My first appointment with my voice pathologist CK was on January 2nd. I felt this was appropriate: a new year was beginning and I had a miracle. I had vowed that if God was going to serve me a miracle on a silver platter, I would do EVERYTHING CK told me to do. I had no idea how quickly this resolve would be tested.
I was still sick, on antibiotics and very congested, so the few voice exercises she started me on were difficult, having to maneuver around the congestion. I kept at it, though, holding fast to my resolve to do everything asked of me. I really had no idea what to expect—my experience for years being that of getting sick, taking drugs, having a few weeks of “well” and then repeat.
CK understood this confusion and gave me a comprehensive explanation of how the subsystems of voice worked (respiratory, phonatory, and resonatory systems). She explained to me that I spoke while holding my breath, in glottal fry voice. Whatever my glottal was, I was sure it was fried.
One of my complaints was that I could not speak without my voice breaking, throat hurting, and feeling like I have to gasp for more air. Because of the position I held in my church [Stake Primary President for the LDS Church] I was required to do a great deal of public speaking. Truly the hardest thing for me to do was to stand, while wearing a painful band of constricting elastic known as a bra, and talk. I always ended up in a state of hyperventilation, unable to speak more than a few words at a time, so "projecting" was out of the question. She explained that glottal fry is the lowest register in phonation, and although it is natural, exclusively talking in glottal fry with an inefficient breathing pattern may be the culprit to my voice and breathing problem. Apparently, glottal fry is created by disengaging a pair of vocal fold muscles so that they flap around creating a creaky sound. She introduced something called resonant voice and explained that all I had to focus on was "easy throat and buzzy lips." I had no idea how making my lips buzz would bring about healing for me, but trusted her and gave it my best shot. It was very difficult. She brought out a cup half filled with water and asked me to blow steady water bubbles with a drinking straw. To my surprise, I could not do it. Repeated tries brought some bursts of inconsistent water bubbles but I could not sustain them for more than a second. Then she started talking about my breathing.
I was breathing inefficiently.
What? I didn’t care how I got the air in just as long as I got it in! But when we started working on breathing exercises, I couldn’t do them. I’ll never forget this session. She told me that the correct way to breath was like a fireplace bellow: our lower stomach and diaphragm expanding on our intake like that of the bellow opening up, our exhale was like that of the bellow contracting. I just looked at her, dumbfounded. I have spent so many years desperate to get air, any amount of air, in my lungs I never once gave a thought to how I did it. When you feel like you’re suffocating you don’t notice your form. [I now know I had spent years—my lifetime, really—breathing high chested: all neck and throat. A BIG no-no]
When I tried to breathe the “bellow” way it felt completely and utterly foreign. Like walking backward with shoes on the wrong feet, up a down escalator…it was horrible. Always so kind and patient, CK had me stand behind her and place my hands on her ribcage and abdomen so I could feel how she breathed, feel the “bellow” expand and contract. This helped me visualize what needed to happen, yet when I tried, my muscles just wouldn’t do it. [The “bellow” imagery is now one of my strongest tools. When I feel my breathing is off—usually when stressed—I visualize a bellow calmly expanding and contracting with life-giving air, and tell myself to “be the bellow; be one with the bellow; I am the bellow.” Works like a charm.]
After several awkward tries at breathing bellow-like, CK told me something that ended up being the first step in helping me trust my body. It was fair to say up to this point I had very little trust that my body could do anything but continually get sick despite my and my doctor’s best efforts. She told me that I was born breathing correctly and although I learned a maladaptive behavior somewhere along the way, my body would remember the right way. I needed to trust that my body would remember how it was created to work. This was my first encounter with the term “muscle memory,” a term I now use daily.
It was determined that I simply did not have the core muscle strength to do the exercises necessary to breathe like a bellow, so she was sending me “across the street” meaning across the 101 freeway, to a land called City North…to do some magical and popular form of physical therapy called Pilates Rehabilitation.
Did she actually say exercise? She obviously doesn’t understand my body because it DOES NOT exercise. It can try, but then it hyperventilates and gets sick. Pilates—isn’t that something rich women do with rubber bands? What would I wear? I don’t have exercise clothes…a whole lot of sick-day clothes but not one stitch of active wear. And what the on earth is a City North??? This was the crazy stream of consciousness going through my mind as I sat and stared in horror at CK as she got out a business card for AZ Body Mechanics and informed me that she would not see me again until I had gone to three Pilates Rehab sessions. She also told me she would be calling them to inform them of what they will need to focus on with me—she had sent several patients who were physically deconditioned from chronic illness and have seen them benefit from individualized physical rehabilitation. This was code for “it all stops here unless you’re willing to take this big step to help yourself and, by the way, I’ll know if you don’t.”
I numbly nodded at her as she gave me the business card and reviewed a few things for me to work on until I saw her again. I walked out to my car in a daze, feeling the “I have a miracle and will do anything” resolve crumble inside me. I followed her directions and drove across the 101 freeway which, of course, was still in Phoenix but could best be described as a Scottsdale-ish nightlife place filled with swanky restaurants with expensive looking condos on top of them. [Scottsdale is one of the more affluent areas in the valley of the sun…picture people who wear ridiculously expensive western wear and buy rubber spatulas at Sur la Table] In the heart of this setting, much to my dismay, was AZ Body Mechanics: a sleek, trendy-looking exercise studio. I parked my car across the street and stared at it for about a half an hour. I couldn’t physically make myself go inside.
What have I got myself into? My body felt heavy and sick and completely incapable of hauling a load of groceries into my house, let alone performing contortions with giant rubber bands. And this whole Scottsdale-like-thing was soooo not me. I was certain that all I had to do was walk in and announce that I live in a rural area known as Lehi, have twelve chickens and a cow, and I would be promptly escorted from the premises.
I just can’t do this, I said to myself as I felt tears roll down my cheeks. But I had told my laryngologist Dr. DL and CK that I was ready to be better…did I not mean those words? Was my commitment to myself and to them so weak that it would dissolve at the first challenge? I didn’t want to be that kind of person and in that moment decided to change—and was willing to try something new and frightening and uncomfortable to bring about this change.
I did not want to be sick anymore.
I closed my eyes and prayed for strength, then cleaned up my tear-stained face, tried to take a bellow-like breath and opened my car door.
To be continued…