Regaining his voice as a volunteer

Thyroplasty brings back a volunteer's voice after nerve damage left him without one

June 20, 2014
Volunteer Robert Nguyen and Dr. Sunil Verma, director of the University Voice and Swallowing Center

Imagine waking up one day and discovering you had no voice. How would you carry on your daily communications? How could you express yourself and manage your life?

That’s what happened to UCI Health patient volunteer Robert Nguyen.

In May 2011, at age 46, while living in Hawaii, Nguyen underwent open heart surgery. What started as one surgery spiraled into several. Nguyen lapsed into a coma.

After three weeks, he was pronounced legally dead. Machines and medications kept him alive.

Then, after months, Nguyen woke up.

He couldn’t talk. When he tried to speak, only a whisper came out.

But he was alive.

“It was a miracle I came out of the coma after two and a half months. My mom and the Upstairs Man were watching over me,” Nguyen said, referring to his mother, who was killed in the Vietnam War when Nguyen was three years old. “They said it wasn’t time for me to go yet. They weren’t ready to take me.”

Repairing a key nerve

In August 2011, Nguyen moved to Fountain Valley to live with his sister, a head nurse who could give him proper care. While everything else returned to normal, his breathy voice left him unable to communicate with others.

One of Nguyen’s new doctors referred him to see Dr. Sunil Verma, director of the UCI Health University Voice and Swallowing Center.

Nguyen could barely speak because the nerve to his vocal cord, known as the recurrent laryngeal nerve, was injured during his multiple surgeries.

Nguyen’s type of injury is not that uncommon, Verma explained. That’s because the recurrent laryngeal nerve runs from the brain into the chest and then travels “backward” up the neck to the voice box,  making it more susceptible to injury. Most nerves in the body don’t have to travel such great lengths to reach their destination.

Everyone has two vocal cords that are in an open position when we breathe in, but which close and vibrate together when we speak or make sounds. In Nguyen’s case, one of the vocal cords was immobile – called vocal cord paralysis – which prevented him from being able to make sounds. While sometimes there is no identifiable cause, Verma says, vocal cord paralysis can occur after thyroid, spine or chest surgery, or any surgery that puts the recurrent laryngeal nerve at risk.

When Nguyen’s vocal cords tried to vibrate together to make sounds, almost nothing came out.  He spoke in a whisper so soft it could not be heard over the normal hum of a car, or in a restaurant.  People could barely understand him and often mistook him for being deaf. His main method of communication was writing.

To restore Nguyen’s voice, Verma and his team performed a thyroplasty, inserting a customized plastic implant – hand-carved by Verma – into Nguyen’s voice box to adjust the position of the vocal cords.

“The most amazing part of this surgery is the patient is awake,” Verma said. “With local anesthesia, we numb the neck skin, and then locate the vocal cord inside the voice box, near the Adam’s apple. A small implant is placed inside the voice box, the patients speaks,  and the voice changes immediately, right on the operating room table! If the voice isn’t perfect, I change the size of the implant and put it back in.”

Talking back

Nguyen’s thyroplasty was an instant success.

”Dr. Verma took care of me in a special way. If it weren’t for him, I wouldn’t be talking to you right now. I would probably be using sign language,” Nguyen said.

Almost immediately after getting his voice back, Nguyen began volunteering for UC Irvine Medical Center five days a week, 8 a.m. to 5 p.m.

“The reason I volunteer is because I want to give back to the doctors and nurses. They are the ones who kept me alive. They were the ones who were there when I needed them the most, especially Dr. Verma and his staff,” Nguyen said. “And with the patients, I’ve been there and done that, so I know how they feel. So I just want to make them feel comfortable.”

Nguyen’s volunteering is a direct reflection of his belief in the rule of reciprocity.

“Dr. Verma and his staff gave me my voice back, and now it’s my turn to give back to them,” he said. “You cannot always take, take, take and not give. To me that’s not fair. If my mom were alive, I know she would be proud.”

— UCI Health Marketing & Communications