June 20, 1997

Well, here I am. I went to speech therapy again today. Jennifer is teaching me esophageal speech. It is pretty hard, but I have just started learning it. I feel like I am trying to talk on a burp! I have been working with an artificial larynx since the surgery. I have the "neck type". I think it looks like a little flashlight, without the light of course. It is small, tube shaped. It also requires batteries. I am going to have to remember to always keep extra batteries around, just in case mine happen to go dead (Web Whispers, 2001).

It has taken some time, but I am getting used to the artificial larynx. It is a good option for me. I do sound a little electronic, but people can understand me better now. I may sound unnatural, but at least I can communicate! Jennifer says that it may take a while to master esophageal speech. A lot of laryngectomees prefer esophageal speech because it is spontaneous and they feel it is more natural (Lauder, 1970). I do not know if I like it yet, though. She says that since I live alone it is important that I be able to communicate intelligibily. She is right. In an emergency, a stranger may not be able to help me, because he could not understand me when I spoke with esophageal speech. And, I love to talk on the phone to my girlfriends and they can understand me much better if I am using my artificial larynx. I have also noticed that people understand me better in public, like in a crowded restaurant or the mall. Jennifer says that in really stressful situations an artificial larynx is good to use because stress makes using esophageal speech more difficult. The electrolarynx makes me sound louder, too (Lauder, 1970). Right now, it is easier for me to communicate using the artificial larynx.

March 15, 1997

Hello, again, it’s me Barb. It’s been a long time since my last entry. Boy, have I been through a lot,and the worst is still to come! About 2 weeks ago, I had an appointment with Dr. Jones. He is an otolaryngologist (I hope I spelled that right). Anyway, my medical doctor referred me to him because I was coughing up blood, had ongoing ear aches, and I was hoarse (The Voice Center, n.d.). Dr. Jones says that I have laryngeal cancer. I have really been struggling with the fact that I have cancer. I know that it is mostly my fault. I should have quit smoking years ago, or better yet, never started! Now I am going to lose my voice, and maybe even my life!!

Because the cancer involves a pretty big part of my larynx, I am going to have to have a total laryngectomy. Dr. Jones thinks all the cancer will be removed through the laryngectomy. That is good, but I am afraid my life is not going to be much after the operation. I mean, I am going to look like a freak! I am going to have a big hole where my larynx is supposed to be, and they tell me a stoma takes a lot of care. I am also going to sound strange when I talk. What man is going to find me attractive now? Not one in his right mind anyway!!

So many things are running through my head. What if I get this laryngectomy and the cancer does not go away? What if it spreads, or maybe it already has and they do not know it yet?! I will have gone through this operation for absolutely no reason!

Dr. Jones has talked to me a little bit about the procedure; what a laryngectomy is and what I am going to be going through. He also set me up to talk to a surgeon. My speech-language pathologist has been the most helpful, though. Dr. Jones recommended her. Her name is Jennifer and she is great. She was really patient with me and answered my questions about how I will communicate after my larynx is removed. We talked about 3 options: TEP, which I believe she called it Tracheo-Esophageal Puncture, esophageal speech, and artificial larynx (AKA electrolarynx). She wants us to try an artificial larynx first because it will be an immediate method of communication right after the surgery. She says that esophageal speech, though many prefer it, is not easily mastered at first (Lauder, 1970). She says that not everyone is successful with it, but that we will try it a few weeks after the surgery. Jennifer also hooked me up with a former client of hers who is a laryngectomee. She thinks it would be a good idea for me to talk to him, since he has already been through the laryngectomy and all. I think it is a good idea, too. His name is Jay, and I am going to meet him tomorrow.