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Wednesday, June 28, 2017

What Singers Need to Know about Surgery

Hi there,

I'm sure everyone knows that surgery under a general anaesthetic is not something to be undertaken lightly. But did you know there is an additional concern when you're a singer? A singer friend told me years ago that his vocal cords got badly damaged when knocked by the breathing tube given to him during surgery under a 'general'. While he and his voice are back to normal now, it cost him months and months of extra work, vocal therapy and emotional turmoil. Is there information someone could have told him that may have prevented it?

I had the misfortune to need fairly major surgery recently and so I recounted my singer friend's story to my surgeon. He explained that in some cases there are different options that may help a singer protect their most valuable asset. He told me it is always worth asking your doctor whether using a mask, instead of a breathing tube, for the anaesthetic is possible. In my case apparently, as with most longer and more complex surgeries, unfortunately there was no choice. Oh well, I filed that away as good knowledge to have for the future. Knowledge that probably would never have been offered up unless I had prompted it. Reminds me of what we are always striving to teach the 7 year old: 'If you don't ask, you don't get'. A more religious person might say: 'Ask and you shall receive'.

So it's the day before surgery, I'm at the Pre-admission Clinic and one of the forms I need to fill out actually asks the question: 'Do you have any concerns about the general anaesthetic?' So of course I state here that I am worried, as a singer, that the use of a breathing tube could damage my voice. Judging by the look on the face of the Clinic Anaesthetist, she hadn't come across this response before. I recounted the experience of my singer friend. She gave me a very direct look and said something like: 'that kind of thing would be pretty rare. It's our primary concern as anaesthetists to keep you alive during surgery, whether that means you can sing or not.' I couldn't argue with her there but also couldn't help thinking she may have underestimated how much my ability to sing is caught up in my personal definition of 'alive'.

Now it's time for the actual surgery. I'm prepared and wheeled in by the nurses. I'm introduced to the anaesthetist who is looking after me for the surgery. After the usual questions about allergies and medical history she asks me, in what seems like a throwaway conversational question, what I do for a living. When I tell her I am a professional singer, she looks again at my chart and back at me sternly. 'You should have said something!' She calls in one of the nurses and says: 'this woman is a professional singer - we need to change the gauge of the breathing tube we're using!' She then speaks to the surgeon and asks him if he is aware of my occupation and tells him that they should take every precaution when it comes to working near my vocal cords. I explain weakly that I had told the pre-admission doctor. Obviously that doctor didn't think it important enough to note on my paperwork. This doctor leans over me so that her face is right next to mine and says quietly: 'every time you go under general anaesthetic there is a risk of your voice changing or being damaged temporarily or permanently. You need to know that and you need to make sure that whatever can be done to limit the risks, is being done'.

All's well that ends well and my voice seems to be as it was before. I have a great deal of respect for medical folk - the study, the hours, the dedication. But they're often pushed to their limits, especially in the public system. And even with every caution, let's face it, we need to be the number one person to care for ourselves. While there are times we may literally have to place our lives into the hands of medical experts, we can try not relinquishing absolute control where possible. I don't pretend that a few anecdotes and a surfing expedition with Google puts me in any position to know more than a doctor, but I do think any extra knowledge that I can bring to the table before I get laid out on one, can only be a good thing!