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While disease can contribute significantly to voice issues, that is not always the cause. Sometimes we do it to ourselves. Because the voice operates more-or-less on automatic pilot ... we sometimes unknowingly put extra strain on our already hard-working vocal folds. 24 U MAGAZINE A fully equipped sound studio in the middle of the center allows patients like Jay to record their voices to test quality and effectiveness. “Our work is all about balance,” says Dr. Long. “The larynx is there to protect the airway, so sometimes procedures to improve breathing or swallowing interfere with a patient’s voice. We often need to strike a delicate balance.” Lucila Toche was one of those patients whose voice was out of balance. For more than four decades, she would run out of breath whenever she talked a lot, walked briskly or went dancing. When she slept, she woke up breathless every couple of hours. Asthma treatments didn’t seem to help so she just learned to put up with it. That was until September 2013 and what she calls her “nightmare at Disneyland.” That day, Toche spent about eight hours showing her nieces from Peru around the Magic Kingdom, translating for them “and chatting, laughing and screaming. We were having lots of fun,” she remembers. Then, suddenly, she collapsed and could hardly breathe, nearly blacking out. “When paramedics arrived, I was terrified of having to go to the hospital, so I insisted that as soon as I stabilized they would let me go home to see my own doctor,” she says. The next day, her doctor took one look at her throat and sent her to UCLA’s Department of Head and Neck Surgery. There, she met Dr. Long and was introduced to the voice center. A quick exam solved the mystery. When Toche underwent thyroid surgery in her native Peru 40 years before, doctors inadvertently injured the nerves in both of her vocal cords, essentially paralyzing the cords so they could not regulate her breathing properly. Dr. Long conducted endoscopic laser surgery to open up the frozen cords in December 2013, and Toche was out of the hospital the following day. “I had not been in a hospital since 1981, and I was really afraid and nervous about staying there overnight,” she says. “But the UCLA hospital and staff made me feel really safe and well- taken-care-of.” Recovery meant almost no talking for three days, and she had to speak softly for a few weeks afterward. The upside: Her breathing was immediately better, and it stayed strong for three months. When it became strained again, in March 2014, Dr. Long performed a follow-up, inpatient surgery. In the months since, Toche revels in how much her life has improved. She says she hasn’t had an asthma episode since the first surgery, she sleeps through the night without interruption, can keep up through an entire Zumba fitness class and doesn’t wheeze when she goes salsa dancing. Her voice sounds a little different than it did before, but “that’s nothing. My breathing used to be so bad, people were always asking me, ‘Are you okay?’” she says. “But nobody asks that anymore.” GEORGE HICKER ALWAYS QUIETLY SUSPECTED that the source of his nagging sore throat was cancer. The discomfort started in 2011, and over the next year his doctors treated him with antibiotics and steroids. But he still had two serious bouts of bronchitis, “and the coughing, pain and hoarseness just wouldn’t go away,” he says. Almost every night, the constant hacking disrupted his sleep. But Hicker, who was 64 at the time, kept working at his industrial-real-estate company in Sherman Oaks, California. Near the end of 2012, just before he was slated to take a vacation in Kenya, the answer finally came, loud and clear. His throat specialist found a growth on his left tonsil, ordered a biopsy, and confirmed that, yes, it was cancer. Surgery, radiation and chemotherapy were recommended. But because of the upcoming trip, Hicker couldn’t wait the weeks it was going to take to schedule an appointment with a surgeon from the health system where he was a member. Instead, he reached out to friends in the medical field and was referred to Dr. Berke. Within a week, Dr. Berke examined Hicker and gave him the go-ahead for his trip. When Hicker returned, Dr. Berke and Dr. Mendelsohn used the da Vinci robotic system to remove the cancerous growth. They also performed a lymph-node biopsy, with only a small incision on Hicker’s neck. A week later, he went back to the hospital for another night’s stay to get an additional procedure to improve his swallowing. Returning home afterward, “I stopped for an In-N-Out burger and milkshake, which I had no problem swallowing,” he recalls. The robotic surgery “saved him six-to-seven weeks of chemo and radiation therapy and damage to his jawbone,” Dr. Mendelsohn says. Hicker took