# Vocal cord paralysis and TT abandoned



## Shonkers73

Just thought I would post an update on how my total thyroidectomy went. It didn't! I woke to discover that my surgery was a difficult one. The 7cm nodule on my left lobe was very vascular and apparently when the surgeon opened me up, blood came gushing out. As he attempted to stem the flow of blood, the nerve to one of my vocal cords was severed. Fortunately, he noticed this and reattached the nerve but given these complications, considered it prudent to leave me with my right lobe intact. This lobe still has 2 x 2cm nodules present.

I am now left with a soft, husky voice and will need to see an ENT specialist and undergo speech therapy. On the plus side, I am hoping that I won't need thyroxine medication and that my right lobe will be able to compensate.

I am saddened by the outcome but not completely surprised. The large nodule ("a big beastie" as my surgeon referred to it) was growing behind my oesophagus and down towards my chest. It had to come out and given it's size, I expected complications. Just not the one I am left with.

I am trying to stay positive and focus on what I do have. After all, it is 2 days post-surgery and i can speak and communicate with my kids. My voice can only improve from this point. My limited googling has revealed that there are a number of things that can be done to improve the voice of someone with "unilateral vocal cord paralysis". I will know more once I see an ENT. I am immensely glad for having been a singer (not professionally, but for fun) as I already have a knowledge of how to project my voice using my diaphragm and am practising already.

I'll try to post more updates on my progress in case it helps others out there in a similar situation.


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## Lovlkn

I am SO sorry you have to deal with this. You will be in my prayers for a full recovery.


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## Andros

Goodness sakes! That is scary!! I am so sorry you had to endure all of this. Do know that you are in my prayers for a complete and total recovery of your voice and the rest of you!

Hugs,


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## KeepOnGoing

That sounds horrible! What an awful experience.

If it's any help, I had voice problems after my thyroidectomy - in my case the nerve was damaged (but not severed!). When I came out of hospital, I could barely speak. My right vocal fold wasn't really moving much at all.

The good news is - my voice came back, to the point where I'm about to resume full time teaching.

The bad news is - it took 3 or 4 months. There was a point when I was in complete despair, thinking I'd have to look for a new and silent career. My ENT said that he wouldn't consider further surgery etc until after a year, because it can sometimes take that long to get as good as it's going to get. Gradually, with the aid of a speech therapist, I was able to use my voice more and more. Now, the only person who notices that my voice has changed is me.

So, hang on in there! You're in my thoughts and prayers.


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## joplin1975

Oh no! I'm so, so sorry. Please do keep us updated.


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## Octavia

So sorry to hear this bad news. Since the doctor was able to reattach the nerve, does that dramatically improve the expected outcome?


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## Shonkers73

Thanks, everyone. Your kind words and replies really help. I'll know a lot more once i see an ent in the next week or so. The fact that the doctor reattached the nerve bodes better for me than if he didn't, but cutting rather than bruising the nerve is not ideal. I can speak and be understood which seems surprising at this early stage. I hope i only improve from here. Fingers crossed! Shonkers


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## jenny v

Ugh, I'm so sorry that this happened. But on a positive note, it's great that you can speak already given all that you've been through.


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## Octavia

I think the fact that you can already speak fairly well is a very positive sign. Sending more positive vibes your way!

:hugs:


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## Fonsini

I just asked basically the same question in the General Forum - how common is partial or total voice loss ?


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## joplin1975

Depends on the expertise of your surgeon. I asked mine that question and he said he's never had a patient with vocal issues.

I was yelling at my dog two days after surgery.


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## Shonkers73

My injury involved complete severance of one of my vocal cords. This is very rare (0.3- 3%) and is usually the consequence of haemorrhage type bleeding. What is more common, is bruising or trauma to the nerve which can cause vocal paresis or paralysis. This symptom is often short lived, however, and the voice usually returns in a few weeks or months.

I'm going to post another update in a couple of weeks but suffice it to say, I'm doing well and would have the surgery again and by the same doctor. Any surgery has its risks, and in this case, i was the one who drew the short straw.


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## Shonkers73

Correction: 0.3- 3% chance of nerve injury, not severance. Apologies!


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## Fonsini

Thanks - and best wishes for a speedy recovery.


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## indigovalley

I hope your recovery is going well. Have the doctors decided what needs to be done with the remaining thyroid? I am in the exact same situation although my nerve was not severed--just bruised---but like you the total thyroidectomy was abandoned. My doctor is trying to decide what should be done next.


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## Shonkers73

Hi there, Indigovalley,

Sorry to hear about your abandoned thyroidectomy. Given the complications with mine, my thyroid surgeon indicated that he wouldn't attempt a removal of the remaining thyroid unless it was "absolutely necessary". I took this to mean cancer or severe constriction of the trachea. Fortunately, he was able to remove one of the nodules on the remaining side, leaving just one small nodule left. Since my nodules didn't appear to be cancerous, it's now just a waiting game to see whether they grow and if so, how quickly and with what sort of complications, if any. I am hoping that if I do need the remaining thyroid removed, that it will be long into the future when modern medicine has found a way in which it can be done safely and with no risk to the working vocal cord on my right side. Any damage to my 'good' vocal cord would mean a tracheotomy for me.

If it's any help, from what I've read, the chances of your vocal cord beginning to work again are pretty good. Unfortunately for you, it's a waiting game to see how long it will take.

With respect to my vocal cord paralysis treatment, I have had 2 injections of a substance called restylane into the non-working vocal cord. This has helped immensely with the volume and huskiness of my voice but each time it is only a temporary fix until I can undergo surgery for a more permanent solution. This will be scheduled in the next 3-6 months, depending on how my recovery is going.

With respect to my remaining thyroid, this appears to be 'just' managing to do the job. In other words, I am on the verge of hypothyroidism. However, I don't feel any symptoms of hypothyroidism and am at odds whether or not I should take any medication. Your post has been a reminder to me that I wanted to ask this community of thyroid peeps their opinions on the matter. I'll post a separate topic with my before and after bloodwork to see what people think.

All the best with your recovery and the decisions you've got ahead of you. Am happy to try to answer any other questions you might have. Kind regards, Shonkers


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## Shonkers73

Last update (hopefully!) - It has been 2.5 years now since my left vocal cord was severed (and repaired) during surgery. Since then, I've had two restalyn injections under general anaesthetic to give my voice back temporarily. My ENT thought I would need surgery to restore my voice permanently but after 12 months, the unexpected happened. My good vocal cord started to compensate for the bad, the bad vocal cord moved into a more favourable position, and some tone returned to the bad vocal cord suggesting some nerve recovery. In short, I had my voice back. It is not the same as it once was. My voice fatigues much more quickly when speaking, colds and viruses seem to affect my throat and voice more than they once did, and my singing voice is less stable. But on the whole, nobody can hear a difference in my speaking voice. I have been very lucky to have recovered so well in comparison to others with this condition who can end up with very serious and debilitating breathing and swallowing problems.

In terms of my thyroid function, my half thyroid appears to be managing just fine. Although, my endo seems to think that as I age (I'm 44 now) this may change and I may need to go on medication. That's when I'll return to this forum again. 

Anyhow, just wanted to post a final update as I know these experiences are useful to read. This forum certainly helped me in the lead up to and following my partial thyroidectomy.

Shonkers


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