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Surgeons removed this patient’s
vocal cords—then helped him speak again
Imagine you’ve lost the power
of speech. Then, for good measure, pre-tend you’re
a bank vice president who needs to spend all day talking
on the phone. You’ll have an idea of what life looked
like for Kerry Jones about three years ago. Jones, now
57, is a survivor of cancer of the larynx, or voice box.
Call him up today, and he’ll tell you the story
in rich, mellifluous tones.
It started in October 1999, when the
Neptune City resident told his doctor during a regular
checkup that he felt fine, but had one problem: His voice
was weakening. And as a vice president at Fleet Bank in
Princeton working in managed assets—“a glorified
term for commercial loan collection”—he needed
his voice every hour of every day.
His doctor sent him to Monmouth Medical
Center otolaryngologists—ear, nose and throat specialists—Eric
L. Winarsky, M.D., (chief of otolaryngology) and Darsit
K. Shah, M.D. Dr. Winarsky examined him with a laryngoscope,
a lighted tube that isinserted through the nose, then
promptly summoned Dr. Shah, who also took a look. “I
could tell just by looking at Dr. Shah that this wasn’t
a go-get-another-opinion matter,” says Jones. “This
was the real thing.”
The doctors had found a large cancerous
tumor on Jones’ vocal cords. Because its position
threatened to block his breathing, Jones was in immediate
danger. As Dr. Shah later recalled, “He was only
hours away from a complete obstruction of the windpipe,
which could have killed him.” The next day Jones
was in the hospital for an emergency tracheotomy, an incision
in his neck to maintain his breathing.
“If I hadn’t already eaten
lunch that afternoon, they would have put me in right
then and there,” he says, noting that the general
anesthesia needed for major surgery requires an empty
stomach. A week later, Drs. Winarsky and Shah performed
a laryngectomy, an operation to remove the larynx and
vocal cords. “The tumor was encapsulated within
the vocal box,” says Jones. “That was fortunate
for me, because nothing had spread to the rest of my body.
But it had frozen the vocal cords—that’s why
my voice had been weakening.” With Jones’s
voice box removed, the doctors created a transesophageal
puncture (TEP). A TEP allows the trachea, or windpipe,
to be connected to the esophagus, or food pipe, with a
plastic valve.
The idea is that air is inhaled through
a permanent opening called a stoma, brought down the trachea,
then transferred through the valve to the esophagus. The
air continues up the esophagus to produce a new kind of
voice.“ It’s like when you were a kid and
you used to swallow air and then burp and talk at the
same time,” Jones explains. His old voice gone,
Jones had radiation treatments and worked on the breathing
techniques necessary to produce speech in this new fashion.
But scar tissue formed over the TEP and made it impossible
to insert the valve.
After returning to work in February2001,
Jones was able to make clients and lawyers understand
him on the phone with the aid of an electro larynx, a
hand-held electrical device held up to the throat to produce
vibrations through muscle tissue.“ But I sounded
like R2D2,” he jokes, referring to the robot sidekick
in Star Wars. Five months after the operation, Dr. Shah
examined Jones and wasn’t satisfied with the quality
of voice he had been left with. He decided to operate
again. “It’s sometimes necessary to go back
if results are not optimal,” the doctor explains.
“Now it becomes a relatively minor procedure, but
the quality of speech can improve immensely.” The
second operation was a big success, and Jones became adept
at controlling airflow to make his vocalization audible
and comprehensible.
Today his voice, while it has an unusually
deep and reverberant tone, is neither unclear nor unpleasant,
and he can talk for hours. Since 2000, his cancer therapy
complete, Jones has had checkups at six-month intervals
and passed with flying colors.
From time to time he has also spoken
with other patients facing laryngectomy and their families
to explain his experience and to show that there can be
life—and conversation—after the voice box
is gone.“I spoke recently with the wife of a man
who was going to have the surgery done,” says Jones.
“We talked for about 45 minutes, and as we finished
she said to me, ‘It’s amazing. I just realized
I’m talking to someone who’s had this done.
It’s just like talking to our neighbors—very
relaxed. “And I said, ‘It just goes to show
what modern medicine can do.’”
For more information on voice restoration
or other ear, nose and throat procedures at Monmouth Medical
Center, please call 732-870-5500.
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