# Voice loss post TT



## Skov (Sep 2, 2013)

(long time lurker, first time poster)

It has now been 7 days since my TT for toxic multinodular goiter. Both lobes were enlarged, the right one with a nodule > 5cm, which was resulting in choking and breathing problems. Due to a family history of rare squamous cell carcinoma of the thyroid and similar trending at my age and progression, I opted for the TT to address the symptoms and future risk.

While I still have some minor pain, tightness, and discomfort, I think I'm past the worst. Calcium is fine so parathyroids are functioning. I have my surgical follow-up at the end of this week to review biopsy results (nothing suspicious previously or mentioned post-op).

My biggest issue now is a* lack of voice*. I feel like I have to constantly clear water from my voice box area but nothing comes out, even after a hot shower. I can only whisper with a raspy voice and this is impacting me now that I'm back at work. The surgeon said everything was clear of the laryngeal nerve. I know that a breathing tube can cause laryngitis for a few days, but should I expect this to go beyond a week unless some sort of nerve damage has occurred? Any advice on how to expedite the process or do I need to wait for the ENT visit for assessment?


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## Octavia (Aug 1, 2011)

Hi. I researched this issue heavily a couple of years ago, and from what I understand, there is no expediting, unfortunately. I had major issues with my voice after surgery. Fast forward, and it's nearly totally fine now. But I will admit it was not fun, and it healed at its own pace, for sure.

The ENT will likely use a camera to look at your nerves. If those are fine, that's a very, very good thing. If they're not fine, then you'd likely have to wait several months to give them a chance to heal on their own. And if they don't, well...there's corrective surgery, but let's cross that bridge if we have to.

Can you talk at all? Is your voice working, but just weak and not projecting?


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## Skov (Sep 2, 2013)

I guess more patience is in order - something I'm usually good at - but it's frustrating with my first day back at work. 

I can talk, but it's either a whisper or a very air/raspy sound that is high pitched (almost a falsetto). I have no normal mid or bass range (male here BTW). The sound that does come out is weak and can't be understood across a room or on the phone. Otherwise, I can go through all the normal motions of speech with just airy output.


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## KeepOnGoing (Jan 2, 2013)

I had voice issues too after surgery - like Octavia says, it tends to get better, but very much in its own time! As a teacher, I know exactly what you mean about it interfering with your work.

I found the first 3 weeks were the worse (when I really thought it was never going to improve!). After that there was a slow improvement and it's now pretty much ok - certainly good enough to teach all day, though I struggle to really shout across the playground! I also found that I got a strange dizzy headache if I tried to talk too much.

It's definitely worth getting them to look at your vocal chords - I felt strangely better when they said that one of mine wasn't moving as well as it should. I also had some speech therapy. I'm not sure if this helped or just coincided with it starting to improve, but it made me feel better knowing I was trying to do something to help it along.


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## Kenwood (Aug 18, 2013)

I'm 4.5 months since my TT (Sept 6th) My voice still SUCKS. No improvement in months.

I can talk on the phone and have an in-person one-on-one conversation. But anything outside of that...is rough. At a restaurant or party...not a chance anyone can hear what I'm saying. It's so depressing and I've grown distant in those situations or I just don't even bother going or I leave early (like New Years Eve). Cant sing, no pitch or range, don't have that loud father voice I used to have. Been scooped twice (Sept & Nov). My levels TSH are slowing leveling out. I'm sure I'm the "special" case...always am! My goiters were crushing my trachea (see my thread for all details). They needed a special intubation tube as my trachea was crushed to 8mm (s/b 25mm). 6+ hour surgery. Last scooped showed no nerve damage, but he stills see the intubation issues (gave me meds). Everyone tells me to be PATIENT....hate that damn word now! I'll see my ENT again Mid-Febraury. But they have told me it could be a year or more.


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## Andros (Aug 26, 2009)

In some cases, depending on the extent of the surgery landscape, the voice box needs more time to recover. It is my humble opinion that perhaps you might need to lay back on that. You could be putting a further strain on things.

Glad you have posted and welcome!


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## Skov (Sep 2, 2013)

Thanks all. Patience is in order. I'll learn more on Friday when my surgeon does the post-op review with me. From what everyone has said, it's likely they'll scope me to assess the state and then tell me chill for a while. I'll need to assess if that means no work or work with some accommodation though, as that is what truly worries me. Well, that, and how to manage an unruly toddler.


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## marion (Jan 23, 2014)

I had a problem after TT surgery which went on for several months. My voice was a miuch higher pitch and very very shaky. Pschycologically because it sounded so frail it made me feel frail and ill. 
Yours will get better I am sure,as mine did, however I do feel for you. One other thing I was a smoker at the time and when I stopped I did find recovery was rapid.
Hope you are in full throttle soon


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## Skov (Sep 2, 2013)

I had my post-op meeting with the surgeon today. Apart from a lovely seroma that is bulging from my neck (he drained 6 cc of fluid to reduce it), everything is healing well. I can remove the surgical dressing that has been on this entire time just by scrubbing with hot, soapy water, and he says it will just peel off!

Based on (lack) of progress with my voice, He estimates it will be 4-6 weeks until my voice returns to a useful level. He indicated that he RLN looked 'thin' in surgery and so the irritation has likely disabled it until it can heal from the trauma of surgery. It most definitely was not severed, but is nonetheless impacted.

In 3 months, they will do some sort of video scoping testing to look at the vocal folds and determine if any voice therapy is needed.


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## Octavia (Aug 1, 2011)

Yeah, I'm not surprised with this "wait and see" approach (it's pretty typical, and these things take a LONG time to heal). I will send positive healing vibes your way! Do keep us posted.


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## KeepOnGoing (Jan 2, 2013)

Yes, that's basically what I was told too - they wouldn't actually do anything until 6 months to a year after surgery, as the vast majority resolve by themselves.

However, this doesn't necessarily make you feel much better, now! All I can say is that, in my own experience, it only started to get better AFTER I had totally despaired of ever getting any voice back. Mind you, it didn't take me very long to despair - I'm a teacher, (and a pessimist!) and I could hardly whisper by the end of the day.

So don't despair. I know how hard it is to "wait and see"...


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## angel711baby66 (May 7, 2013)

I had my TT last April and for about 4 months after my TT I had to keep clearing my throat when I talked. After surgery was over there was concern because my one nerve wasnt registering on their instraments at all! They told my family that either the nerve was dead or in shock. Thank god it was just it was just shock and that I'm able to talk. Everything is fine now expect after I have been talking for a long period of time or talking loudly...then I have a sore throat. I have never had this issue before but these occassions are rare and so I dont pay it much mind. The voice part is the least of the troubles that have come to me not having a thyroid!


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## gelf (Jun 20, 2011)

how soon did you go back to solid food after the TT? i didn't have much trouble with my voice, just the swallowing, so i stayed on the softer diet a little longer (course I love jello and icecream!).. i also sucked a lot of lemon drops that first month.


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## Skov (Sep 2, 2013)

I was eating more solid foods after 2-3 days. It wasn't too bad.


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## Neska74 (May 3, 2013)

I'll be honest, it took 6 weeks to get my voice completely back to normal following TT. It would seem to get better, then the next day I'd be back to a whisper. Nothing was damaged at all during my surgery, all went great, just seemed that my vocal cords needed time to recover.

Patience really is a virture ...


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## JessiKa (May 31, 2013)

I had my surgery May 28th 2013 and I still have problems with my voice. I lose it often and am often "clearing" my throat. I feel like I will be doing that for the rest of my life. I work with phones, and often get asked if I was sleeping, when I wasn't( which is really frustrating to me!), I am always have to explain that I had surgery on my throat, they stretched my vocal chords and now I sound like that once in a while.


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## Skov (Sep 2, 2013)

To close this out... My voice started to return a week ago. It was like a switch just flipped. It wasn't sustainable and would fall back to raspiness quickly. Each day it did get stronger and now it isn't a problem at all even with strength or projection. I still have issues singing in a higher range but I think that will pass too.

For those planning a TT, don't underestimate the importance of your voice and need for patience while you recover!


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## KeepOnGoing (Jan 2, 2013)

Good to hear it came back! You must be relieved.


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## Octavia (Aug 1, 2011)

That's fantastic!!! So glad to hear it.


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