When was the last time you thought about your voice?
A personal story and reflection from Chris Reeves, Solicitor and Mediator
Your voice is a precious gift that defines who you are. It is a powerful tool that can express your emotions, thoughts, and personality. But what if you lose your voice? How would that affect your life? Imagine the challenges you would face in communicating with your loved ones, pursuing your career, and socialising with others. Losing your voice is not just a physical problem, but a psychological one as well. It can rob you of your identity and your confidence.
I was diagnosed with a very rare voice condition in January 2022, having had bouts of hoarseness over many years – which I had shrugged off and put down to the job until I reached the point where the effort to talk became too much to deal with. I stopped making phone calls. Working from home was more appealing than facing colleagues in the office. It was easier to email clients rather than engage in a conversation. Conversations I did have were cut short. I became frustrated with the effort as fatigue set in. By lunchtime I was done. The afternoon seemed unreachable. “Silence is golden” – indeed, but its nice to have the choice.
Mediation and legal practice heavily rely on voice skills: volume, pitch and intonation, not to mention stamina. When you have a voice disorder, the symptoms may alter your voice’s volume, pitch, and tone. This may change how your messages are conveyed and even received, causing frustration to both the speaker and the listener.
I therefore declined invitations to act as mediator which cut short my mediation career having just established Mediation4Construction. Were it not for the support of my team, my newly launched legal practice would also most likely fold.
This rare condition robs you of even simple things like talking on the mobile phone or ordering at a drive thru. Speaking takes a lot of effort. You drain the tank.
Diagnosis took years. The American cartoonist, Scott Adams (creator of Dilbert) described it quite well “I could speak to my cat but not to my friends on the phone”. You can forgive the ENT consultants for thinking my condition was brought on by a psychological condition. After many rounds of speech therapy (which resulted in absolutely no improvement) I took matters into my own hands and turned to our favourite diagnosis tool – google. I searched “opera singer therapist” – opera singers must get broken voices right? I was soon on a Zoom call with a specialist. I was lucky enough to have found someone who was aware of the condition and she suggested I go back to my consultant and ask for a specific test – turned out she was right.
The condition is abductor type spasmodic dysphonia (ABSD). ABSD affects around 1 in 500,000. People with this disorder have uncontrolled spasms that make the vocal cords stay open, preventing the production of sound. The diaphragm overcompensates to force the sound out. ABSD therefore drains you to the point of complete exhaustion. The nervous system is overloaded, making it hard to focus on tasks or maintain interest in work or activities you usually enjoy.
The cause of ABSD is not well understood, but it may involve problems in the part of the brain that controls movement. There is no cure, but some treatments can help reduce the symptoms and improve the voice quality. These include botulinum toxin injections. The drug is injected into the posterior cricoarytenoid (PCA) muscle located at the back of the larynx, which is responsible for opening the vocal cords. I chose to have the injection under local anaesthetic with electromyographic (EMG) guidance, which helps locate the muscle and avoid damaging other structures. Injections are not a cure and need to be repeated periodically to maintain the benefits.
I commenced injections in August 2022 and have repeated them every 3 months. I now get periods of “good voice” and more importantly relief from fatigue. The effects however are unpredictable and as experienced recently come with the risk of suffocation.
So I am sorry for declining those mediation invitations and to the clients who found the experience frustrating. I now live with my ABSD and have returned to mediation and legal practice with my new voice. If you are interested in the results of my treatment, then I would be delighted to show you. I am proud of my construction mediation track record and now find myself re-energised ready to go again.
26 January 2024
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