My Health Experience: ‘I know now that anyone who is hoarse for more than six weeks should have it investigated’

I was alone in the house the day the consultant rang to tell me I had cancer. It was coming up to 4pm a few days before Christmas Day 2012. I had a fry on when the phone rang. The dog got the rashers and sausages.

The doctor, Robert Gaffney, was a gentleman. He asked if there was anybody with me and then he said “Do you want me to tell you?” I said “Go ahead,” and he told me to relax and sit down. We had been told I would get the results of a biopsy after 14 days and this was the 14th day. The first thing you think when you hear the word cancer is “funeral”.

At this stage I had been hoarse for about two years. I had gone to the GP after a week or two and he put me on antibiotics. I had no pain, no soreness, no difficulty swallowing but the hoarseness went on and on. It was annoying and hard for people listening to me. I know now that anyone who is hoarse for more than six weeks should have it investigated.

I saw a consultant after about six months. I really wanted answers but felt I wasn’t getting any. Eventually we pushed for a second opinion and this time I was put on Zoton and it worked for a while.

I am a farmer and one day I was at a mart in Ballina and I realised I could not talk over the noise and I went home and told my wife, Mary, “This is doing my head in,” I said. She was already worried because I had a bad colour and I had started to lose weight. Mary insisted that we had to get a third opinion.

Twenty minutes after we met Gaffney in Beaumont private hospital, he told me, in the nicest possible way, that he could see something on my vocal cords. He had examined my ears and my sinuses very quickly but I noticed that he hesitated as soon as he looked at my throat.

“Odd one out?”

Once I got the results I was referred very quickly to Prof Michael Walsh, who told me that I had a choice: radiotherapy or surgery. He said the treatment had a success rate of 80 to 90 per cent. I remember saying to him, “Will I be the odd one out?”.

Two days after Christmas Day I was back in Beaumont getting fitted for a mask which they put over the face when they do the treatment. You are more or less tied to a table to make sure you don’t move. I had 30 sessions over six weeks.

I used to go up and down on the bus every week from my home near Easkey, Co Sligo: it was four hours door to door. It got harder as the weeks went on. I was very tired and my mouth was dry. It was very hard to eat. I was on smoothies and soft drinks. My neck got burned and my breathing was affected – but it did no good for the tumour. When it didn’t work, Walsh once again gave me two choices, laser surgery or an operation to remove the vocal cord.

It would take a long time to even list all the different things they tried before I eventually had a laryngectomy, but Mary started a diary in 2012 and it is all in there. I have spent so much time in Beaumont Hospital that the nurses in St Anne's ward are close friends now. I can't thank them enough for all they have done for me.

The laser surgery did not work because they could not get all the tumour. A week later, in June 2013, they did surgery to remove half of my vocal cord. It had to be rebuilt with muscle fibre. I was in hospital for five weeks then. I could not talk after the operation, so I had to write everything down and I was forced to learn how to text. When my three-year-old grandson Jack visited me after the operation, he could not understand why Granda would not speak to him.

I had to be tube-fed for a while. I’ll never forget the taste of the first scrambled eggs I had after surgery. It is amazing how many things are affected when you have this kind of cancer: speaking, breathing, swallowing, eating and drinking.

I can’t tell you what it was like to get home after that surgery and to just feel the fresh air. You can see Killala Bay from our kitchen window: I can pick out the spot where the French landed. My land is down at the seafront. It was a great summer in 2013 and I never enjoyed walking along the shore so much.

When I got out of hospital I found that the silage had been cut and my turf was in. We have very good neighbours . I suppose everyone who knows me knows that I was always a man who loved to talk so it is strange that this happened to me. I have always enjoyed chatting to people.

Everybody asks if I was a smoker, but I never smoked. I was someone who would jump over the garden wall rather than walk in the gate but that summer I could hardly walk. Soon I had to have surgery to dilate the airways.

Larynx removed

I remember going to a wedding in Inishmaan, but I had to go to bed after the meal. My breathing was really bad and there was no doctor on the island so I got home as fast as I could. My daughter Aoife drove me straight to the emergency department in Beaumont.

Walsh had retired but Prof Paul O’Neill sat me down and told me the only option was to have my larynx removed. He said if I felt able for it, he was the man to do it. He explained everything so well that I really trusted him.

It is called “salvage surgery” and it happened on October 14th, 2014. According to Mary’s diary, I was in theatre from 8am to 9.45pm. There were two teams involved: O’Neill’s and a plastic surgery team led by Prof Barry O’Sullivan.

It is hard to believe what they did. They had to graft skin and muscle from my thigh and skin from my chest. They needed to do this because they were reconstructing my throat and also replacing skin at the front of my neck.

I had to spend five days in 30 degree heat to help the skin grafts to heal. My neck was all swollen after surgery. I could not even lift my head, I had so many stitches. I could not believe I was alive.

The first week was the worst. They told me that I was lucky that I was so thin and fit. I spent 12 weeks in hospital. I had to learn how to speak again, how to put my finger in the hole in my neck. It’s called a stoma. It was very, very hard. My nose and mouth have no role now in my breathing.

I had a brilliant speech therapist, Marie Therese O’Callaghan, who would not let me give up. She took the Biro off me to force me to speak.

I cannot raise my voice now. I can’t speak over the telly or music or people talking or a tractor which is left ticking over. I can’t shout at the dog when we are out after sheep – the poor dog does not know what I want him to do. But I can speak. I have a little prosthesis in my neck that helps project my voice.

O’Callaghan is determined to improve my quality of life. She got me a hands-free device so I don’t have to put my hand to my neck all the time to block the air when I want to speak. I am the first person in Ireland to get this and I have no problem eating now.

I suppose I did feel hard done by for a while, but you have to accept your situation. You don’t have a choice. I am back farming – well, giving orders anyway. While I was ill, my son Alan had to carry on and he probably did a better job than I would have done.

You never know how many friends you have until you get sick. Some friends who called to the house after I was diagnosed and warned me to look after myself, are no longer with us. It has been a long hard road but I know the cancer is gone. It took a long time, but they got it all.

In conversation with Marese McDonagh