Following a laryngectomy last year, Guardian's head of strategic partnerships had to learn to breathe, swallow and speak all over again. Now back at work, COVER recently spoke with Mike Devaney to hear about how he overcame the ‘toughest challenge' of his life and returned to the protection industry with a whole new perspective
In June 2018, Mike Devaney was diagnosed with throat cancer at the age of 36. Feeling as fit as ever, he had not long ago climbed the highest peaks in Scotland, England and Wales in 24 hours as part of the Three Peaks Challenge.
Other than a persistent hoarse voice at the start of the year, following what he thought was a bad case of man flu, Mike initially assumed there was nothing untoward.
“All your assumptions about what you plan to do, your life plan, it’s all thrown up in the air, and the feeling is sickening, like being punched in the stomach"
"Being a typical bloke, I waited until May before I thought it was appropriate for me to see a GP about it," he tells COVER.
Due to mild suspicion about symptoms that had lasted so long, he was sent for a chest x-ray and blood tests, which were all clear. Mike didn't feel sick. He only had a husky voice, which his friends and colleagues, as you might expect, naturally found quite funny at the time.
On referral to an ear, nose and throat consultant, he had a camera inserted up his nose and down into his voice box. Mike was later told that they had discovered what looked like a tiny benign polyp - or lump - on his right vocal cord.
It was nothing to worry about, Mike was told. It would need to be removed, but would only require day surgery.
At this point, rather than wait for an NHS operation, Mike took advantage of the private medical insurance (PMI) available through his workplace benefits and booked an operation within a few weeks.
"I remember now I was on a night out in Edinburgh during the festival just before my op," Mike recalls. "Out of nowhere I started to sweat buckets, unlike anything before, it was like a tap had been turned on. My shirt was soaking and there was nothing I could do to stop it. Looking back, I think it was my body reacting and was a clear signal something wasn't right."
Everything seemed to go fine for the first operation, however Mike's suspicions were raised when it transpired that the surgeon was unable to remove the whole lump - there was more than they had expected.
After resting his voice for a few days, he went back to see his consultant three weeks later. "The worst I was expecting was that I would need to have another operation. I even had my middle son with me as I expected it to be a quick five minute consultation.''
Mike was then hit with what he himself describes as a "bombshell". The pathology results were back - he had cancer.
"I was stunned," says Mike. "All your assumptions about what you plan to do, your life plan, it's all thrown up in the air, and the feeling is sickening, like being punched in the stomach. My initial reaction was to try and make sure that my son did not comprehend what was happening. I managed to get him put in a side room with his Kindle. I think that stopped me from taking the news in fully."
Driving home, Mike contemplated whether his son had understood the reality of what was happening. Surreally, and still in shock, Mike stopped at McDonalds in an attempt to take their mind of the situation. "My concern at that time wasn't really about me, it was more about my kids and how do I break the news to my wife?" he says.
Mike's consultant was confident that, because they had caught it early, they could use advanced tools to dig out the disease and then laser the surface of the vocal cord. The only real concern was a second operation on a delicate vocal cord which could result the loss of his voice completely. "Of course, when you know you have cancer, you're happy to accept a husky voice as long as you can be cured."
After the operation in September, Mike sensed that things were not as straightforward as first assumed. His voice, while rough, did return after a few days.
Fast forward to October, Mike received a call from his consultant. It was more bad news. The biopsy results suggested that the cancer was now invasive and Mike needed radiotherapy as soon as possible.
Over the next few weeks, Mike prepared for treatment. He had a special mask fitted and was talked through the possible side-effects of the radiation.
Mike was determined to carry on working until the day before the treatment, using email to communicate rather than speaking on the phone because his voice was so bad.
From mid-November, he visited Addenbrookes Hospital in Cambridge for 20 days in a row to receive a five-minute blast of radiotherapy each session - the complete course.
Luckily, his employer, Guardian Financial Services, was hugely supportive and flexible during this time.
"I dreaded going in for the radiotherapy each day," Mike remembers. "I would be in the waiting area surrounded by other cancer patients who were much older than me and potentially were nearing the end of their lives. I remember there was a lady who had a brain tumour which impacted her short-term memory, and every day she re-introduced herself to me and wanted to tell me her story. I felt really bad, but I just wanted to go in, not speak to anyone and get out. I looked like a fit and healthy 30-something, that shouldn't be in this situation."
On the Sunday after his first week of radiotherapy, Mike felt so physically healthy he ran a half marathon. "I was so determined to defy my diagnosis and situation that I ran a personal best. One hour and 37!"
Following the radiotherapy, Mike's neck was badly burnt, drinking and eating became difficult and thick mucus would build up in his throat. For three weeks after his treatment, Mike could hardly get a word out, however two days after Christmas, his voice returned.
"It was a huge relief," Mike says. "I started to think that I could return to a normal way of living and the illness wouldn't have any long-term impacts on me."
Mike received a critical illness insurance payment within a month or so of being diagnosed with invasive cancer. His cover was with Royal London who he'd worked for 15 years before moving to Guardian in 2017. He decided to use a small portion of the claim payment to travel to Barbados with his dad to watch England play cricket. The rest he put aside as a safety net. By the end of January 2019, he was back working full time and things were getting back to normal.
However, by March, his voice began to deteriorate again. "Initially the consultant couldn't see any evidence of the cancer returning, so it was decided that I just needed to get some speech therapy," Mike explains. "Like everything I gave this my full dedication and followed the exercises and diet guidance to the extreme. However, two months later, my voice was still getting worse. I was on holiday in Spain, and I started to have a continual cough with unusual frothy mucus, and I knew something was wrong."
According to Mike, the day after he returned from holiday was probably the worst day of his life. The cancer had returned and he was informed that the complete removal of his voice box was the only surgical option available.
"I was devastated," he admits. "I had been through two operations, and tortuous radiotherapy and still the cancer kept coming back. I wasn't willing to accept that at 37 I was about to lose my vocal cords and potentially the ability to speak again. How would I speak to my wife and kids? How would I work? These were the first concerns. Then the more I researched the scale of the operation (total laryngectomy) the more daunting it became."
Second medical opinion
In a bid to find another solution, Mike utilised the RedArc second medical opinion service available through his protection policy.
A specialist consultant with offices in The Shard and Harley Street suggested a partial laryngectomy, which meant he could potentially save his voice. "For me, this was a no brainer," he says. "If it meant I could maintain a more normal life then I wanted to explore it."
Despite this small glimmer of hope, Mike was dealt another crippling blow. Another MRI scan revealed that the cancer was spreading aggressively and it had grown beyond the voice box, effectively ruling out anything other than a total laryngectomy, which he urgently needed.
"Whilst this was terrible news and a bit frightening, I did get some comfort from the fact that I had explored all potential options," Mike reflects. "Despite the laryngectomy being a major and life-changing operation, it was also a life-saving operation for me. Being able to accept this helped me get into a more positive mindset ahead of the big day, July 31."
Mike describes his recovery from the laryngectomy as the "toughest challenge" of his life.
He was in surgery for 10 hours and as well as his voice box, as a precaution they removed his thyroid gland and 36 lymph nodes from his neck. Mike needed to spend two weeks in hospital after the operation and was nil by mouth for the first 10.
Mike needed to learn how to breathe, swallow and speak all over again.
"Learning to speak again felt like a long process however feedback from my consultants was that I've progressed really quickly," he explains. "For about the first month I didn't really want to try. I was partly letting the swelling come down, but also didn't like the sound of my voice when I did try."
He learnt to breathe using his stomach muscles, which allows him to create his voice on exhalation.
"It's a completely different technique but I feel like its second nature now. For the first couple of months I was using an iPad and whiteboard to communicate. Given my horrendous handwriting I really had no choice but to get speaking again."
While adjusting to life after the laryngectomy, Mike said the biggest challenge has been coming to terms with it all.
"After the initial ops and radiotherapy, I was confident that I could live a normal life and I wouldn't be noticeably scarred by cancer. Now there is no escaping it. Every morning I wake up and am instantly reminded of the ordeal I've been through," he says.
As a result of having his lymph nodes removed, Mike's face became badly swollen but over time - and with the help of complementary therapies arranged by RedArc - this has reduced almost back to normal. He's also using his PMI for lymphatic drainage therapy.
"I feel like I've overcome the challenge both physically and mentally now," Mike says. "I'm back at work, I can speak clearly, I can run, I can play golf and I can eat and drink completely normally. I'm lucky in the respect that very few patients who undergo a laryngectomy are ever able to get back to this level of normality."
Above all this, Mike said his mindset has needed to change. "Initially I was so determined on getting the ‘old Mike' back. However, I've realised that this was an impossible target; rather than be disappointed by this I've learned to reset my goals and focus on becoming a better version of ‘old Mike'."
A few years ago, Mike assumed that his life would follow a linear path - go to uni, get married, work hard, buy a house, have some kids, then retire.
"My life plan was set and showed no signs of derailing. Then it hit a major bump. Through my recovery there were days were all I longed for was to be able to drink a glass of water. I hoped that I would be able to play with my kids and read them bedtime stories. I want to be there when they graduate from uni and get married and so on."
He says these are things many of us we take for granted every day. "For me this whole process has taught me to perhaps slow down a little bit and appreciate what I have."
Mike hopes that by sharing his story, his experience can benefit others. He is also extremely grateful for the support he has received along the way.
"One of the struggles in being critically ill, is accepting that through the recovery and treatment your independence is compromised. Instead of being there for my family and colleagues, you are in a position where you are dependent upon them.
"I've had so much support, which has been very humbling. I find it difficult to accept support and help. My natural instinct is to prove that I can cope by myself. So, I would find it horrendous to be in a position where I needed to depend on anyone else financially. For many critical illness sufferers, who do not have cover, they would be in this position."
Hence, the whole experience has only reinforced the value of health and protection insurance.
"If I had been uninsured, there would have been an additional layer of financial worry," concludes Mike.
"My cancer came back three times, twice after operations and again after the radiotherapy. Thankfully I was given the all clear following a scan six months after my laryngectomy. But I'll always be concerned that it will come back a fourth time
"Having a financial safety net doesn't alleviate that anxiety but it does give me options for the future. And I feel even more strongly than I did before. Everyone should have critical illness cover."
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COVER Podcast #10