Google’s Page Describes Speech Malady, Funds Research

Google Inc. Chief Executive Officer Larry Page disclosed a health condition that can result in hoarse speech and labored breathing, though according to doctors won’t impede him from running the Web-search provider.

Page wrote in a blog post yesterday that he’s been diagnosed with left vocal cord paralysis, a condition that restricts vocal-cord movement, and is also experiencing impairment on the right side.

The malady can make it hard for the Google co-founder to exercise at peak capacity and limit his participation in some company events, such as quarterly conference calls. He also said that his condition has improved and that he’s able to do all that’s required of him at work and home.

“Usually people with vocal-cord paralysis can find a way to accommodate the vocal injury and still do what they need to do,” said Brian Eldon Petty, a speech-language pathologist at Emory Voice Center in Atlanta.

Google climbed 3.3 percent to close $915.89 in New York, a record high. The stock has advanced 29 percent this year, compared with a 16 percent gain for the Standard & Poor’s 500 Index.

Page, who also disclosed that he has a thyroid disorder that may play a role in his condition, said he detected impairment in his other vocal cord about a year ago.

‘Fully Able’

“After some initial recovery, I’m fully able to do all I need to do at home and at work, though my voice is softer than before,” he wrote in the post.

The revelations come almost a year after Google Executive Chairman Eric Schmidt told investors that Page would miss several company events, including annual meetings for shareholders and developers, because of his voice condition.

“Now that we’re fully aware of what has gone on here and how it’s affected Larry Page, I can’t imagine it having that much of an impact on his ability to successfully run the company,” said Scott Kessler, an analyst at S&P Capital IQ. “He’s provided more than sufficient information and transparency about these circumstances.”

Cancer, which can in rare instances develop in patients with Page’s type of thyroid disorder, has been ruled out as a cause for Page’s vocal condition, according to people at Google familiar with his treatment over the past year, who asked not to be named because the details aren’t public.

‘Very Lucky’

Page said that his ability to exercise strenuously has been “somewhat reduced” because vocal-cord nerve damage can affect breathing. He uses a microphone even for small staff meetings, people familiar with his condition have said.

“My friends still think I have way more stamina than them when we go kite surfing,” he said. “And Sergey says I’m probably a better CEO because I choose my words more carefully. So surprisingly, overall I am feeling very lucky.”

Sergey Brin co-founded Mountain View, California-based Google with Page in 1998.

A patient with vocal-cord paralysis might need regular speech therapy, “particularly in a corporate arena where they have a lot of communicative involvement on an average day,” Petty said, speaking in general terms about the condition.

Beyond that, a surgeon might inject a substance such as Medicis Pharmaceutical Corp.’s Restylane -- an injectable gel that stimulates collagen production -- into the vocal cords to improve speaking ability or perform an operation to reposition the vocal cord, Petty said.

Hashimoto’s Disease

Doctors still don’t know the exact reason for the lasting damage to his voice, Page said. He also has Hashimoto’s disease, an autoimmune disorder that causes chronic inflammation in the thyroid, a butterfly-shaped gland in the front of the neck below the voice box that produces hormones involved in many bodily functions, from breathing to metabolism.

“It is possible that has something to do with it, or that it is just virus related, or some other unknown cause,” Page said.

Hashimoto’s, which typically affects middle-aged women, can be treated with hormone-replacement pills such as Abbott Laboratories’ Synthroid. Very rarely, thyroid cancer may develop, according to the U.S. National Institutes of Health.

Vocal-cord paralysis occurs when one or both of the elastic bands of muscle tissue in the voice box fail to open or close properly. Normally functioning vocal folds open when people breathe, close when they swallow, and vibrate to enable speech.

Breathing, Swallowing

The condition can be caused by an injury to the head, neck or chest, by lung or thyroid cancer, or by a viral infection. It can alter the sound of a person’s voice, causing hoarseness, and also lead to difficulties breathing and swallowing.

Paralysis of both vocal cords is rare, according to the NIH. It is also more dangerous, according to Priya Krishna, incoming director of the Voice and Swallow Center at Loma Linda University Medical Center in California, who spoke in general terms without referring to any specific patient.

“The danger there is the person’s airway is compromised,” Krishna said. “It’s definitely going to interfere with your energy level. You’re working harder to breathe, so you’re expending your energy you use to walk or talk to breathe.”

When both vocal cords are paralyzed and positioned closely together, a surgeon might perform a procedure known as a tracheotomy, making an incision in the front of the neck and inserting a breathing tube to restore air flow.

Treatment Options

“If they are close together, the person will have trouble breathing, and if they are really far apart, the person will have trouble speaking,” said Michael Benninger, chairman of the Head and Neck Institute at the Cleveland Clinic in Ohio. “You either have no voice or no airway.”

The risk of developing paralyzed vocal cords from two different viruses is exceedingly rare, Benninger said. While paralysis of a single vocal cord may stem from an infection and often clears up, bilateral damage is most often the result of surgery or cancer, he said. The cause is unknown in about 10 percent of cases.

Hashimoto’s disease can also damage the vocal folds, Benninger said. Steroids are sometimes used to reduce inflammation caused by the disease, he said.

Treatment options for vocal-cord paralysis may be tailored to the lifestyle requirements of an individual patient. Entertainers or public figures may prioritize protecting their voice, while athletes might opt for alternatives that preserve aerobic stamina, Benninger said.

Page’s Donation

“Ultimately, it’s the patient’s decision,” Benninger said. “Broadcasters and singers can’t tolerate a breathy voice, while truck drivers may not care if they are a little raspy or hoarse.”

Page is making a donation to fund a “significant research program” into vocal cord nerve function at the Voice Health Institute, which will be led by Steven Zeitels, chief of the Center for Laryngeal Surgery and Voice Rehabilitation at Massachusetts General Hospital in Boston. The donation will be in excess of $20 million, a person familiar with the matter said.

Zeitels has performed vocal-cord surgery on high-profile patients including Grammy-winning pop singer Adele. Zeitels said in a statement that his research team will use Page’s donation to help develop new voice-restoration surgical procedures. He declined to be interviewed about Page’s medical condition.

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