Vagus the wanderer

There’s a nerve which runs from the brainstem down through the neck, chest and into the abdomen. Because it rambles round much of the upper body, it’s called the Vagus nerve from Vagus, the Latin for wanderer.

At a point roughly between the heart and the lungs, it branches off, curving back up into the neck where it sends signals to the muscles controlling the vocal cords. Because this nerve is relatively long and prefers to go the pretty way rather taking a more direct route, it’s at risk from injury in any surgery involving the head, neck or chest.

A few years ago I had a secondary bowel cancer tumour sitting roughly between the heart and the lungs - this nerve got a bit of a pasting during surgery, resulting in paralysis of my left vocal cord.

Not only does the vocal cord open and close when breathing or coughing, it also closes when swallowing. Or at least it should do. The procedure I’ve just had is not just about trying to improve my ability to speak but it’s also to stop me choking when I eat or drink. Now you know why your mother told you not to speak with your mouth full ….

Vocal cords are supposed to shut close, like a pair of sliding doors, in the centre of the voice box. Mine don’t. The right hand one makes the effort and sits there waiting, but the left hand one doesn’t; it skulks against the side of the voice box, refusing to move. So I’m left with a gap between the cords which means air is constantly escaping from my lungs. Wheezy voice coming out and food and drink occasionally going in.

I had a previous operation which involved injecting Botox and Teflon into this moribund cord in an attempt to fill it out, so it could meet the active one halfway. It didn’t work - too much went in and the left cord ended up looking like an over-inflated banana.

I was lucky and got a referral to one of the best ENT surgeons in the country. His plan is to try and remove some of the excess ‘gunk’ and straighten my banana, so to speak. And thereby help me to speak.

It’ll be a while before we know if its worked or not. In the meantime I am conversing with Anniemay by pencil and pad as she speaks. It’s all very well when we have a measured exchange such as ‘would you like a cup of tea?’ YES, I write back (I’m not shouting, it’s just my hand writing is appalling.)

But when things become more excited, like 'what's your blip for today ...?' these exchanges become scribble on my part and I’m going through paper like there’s no tomorrow. Not very environmentally friendly. I’m going to have to resort to text messages.