Reply Fri 10 Feb, 2012 11:44 am
How My Voice Went Silent
by Richard Harris
February 10, 2012

Everything looked fine on my CT scan, but I didn't sound even close to right.

There's an old joke around newsrooms: News is something that happens to your editor.

If you'll pardon the self-indulgence, I'm going to take this truism one step further: News is what happened to me.

I was laid low the week before New Year's Day by a mysterious headache and a blazing sore throat. A few days later I lost my voice.

My doctors eventually pinpointed the cause by snaking a small camera down my nose. My left vocal fold (or vocal cord if you prefer) had stopped working. It was essentially paralyzed, other than the occasional twitch.

Being a science reporter, of course I dived into the medical literature to see what was up. It turns out that good statistics are hard to come by on how frequently Americans suffer from this condition, unilateral vocal fold paralysis.

Dr. Thomas Carroll, a voice specialist at Tufts Medical Center, told me he sees about 100 cases a year. The same is true for Dr. Lee Akst, who ultimately treated me at the Voice Center at Johns Hopkins.

So, given that there are about 150 voice specialists in the U.S., that means there are probably something like 15,000 cases a year that come to their attention.

Other research suggests that about 1 percent of the population may have only one working vocal cord, but the effect on the voice is slight enough that it can go undetected. It may take two to tango, but one vocal fold vibrating next to a silent partner is good enough for a soliloquy.

The disruptive cases, like mine, are often caused by a surgeon who accidentally nicks the nerve that controls the left vocal cord. That nerve actually travels down into the chest, so it's potentially in harm's way during heart surgeries. That kind of medical boo-boo is known in the trade as "iatrogenic," which I guess is what the ancient Greek physician Hippocrates would have said when he meant "oops."

I hadn't had chest surgery over winter break, and a CT scan revealed no obvious cause. So doctors call my kind of case "idiopathic." That word has the same Greek root as "idiot," but in this case it applies to medical ignorance. So they half-heartedly blame a virus, the typical medical fall guy.

Whatever the cause, unilateral vocal fold paralysis is not particularly salutary for someone who makes a living on the radio. To give you an idea of what I mean, here's a snippet of a report I did back in October, when my voice was hearty and hale:

A healthy Richard Harris.

And here's what I sounded like in mid-January:

Richard Harris down a vocal fold.

One doctor said the easiest course of action was simply to wait it out. Sure, it could take a few months for my voice to return, but what's the rush? But waiting isn't the only option.

It turns out this disorder is common enough that there's a line of medical products to address it. My specialist at Johns Hopkins showed me a box of the stuff. Inside was a vial containing water, gelatin and sodium carboxymethylcellulose. Yes, cellulose as in the indigestible fiber that tree trunks and paper are made of.

I'll spare you the gory details, but suffice it to say the doctor injected that gelatinous stuff next to my paralyzed vocal fold, and pushed it over so it was lined up next to the one that's still working fine.

That closed the yawning gap that made my voice so breathy. And the result isn't bad, as you can hear:

Richard Harris recovering.

Over the next six to 10 weeks, the carboxymethylcellulose will degrade in my gullet. That will buy time for the nerve to heal, which it often does. And in the meantime, I'm back on the air. It may sound a bit like I'm suddenly smoking two packs of cigarettes a day. But don't look for me outside by the ashtray.
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Type: Discussion • Score: 3 • Views: 2,495 • Replies: 11
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Reply Fri 10 Feb, 2012 12:25 pm
Must have been very scarey for him.

NPR's Diane Rehm (sp?) has a vocal chord disease, too. That must be very upsetting for people who make their living by their voice.

When I see singers, announcers or DJ's smoking cigarettes, I just shake my head.

Reply Fri 10 Feb, 2012 12:37 pm
Diane Rehm suffers from the same diseas as RFK, Jr.

"Spasmodic dysphonia (or laryngeal dystonia) is a voice disorder characterized by involuntary movements or spasms of one or more muscles of the larynx (vocal folds or voice box) during speech."
Reply Fri 10 Feb, 2012 12:46 pm
I didn't know that. Thanks for the information.

Reply Fri 10 Feb, 2012 02:32 pm
YVW. I listen to her often here in Sarasota, FL on her show on FM NPR. RFK Jr having this same illness was a surprise. Prior to this recent awareness, I never heard of the illness nor knew anyone to have it.

On a different note (pun intended), the singing mega-sensation Adele, just had surgery for a hemorrhage to her vocal cord - undoubtedly brought on by her abusive smoking and concert schedule. The Grammys will be her first public concert since her surgery.
Reply Fri 10 Feb, 2012 02:40 pm
Speechless: Dilbert Creator's Struggle to Regain His Voice

The rules dictated when and where Scott Adams, the chief engineer of the Dilbert comic empire, was allowed to speak. He could neither control them nor predict exactly when they'd go into effect. All he knew was that he'd woken up one morning and found that his voice had turned against him, imposing a set of bizarre restrictions.

Take the rule about crowds. If Adams was at a party with friends, he'd open his mouth to talk, only to find the words tumbling out in a raspy, imperceptible staccato, chopping off sentences before they had a chance to form. If he tried to say, "Tomorrow is my birthday," for example, it would morph into a weak "Ma robf sss ma birfday." But if he was on the lecture circuit, delivering a prepared speech to a crowd of thousands, he could stand behind the podium and—"Hello!"—his voice would whir back to life, if only for the hour he was onstage.

There was also the rule about being alone. Adams might be sitting at the desk in his Bay Area office, working on a new Dilbert strip, when suddenly he'd be able to form words. He'd call out to others in the house—"I can talk!"—but the moment somebody stepped into the room, his voice evaporated.

Then there was the rule about the rules themselves. For some reason, if Adams were to explain his condition to you, his speech would suddenly become clear and strong. Change the topic, however, and his voice would jumble again.

But if you were to place a video camera in front of him and have him talk into it—well, in that case, he could be relatively lucid about anything.

That one still baffles him.

Reply Fri 10 Feb, 2012 02:42 pm
Could it be hysteria of some sort affecting the nerves?
Reply Fri 10 Feb, 2012 02:45 pm
Something called "Spasmodic Dysphonia."
Reply Fri 10 Feb, 2012 02:46 pm
Wow, that's fascinating. What a trip, as they used to say. (I deny ever saying that.) Thinking about it, I might have surmised it would go the other way, not being able to talk in a sort of dramatic situation, and yet being able to around pals.

Like your sig, by the way.
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Reply Fri 10 Feb, 2012 02:51 pm
Yes, as was discussed ... similar to Diane Rehm and RFK Jr.

Waving to Osso Wink
Reply Fri 10 Feb, 2012 03:00 pm
Hi, Raggie.

Also we have our own Roberta, who has a vocal problemo after a surgical procedure. Tough thing to go through as an aftermath to an already tough thing.
I heard her in person pre this trouble; that woman could talk you (well, all of us) around a tree.
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Reply Sat 11 Feb, 2012 09:00 am
I think a lot or raspy voices can be traced back to GERD.

We are just now finding out the damage stomach acid can do to the entire esphagcal system.
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