VI. Seven Weeks After Surgery

Wednesday, July 8th, 2015 

After 6 weeks, I finally went back to my church job on July 5th, sang in the choir, and taught Children's Choir. I get to start teaching my private students and summer camps this week, and I cannot wait! 

My voice has never felt better. After 5 years of trying to "make it work," I forgot how effortless singing used to be - until today. For years, I would listen back to myself and feel like I was listening to someone else. Singing was filled with pain, fatigue, worry, MORE WORRY, and disappointment. 

Having this surgery was one of the best decisions I have ever made. It has given freedom back to my voice. It has stripped the fear away from my mind about my future and career. This journey challenged me to find my true self and to feed my soul. It is because of these 6 weeks of healing that I love to run. I ran two 5K races in a month and I do not want to stop there. I love to take the time to read and to actually finish novels. I LOVE YOGA...but most of all, I love to sing again. Wow. I would have never thought in a million years I would be saying any of that if it wasn't for this journey. Thank you to everyone for their support, prayers and positivity through this huge journey.

Is the journey over? No. There are many hours of practice and strength training to bring my voice back to it's full potential; several habits to fix. I feel like a musical athlete that just received a new pair of legs. The journey will never be over. A wise woman, teacher, and friend once said:

"It is not about the journey, but the destination."

That saying keeps playing over and over in my mind. I wouldn't ever want to take back this experience and these past five years of fighting to keep my voice. 

The journey will never be over. The path will never dead end. I'm excited to keep moving forward and singing with my new musical "set of legs."  

VI. Five Weeks After Surgery

June 24th, 2015

Today's post is going to be short and sweet because that's how my week was: short and sweet!

I am recovering fairly smoothly still, with some minor bumps along the way. I had another therapy session two days ago and it was exhausting. I am still trying to discern the difference between proper closure between the vocal cords and squeezing. It is really fascinating to feel how different singing is without that polyp in the way. I had gone over five years with that thing in there and discovered ways on how to make the voice work; now, I am trying to uncover the bad habits I formed and reverse them, slowly but surely.

My vocal therapy lesson lasted over 30 minutes, and by the end, my voice was SO TIRED! It is crazy to think that before this I would partake in rehearsals and gigs lasting 2-3 hours! As of now, that seems miles away. This week, my therapist built on the previous vocal exercises and also gave me another one to start.

1. Holding [i] ("eee") from C4-C5 individually, and as quietly as I can 
- Last week, G4 was a struggle for me. Now that note feels EASSSYYYY compared to my new notes that were added! (Which is how it should be!) Even before my surgery, B4-D5 were always troublesome - not only because of my break, but because of the pseudocyst. As you sing higher in pitch, your cords lengthen and stretch. With a polyp (and for some time, polyps) in the way, my cords would try to stretch and not be able to touch completely.

- I found my first bad habit I have to fix! I knew it was always there... tongue tension. My tongue tries to reach back and help squeeze the cords together as I get higher. My therapist made me take a napkin, hold out my tongue, and move it around to get rid of the tension. I have to do this exercise all week with my tongue out. I can hardly phonate as of now on B4 and C5, and I feel my tongue quivering because it wants to help out.

2.  Practicing onsets on [i] ("eee") from C4-C5 five times on each pitch, holding the last pitch
- From years of fear and attempting to avoid irritation and swelling of the polyps, my closere is too soft and let's too much air escape. This exercise helps practice this.

I have to do these exercises twice a day.

By the end of the 30 minute session, my voice felt almost sore, but not hoarse. My therapist advised me that this is the sign that you are doing things right. Throughout the day, my voice was so tired I was scared to talk. I attempted to start the exercises again later in the afternoon, but the cords kept breaking and two pitches formed. I got really protective and decided rest and lay low the rest of the evening. Luckily, that hasn't happened since Monday evening.

It's a process and I am making headway this week.

I am counting down the days before I can start teaching and singing at church again. A week and a half to go!

V. Four Weeks After Surgery

June 17th, 2015 


I am now a little more than halfway through my healing process, and I am so excited to see what happens these next few weeks.

First thing on the docket: I ran my first 5K this weekend. Because of the many weeks of limited speech and the countless walks/jogs, I decided to try and train to run 3 miles without stopping and signed up for the Color Run in Los Angeles. For those of you that know me, this was a really tough goal. I have never been a runner. But this goal to run without stopping and "finish the race" really made my dreams for vocal healing tangible. It reminded me that your mind is a powerful thing. Even though your muscles might be aching, you have the power to keep running.

In conclusion, I received the gold medal at the 2015 Color Run at Dodger Stadium for winning first place and being the fastest runner they've ever seen. The USA Olympic coaches have been contacting me nonstop, but I said I'll think about it. *

*(Yes, everyone received gold medals. Yes, I kept a 10 minute mile pace. Please...Don't shatter my dreams)

Last Thursday, I started small, short singing exercises with my speech therapist -

IT. WAS. AWESOME.

I was cleared to speak for 15-20 minutes per hour, and was given a set of three singing exercises to do, twice a day as well as the previous exercises as a warm up, until my next therapy session.

Because that pseudocyst was there for so long, my muscles and vocal cords found what worked. Now, as I am beginning this process, I have to retrain my brain and muscles to do something completely different and break old singing habits. You'll see in the video below I am moving my neck around to promote no tension while singing.

Within each day, there are good moments and then moments where my voice seems to be really struggling and fatiguing quickly. It has been hard to determine whether something is wrong or if the voice is just getting tired and I need to take a break. Another difficulty of mine is deciding whether my voice is too tired to do the singing exercises or if the exercises are just what I need to do to build them up. Pretty much a lot of:

I'm worrying about nothing stop worrying should I worry the worrying is making it worse.

....aaaaannnd your 15 minutes are up. haha

I have attached a video below to show you where my speaking voice is at and the singing exercises I am doing every day. I am really excited to show you my progress!

IV. Two and a Half Weeks After Surgery

June 7th, 2015 

Hi everyone - It has been 19 days since my surgery and the real work has begun.  I am sorry I have not written sooner, but this week and a half has been very emotional and taken a lot of patience. I have been trying to find the right words.

On Thursday, May 28th, I had my first speech therapy appointment and began to speak and use my voice again. My speech therapist cleared me to speak for 5 minutes every hour and gave me three vocal exercises to do, five times each, five times a day. Believe it or not, it is harder to speak in small increments than it is to remain completely silent.  The therapist said one thing that really stuck with me -

Speaking promotes blood flow. Blood flow promotes healing. 

 This has become my mantra and one of the first things I say out loud before I begin my exercises. I like to imagine my brain sending little red blood cell workers with yellow hard hats to my vocal folds to work on them.

It was incredible to be told to speak for the first time after a week and a half of silence. I guess a part of me was hoping for a glorious, strong, and easy sound to come out, but that was not the case.

It felt weak. It felt hard to project.
It felt... weird.
I wish I could describe it better to you, but I just can't seem to find the words.

My therapist prepared me and explained that the middle of the range is usually the last thing to come back. I spoke for 5 minutes/hour from May 28th to June 4th, and just started to talk for 10 minutes/hour on June 5th.

That first day was the hardest. Because of the bruising on the vocal fold, I was informed to be extra cautious and to really be aware if my voice to going hoarse quickly or if I felt any pain or extreme fatigue. Fear and worry really find a way to try and take over your mind in these times of weakness. The thought of somehow hurting my voice in this week terrified me. Another thing I noticed was that many people seem to feel nervous when I began to talk. Many would stop me to say:

"Don't waste your five minutes on me. Save your voice."

This really frustrated me at first, but I realize that this gesture is out of love and protection. I have so many people rooting for a full recovery and know that many are just trying to help. The more I have begun to speak and use my voice, the better and better it has begun to sound. There have been moments where my actual voice pops in for a few sentences and leaves - THOSE ARE THE BEST DAYS EVER. 

I have made a little video and have attached it below to show you the exercises I have to do and how my voice sounds at this point in the journey. 

I cannot WAIT for my speech therapy appointment this Thursday. I am going to get to sing for the first time in 3 weeks! Talk to you all soon, and remember - 

There is always hope.

III. One Week After Surgery

May 26th, 2015 

Happy Tuesday!
Today marks the seventh day that I have been on strict vocal rest, and MAN OH MAN it has been quite the adventure so far. Let's start from the top.

My Week of Silence:
The throat, jaw, and tongue soreness lasted until about the 22nd, or three days after surgery. I stuck to soft foods until then. Now, I am able to eat whatever I like. I am still staying away from spicy foods to avoid any burning or a case of the hiccups. (THIS IS SO HARD FOR ME. I LOVE LOVE LOVE SPICY FOOD.)

Because I am not allowed to weight lift or do any strenuous exercise until I am cleared, I found myself going on long walks throughout the week to get out of the house, listen to some music, and relax. I have been shooting for about 3-4 miles a day.

 I did really well refraining from making sound all week. I decided on using the British voice option on my iSpeech: Text to Talk application, and it's been THE BEST DECISION.

 I am becoming a bit more proper with every passing day. It's been rather splendid, ol' chap. Just drinking a cup of tea and eating some baguettes along the countryside. (I hope you read this in a British accent, or I'll probably sound a little crazy...) 

I suffered from a few coughs and sneezes here and there, but there is only so much you can do to avoid an involuntary action.  I had a few nightmares of trying to speak out loud in my dreams and would wake up terrified. The days passed, and no talking ...

until Sunday night and Monday morning.

1. (Cue Law and Order sound) Sunday evening, I was sitting in the living room with my dad when I started to hear loud booms outside and without thinking asked, "Are those fireworks?" My dad answered and I laid my head back down, only to realize I had spoken. I jumped off of the couch and cupped my hand over my throat. I tried to let it go and knew I wouldn't let it happen again.

2. (Cue Law and Order sound) The next morning, I spent some time in my room reading and finally decided to get up and grab some water around 10AM. Right as I was pouring my glass, my dad came out of his room, still in his pajamas. (Back story: my dad is an EARLY riser, and is usually up and about by 7AM.) Shocked, I looked up and said, "You just wake up?"

AH!!!!!
I couldn't stop screaming in my head.
I tried to stay calm, holding tears back.
How could I mess up again?

I was so emotional and frustrated that I ended up pushing away my dad who was chuckling and trying to put his arm around me in an attempt to relax me. I know what some of you might be thinking -

Seven words. That's all you said the ENTIRE week. 

This surgery is a true test of inner strength and patience. It has stripped away all of the things that I have used to define myself: jobs, working out, etc. It forces you to sit with yourself.


In silence.


 This surgery is challenging me everyday to discover who I am without my job. It dares me to find hobbies and activities that feed my soul. It forces me to spend time taking care of myself.

It reminds me constantly that it is about process, not perfection. This surgery is not only going to help me sing healthy again, but it is also going to help me evolve as an artist and a human being - emotionally and spiritually.

My Post Operation Appointment:

5/26/15 Waiting to see my cords and make sound!

I met with my ENT this afternoon to discuss the surgery and to check up on how the cords were healing. She reiterated how well the surgery went and that my polyp had shrunk so much, she couldn't even send it to pathology!

Dr. Gupta uses a Laryngeal Stroboscope to check on the larynx and vocal folds. This machine makes a video recording of a person while singing, and it strobes the vocal cords to slow down the motion. The doctor and patient can then review the findings together immediately after. 

Here is a photo from today's check up:

Photo: Vocal cords one week after surgery

As you can see in the picture above, I have some minor bruising and redness on the right side (left vocal fold) where the polyp was. This could be from some coughing or even the steroid injection that she did after the pseudocyst was removed. 

 As much as I was looking forward to having some talking today, Dr. Gupta has advised me to continue my vocal rest until this Friday. 

Looking at this before/after picture, I am filled with so much hope.  

March, 2015 (left side). Today(right side)

                                                                

Is there a bruise? Yes. Are they swollen? Yes. But look at the bottom of the new picture. THEY ARE TOGETHER. They are touching for the first time in five years and a half years. This is a great day.

II. Day One After Surgery

May 20th, 2015

I did it! My journey has officially begun.

I completed my vocal cord surgery yesterday at 12:30PM at the Osborne Head and Neck Institute in Los Angeles, CA with Dr. Reena Gupta (the BEST ENT in the UNIVERSE - totally not biased).

The Surgery:
I will do my best to explain my procedure and apologize in advance for any mistakes. I am sadly not a doctor. Bummer, huh?  Dr. St. Marseille has a nice ring to it...

Say "hello" to my vocal cords! 

I know what you're thinking: 

"Rachel, are you sure that's not an alien?"

This is the last still photo that I have of my cords from a video Dr. Gupta took of me singing in March 2015. In the picture, the right side is actually my left vocal fold and the left side is my right vocal fold. Before this photo was taken, I previously had two polyps on either side. I worked very hard to minimize swelling, and in doing so, got rid of one of those pesky buggers. This made surgery a lot easier because Gupta only had to operate on the left side. 

As you can see here, the psuedocyst (Right side in photo, actually left fold) was the only thing that touched when I sang. It caused a gap in between my folds on the top and the bottom, causing difficulty with my upper vocal range, fatigue, and pain from muscle compensation. 

In this surgery, Dr. Gupta removed that polyp. I decided to hold off on injecting a filler to the fold to ensure a better closure; My hopes are that with the polyp removed, my cords will be able to fix themselves. If not, a filler injection is always an option for the future.  

The Night Before:
My doctor and the anesthesiologist both called me in the evening to confirm my surgery time and what I needed to do before I arrived. Because I was put under with general anesthesia, I was asked to fast for at least 8 hours, and stop drinking liquids by 8:00AM the day of. I had to bring any medications I was taking and wear comfortable clothes (nothing that went over my head.)

The Day Of:
I woke up feeling a little nervous, but mostly filled with excitement and peace. Twenty minutes before I had to leave for the procedure, a song started playing in my head over and over, so I decided to make a video of me singing one last time before I was on vocal rest/limitations for a month or two. Watching the video again this morning, I can't help but smile. I decided to put it up on my youtube page today so I could post it here on my blog:

I've Got The Music In Me (Cover) - Rachel St. Marseille

This was an outpatient procedure, so my mom drove me there and back home hours later. Once I walked into the surgery room, it all started to feel real. I put on the gown, the comfy hospital socks, and laid down on the surgery table.

Anesthesia is a funny thing. My doctor said that my anesthesia was named Margarita and once it was in my IV, I was out like a light. I wish I could say I had an incredible dream where Celine Dion and I were riding horses into the sunset and singing "My Heart Will Go On," but Margarita did a number on me and I woke up what felt like five minutes later, surgery complete. One of the nurses stayed by my side as I wrote an essay on a piece of paper, asking her how it went and if she enjoyed her job. I guess even vocal surgery can't stop me from "talking" up a storm!

The entire procedure from start to finish (waking up from the anesthesia, etc.) lasted about an hour and a half. Dr. Gupta came in and told me the surgery was a big success and went smoothly. I ended up making a CD for Dr. Gupta, just so she can have a little piece of my voice before all of this happened.

5/19/15 - photo taken after I was out of surgery

The pain from surgery feels like a bad case of strep throat. Both my tongue and throat are still tender and sore this morning, but at least that lets me have ice cream for breakfast.

I am on strict vocal rest for the next seven days, and am not allowed to make any sound at all. My paperwork even says to try and avoid coughing, clearing my throat, and sneezing, if possible. Just reading that makes my throat tickle.

Come on, don't you feel like you have to sneeze or clear your throat now?


......How about now? :)

Friends keep asking me if it's hard to stay quiet. At this point, it is almost serene. I have a whiteboard to write on as well as an application on my iPhone, called iSpeech: Text to Talk. I have the best mom in the world, playing nurse and taking care of me. I have the support of my family, my incredible boyfriend, friends, teachers, and church family.

 I have hope.

I. One Week Before Surgery

May 13th, 2015 

Hi -
My name is Rachel St. Marseille.
I am a singer and I have vocal polyps.

After more than five years of struggling with this vocal injury, I have decided to have surgery to remove them next week on May 19th. 

In 2009, I was diagnosed with Thyroid Cancer and had to undergo major surgery and iodine radiation. Today, I can proudly say that I am five and a half years cancer free; my voice, on the other hand, has been a rocky road. 

The disease ended up weakening my vocal folds, causing a space, paralysis on one side, and polyps (pseudocysts). I have gone through years of voice therapy and rehabilitation to try to get rid of my polyps for good. Because my vocal folds do not close completely when I sing, I suffer from fatigue, pain, holes in my vocal register, and my polyps flare up once or twice a year.

After a busy holiday season, I made an appointment with my Ear, Nose, and Throat Doctor (ENT) in January 2015 because my voice was feeling "off" again.  Sure enough, the polyps had flared up. I couldn't help but sob.  My ENT informed me that after years of trying, this was the best my voice was going to get with vocal therapy. The only other option was to have surgery to have the polyps removed, and possibly injecting fat into one of my vocal folds, in order to create a better closure.

I felt like a failure. I was ashamed. Embarrassed. Defeated.

It took me months to decide whether or not surgery was the right thing.  I searched the internet to try and find articles, blogs - ANYTHING from singers who had surgery, experienced the healing process, and how their voice was doing now.

I found nothing.

I realized that singers do not like to talk about vocal injuries. So many thoughts crossed my mind:

- Will people take me seriously if they knew I was hurt?
- Why couldn't I fix this myself?
- Will my vocal students still trust me ?

After talking with my family, friends, and constant prayer, I knew that surgery is the answer.

This blog is to remind myself, other singers, musicians, artists, anyone with a dream:

There is always hope.

This blog is to help inform others who might be struggling with a vocal injury and not know where to turn. You are not alone. This isn't the end of your musical journey. You are strong. You are beautiful. You have a song that no one else can sing but YOU. Do not give up.

I rarely feel joy through the pain and fatigue. I've wanted to blame others for my voice being the way it was. I've wanted to scream every time I could hear myself out of tune, but couldn't control it. I now know that there is nothing to fear. There is nothing to be ashamed of. This was the hand that I was dealt, and if my passion to sing is worth fighting for, then I need to fight with every bone in my being.

I've spent years in a musical prison, constantly worried about my voice. This injury took away my freedom to sing. I am ready to break myself out. 

I will spend the next few weeks documenting my recovery in this blog and include videos and pictures of my journey. 

SURGERY IS NOT THE END OF MY DREAM.
It's the beginning of a new chapter.

Surgery, here I come.

6 days and counting.