Voice Problems

ToBeGolden

I finished 6 weeks of rads for a tumor that was almost totally confined to one vocal cord. On the last 3 days, the vocal cord got blasted, and my voice has become very weak and almost useless. My wife needs to stand right next to me in order to understand what I say. I am just one week, post treatment. All other effects of the radiation, pain and fatigue, are within my expectations and they are starting to slowly improve.

Anyone had voice challenges? Where you told to rest your voice? Any experiences with this challenge? Thanks.

timreichhart

about the voice
I finished up my radiation treatments about 4 weeks ago and I am still having problems talking and hearing. Only thing I can tell you its going to take time to heel.

charles55

voice
After three years post treatment, my voice is still coarse. Better now than back then, though. It is more scratchy in the mornings and gets better throughout the day with use. I found the nadir came about two weeks post radiation since that is when the last treatment's effects really hit. I guess it is from edema caused by the radiation. The scarring left behind ruins the lymphatic system drainage so edema can be very long lasting. I miss singing. I have named my vocal range Gravelotto. I tell myself that my voice is not hoarse, it's husky. But the blessing is we still get to speak through our mouth.

ToBeGolden

charles55 said:

voice
After three years post treatment, my voice is still coarse. Better now than back then, though. It is more scratchy in the mornings and gets better throughout the day with use. I found the nadir came about two weeks post radiation since that is when the last treatment's effects really hit. I guess it is from edema caused by the radiation. The scarring left behind ruins the lymphatic system drainage so edema can be very long lasting. I miss singing. I have named my vocal range Gravelotto. I tell myself that my voice is not hoarse, it's husky. But the blessing is we still get to speak through our mouth.

Another Question
I'm sorry you miss singing. I couldn't carry a tune before my treatment, but I love to listen to music and I try to play classical guitar.

What I am specifically concerned about is: Will my voice likely be good enough so that I can hold a job dealing with the public. Such as a customer service representative. Or a retail sales position. Will I be able to pick up some part-time work this Christmas season?

I know the only "real answer" is wait and see. But it would be comforting to know that some voices which were damaged after therapy to the point that holding such jobs would be impossible, that these voices recovered sufficiently to hold the job. Thanks.

MarineE5

Time and Fluids
Golden,

It took me about 1 year before my voice returned to what it was before my surgery of Base of Tongue cancer. My family says that I sound like I did before. I do have times that I have a hoarse voice and that seems to happen when I am dry mouthed.

Our throats get dry as well. If I continue to sip water, chew gum, etc., I am pretty good during the day. I have no saliva. Right after the radiation, my voice was just a whisper and my wife did most of the talking for me. My voice improved slowly, but please take in fluids to keep the voice box moist and that may help you.

My Best to You and Everyone Here

charles55

ToBeGolden said:

Another Question
I'm sorry you miss singing. I couldn't carry a tune before my treatment, but I love to listen to music and I try to play classical guitar.

What I am specifically concerned about is: Will my voice likely be good enough so that I can hold a job dealing with the public. Such as a customer service representative. Or a retail sales position. Will I be able to pick up some part-time work this Christmas season?

I know the only "real answer" is wait and see. But it would be comforting to know that some voices which were damaged after therapy to the point that holding such jobs would be impossible, that these voices recovered sufficiently to hold the job. Thanks.

I don't think any of us know the exact answer of how much and how long for your case. Different patients at different stages with different doctors using different care plans is a lot of variability. But on an encouraging note, I haven't heard of one person on this board who still have their voice box writing in to say they can no longer talk. If we are anything close to a statistical population, you are going to do well. I am a registered nurse who is both at the bed side and I teach some in the hospital in a classroom setting, and I make it just fine. And I started with no voice at all during most of my radiation and for a while afterwards.

Chas616

I am one year post treatment for SCC on both vocal cords.My voice has gone from really good to awful to pretty good and back to really good.For the first eight months both cords showed edema and swelling to point where my ENT started to become concerned.I would start the day really good and then get really dry and cough alot.It seemed that one thing fed off the other.One of the technicians who performed a video strobeoscopy on me told me to try throat cote tea and slippery elm.Both seemed to help. You can find them in a good health food or vitamin store. Only use the slippery elm liquid not the pills.Also my ENT told me never to whisper it does more damage than good.If it hurts to speak or you have to strain to talk don't do it.The fact that you can speak means the cords are at least moving.Remember you just finished radiation and it will take a long time before things are back to normal.Dont panic if you have a couple of good days and then have a few problem days.It seemed like it never failed that I would do great for a week or two and then the day before my doctor visit my voice would turn to crap.The bottom line is everybody heals differently and at their own pace.You are just starting the healing process and unfortunately sometimes you have to take three steps forward and two steps back before you get there.Try to stay positive improvement comes slowly.

ratface

Chas616 said:

I am one year post treatment for SCC on both vocal cords.My voice has gone from really good to awful to pretty good and back to really good.For the first eight months both cords showed edema and swelling to point where my ENT started to become concerned.I would start the day really good and then get really dry and cough alot.It seemed that one thing fed off the other.One of the technicians who performed a video strobeoscopy on me told me to try throat cote tea and slippery elm.Both seemed to help. You can find them in a good health food or vitamin store. Only use the slippery elm liquid not the pills.Also my ENT told me never to whisper it does more damage than good.If it hurts to speak or you have to strain to talk don't do it.The fact that you can speak means the cords are at least moving.Remember you just finished radiation and it will take a long time before things are back to normal.Dont panic if you have a couple of good days and then have a few problem days.It seemed like it never failed that I would do great for a week or two and then the day before my doctor visit my voice would turn to crap.The bottom line is everybody heals differently and at their own pace.You are just starting the healing process and unfortunately sometimes you have to take three steps forward and two steps back before you get there.Try to stay positive improvement comes slowly.

The frog eventually jumps out
It took alost 8 months for my voice to return to normal and I did not receive radiation directly on the vocal cords.I think your doing remarkedly well for where you are at and certainly you will be able to perform one of those jobs. Comunication is over 90% body language anyway. Don't rush it and it will conme. I could never sing anyway!

ToBeGolden

Thanks
Thank you for sharing your experiences. My logical brain knows that recovery will take some time, but my emotional brain feels that I should be well now. I had an emotional let down as the last day of treatment passed. I felt that I should be "over it", but I found myself in the middle of the battle. Well the let down has passed, and I am more my normal self. Today, I get to replace a blower wheel on our clothes drier. What fun. Actually, it will be fun. I will start tearing down the drier within the hour, and then I need to wait for the delivery of the blower wheel. Rick.

Greg53

ToBeGolden said:

Thanks
Thank you for sharing your experiences. My logical brain knows that recovery will take some time, but my emotional brain feels that I should be well now. I had an emotional let down as the last day of treatment passed. I felt that I should be "over it", but I found myself in the middle of the battle. Well the let down has passed, and I am more my normal self. Today, I get to replace a blower wheel on our clothes drier. What fun. Actually, it will be fun. I will start tearing down the drier within the hour, and then I need to wait for the delivery of the blower wheel. Rick.

4 weeks without voice
Rick,

Starting 2 weeks before end of treatment and going for a total of 4 weeks I totally lost my voice. It would come and go, but I mainly walked around with a board and marker. I started speech therapy at about a month out and that helped tremendously. I'm 5 months out and they tell me my voice is back to normal. When I talk too long with no water it tends to fade still, but overall it's back.

The good thing, my wife and I kick butt playing charades now after all the practice. Glad you're feeling better. Have fun with the dryer.

Greg

jbgoodjohn

My present concern is my voice has become very gravely with difficulty trying to clear my throat to speak. It turns out I had a lesion growing on my vocal cord. After surgery my voice was close to normal for 3 - 4 months, but six months later my voice feels very weak and sounds gravely again. After recent visit to Doc, everything looks good - no lesions. I have trouble speaking loud enough to order something at a drive thru .Voice is not strong enough to speak in a noisy atmosphere. I have had this 2 other times in 2012 & 2013 and after surgery in 2013 my voice has been fine. This time the Doc said its my age 60+, the 35 radiation treatments and being 20 years since being diagnosed with stage 3 squamous cell carcinoma cancer, that its not going to get any better. My question to anyone is there something other than water to keep the throat moist longer to reduce this problem a bit. A throat lozenge or a gargle mix to loosen the phlegm?

P. S If I can help anyone with my experience I would glad to do so. Good Luck

Thanks , John

wbcgaruss

Hello John, and welcome to the CSN H&N discussion forum.

I would recommend you check out the Superthread at the top of the page there are loads of information in there with links and you will find it helpful.

John, you are not alone I also can't order from a drive through I go inside and sometimes they have some trouble understanding me and I have to repeat some words. I had lymph surgery and I think my nerves were damaged during the surgery. I believe my cancer was a bit more extensive once they got in there and had to cut more than expected to get all the cancer. I have paralyzed vocal cords and I also had 35 radiation treatments and am also over 60 and you are correct as we age these treatments and aging are sort of a double whammy. We have to try our best to keep what we have and maintain it if that is possible. But damaged or paralyzed vocal cords, as far as I know, there is no way to repair them. Are you ever short of breath? Damaged vocal cords do not open far enough to give us enough air during elevated physical activity. I used to think vocal cords were just for talking but they also control our air intake. I know of at least several people on here who share the same problem but some of them are worse off and can barely whisper and do not talk on the phone because some can't and others that can whisper or talk very low get frustrated working hard t talk to someone and repeating words a lot.

As far as something other than water to keep your throat moist there is nothing in particular that I know of, just try different drinks or fluids till you get the best thing that works for you. Also, it may help to thicken your drink of choice a bit with a product called Thickenup it is worth a try and I will post pictures below. Possibly milk or milkshake mix, carnation breakfast drink. Go to the store and check the drink section, maybe you can find a juice drink or soda to try. The only problem I see is if you do use milk or milk-based or find a thicker drink of some sort it may solve your moisture problem but add to the phlegm problem you have. So I would say experiment with different drinks and lozenges, there are tons of lozenges out there, or maybe chewing gum, that stimulates saliva, I do that quite a bit. If you chew gum choose one with a high content of Xylitol and the way to figure that is the closer to the top of the ingredients Xylitol is listed the more Xylitol the gum has in it. Also, you may want to try a product called Xylimelts which are small discs that adhere to your tooth or gum so they are safe to use at night. A lot of it is just trial and error and what works for you as an individual in your situation.

As far as a gargle to loosen phlegm I would recommend trying what most of us used during treatment when we got the thick saliva during radiation and chemo treatment. You can mix it at home and it is a basic mix of salt and baking soda, rinse as often as needed. I will post the recipes for it below with pictures of all the products I have mentioned, and I also have a couple of videos about vocal cords. I hope this may help you in some way. Please scroll to the bottom of the page to see everything posted.

Wishing You The Best-Take Care, God Bless -Russ

Laryngology: Vocal cord paralysis

https://www.youtube.com/watch?v=pcTPOmNStPI

What Singing Vocal Cords Look Like

https://www.youtube.com/watch?v=D6mLc9gOgVA

Products Mentioned...

Salt and baking soda mix recipes...

John Here Are Recipes

For the salt/baking soda mixes.

Rinse as often or as little as needed to deal with thick saliva even the stringy stuff.

The trick is to stay ahead of it as best you can.

There are no easy solutions but this will eventually quit.

You may find it beneficial to sleep in a recliner to keep the thick stuff out of your throat and airway.

Laying down directs it to the back of your mouth/throat area.

Even in a recliner I would wake up at times with my air cut off and had to work at getting it cleared out.

Wishing You The Best-Take Care-God Bless-Russ

Mouth Rinse Recipes to Use During Chemotherapy

Soda and Salt Mouth Rinse

1/4 teaspoon baking soda

1/8 teaspoon salt

1 cup of warm water

Mix well until salt dissolves. Rinse your mouth gently, being careful not to swallow the mixture. Follow this with a plain water rinse to clean out any remaining salt or soda.

Soda Mouth Rinse: A Good Rinse for Before You Eat

1 teaspoon baking soda

1 cup of warm water

Mix well to dissolve the baking soda. This is a good rinse to use before and after a meal because it may soothe any mucositis pain you have, making it easier for you to eat well. Swish and spit, but don't swallow this mixture.

Saltwater Mouth Rinse

1/4 teaspoon salt

1 cup of warm water

Mix well to dissolve the salt. This saltwater rinse is close to the natural chemistry of your own saliva. This may make mouth sores feel better. Rinse well with plain water to remove excess salt.

Salt and Soda Rinse for Gummy Mouth

Some chemotherapy drugs can increase the acidity in your mouth, leading to thick saliva that can be very annoying. This rinse works well for "gummy mouth."

1/2 teaspoon salt

2 tablespoons baking soda

4 cups of warm water

This rinse will help to neutralize the acid in your mouth and will help dissolve or loosen thick, gummy saliva. Don't drink it, just rinse and spit it out.

Peroxide Rinse for Crusted Sores

If your mouth sores are crusting over, it's important to allow the natural healing process in your body to continue, so a peroxide rinse should be used for no more than two days consecutively.

1 cup hydrogen peroxide

1 cup water or

1 cup salt water (1 teaspoon of salt in 4 cups of water)

If you have crusty mouth sores, try using this rinse three or four times a day for two days. Don't use it for more than two days at a time, because it could prevent mucositis from healing.

Use a non-peroxide rinse for two days, before returning to this mixture.

Other products I mentioned that might help your situation or a dry mouth situation...

jbgoodjohn

Hey Russ, I really appreciate all the information you have provided, some tips I was not aware of, but the bottom line is we just have deal with it the best we can. I will try some of the your suggestions and hope to maintain some level of confidence when I speak. I worry about losing my voice altogether. If I can get 10 more years in with having a voice that is not worse than right now I would be happy.

Thanks again, John

wbcgaruss

John, you are very welcome, if I can be of help let me know by posting or private message. You are correct in saying we have to deal with it the best we can. I'll tell ya sometimes it's rough but you just gotta push through to the next day and hope for a better day. Also, I like to pray and trust in God for help in my times of trouble. Blessedly lately my troubles are light and they come and they go. I like it the best when they go. OK John take care. Russ

NEGU (Never Ever Give Up)