I love being able to go to church and sing praises to the Lord. Don’t get me wrong, I’m not a trained musician and my singing is little more than making “a joyful noise” to the Lord, but singing has always been a real joy in my life. Until this past Sunday.

Easter Sunday, I was grateful to finally be able to attend one of the worship services at our church. This was my first time actually being in a worship service since having extensive neck surgery last July. My husband and I have been going to our Sunday School class, but he was concerned that going to both that and the worship service would be too tiring for me. Then on Easter, Sunday School classes were cancelled and we decided to go to one of the worship services. I was doing fine until I tried to sing.

During my neck surgery, the nerve in my right vocal cord was damaged, and as a result my right vocal cord is now paralyzed. This has caused numerous problems with coughing, projecting my voice and even swallowing, but it seems to be gradually getting better so I was surprised at what happened when I tried to join in the singing. I could get out a few words and then my voice would crack and I couldn’t continue. It quickly became obvious that I would not be doing much singing. So my worship became silent, in my heart.

WHAT IS VOCAL CORD PARALYSIS AND WHAT CAUSES IT? 

Vocal cords are flexible bands of muscle tissue that sit at the entrance to your trachea. You have two vocal cords, which come together and vibrate to make sound when you speak (or sing!). According to Mayo Clinic, vocal cord paralysis occurs when something happens to disrupt the nerve impulses from reaching your voice box (larynx).

One of the main risks factors for vocal cord paralysis is undergoing throat or chest surgery, either from the surgery itself or from prolonged use of a breathing tube during the surgery. I knew of this risk prior to my neck surgery, but my neck was in such bad condition that the pain was debilitating and not doing the surgery came with an even bigger risk, complete paralysis from the neck down. So after much prayer, we made the decision to go ahead with the surgery. In spite of the complications I’ve experienced, I don’t regret this decision. 

Other causes of vocal cord paralysis include certain neurological diseases including Parkinson’s disease and multiple sclerosis, viral infections involving the larynx, tumors of the neck, chest or skull, and blunt neck or chest trauma.

SYMPTOMS OF VOCAL CORD PARALYSIS

Shortly after my surgery, I suspected one of my vocal cords had been damaged, because of a chronic cough and hoarseness when I tried to talk. Since then, I’ve learned that several other symptoms I had – and a few I didn’t have – are characteristic of vocal cord paralysis. They fall into three main groups:

1. Voice changes, including a breathy quality to the voice, prolonged hoarseness, loss of vocal pitch (especially difficulty with high notes when singing), and loss of volume.
2. Airway problems, such as shortness of breath with exertion, noisy breathing, and ineffective cough.
3. Swallowing problems, causing choking or coughing when swallowing food, drink, or even saliva, and food sticking in throat.

DIAGNOSIS OF VOCAL CORD PARALYSIS 

My paralyzed vocal cord was diagnosed by my otolaryngologist (ear, nose, and throat doctor), using a test called a videostrobolaryngoscopy. This uses a special scope that contains a tiny camera at its end, which the doctor inserted through one of my nostrils. By observing the lack of movement on the connected monitor, he was able to determine that my right vocal cord was totally paralyzed. Another test frequently used to diagnose this problem is a laryngoscopy, which uses a mirror or a thin, flexible tube (known as a laryngoscope or endoscope) to observe the vocal cords. Other tests include electromyography of the larynx, and if the cause is not known, sometimes blood work,  X-rays, MRI or CT scans.

TREATMENT AND PROGNOSIS FOR VOCAL CORD PARALYSIS

According to the doctor who diagnosed my vocal cord paralysis, this is a condition that sometimes corrects itself. Nerve damage, the underlying cause, often is reversed with time. Therefore, most doctors wait for a year or more before considering any treatment. My ENT said even if the damaged vocal cord doesn’t heal, sometimes the healthy one will move over and result in a reduction of symptoms. If this doesn’t happen, voice therapy is often prescribed. If your vocal cord paralysis symptoms don’t fully or at least partially recover on their own, there are also several surgical options available.

It has now been nine months since my neck surgery and four and a half months since my diagnosis with a paralyzed right vocal cord. Overall, the symptoms are mangeable and seem to be gradually improving. So I’m coping fairly well with this problem. I’m still hopeful that the damaged nerve will eventually heal and my voice, airway, and swallowing problems will be past. But right now they require using caution and being sure I’m sitting upright when eating or drinking and being careful to not strain my voice. And, as I learned last Sunday, singing may be on my DO NOT ATTEMPT list for a while still. But something positive came out of this Easter Sunday exeperience. 

I’ve loved Ephesians 5: 18-19 for many years, but suddenly these verses took on new meaning. I was reminded that true worship is more than singing. It takes place in the heart, and I had a delightful time of worshiping the Lord on Easter Sunday, even if I couldn’t sing.