State Of Play.

So it's been six weeks.

Six weeks since the surgery that turned my life sideways. I was going to say upside down, but that sorta seems overly dramatic and not altogether justified. 

Or maybe it's just me being uncomfortable with the significance of all of this. 

So where am I at?

I still can't talk with any decent quality. I'm good for a few rasping sentences but I'm stuffed after about an hour a day and then I just can't make it work. Which presents a problem because, before all of this surgery, I committed to an author talk at a suburban library here in Adelaide later this month. I still want to do it so I've been resting my voice as much as is humanly possible and I've been working on my exercises three and four times a day in order to stretch the muscles in my throat because I really want to do it. I feel as though I need to do it. 

(Week 3. Would you wanna kiss this??)

My throat hurts like a mother f***er - all the time. 

I saw my surgeon earlier this week and he passed his camera down into the area where he operated. While it's healing, it's become inflamed and hyper sensitive due to some reflux I've developed. I'm now popping Somac daily (a protein pump inhibitor) to address the reflux and I'm swallowing Gaviscon four times a day. The Gaviscon is a thick cement like liquid - that tastes awful - which coats my throat and protects it against acids my natural desire to actually fucking speak.

It's ironic that the exercises I'm supposed to be doing are actually contributing to all of this. 

Oh - and I think I'm addicted to coedine.

I'm popping Panadiene like a junkie - well it feels that way - even though I'm actually sticking to the requisite recommended dosing of 6 hourly. The pain has localized itself to my throat, in the vicinity of my voice box - what's left of it and it feels like razor blades everytime I so much as swallow my own saliva. You would be amazed just how active the tissues and muscles of the throat are, even when you aren't doing anything. It's nigh on impossible to get any respite from it. And, of course, as all knowledgeable persons would know, Panadiene plays havoc with one's bowels. I am so constipated that I've added several classifications to the Bristol Stool Scale. Our toilet has become the equivalent of a missile testing range when I'm in there. It's hazardous.

I hate eating. 

I don't enjoy food at all right now. Between the pain from my still healing palate and my throat, meals are just a chore. It all tastes like metal and flesh. I approach the act of swallowing solid food with dread so much so that I'm starting to avoid them altogether. 

But it has done wonders for my waist line. I've dropped 5kgs in the past month and I'm still shedding.

Suck on that Michelle Bridges!!

I'm back at work. 

Because I do night duty, I can avoid talking for the most part outside of handover and introductions to my patients. They have been very understanding and have kinda dug having a largely mute ICU Nurse caring for them. My colleagues have been hugely supportive and somehow make it work so that I can work. 

(Walhalla - where I want to set my new novel.)

But I'm sinking into a state of functioning depression. 

I want my life back. Beyond waking and doing what I have to do to make it through each day, I'm not motivated. I am trying to write. I've largely mapped out a new novel but it all feels like a chore right now and I don't enjoy it and that's dangerous for a writer. I don't get out much. I clock watch a lot, waiting for the next time where I can pop some pills or drink some cement to ease my dysfunctional throat. It all weighs heavily on my mental well being. At the moment, life consists of just getting through and I want to do more than just fucking get through...

You know...?

DFA.

Isolation, Silence & Dysfunctional Fandom.

It's been a week since my surgery.

A long, slow, grinding week, characterized by constant pain, an inability to eat anything more substantial than liquids or pureès, an inability to form anything more than a few words that register above a whisper. I've spent long hours looking at the walls, wrestling with the most basic of decisions - (should I pick up that empty toilet roll tube off the floor so that the dog doesn't chew it - or no?)

I took a photo of the visible part of my throat last night. I wasn't sure whether I wanted to see it and I when I did see it I was sure that I didn't - and I wish I hadn't.

It is raw. It is mutilated. It is green! There is so much putrid slough in there that mere sight of it makes me want to gag. If only I could gag.

In short - I am thoroughly sick of myself.

I'll understand if you choose to vague out now because I know my misery can be interpreted as self indulgent. But I will say that blogging about this experience has gone some way in helping me cope with the situation.

And I will say that on Thursday, I had a slight bump in energy and motivation - enough that I took my dog Sam for a walk to the park and let him off to run around for a bit. Adelaide's parklands near my house are a wonderful open space, safe from traffic and just perfect for burning off some canine energy. Sam was, of course, as pleased as punch. The walk ruined me but I was glad I did it.

I also did some writing on Thursday. Not much - around two thousand words; but they are new words I've committed to a project I've tentatively called Walhalla - one that I've been trying to get going for a little while now. Again, my concentration collapsed after a few hours but, for a time their, it was really nice to just write something - to have some creativity flowing through me. I have only the vaguest idea of where this material will fit into an eventual story. That doesn't matter to me though. These things can be worked out later.

As I predicted, the pointy end of necessary human interaction is beginning to make itself felt and it is not encouraging. Of the few trips I've made to my local grocer this week, I've found them to be understanding without having to divulge the circumstances of my situation. Other places have regarded me with confusion, a latent suspicion and unabashed antipathy. One lady at the chemist the other day when I was trying to mouth the word tramadol, came right out and said, rather incredulously, "You can talk you know!"

A predictable ignorance.

The minute you hope for understanding, human nature comes in and shits all over it.

So I'm avoiding going out unless it's absolutely necessary. Soon, sadly, it is going to be necessary. I'm dreading that.

I think I'm done with pop culture. Looking through my social network feed this week, I've seen a number of spot fires raging around controversies within the Marvel and Star Wars universes and they are just so hack. Something about Captain America being a Nazi now and, shock horror, the forthcoming Rogue One film has to undergo some reshoots - like that never happens.

The pretentiousness of these hyper fans is really difficult to cope with and I feel as though there is an expectation on the part of some of them to engage in a war to justify some sort of defense of an ideology. It's fucking fiction! It's not key to human survival. Their consistent argument is that "my fandom is bigger than your fandom so your opinion has no validity!" I've encountered this personally in just the past week. It is confronting.

It's indicative to me that fandom is essentially broken and that maybe it is time to abandon certain franchises - *cough* Marvel *cough* that have already been twisted up in so many knots, the ability to ret conn them is virtually useless.

Further, I find that fans in my own beloved franchise have hitched themselves to it in sych a way that they have begun identifying themselves as "Star Wars" celebrities. That, because they flaunt their fandom as though it's some kind of penis symbol, they have assumed the right to be intertwined with the universe - almost as if they were in the fucking films themselves. It is annoying. Infuriating even.

I am trying to pay attention to the Federal Election campaign here currently because I like to think of myself as a responsible civic citizen and I want to take my vote seriously. But, I can't make sense of any of the arguments being put forward by the participating political parties. It's becoming lost in confusion and slogans. The only things the nation seems to have been talking about is the economy, superannuation, tax and jobs. Nothing about the arts. Nothing about social justice issues. Nothing about climate. We are a nation obsessed with money and the problems we face as a nation going forward require more than just money to address them.

But then I'm lost again.

Anyway, I have gone off on a major tangent. But it is illustrative of where my mind is at right now. I am unable to focus on anything for more than a short period of time before I am quickly distracted - then disinterested.

And I sit and look out the window.

There's a toilet roll tube on the top of the fence paling.

DFA.

Ground (Snore) Zero.

It's a damp Tuesday morning and I sit here, in the study, my mind swirling - literally. 

When I woke from my otherwise broken sleep at 6.30 this morning, the first thing I did was prepare my morning cocktail of medications. I'm currently on a regimen of pain killers including Celebrex, Tramadol, Panadol, an anti-inflammatory called Dexamethasone, a drug to prevent bleeding called Tranexamic Acid, an antibiotic called Amoxycillin and an antiseptic mouth wash called Difflam. Through out the day, I have to dose these out, interchanging the pain tablets with the others, so I can get a balance of effect that lasts.

Remember that scene in Prascilla - Queen of the Desert when Terrance Stamp's Ralph sat preparing his morning hormone pills by simply tipping them into a breakfast bowl and pouring milk over them? 

Yeah - that.

(I was seeing orange unicorns here.)

The downside of all of this is that it sends me loopy. My head is spinning, my balance is shot and my mind is foggy. Oh - and I'm having some awesome hallucinations. It's either that or endure a constant feeling of razor blades slicing at the back of my throat. I'm also experiencing a neuralgic pain that shoots up into my ears from either side of my jaw. I have to time the taking of these painkillers right so that the analgesic effect kicks in before I even contemplate eating anything. 

Eating. 

Everything I am eating presently is either soft or pureed. Which isn't actually as bad as it sounds. When I was in hospital, they brought me a little tub of pureed apple on my breakfast tray which actually tasted really nice so when I came home and Emily asked me what I would like from the shops, I made sure to write that one down. I've started pairing it with some Greek yoghurt and for the time being, it's a little treat to myself. I look forward to that one. I'm also sharpening my vegetable soup making skills. A soup pack from the shops containing a couple of carrots, celery, an onion, a turnip, a parsnip, a sweet potato costs like a couple of dollars. I add to that half a butternut pumpkin and slow cook the lot in some stock until it's all ready to be zipped into a puree. At the moment, I love this soup but I fear that I may tire of it quickly. I can drink cold tea - a Twinings earl grey. It's a bit pedestrian but, even cold, it's okay. 

My swallowing function, while it's affected by the post operative swelling and inflammation, is serviceable - so long as I don't have anything remotely solid. I tried some banana the yesterday. It sent my throat into a spasm that had my eyes bulging out of my head. 

I can't speak. My voice has been reduced to barely functional whisper and when I have tested it, it bloody hurts. I knew this was going to be the case but it now that the reality has set in, so has my depression. Trying to communicate with my family has proved challenging with me trying some rudimentary signing for obvious things and mouthing words in the hope that they will understand me. It works about fifty percent of the time but it has been bloody frustrating. 

So, I'm here alone in the house. Trying to keep my mind busy with reading and counting down the time to my next lot of pain killers. I have plenty of movies and a PS4 - I watched Deadpool yesterday. What piece of shit that was. 2 hours of my life I won't get back. Gaming is good for short periods but the games send me even more loopy and they make me feel sick. 

(Lucy makes the best Get Well cards.)

In all of this, there may be some light to look forward to. The surgery went well - very well in fact, and while the surgeon had to remove the bone from my voice box as was planned, he was able to preserve the anchor point between that bone and the right hand vocal cord. It's in a precarious state right now so I am forced to rest it completely - at least until the healing process is complete. 

So there's a chance that I can salvage some of my voice. A little one - but I'll take that right now.

DFA.

Listen to my interview with Alice Fraser, recorded before all of this malarkey.

The Snore Of Destiny Part Trois.

As I write this, I'm at a rather low ebb. 

A few weeks ago, as regular readers may recall, I underwent surgery on my throat to address an issue I was having with swallowing and choking - as well as an annoying snore. Throughout the course of investigation, it actually turned out to be a more serious issue than I had anticipated, involving the paralysis of one side of my vocal cords. You can recap on the short history here and here. 

The objective of the surgery was to create an area of scar tissue that would have the effect splinting my airway open so that it wouldn't flop inwards, particularly when I sleep and thus cause the snore. It was also going to address the problems I've been having with my swallowing which has, in a word, become scarily dysfunctional.

To cut a long story short, that surgery did not have the outcome we were hoping for. 

It didn't work. 

My swallowing remains dysfunctional and the snore wasn't neutralized. In fact, if anything, it's worse. 

I have tried to cajole myself along in the hope that it would all settle down, and once the healing process had run its course, all would be well. But it didn't turn out that way. 

So last week, after visiting my surgeon, I had to make a decision. 

I was presented with the option of returning to hospital and having a dual procedure that involves removing some of the tissue around my palate. This includes the uvula - that dangling, tear drop shaped piece of flesh that hangs down from the roof of the mouth and swings back and forth. The effect of this palatal flap surgery will be that it will open that section of the airway up and reduce amount of negative pressure that can be exerted on it when I sleep. Simply put, it won't vibrate and therefore I won't snore. 

The second part of the procedure is the trickier proposition. It involves going back to the area of my vocal cords that has been affected by the paralysed nerve supplying that region of my throat and removing the bone that anchors my right vocal cord. This is called the arytenoid bone. By removing it and applying the laser to that area of the throat, it will widen the airway as well as strengthen it by deliberately forming scar tissue. It will prevent food and fluid from entering that area of my airway that was sneaking in underneath the epiglottis. That's the flap of tissue that closes over my airway during swallowing and prevents food and fluid from falling into my airway. 

This is happening this week - this Friday.

The trade off?

My voice. 

I have to face the fact that this surgery will have a profound and permanent effect on my voice and my ability to speak. 

It has come to that because of the dysfunctional nerve that supplies my voice box. It won't recover from the viral neuritis that has affected it and so, what is being done now amounts to damage control. And I've chosen this route because - basically - I don't want to choke to death in my sleep because of some small fragments of food and fluid that has snuck into my airway.

I will require therapy afterwards to kinda retrain my throat and the muscles in it to adapt to this more extensive surgery. So I expect my recovery to be a lot more complicated.

But to sacrifice my speech...

Our voice is everything. It is a key part of who we are and without it, how are we to express ourselves?

I've been thinking a lot about this over the past week. Of course, expression and communication in this written or text form is so much a part of who I am & so I don't doubt that I will continue to express myself in this fashion. 

But, expression and communication is much more than simply words on a page. 

It's conversation. It's interaction with others. It's expressing ideas. It's singing shitty pop songs in a moment of abandon - either alone or in the presence of others. It's talking on the phone to loved ones far away.

It's reading stories to my children. 

I've been thinking about that one a lot. I remember a promise I may to my daughter recently that I would re-read to her The Guernsey Literary & Potato Peel Pie Society. I used to read it to her when she was first born as a way of getting her used to my voice. She always loved hearing me recount that.

What am I going to be without my voice?

I'm scared. 

...Friday.

DFA.

The Snore Of Destiny - Part Deux.

It's quite a thing to be travelling along, living your life and dealing with the mundane problems of life and then, suddenly, be forced into a sudden left turn that, literally, shakes shit up. 

So, remember that time when I was talking to you about a little problem I had with snoring? You know - when I'd resorted to a handful of "home remedies" in the hope that I could stop this throaty rumble that had people running from me as if I was the xenomorph from the Alien film series?

Well...it turns out that there is a reason for this snore - and it is one that I hadn't anticipated. At all.

I won't go into a long winded recap of the whole snore-fest. You can click through to read my original post and the rather screwy lengths I'd gone to try and stop it. 

After we returned from our family holiday on Kangaroo Island, I'd resolved to give this thing proper medical attention and I went to see my G.P. with the intention of nipping this thing in the bud right away. After examining me and determining that there was no obvious reason for me to suddenly have begun snoring, my GP and I decided to refer me to an ear, nose and throat surgeon. Because I'm *in the business*, as it were, I know a number of fine surgeons in this field. An appointment was duly made.

Upon visiting the ENT surgeon and having the somewhat wierd experience of a camera being threaded down the back of my throat right there in his rooms, a rather alarming discovery was made. It turns out that my right vocal cord is paralysed - specifically, the arytenoid cartilage that anchors the vocal cord to the  result is that during things like speech, breathing or the act of swallowing, the right side of my throat is collapsing inwards whenever the cords come together so that they don't close up properly.

image credit: Mayo Clinic.

In my discussions with both the GP and the ENT surgeon, a couple of things were happening in addition to the snoring that I'd kind of disregarded but were now, with the advent of all this, things that I should have paid more attention to. Over the past few months I'd noticed, on occasion, that whenever I engaged in exercise I would, after a while, find it difficult to breathe and in addition to that, my breathing had become quite noisy. I was producing a stridor. After exercise, I'd noticed that I had the feeling of a lump in my throat without any real explanation. It was uncomfortable but I'd gotten used to it and therefore dismissed it.

And, very occasionally, I'd noticed that I have struggled with swallowing - whereby I have actually choked on small morsels of food that would otherwise be considered innocuous. There have been a few instances of this that have garnered wierd stares and chuckles from my family but they didn't occur so often that we'd conisdered anything untoward about them. All these symptoms have gotten progressively worse in the last month or so and they've been harder to ignore.

So, on the day that I'm sitting in the surgeon's rooms and we're discussing a paralysed vocal cord, two things came up as causators for it - the first being a viral neuritis leading to an inflammation of the nerve that supplies the right side of my vocal cords. The cause for this is generally sheeted home to a viral infection which can be something as general as a flu. 

The other possibility was a lesion or tumour.

Alarm bells sounded in my head on that one as I recalled memories of my experience of the spinal cord tumour that disrupted so much of my adolesence. Whilst I'd been told that the chances of me having another tumour like the one I'd had in my spinal cord was remote, there was always a slight possibility there could be another schwanomma lurking around inside me. 

In light of this, it was decided that I should undergo two tests to bed down what we were dealing with - a sleep study to monitor the severity of my snore and its affect on my sleep and an MRI scan of my neck and chest to rule out the possibililty of a new tumour growing on the cranial nerve.

image credit: Auburn University.

If you've ever had an MRI, you'll know that it is, at best, a disconcerting experience. You are essentially placed inside a tunnel that isn't much wider than the average person from shoulder to shoulder. It is an uncomfortable and claustrophobic environment and moving inside the tunnel is not an option. Furthermore, a series of huge magnets revolve around you that create a noise unlike anything you've ever heard. It's loud and it's a little scary. 

For my scan, I had the additional *delight* of having my head and neck encased in a rather medieval cage, securing me in such a way that even subtle movements of my head were impossible. Scratching my nose was out of the question. For 45 minutes I was inside this machine, completely helpless and at the mercy of noise that would make Darth Vader quiver. 

The sleep study was a world away from that experience and I was able to complete it at home with a minimum of fuss. It's not really worth mentioning to be honest, but here's a nice picture.

The week long wait following the scan passed in a blur and I was pretty withdrawn for much of the time. The thought of possibly having a tumour - another tumour - was breath taking. Recalling those memories as a kid, going through serious surgery was unpleasant to say the least and it was all I could to keep myself from descending into panic.

Fortunately, the MRI was clear of any sign of a tumour. My relief at having dodged that bullet cannot be understated and I almost had an episode of urinary incontinence in the surgeon's rooms. The scan was able to visualize the defect in my vocal cord and noted the swelling caused by the snore and the general irritation of the tissues in my throat. The sleep study cearly showed that the snore accompanying my sleep state was significant though my overall sleep was rated - surprisingly - pretty decently.

So what's the next step?

Well, in a few weeks time, I will be admitted to hospital to have a more thorough study of my throat known as a nasoendoscopy. During that procedure, I'll be anesthetized and the surgeon will examine how the defect with my vocal cord causes my snoring. He also intends to examine my throat further down, to rule out any other causes or problems with my throat that might be contributing to all of this. The bigger part of the surgery, the part that I'm the most nervous about, will involve the surgeon applying a laser to an area of my throat adjacent to the vocal cord. He will, literally, burn it, creating an area of scarring that will, hopefully, prevent the vocal cord from collapsing in, causing the snore and the asymmetrical airflow over my cords that has caused so much trouble for me over the past few months. It will be a little painful and I may have some temporary difficulties with speech and swallowing but the snore will be gone and my wife will want to share the same bed with me again so that's gotta be a good thing right!???

This was a left turn I didn't expect to be taking and I certainly didn't expect that a snore would have a decidedly more complex root cause as mine does.

I get to be a patient. As a clinician - that's going to be a *fun* experience. 

You know what they say about nurses and doctors making the worst patients...

DFA.

The Snore Of Destiny.

So...I have a snoring problem.

I've had it for some time and it appears to be becoming more consistent. At least, this is what my partner tells me. For a while, I did the oft-done thing by...well...men and denied it. Told her that she must be dreaming it and I know for sure that I do not have a problem. And here was my first downfall - because my partner has an iPhone...and she knows how to use it.

Now, with this rather sobering evidence in hand, we both agree (trust me, I've checked) that my snore is not ground shakingly terrible, nor is it constant. But it is significant enough that it is waking my partner (who is a light sleeper) at night and forcing her to leave our bed. This is  depressing on two fronts.

Depressing that she has to leave the bed and thus I wake in the morning, alone...and depressing because of the realisation that another night has gone by in which I have snored.

Once I got over myself...and admitted that I have a problem, I have set about trying to solve it non surgically. Since my snore, as I've said already, is not an extinction level event - yet - it is reasonable to assume that I can correct this without resorting to cutting my throat out. I began by trying to contort myself into positions in bed and on pillows in such a way that would enhance airflow into my throat and neuter my snore. All I suceeded in doing was straining parts of my body that I did not think could be strained.

So, I proceeded to the next stage of non-surgical remedies - the kinds that grace many a pharmacists shelf. But herein lies the rub. There are so many non surgical "remedies" out there that it is almost impossible to work out what is B.S. and what is, well, not B.S.

I like to think I have a reasonable bullshit meter but, in the interests of solving this problem, I have committed to trying as many as I to see if I can hit the jackpot.

I first happened upon a packet of adhesive nasal strips or "splints" at my local chemist that are supposed to open ones nasal passages to allow greater airflow into the nose and throat. On night one, I applied one of these strips and, right away, I was dubious at best. At worst, I felt like a dickhead. Come morning, the snore hadn't resolved and the strip had disappeared from my nose and it was a complete mystery to us as to where it had gone.

Until I went to the toilet.

The adhesive is actually really strong. My pubes can attest to this.

The next remedy I tried was an anti-snoring throat spray. "Clinically tested" and boasting a "92% reported reduction in snoring" I gave it a go.

This shit is a cross between that cream in a can you can buy mixed with diesel fuel. You are required to insert the supplied applicator as far back into your throat as possible and spray for at least a full 1 - 2 seconds. It fills your throat with a foam that temporarily blocks your passages until it coats your throat in a disgusting slick.

It didn't work.

Yesterday, whilst on a leisurely drive out here on Kangaroo Island, we stopped by a Eucalyptus Oil Distillery at Emu Ridge.

Entering the shop attached to the Distillery and seeing the rows of little bottles of essential oils on the shelf, I immediately began to wonder if there might be a remedy worthy of exploration. There was, contained in a little booklet, just such a remedy supplied by a lady from Victor Harbour, who I am sure is a lovely lady who wears floral aprons a lot and bakes beautiful sponge cakes. The remedy consists of one drop of Eucalyptus oil, one drop of Tea tree oil and one drop of Lavender oil onto your pillow or a tissue at bed time.

Attracted by the thought of not having to shove a probe down my throat like a Face Hugger from "Alien", I bought three small bottles of said oil. Last night I tried the recipe on a tissue and couldn't decide whether to lay the tissue daintily on my chest or shove it up my nostrils. I tried both and dropped off to bed reading "The Casquette Girls" by Alys Arden.

I woke this morning, alone again...naturally.

These are early days admittedly, and the three failed experiments I have outlined here were always going to be a little out there. But, for the sake of my marriage and a harmonious budoir, the search for the Holy Grail continues. I'm the Indiana Jones on the trail of the Lost Ark of the Banished Snore.

I'm not happy.

Oh, and by the way...Happy Fucking New Year.

DFA.