DanielYKL

February 12, 2007 – that’s the day I had my laryngectomy surgery. I was wheeled from my bed to the surgery room at around 10am. And the next thing I know was that the doctors and nurses were inserting needles all over my body, from my ankles to my neck. At this moment I felt a bit drowsy must be due to the medication that I took earlier but still mindful of what’s happening. I remember there were at least two or three anaesthetists attending to me and a couple of nurses. They were deciding where they should insert the needles. And apart from all that, a lot of wires were stuck to body, I can’t recall where. Then I was wheeled into the proper surgical theater. There were at least four to five doctors waiting there. Then they transferred me on to the surgical bed and the nurses and doctors were crowding around me, and at this point I could not think of anything. This is it!  “Father, into thy hands I commend my body, spirit and soul”

Prior to the surgery, I can still think about how the surgery is going to be – whether will it be successful or not and will I make it through the surgery and what will happened to me even if the surgery is successful. Many other things run through my mind. After all this is a major surgery. It was a difficult decision to make.

Now back to the surgical room: Then I heard the doctors talking to each other and deciding what to do and how to do the surgery. Then this young surgeon, who is going to perform the tracheostomy, which is a surgical procedure on the neck to open a direct airway through an incision in the trachea (the windpipe), decided to start the procedure and was coordinating with the anaesthetist on how is she going to insert a tube through the stoma so that I can breathe. He then shaved some of the hair around my neck and marked the area where they are going to do the incision for the laryngectomy surgery. Then the last thing I remember was the anaesthetist telling me that she is going to put me to sleep and she is going to count to ten and I’ll be asleep. I only remember her counting to two and the next thing I know is that I woke up in the recovery room 10 hours later with a nurse calling my name. Yes the surgery took 10 hours! And that was exactly 1 year ago today! 12th of February is Daniel’s Day – haha!!!

Yes, I really thank God for his mercy and grace that sustain me through that painful period. It has been a difficult time, with the decision I have to make and not knowing what is going to happen. I told God that I just have to leave into His hands. One year before the surgery, I did a 33 course of Radiotherapy and after 8 months or so there was a recurrence. And now I have no choice but to do the surgery and I told God I’m not going to struggle with it anymore and it’s up to Him to decide on what will happen to me. Like St. Paul says: “For to me to live is Christ, and to die is gain.” So whether I live or die it’s in the hands of God and whichever it is, it’s for the glory of th Lord Christ Jesus.

So what is life after one year as a laryngectomee? (That’s someone who have gone through the laryngectomy surgery and survived) All I can say is, “Thank God I’m Alive!”

Anyway when you ask laryngectomee like me about the consequences of laryngectomy surgery you are likely to get a negative response. This is the natural thing for me to do. The reason is that there are so many changes in my life and  the physical difficulties I have to go through.  As many decisions are, this one involves trading off one bad thing for one or more other bad things. The decision is therefore a very personal one. What needs to be considered is not to focus solely on the bad thing which exists now (the inability to talk) and which I am now very familiar with, but to also have the imagination to take into account the bad things which result from not making the choice for an elective total laryngectomy. It is very easy to focus too much on the present situation and not give enough thought to the possible or probably consequences of making the other decision.
 
Currently the problem is the inability to speak normally. And that is a major loss. But having a total laryngectomy involves a number of negative consequences as well:
You lose your voice permanently unless you do a voice replacement:
* Replaced with a voice prosthesis placed in the tracheo esophageal puncture created by the surgeon. The voice prosthesis vibrates the esophageal tissue in lieu of the larynx.
* A second method is the use of an electro larynx.  An electro larynx is an external device that is placed against the neck and creates vibration that the speaker then articulates. The sound has been characterized as mechanical and robotic.
* A third method is called esophageal speech. The speaker pushes air into the esophagus and then pushes it back up, articulating speech sounds to speak. This method is time-consuming and difficult to learn and is seldom used by laryngectomees.
* A fourth method is the use of the UltraVoice speaking device which is built into an upper denture or retainer and worn inside the patient’s mouth. The speech from the Ultravoice has computer controlled prosody which changes the pitch creating a more natural sound than the electro larynx.
Whatever method you use, you will never, never have your original voice again. As for me, I’m still voiceless – haha! But sometimes I do shed some tears when I hear my own voice which I recorded before the surgery.
 
You basically lose the ability to smell. This is because the incoming air goes directly into the throat and down into the lungs bypassing the nose. Still I have learned some tricks which help me smell some occasional smell, but this sense is at least reduced. You can lose some of the ability to taste, or the sense of taste can change. But I have recovered virtually all of my sense of taste. Thank God!
 
The quality of the air reaching the lungs is drier, dirtier, and colder than before. Although this can be compensated for by wearing an HME (Heat/Moisture Exchange) filter, it is not possible to get this in Malaysia and even if you do it will be very expensive. So I just do without it and just wear a bib around my neck to cover the stoma. Since the air goes directly into the trachea and into the lungs (instead of through the nose and throat) it is actually easier for me to breathe - there is a loss of resistance from having to move air up our noses and down the throat. As a consequence the lungs do not have to as fully inflate as they did before the surgery. Since air goes directly into the lungs I need to be careful around water and better to avoid it altogether. But still I have to take my bath! This too I have mastered how to avoid water from getting into the stoma while having my shower.

Although it is a minor issue for me, having a hole in the neck is considered by some to be disfiguring. For me being laryngectomee is something which is noticeable and marks me as different. But that doesn’t really bother me anymore as the people around has accepted me as who I am. But most importantly, I have accepted myself as who I am.
 
Laryngectomy surgery is major surgery. And every surgical procedure carries risk. Recovery from total laryngectomy surgery takes quite awhile. It is not measured in weeks, but months and even years. The thyroid gland was removed during the surgery, so I may have to take thyroid medicine for the rest of my life.
 
There are some positive consequences of becoming a laryngectomee. One is that I no longer SNORE! And I should not choke on food since the air and food tubes become totally separated. Still I do occasionally get choked when I try to swallow a big piece of food but I have learned how to manage it.
 
I will end as I began and say that this decision to do the surgery is a very personal one and involves weighing the importance of the probability of being alive versus the probable and potential downsides. “Quality of life” is very much involved here, and defining that is individual. My total laryngectomy was necessary to save my life and I have made what I think of as a very successful recovery.

I have not fully rehabilitated but it is in the process. My surgery was required to save my life (not elective), and I just have to make the most of the condition. Another year in the LORD and I believe there will be many more to come. Thank God for life and life abundant! 

Hope and Courage are miracles that always work. Keep your faith and you shall overcome… To God be the glory!
 

This entry was posted on Wednesday, February 13th, 2008 at 12:45 am and is filed under LIFE, PICTURE TALK, LARYNGECTOMY. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.