Silence to Strength: David's Story
David Tocholke is a dedicated truck driver for an excavating and sewer company, where he works long hours at job sites around the Twin Cities. His work includes; hauling pipes, leveling ground, and communicating with coworkers at high volumes in busy work environments. Despite the physical demands, David keeps things light with jokes on site and enjoys spending his weekends with family and friends.
True to his diligent nature, David went in for a routine check-up with his primary care physician, Peter Berg, MD, a Family Medicine physician at M Health Fairview - North Branch. Routine testing revealed that something more serious was unfolding. Dr. Berg noticed that David’s calcium levels were three to four times higher than normal. David had not noticed any unusual symptoms beyond his known high blood pressure. As a precaution, Dr. Berg ordered additional lab tests, which pointed to a possible issue with David’s parathyroid glands. He was then referred for an MRI for further evaluation. The scan revealed a golf ball-sized tumor on David’s parathyroid gland, located near the right side of his collarbone.
In December 2023, David underwent surgery to remove the tumor outside the University of Minnesota. The procedure was successful, and surgeons were able to completely remove the mass by accessing it between his ribs. However, during the surgery, a nerve responsible for controlling movement of the right vocal fold was damaged, leaving David with difficulty speaking. David described it as “talking like Batman trying to whisper”. The nerve injury left David without a voice for nearly two months, until he received a vocal fold injection. David remained in high spirits and continued working with a small external speaker and whistle on the job site to communicate.
In 2024, David began a treatment plan recommended by Raluca Gray, MD. As part of his care, he worked with the Speech Language Pathology (SLP) team, where he underwent several evaluations including a Pulmonary Function Test (PFT). The testing indicated that David was losing two to three times more oxygen while speaking due to his paralyzed vocal fold. The SLP team explained that without undergoing rehabilitative vocal fold surgery with Dr. Gray, the additional strain on the lungs could worsen over time and potentially lead to the need for oxygen support.
After undergoing numerous check-ups, tests, rehabilitation, and a major surgery, David was understandably dreading yet another procedure. However, a few days before his scheduled surgery, while driving his truck to work, David had a moment of clarity. He realized that this is God’s plan and Dr. Gray was an extremely talented physician. By placing his trust in both her and God, David felt that everything would turn out all right.
Finally, the day of David’s surgery arrived. Despite his nerves, he was ready to move forward and begin his journey toward restoring a full and healthy voice. In the operating room, Raluca Gray, MD, carefully performed a laryngeal reinnervation procedure to help restore movement and function to David’s paralyzed vocal fold. Describing the precision required for the procedure, Dr. Gray explained, “In this procedure, we dissect and identify the non-functioning vocal fold nerve and connect it to a donor nerve nearby in the neck (typically the ansa cervicalis). This microsurgical reconstruction is performed under high magnification using ultra-fine instruments. Maneuvering these structures—which are often as delicate as hair fibers—demands meticulous microsuturing and precise, minute movements.”
The surgery was a great success, and after spending one night in the hospital, David was discharged home. Over the following months, as the nerve regenerated and David attended vocal therapy lessons with Dan Weinstein, MM, MA, CCC-SLP, and the Speech Language Pathology team at the Lions Voice Clinic, he gradually regained a natural, strong voice.
Filled with gratitude and restored health, David said, “Dr. Gray was incredibly caring and empathetic throughout my journey. She was by my side every step of the way—from nerve testing and nasolaryngoscope procedures to the day of surgery. She was attentive and reassuring, which was very comforting and made the decision to have the surgery a much easier one. I can’t thank Dr. Gray enough.”
Today, David has returned to what he loves most: sharing laughs, enjoying the outdoors with his wife Kelly, and spending time with his 13 nieces and nephews.
