By Stephanie Stetson, Los Angeles Musician
It started as a routine doctor’s appointment. I don’t go very often, so it was a physical that probably hadn’t been done in years. “There are some lumps in your throat and you need to get an ultrasound,” said the doctor. After the ultrasound, I was told there were a handful of thyroid nodules- growths on my thyroid. I was handed some brochures about them. The doctors didn’t know much about them….not why they grow, what causes them, or even how to get rid of them. They just told me that I needed a needle biopsy to check and see if there were any cancerous cells. I’m not a good needle person, so I didn’t like this procedure very much. I was worried about playing my horn even after the biopsy, but things were fine at this point. A week or so after the procedure, I was told that the needle biopsy was inconclusive and that they wanted to do another one to get more cells. I was disgusted and didn’t go back.
I scanned the internet and read whatever I could on thyroid nodules. I even tried natural methods to get rid of the nodules, to no avail. I think it was 2 years later when I knew that I needed to go back to a doctor because the growth was now visible, and I could see it poking out from my neck. I had changed insurance companies by this point and after getting my records transferred and a referral, I could see a different endocrinologist. A new ultrasound showed that I had 5 growths that they could see, and the largest one had now doubled in size. The doctor ordered a more serious needle biopsy where they do lab work before they finish, and the results were normal, thank goodness. About a year later, because they wanted to keep an eye on the situation, they did another needle biopsy. These results came back as “abnormal cells” and they wanted to do another one. By this point I was having pain when trying to play the horn a few hours after the biopsies, I was still not in love with needles, I didn’t want to keep doing this every 6 months, nor did I want a growth coming out of my neck, let alone the concerns about cancer.
…a known complication from this surgery was a slight chance they could knick a vocal nerve, and if so, I probably wouldn’t be able to play the horn again.
The endocrinologist recommended a thyroidectomy. She said that the growths would be removed and I would not have biopsies and worries about cancer to deal with, I would just need to take a small pill every day for the rest of my life. What a bummer! My thyroid was even functioning properly and all my hormone levels were normal. So what did this surgery entail? Oh, they just cut about 4-6 inches across your neck line and pull the area up toward your face so they can see directly to the thyroid…! The doctors said that neck surgeries were serious because of all the important things in your neck: arteries, vocal chords, nerves etc….They said that a known complication from this surgery was a slight chance they could knick a vocal nerve, and if so, I probably wouldn’t be able to play the horn again.
I thankfully had a great endocrinologist who recommended an amazing surgeon that had performed thousands of these procedures. I had expressed my fear about this surgery and how concerned I was about being able to play the horn after it. I tried to find some articles online about other musicians, hopefully brass players, who had gone through this surgery for some reassurance, but I couldn’t find any information. I even brought my horn to my last appointment with the surgeon so he could see what I do to play the horn and how much pressure is on my neck. He was sure that everything would be fine and that I would only need 2 weeks off. I thought that he was crazy, so I planned on taking 3 weeks off just to be sure.
The doctors said the surgery was a success and they removed my thyroid along with all the nodules, and thankfully didn’t find any on my para-thyroid. Taking my one pill a day also has gone fine, and I have had no issues with effects from the medication or troubles with dosages. I did lose my voice for about 3 months, which my family didn’t really mind. The surgeon did a great job with the incision and unless you know to look for it, it is a hard scar to see.
Three weeks after the surgery I took my horn out, I had one week to get back into shape and be ready to play. I was hoping I would be able to play, I really was scared as I put the horn up to my face and blew into it. But, I was seriously relieved! I made a decent sound and It even felt normal,thank goodness! A few minutes in, though, I realized it was pretty hard to take a full breath, my throat area did feel different since the surgery. I was afraid to touch it, there were some numb spots, and there was some tightness and the loss of my voice. When I tried to take a breath, my vocal chords weren’t moving out of the way. If I bent my head down, then they were more slack and I could take in more air. The surgeon said that when vocal chords get harassed from intubation from anesthesia, they take a while to come back. Mine were still not vibrating, and so were not moving out of the way when I tried to take in a lot of air for a breath. So, for about 6 months, I would bend my head down if I needed a really big breath before I played!
Oh my gosh, I couldn’t tongue!
During my first practice session, after the relief of making a sound and realizing that I would need to bend my head to help with breathing, I moved on to an etude that required I use my tongue. Oh my gosh, I couldn’t tongue! It felt really weird. Things felt hard and in different places and I wondered why changes in my neck made this happen?! It took a lot of effort to get my tongue to do what I wanted it to, and it felt very different to make it happen. It felt foreign, like muscles and other moving parts were new to this tonguing thing. It felt like re-training, and I had to learn how to fine tune the ability once again. I have not done the anatomical research to know what was affected in my neck and why that would affect my tonguing, but it was a little scary. Thankfully over time, my tonguing has a new normal and things feel ok.
It has now been almost 3 years since the surgery and I’m still playing the horn and doing well. I think waiting 3 weeks was good before I tried to play. I had some demanding things to play the first couple weeks back and I was worried that my throat would give out or something might rupture, but nothing bad happened. I set goals and tried to be realistic and kind to myself. I even pushed myself and took an audition about a month after I came back. I wanted to work really hard and not lose a step. I’m thankful that I only had a couple issues to work through, and through daily practice (focusing on good air support and relaxation) and patience, was able to overcome it.