9th Report on Vocal Fold Paralysis

Course and distribution of the glossopharyngea...

Course and distribution of the glossopharyngeal, vagus, and accessory nerves. (Photo credit: Wikipedia)

English: Scheme of path of the recurrent laryn...

English: Scheme of path of the recurrent laryngeal nerve in Giraffa camelopardis. Русский: Схема прохождения возвратного гортанного нерва у жирафа. (Photo credit: Wikipedia)

This is the 9th report on my


personal journey through vocal fold paralysis. It is preceded HERE by the first eight posts. If you are a singer or a vocal music educator or coach, please consider reading through the posts to learn to identify symptoms and diagnosis process.

Today’s post is divided into three sections: 1 Psyche, 2) Science, 3) Poetic Expression

After about 5 months of steady improvement, measured in very small victories such as establishing some neurological connection to the middle vocal range, things seem to have gone backwards.  While I am sure that this is normal, the cha-cha of improving slightly to phonate a thin “sound” just to return to a strangled “bark” has caused deep discouragement. All the bravura and courage and stepping forward with trust and confidence have disappeared down a giant sink hole.

3 weeks ago I managed to progress from making the weird vocal therapy noises to actually singing the beginning two measures from Sibelius’ amazing romantic Swedish art song “Flickan kom ifrån sin älsklings möte.” (The Tryst) This song was part of the last series of recitals I sang in Washington, DC, concluding at The New House of Sweden for the Smithsonian Resident Associates.

I was so thrilled at singing two measures that I called Jeannie Lovetri, the singing voice specialist with whom I have been working, and she actually picked up the phone. “Jeannie!” I squealed. “Listen to this!!!” And I sang the phrase again. Jeannie and I chatted excitedly. I then called my principal teacher, Liz Daniels, and sang into her voice mail the same phrase. Then I called my mother and sang it to her. If a 77-year-old woman with two replaced hips could jump up and down, that is what she would have done. At that point, my husband came in the front door from work and I greeted him with the same phrase. He said, “well, alrighty then!”

And I haven’t been able to do it since. Not even close.

Recently I allowed myself some sad, pity-party days, which were an enormous relief. By letting go, I gave myself room to figure out that practicing my tertiary instrument, which I hadn’t really played in forever–flute–before I did the vocal therapy exercises, helped with the slog.  Making music and practicing Bach flute sonatas and Ian Anderson tunes were a wonderful balm to restoring motivation to do the tedious and difficult therapy exercises. I also returned to dancing to vintage belly dance music as a way to burn off frustration and begin to “dance” with my present life more completely.

For the first time I thought about the surgery the doctor recommended last February. But here’s the rub–if the vocal cords are healthy, which mine evidently are, and it is the nerve impulses that are not getting through, how is surgery going to help?  The otolaryngologist admitted it would be a trial to see if “it worked.”  As I have stated before, I have had way to much surgery in my life and decided to explore non-surgical alternatives.

II. “Anatomical Portion”

I have taken the opportunity to learn a bit more about the nerve pathways that govern the function of the vocal folds and larynx. The recurrent laryngeal nerve, responsible for making the vocal folds do their thing, takes an interesting and circuitous route through the body. Neurons which supply the laryngeal muscles with nerves, descend into the thorax and loop around a large artery before rising up along the trachea and esophagus before returning to the neck. In other words, these nerve pathways, after branching off from the vagus nerves (which exit the skull and run along side the arteries that supply blood to the neck and head,) dip down into the top of the chest, fairly near the heart, and come back up. Tracking the pathway of the nerves made the phrase, “sing from your heart,” take on a whole new meaning and shows once again the relationship among body, mind and heart.

III. “Poetic Reflection”

In the Biblical Psalms, often the singer/poet starts with a cry of fear and sorrow, and ends his lament with turning his eyes to the Prize, to “the hills from whence comes my help.” I am lucky in that I still have my speaking voice and a few low notes. I have an otherwise healthy body (ok, there’s 15 extra pounds) and lots of love around me.

But this poem speaks for me, a mirror for the conscious transformation and alchemy that seem to be my life path.

Rumi’s “Your Defects”

An empty mirror and your worst destructive habits,
when they are held up to each other,
that’s when the real making begins.
That’s what art and crafting are.

A tailor needs a torn garment to practice his expertise.
The trunks of trees must be cut and cut again
so they can be used for fine carpentry.

Your doctor must have a broken leg to doctor.
Your defects are ways that glory gets manifested.