Good morning everyone! I will keep this strictly to our most recent consultation with Dr. Hutcheson in the Head and Neck Center at MD Anderson.
Not much progress, unfortunately. However, all things considered, things could be worse, much worse!
Going forward, it would appear the healing has come to a standstill. We have several options, but nothing will fix the damaged nerve innervating the left vocal cord.
First, a little background on what is wrong. The right vocal folds are working great. It is the left vocal folds that are mostly paralyzed. I say mostly because there is a slight twitch in the cricoid cartilage (provides numerous attachment points for the muscles of speech production) but not nearly enough movement to be fully functional. With this said, the vocal folds normally meet in the middle (midline), but mine do not. No matter what, right now I have a slight opening whenever I speak because the vocal cords never come into contact with eachother. This causes me to lose additional air causing me to only speak in shorter sentences. When you speak with me, you may feel me get short of breath and have to inhale midway through a long sentence. This has everything to do with my vocal cords not connecting, and absolutely NOTHING to do with me having one lung. In fact, my right lung function is operating at the capacity of near normal two lung people, at about 3.5 liters on my incentive spirometer. Furthermore, my voice is hoarse and scratchy.
The options to “fix” this problem will only mechanically push the left vocal fold towards the right vocal fold. This will allow them to make contact. It should make my voice clearer and louder, but my voice will most likely never sound like it did and may be slightly hoarse. There is no fix for the nerve damage. The options to cosmetically fix this problem are several:
1.) I can get 1 of several shots where they inject a collagen-like substance into the tissue surrounding the damaged vocal fold. These are not permanent injections and they wear off in time. One shot wears off in about 3 months while the other wears off anywhere from 6-18 months. This can be done as an office visit. They would use local anesthetics to numb the area and stick the injection needle into my vocal cord. If I like how it affects my voice, I can keep getting shots when the previous injection is absorbed. OR
2.) I can get the shot as stated above. However, if I like how the shots effect my voice, I can get a permanent implanation that does much the same as the injection, but it doesn’t get absorbed. This is done surgically in the operating room. OR
3.) I can just skip the shots and go straight to the surgical insertion of the implanted device.
At this point, we have decided to go with option 2. We have temporarily scheduled to get the injection during my next scheduled scan/consultation (should be at the beginning of August). I will be getting the shot that lasts anywhere between 6 and 18 months, and, if all goes well and things sound better, will be getting the surgically implanted device. Not the best news, but it is most certainly better than the alternative!
I have requested my DVD footage of the scope from both consultations. This will, hopefully, give you a better idea of the anatomy I speak of, and an excellent visualization of the area. I’ll keep you updated!
Let’s keep praying for spontaneous recovery (which is what we have been praying for)! Thank you for all of your thoughts and prayers. We love you all so very much! — with Melissa Chinn and 27 others.