that I couldn’t get rid of it. My voice came back well as a result of the exercise—I was so surprised that it actually worked on the spot! So give the process a whirl. Who knows? It may work for you too.

Now we all know I will likely never get my radio show voice back, but then again I was kidding myself and everyone else about the whole Anne Archy thing, too. Not only that, but who could hear me anyway to do a comparison now that nobody has cassette players anymore? That sad fact didn’t stop me from keeping my radio show on cassette, along with all the mix tapes my brother made, and the mix tape Scott made me the summer we were 17, and the mixes Tim Jones made me, too. Don’t ask me why. That’s just how I am.

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12 thoughts on “Day 249. The Heartbreak of Presbylarnyx.

  1. 1) I know a good ENT…too bad she’s in SF. 2) I still have both my Walkman and my Discman. 3) Your voice sounds fine to me. Am I just not noticing, or did you start with the vocal calisthenics before we starting talking?

    • That is amazing that you still have a Walkman–it’s probably valuable at this point!

      Nice of you to say about my voice, but no, I just started a couple of weeks ago. I have had such problems with clearing my throat and being froggy when talking to you, I recall! Much better now, though!

  2. If you could hear the sound emanating from the vocal chords of all the Stars in the Universe…they would surely be saying “We Love You Just the Way You Are Heidi!!!”

  3. I do have tapes and LPs (remember those?) and I have a cassette player and a turntable. And there’s something hypnotic about looking into a cover of an LP versus one of a CD or the little thing you get if you download a music file. Not quite the same, methinks.

    As for your voice, I always find raspy voices HIGHLY appealing. If you had a whistling voice, then, Houston, we would have a problem, but you don’t, so we don’t.

    • You have the most amazing music collection on the earth, I believe. You’re also correct about holding an album cover. I love them. There is no substitute.

      Thanks for the vote for the raspy voice. Mine never achieved the attractive husky sounds of, say, Lauren Bacall, tho. It would be my luck to sound like a truckstop waitress. Still, I maintain some rasp, with a dose of honey–luckily–since you appreciate the rasp!

      xoxo

  4. I wanna come play with the baby seal!!! Thanks for making me laugh out loud and frighten the roof guys! And I’ve never noticed anything about your voice, other than how you gracefully humor and truth combine in it…

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