Treatment
Correction of the underlying voice abuse cures most nodules and prevents recurrence. Removal of the offending irritants allows healing, and voice therapy with a speech therapist reduces the trauma to the vocal cords from improper singing or protracted loud speaking. Nodules usually regress with voice therapy alone.
Most polyps must be surgically removed to restore a normal voice. Cold-knife microsurgical excision during direct microlaryngoscopy is preferable to laser excision, which is more likely to cause collateral thermal injury if improperly applied.
In microlaryngoscopy, an operating microscope is used to examine, biopsy, and operate on the larynx. Images can be recorded on video as well. The patient is anesthetized, and the airway is secured by high-pressure jet ventilation through the laryngoscope, endotracheal intubation, or, for an inadequate upper airway, tracheotomy. Because the microscope allows observation with magnification, tissue can be removed precisely and accurately, minimizing damage (possibly permanent) to the vocal mechanism. Laser surgery can be done through the optical system of the microscope to allow for precise cuts. Microlaryngoscopy is preferred for almost all laryngeal biopsies, for procedures involving benign tumors, and for many forms of phonosurgery.
Last full review/revision July 2008 by Clarence T. Sasaki, MD
Content last modified July 2008
http://www.merck.com/mmpe/sec08/ch092/ch092h.html
So the next step is preparing the necessary documents to make this happen. The current plan will be to ship me to Panama, to a hospital PC uses for the region, where I will have to be reassessed by additional doctors there. Pending that everyone agrees, I will have the little procedure and most likely be on the silent requirement for a few days. From what my PCMO told me, I'll expect to be off island for 10-14 days. What is up in the air is a recent request I've made to have the process done back in Washington DC. I've had some discussions with a volunteer on St. Lucia and was told that is the best way to go. Since my PCMO had mentioned DC or Panama as an earlier option--I hope it isn't too late to shift to DC. Heck, they'll have to fly me to Miami just to bounce me back to Panama instead of the hop up to DC.
---UPDATE TO BLOG (2 July, 10:20am): Just had a conference call with my PCMO and Country Director (boss of all the Eastern Caribbean islands on post). It seems that Panama is my only option for treatment--take it or leave it. By leave it, that means a refusal of proposed medical care which was clear spelled out (by PC policy) a request for early termination of service. So...that was an easy choice, I'm going to Panama although the exact dates are still TBA.---
If things stick to the intended schedule, I'll be going sometime during the week of July 12th... At first I figured the time away would really mess with my work plans here and then I realized that I haven't really been giving myself much of a break. No I don't consider time I spend on the computer as a break; even though I spend too much time in my opinion on the computer--half of it is work related anyways. So if I get sent of island for the operation, I can use that time to catch up on studying my LSAT prep books. Yeah, I haven't opened them in well over a week. >.< I need to get on that..
More info to come as I get it.
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I've heard from several people back home...and times are hard. Financially, emotionally, physically people I know are facing difficulties from so many different directions and some are a bit lost on what to do with themselves. Even though things move and shift here at their own West Indian pace of life--I feel somewhat removed as if living in a vacuum from the rest of the world. I read some news headlines on the net and get email/chat updates from friends and family. Still, it seems a bit awkward not being able to do much of anything from here.
Back home, friends and family could always count on me to pause whatever projects I was working on and give a hand where it was needed. Sometimes it would be spending hours talking at Dennys just till life's mysteries seemed to make a bit more sense. One more than one occasion it was surprising homies with several bags of groceries and things they could use to help out when they were down. It was answering the call in the middle of the night to settle disputes or roadside rescues.
If it is one thing that life assures us, it is that the drama will never stop. I used to claim that life is one giant soap opera--every day is like another episode and depending where you are and who you're with it's like guest starring in a different show. Right now, I'm in a different show and I can't make the cameo role back home. Nonetheless, the drama continues in both places. Personally, stress is what we make of it and managed as best we can. Even with my throat situation and the many tough experiences we have here as volunteers, I'd say my stress level is near negligible. Even with the varied levels of chaos back home amid friends and family alike, my personal stress levels are again negligible. Yet I can't help but feel isolated from it all--helpless, unable to be that person I always was.
Not much sense in complaining about it. But for any of my readers from back home--know that at least my thoughts are with you.
Sometimes a song strikes a chord. For those unfamiliar with Within Temptation, I highly recommend them.
Stay safe and happy
ciao tutti
~your local wannabe jedi
~Shawn
2 comments:
Wishing you the best on your throat problem Shawn.
Yeah, it's at least good to know that something will be done about your throat pretty soon. Best wishes.
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