Can You Hear Me Now?

Before all the craziness in Hawaii, I wrote a blog post about my voice and how one side of my vocal cords is paralyzed. This gives my voice a higher pitch, and means I get mistaken for a woman on the phone. To help fix this problem, and to make it so I don't aspirate quite so much, I go to Vanderbilt University's voice clinic periodically. It had been a while since I last visited them (almost two years) so we decided to make another appointment. We made the drive to Nashville shortly before our vacation to Hawaii, and I'm just now getting around to describing the procedure I went through and how it felt. (Spoiler Alert: it ain't fun)

Basically, what the doctor does is inject collagen into my left vocal cord to 'beef it up' so the right cord doesn't have to stretch so far to meet it, ideally giving my voice a lower pitch. This is called a 'Laryngoplasty' (click on the word if you're dying to read all the details about it...DO IT!!!).

So, there are needles involved. Large needles. Into my vocal cord. 

I tried to use Grace as a human shield so I wouldn't have to go through it

The doctor who does the procedure, Dr. Garrett, is very nice and does this particular injection pretty often (they treat a lot of country music singers here). She started off by spraying lidocaine up my nostril so I wouldn't feel the tube with a tiny camera they're about to shove down my nose. The camera gave her a nice view of my vocal cords so she wouldn't accidentally spray too much collagen into my larynx, causing me to choke to death in front of my wife and daughter (I'm being overly dramatic here; that almost never happens).

Next, the doctor's kindly resident, Dr. Greene, injected more numbing stuff into my throat with a small needle so I wouldn't feel the--much larger--collagen needle. I asked Dr. Greene if he'd ever done this before and he said no, but he'd seen a youtube video of it so he had a pretty good idea of where to inject me. Ha ha ha. Very funny, funnyman.

"I think I'll stick you rriiiiiiiiight here"

 

"ow"

As Dr. Greene began to push the camera into my nose I screamed loudly in pain just to scare the crap out of him. He gets paid the big bucks to stick me with needles and ram stuff up my nose so don't tell me he didn't deserve it!

Once the camera was in place right at the point in my throat where I started to gag (the sweet spot), the doctors had a nice view of my vocal folds so they could make the injection.

My vocal cords either resemble Sauron's eye or a vagina. You be the judge.

Vagina. I can't be the only one thinking that.

As Dr. Green held the camera steady, Dr. Garrett carefully stuck a fat needle in my throat to inject the collagen.

"Whoa. This dude's throat is messed up."

The first attempt didn't go so well. She ended up missing the vocal cord and getting the collagen in my throat so I had to cough up a bunch of the stuff before she could try again.

"How would you like a mouth-full of collagen?"

The second try went better. Throughout the procedure I had to sit perfectly still and make noise (usually an "eeeeee" sound) to see if she was putting in enough collagen. Yeah, that's just what I wanted to do right then. Make noise without moving while a camera rested on my epiglottis.

"Go Broncos! Also, why are you hurting me?"

Following the injection, my voice was definitely deeper. I was also very hoarse and coughing up some blood. Dr. Garrett explained that this is normal and would go away after a couple days (which it did).

"It's so fun when daddy's miserable!"

The problem with this procedure is that it's not permanent. The collagen gets reabsorbed and/or leaks out of the vocal cord after a few months and I think my voice is already getting higher. I try to put off going back to Vanderbilt until I've forgotten all the pain I went through last time or until I get really sick of people calling me "Mrs. Liebenow" on the phone. So, if you call our house, just assume it's me, even if it sounds like Grace.

Jesse Jones

He's got a button and I have a PEG. Otherwise we could be twins.

I've mentioned my friend Jesse Jones previously. He had throat cancer in 1984 and it relapsed in 1987 and 1988. He received a very high dose of radiation to the left side of his head and neck to eradicate the cancer and it left him with symptoms very similar to my own (can't use his left arm, limited feeling on the right side, eats through a feeding tube). As an added bonus, Jesse is unable to speak above a whisper and he has to be on oxygen 24/7. 

We both like to throw our left arms around

Jesse has dedicated the rest of his life to helping others in similar circumstances:  tube feeders, cancer survivors, and all those on oxygen. He runs a website called drinkyourmeals.com. It's a great site where you can access more than 200 liquid diet recipes for people who are unable to chew or for tubies like me--or if your on a juice cleanse or something. Among other things, you can also build your own recipes, create shopping lists and connect with other people on a liquid diet for assistance and psychological support. Jesse has been blending his meals far longer than I have (12+ years), so he knows a thing or two about blended diets.

I'm extremely envious of Jesse for two reasons. The first is that he has this view from his apartment in Honolulu:

Grace was ready to move in

The second reason is Jesse's recumbent trike. Check out his awesome ride:

With 21 speeds, speedometer/heart-rate monitor and a sunroof!

Note the windshield, rear basket, clip-in petals, I.V. pole for hydrating fluids, and the fact that he has 21 speeds to choose from.

I also have a trike. My friend, Mark Brogan--a disabled veteran here in Knoxville--got a recumbent trike at a fundraising event. He wasn't getting any use out of it and he heard that I was trying to get one through the Veteran's Administration, so he generously gave me his. I love my trike. I ride on it most mornings to the grocery store, to Target, to Trader Joe's or out to the Knoxville Greenway near my house where I can ride to a whole lot of other stores (or, you know, exercise and stuff). Yet after seeing Jesse's beautiful, tricked-out trike I have to admit I'm a little jealous. Lets look at me on my trike:

7 lousy speeds, and how can I tell how fast my heart's beating??

Jesse is taking part in a 100 mile bike ride on September 28. He's riding in honor of the child of one of his best friends, who lost his battle with cancer. He's also doing this to inspire people on oxygen, cancer survivors, tubies, and anyone going through health issues to show us that these setbacks don't need to keep us from achieving our goals. You can follow Jesse's training on youtube: https://www.youtube.com/watch?v=0tS4ew7R2gE

He also has a fundraising website to collect funds to help him train if you'd like to support him on his journey: http://gogetfunding.com/project/ride-of-the-century. 

Still waiting for him to deliver my pizza...might be a little cold.

Now, of course, I'm looking for a 101 mile bike race in Tennessee just to one-up Jesse and prove I can do it (preferably a race with no hills). You Rock, Jesse!!!!!

Have I Mentioned Real Food Blends Before?

There are so many times when Real Food Blends isn't just a convenience but a necessity when I'm away from home. The importance of this product in my life was recently highlighted during our extended vacation last month. 

That first night of our trip, we stopped at a tiny Air Force base outside Riverside, California. We didn't have a car, so we walked to base lodging and then on to our room. There were no restaurants on base and the base grocery store was closed. Betsy walked over a mile to get to a fast food place outside the gate to get something for her and Grace. What could I eat? Our room didn't have a kitchen, and it's not like I had anything to cook anyway. Trying to blend up a burger and fries from Carl's Jr. would not have been ideal. Sure, my wife and child were forced to eat crap food, but me?!?

Any type of formula would've made me nauseous. Breaking out the Vitamix to blend fast food and having to clean it in the bathtub would've been extremely time consuming and inconvenient. The only thing I could eat was a Real Food Blend. An awesome bonus for RFB is that it's a shelf-stable product that doesn't need refrigeration. I had about eight meals in my suitcase ready to go.

Then, of course, there was the plane ride to Hawaii. We were at the back of a KC-135 air refueler, sitting on mesh jump seats. It was extremely noisy, uncomfortable, long (the California to Hawaii leg alone was 7 hours) and very cold at our cruise altitude. Yet, it was awesome. We could walk around freely. The plane wasn't too full so we could stretch out. The best part: we got to watch F-16s maneuver in behind the aircraft to get refueled the whole time.

They're also making a "Jet Fuel" Real Food Blend; all natural ingredients

But, what could I eat on this long flight? Two or three nausea-producing Ensures? That would've made the trip so much less enjoyable. Instead, I was treated to a Real Food Blend administered by my wife:

So Betsy was basically my flight attendant

That meal completely satisfied me. It didn't feel like I'd just swallowed a brick and incapacitate me while I tried to avoid puking in the uncomfortable, unregulated climate. It gave me a full stomach and the ability to weather the rest of the journey without gnawing hunger. 

The whole reason we went to Hawaii was the beaches--mostly because my daughter wanted to bury me in the sand. The only problem is, how could I eat lunch? Breakfast was no problem. Half the time we were in Hawaii, we stayed at places that included a small kitchen. So, I could make eggs and bacon and add fresh fruit and nuts from the grocery store to my blends. For dinner, we typically went out to eat and I could have the chefs mix up my meal in the Vitamix (if we go again, it is much more cost effective to make our dinner). What about lunch?

In the middle of the day, we were normally at the beach, or visiting a waterfall, or touring the Polynesian Cultural Center or the pineapple plantation. This was no place to break out the Vitamix and I certainly didn't want Ensure-induced nausea to slow me down when my daughter was jumping around the waves. Real Food Blends saved me once again. We were in Hawaii so long that I used up my store of the delicious packaged meals. Luckily, I knew another tubie in Honolulu, Jesse Jones, and he gave me some of his meals (actually, he brought them to my hotel on his trike because he is racing 100 miles next month and he's a badass). 

It's how he delivers pizza too

The lesson from the past few months? I cannot go on long trips without Real Food Blends.

FYI: there's a Real Food Blend in that blender bottle and I'm in Hawaii

I cannot go camping without Real Food Blends. 

My flight attendant follows me everywhere (stalker!)

I cannot go hiking without Real Food Blends. 

Admittedly, this was before the hike. I was much happier then.

Basically, I cannot go on any daytime outing without Real Food Blends. 

And that's what a Real Food Blend looks like in Snowmass, Colorado

Here's another little fact in RFB's favor. A bottle of milk chocolate Ensure Plus has 22 grams of sugar. Seven bottles a day (what my nutritionist initially wanted me to drink) gives me 154 grams of sugar every day. That's around 40 teaspoons, almost a full cup of sugar every day. According to the American Heart Association (AHA), how much sugar should I eat in a day? 37.5 grams, or 9 teaspoons. How much sugar is in my favorite Salmon, Oats & Squash Real Food Blend? Nine grams (two teaspoons). Unlike Ensure, this is not added sugar (Ensure Plus' 3rd ingredient is sugar). It is naturally occurring sugar in the meal's few ingredients (water, squash, salmon, pomegranate juice, rolled oats, and flaxseed oil). Natural sugars are not a concern to the AHA. They are not associated with obesity, type II diabetes, cardiovascular disease, certain cancers, tooth decay, and non-alcoholic fatty liver disease. 

If you're a tubie or the caretaker of a tubie, you need to seriously consider switching from formula to Real Food Blends, not just for the long trips and family outings, but for your daily meals. I expect to be making full use of their meals for the rest of my life.

Eating in Hawaii

I love sushi. A delicious piece of fish, eel, octopus, whatever--I'm not choosey--wrapped in a thin layer of seaweed, surrounded by a bed of rice, then dipped in soy with a touch of wasabi. It is the perfect bite of food. Betsy claims to like sushi, but she only eats California rolls. Sorry, Betsy, but imitation crab meat, cucumber, and avocado does not equal sushi. You, and Wikipedia, may claim differently, but I'm pretty sure I'm right about this one.

Hawaii has some great sushi. I can't really call myself a sushi connoisseur since I've never been to Japan or had sushi outside of Hawaii, Florida, and California, but Hawaii is where I first tasted and fell in love with it.  I wish I could say that I ate at awesome, local, hole-in-the-wall sushi bars the whole time I was in Hawaii. The truth is a whole lot more disappointing.

Here I am at Ruby Tuesdays on the southwest side of Oahu:

Almost as bad as going to Italy and only eating at McDonald's

We also went to an Outback Steakhouse in Waikiki and a Macaroni Grill located inside a large mall:

Bought a can of Pam when we arrived and used it the whole time to oil my plunger

I played it safe the whole time we were there. It's hard for us to bring a Vitamix into a restaurant and describe how I eat through a tube and explain how to blend up my meals. If I go into a great sushi place where everyone speaks Japanese, I feel like there's a communication barrier. Eventually I need to get over my own trepidation if I'm going to travel to China with Grace in a few years.

I did go to one restaurant in a hotel that caters to Japanese tourists. When I met Jesse Jones at his apartment in Honolulu, he took us out to the Miyako Japanese restaurant at the New Otani Kaimana Beach Hotel.

Look, I'm giving the Shaka sign and that means I'm Hawaiian

The hotel caters to Japanese tourists so I stuck out there like, uh, a white guy in Tokyo (I suck at metaphors). I had a grass-fed burger (without the bun) and fries, but they refused to bring the blender into their kitchen. Instead, Jesse and I plugged it up in the dining area and blended my meal. I can't say I blame them for not blending the meal in the kitchen. I can see how some restaurants might be afraid that if the blender broke, I could hold them liable for the damages. This couldn't be further from the truth though. Vitamix has an excellent warranty and they'd replace the blender no matter how it broke. Plus, I am so thankful to every establishment that has blended my meal and allowed me to dine out with my family. The last thing on my mind is suing them for even making the attempt. This is why I always give big tips in the hope that these restaurants will remember me in a positive light and be more open to blending tubie meals in the future. All this was kinda hard to explain to the Japanese waiters at Miyako though.

So besides eating at Americana restaurants like Ruby Tuesdays, we ate on base or in our hotel restaurants a lot. The first couple nights we stayed at Kaneohe Bay Marine Corps Base. We went and ate at the golf course. The golf course diner on base isn't really a sit-down restaurant; more of a café. You just order your food at the counter and sit down anyplace. So, we set up the blender off to the side and I ordered a big salad (the salad was actually a little too big so they only put half in my blender).

The blender turned a few heads when it was on 'High'

I only brought four shirts so you might see the same one in these pictures

Since we spent quite a lot of time at the Air Force Base terminal waiting for flights, we ate several times at Sam Choy's Seafood Grille at the Hickam golf course. The restaurant has an amazing view of the runway so we could watch both civilian and military planes fly in and out (my favorite was the F-22s). We got the same waitress, Kaitlyn, every time we ate there and she gave us fantastic service.

Can't quite remember what I ate; think it was the ahi tuna

Another time there:

For this meal, I just had a Mai Tai

We ate at Sam Choy's right before we went to the airport to fly home and someone who wanted to remain anonymous paid for our meals. It was the perfect end to our vacation.

We visited the USS Missouri Battleship and USS Bowfin Submarine in Pearl Harbor the last few days we were there. There is a restaurant right next to the bridge over to Ford Island with great views of the harbor called Schooner, so we had lunch there. I had another burger (no bun) and fries:

As usual, the restaurant had no problem blending up my meal

We had to go to the Navy Exchange while we were in Hawaii. Base Exchanges (BX) are like large department stores on base where you can get a lot of cheap stuff tax free. The store at Pearl Harbor is the biggest BX I've ever been to. Two stories with a large food court, barber shop, salon, grocery store, and every product you could think of. We had lunch at the food court, which meant finding an outlet in the dining area:

There were actually a lot of people there, just not near the blender

Beef and broccoli from the Chinese fast-food place

Grace is getting better at taking pictures

I ate in my hotel room a few times. Here I am in our room on Schofield Barracks Army base in the middle of the island.

You know we're desperate for a room when we have to stay on an Army base (no offense)

Sometimes, if there was nowhere else to eat, I had to improvise, like when I ate outside a small coffee shop at Pearl Harbor Naval Shipyard:

These pictures don't show them, but there were birds around our tables EVERYWHERE

It was much easier when I had my own kitchen. We were in a small condominium on the North Shore next to Turtle Bay a few nights so we could get some groceries and cook a few meals in our room:

Had to get the Haleiwa picture in the background

There was also a nice restaurant within walking distance of our condo on the north shore called

Lei Lei's Bar and Grill. It was right on their beautiful golf course and we got great service. The cook said he used to work at a hospital and he knew exactly what I needed.

We forced Grace to wear a flower in her hair the whole vacation

The hotel we stayed at the most in Hawaii was the Hale Koa, which is a hotel right on Waikiki Beach that caters exclusively to the military. It's pretty amazing we were able to stay there five nights because we were never able to get reservations. We just begged them for a room every day at check-out time. We usually got to stay in the same room too. I had breakfast quite a few times at their buffet (at Bibas). I just put all my food in the blender (they had a good omelet bar) and they let me plug up my blender at the bar since it was closed in the mornings:

Should've just left the blender there all day

Pretty sure I've worn that shirt before (Bad B.O.)

We also had dinner at the Hale Koa one night

And I made use of their bar for Mai Tais in the evening

While we were in Waikiki, we went out to Gordon Biersch Brewery at Aloha Tower. This is one of the places my sister took me when she lived on the North Shore and I used to visit. They have some awesome garlic fries there that you do not want to eat on a first date because they add a TON of garlic.

Grace photo-bombed me

We also went down the beach a little way to the Sheraton and ate at RumFire. A friend of mine who lived in Hawaii a few years loved this restaurant and highly recommended it to us. It had an awesome view of all the surfers with Diamondhead in the background.

There are no windows at most of these places because it's Hawaii and who needs windows?

One of the items on our list of things we had to do was taking Grace to the Polynesian Cultural Center. It's one of the most visited attractions on Oahu. Most of the staff there attend BYU's Hawaii campus next door and come from the islands showcased at the Center (New Zealand, Fiji, Samoa, Hawaii, Tahiti, Tonga, Marquesas, and Rapa Nui). Grace loved learning about all the different cultures. Her favorite part was the coconut demonstration in Samoa because the Samoan presenter was hilarious.

For dinner, we were treated to a luau. They roasted a whole pig for hours, wrapped in banana leaves. We got to watch them unwrap the pig and after seeing the poor animal, Grace declared that she wanted to become a vegetarian "as long as she can still eat bacon."

We talked to the staff before I went to make sure I could bring my blender. They let me keep it in their kitchen while we walked around the park. At dinner, they were happy to blend up my meal after I filled the pitcher with the yummy food at the buffet-style luau.

She had a whole lot of that pig, the little hypocrite

I'd eaten at the Polynesian Cultural Center years before and I remember that my favorite part was the purple, Taro dinner rolls. I probably had 3 or 4 of them the last time I was here but I was unable to enjoy them this visit because they have gluten. So, Grace took the opportunity to rub it in my face:

"You're right, daddy, this is the best thing I've ever eaten in my life!"

Fantastic vacation!!! I'm sitting here in the muggy, Tennessee air right now already missing Hawaii and looking forward to going back (preferably not when there is a hurricane anywhere nearby). If/when we go back, we'll try to rent a cheap place off VRBO.com that has a kitchen so we don't have to spend so much money going out to eat!