When my voice got croaky about three weeks ago, I thought I’d just been talking too much. I had a sore mouth and was struggling to speak through uncomfortable dental fixtures, not to mention my usual problem of saliva pooling behind my numb left lower lip. It’s such a struggle to speak when saliva leaks out as soon as you open your mouth.
So three weeks ago on 20th May to be precise I was at the Writers Festival to see Eleanor Catton at 7 pm on a Saturday night. It was stormy with the bridge opening and closing all day so I’d gone in early. Waiting for the talk, I met various interesting people I knew or didn’t know – they all looked like English teachers to me – and I talked my head off. Went to the event and was quiet for an hour then talked all the way home on the bus. That was a lot of excited talking for someone who struggles to talk – I thought I was in my element.
Three days before, I’d been given an all clear at Auckland Hospital by a team of people. They looked down my throat with the endoscope to where I’d had the throat surgery in 2021 as well as checking the more recent surgical site. They agreed though that I probably had thrush because I had noticed that my mouth was stinging again when I used toothpaste. Thrush is often deep seated for me – not obvious in the abundance of scar tissue in my mouth.
I said I couldn’t take Fungilin lozenges, the most effective anti-fungal after the drug Fluconazole, because I couldn’t hold a lozenge in my mouth (I’m half choking on one right now) so they gave me Nilstat and Daktarin Oral Gel to try. They were both awful – I’d had both before – causing extreme stinging on my native tongue and making the whole mouth a place of misery. I thought there was something wrong at the Writers Festival but when I got home and for the whole next day I felt dreadful, my throat was hoarse and I decided that mild thrush was better than Nilstat and Daktarin.
I did improve after that. I even put some Oracort on the stinging part of my tongue and that gave me huge relief. My voice never really recovered but I wasn’t as croaky as I had been at the end of the festival night. Went about my daily activities, socialised quite a bit until last weekend when I tired myself out. I’d had a bad sleep and on the Sunday walked right around the Orewa Estuary which I hadn’t done for a while. That afternoon I had another crash with my voice failing me and a feeling of slight feverishness.
I wondered if untreated thrush was the cause of some of my problems so emailed the clinical nurse specialist after King’s Birthday Weekend explaining that I needed to force myself to use Fungilin because the other meds were evil. The script came through that day but I couldn’t pick it up until Wednesday night.
On Wednesday morning – two days ago – I was really hoarse. I had rested my voice all Tuesday in preparation for our support group meeting. Because I live alone I hadn’t spoken to anyone apart from the odd phone call since Monday. When I got to the meeting I realised that my voice was a problem and I was glad there were other spirited talkers there! My voice faded on me a couple of times and the CNS present took one look at me and texted her colleague, my own CNS, to make me an appointment. I’ve got the appointment tomorrow – a Saturday clinic with the Fellow who knows me well.
That was the first time I’d separated the strained voice from the mouth problems and on the drive home through sunlit winter steets a heavy feeling of dread settled deep in my chest. My 2021 surgery had been half way between my tonsils and voice box. There was so much dysplasia they expected new lesions and it had been a surprise that the next one turned up in my cheek. It would make sense if there was a lesion on one of my vocal chords.
That afternoon I had to race back to Orewa and change into gardening clothes for a planned walk across mudflats with my weeding group. My heart was heavy but our little expedition to Crocodile Island was a pretty good distraction. I made up my mind that I’d go back there one day just to enjoy the gloriousness of being on an absurd little island – have a cup of tea, watch the birds.
This happens often – once I got home and could process the information I could cope. That night I picked up the Fungilin script, had my first lozenge and figured that the voice might be affected by thrush. I recovered my spirits fully. Attended another small support meeting the next day, really struggled to speak but remined hopeful or at least neutral. I also read that gastric reflux can affect the voice but it is much less likely. I certainly had had a lot of reflux lately
Friday: was there a small improvement I think but my voice, always deep and deeper after all my treatments, sounded and felt like a hoarse bark to me.
Now it is Saturday morning. Another hour or so and I’ll be on my way. If my throat is all right, I’ll never complain about the gods again … and now it’s 2.31 and I’m back home after another sunshiny trip to the hospital. I’m fine! The vocal folds look okay but there is a swollen red patch in the throat probably caused by gastric reflux. I’m already taking Omeprazole but he says I should take Gavscon as well. He’ll also refer me to an SLT.
I should sip water frequently and inhale steam twice a day to moisturise my throat.
While there are still some concerns about my prosthesis rubbing on my cheek, I’ll take this result with bucket-loads of gratitude.
Thank you so much Auckland ORL team and cancer gods.