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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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Otolaryngology (ENT)
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