West said that he began to experience "some vocal fatigue" in April 2007. He said "I had lost some of my vocal range, staying on higher notes and lower notes. I even began having a hard time speaking." At a vocal check-up in response to the issue, West's doctors at the Nashville Vanderbilt Voice Center discovered "hemorrhaging caused by some polyps". He was told by his doctors that vocal surgery was the only option, since a few weeks had passed. The surgery took place on May 17, 2007, a process that he said was "career threatening." Afterward, he was prescribed a two-month period of silence for vocal rest.