Friday, November 14, 2014

Hoarse Voice

For the last several years, I have experienced hoarseness in my voice, had the sensation of a lump in the throat (this symptom only after drinking MatTea vocal elixir for 7 days in a row), post-nasal drip, stuffy sinuses, chronic throat clearing, excessive throat mucous and a sore throat. I used to have a great singing voice (not professional, but I do talk for a living) but now I can barely make it through a song and I sound like an 80 year old smoker (and I am neither). I've been to ENT doctors and a speech therapist at Stanford, but nothing seems to help (and acid reflux medication seems to make it worse). I don't have nodules. Please help!

Melissa Kim, M.S., CCC-SLP writes...

There are any number of conditions that can contribute to the symptoms you describe, so to suggest a possible diagnosis would be conjecture. If you've seen general Ear, Nose, and Throat physicians for prior assessments, then I would suggest seeking out a laryngologist, an ENT who specializes in the treatment of voice disorders. Ask your physician for a referral or visit the American Academy of Otolaryngology at www.entnet.org to search by sub-specialty.

Good luck to you!

Monday, October 27, 2014

Hoarse Voice

I had loss of voice beginning of April after a URI, followed by 8 weeks of raspiness, hoarseness before being seen by an ENT doctor and diagnosed with laryngeal reflux. I was put on a PPI, liquid antacid at bedtime diet modification, head of bed elevation,etc. in June.  I am a frequent singer but have not sung since March. I stay well hydrated. My voice is still raspy and rough, gets easily tired though there has been some improvement. How long should I expect these symptoms to continue? Do I need different medicine, a second opinion? Any thoughts would be appreciated.

Melissa Kim, M.S., CCC-SLP writes...

Persistent hoarseness following an upper respiratory infection may indicate a related functional voice disorder. Muscle tension dysphonia, a general term to describe excessive and unnecessary tension of laryngeal muscles during voicing, is often seen following any condition that causes irritation and subsequent compensatory change in vocal technique (e.g., upper respiratory infection, laryngopharyngeal reflux) Treatment involves intervention for any underlying conditions, and voice therapy with a speech pathologist who specializes in the treatment of voice disorders; ask your physician for a referral.

Good luck to you!

Monday, October 20, 2014

Recovery from a paralyzed vocal cord

For the last 6 months I have suffered from a paralyzed right vocal cord as a result of a viral neuropathy. Six months later I am beginning to progress and believe the nerve to be healing. I am able to gain some voice, though it is strained and croaky first thing in the morning. The rest of the time it sounds like a forced whisper with much improved breathing. Would I cause damage by returning to work as a teacher of 9-year-olds, or would it be more advisable to wait a while until my voice has healed properly?

Melissa Kim, M.S., CCC-SLP writes...

You will not cause any further damage by attempting to use your voice for teaching purposes - although you may experience a good deal of vocal fatigue. There are many treatment options available to individuals with a paralyzed vocal fold, however, including both surgical and therapeutic options... discuss available treatment with your physician.

Best of luck to you.

Monday, October 6, 2014

Vocal Cord Nodules Treatment

Hi, I have had acid reflux and asthma for a few years and since the summer have been experiencing chronic bronchitis which has worsened the asthma. I was hospitalized for a week and I have lost my voice since September 15th, 2014. Initially they thought laryngitis but I saw the ENT and had a stroboscopy and they found beginning growths, nodules and callous like growths on my vocals chords along with a lot of swelling and mucous and they could see the blood vessels. My throat and glands are painful and burn at times. They have put me on vocal rest until further testing and encourage me not to whisper. They said depending on what happens and the ENT decides after seeing the results will determine next steps. Is there anything I can do to help?

Melissa Kim, M.S., CCC-SLP writes... 

The treatment of choice for vocal cord nodules that are newly formed is voice therapy with a speech pathologist who specializes in the treatment of voice disorders; I would suggest that you ask your ENT if voice therapy would be indicated, and if so, if they have a referral source. Vocal rest is indicated if the nodules were observed to be particularly traumatic or hemorrhagic, though rest alone won't typically resolve nodules otherwise. In the interim, however, good vocal hygiene would be recommended, including conservative voice use, adequate hydration, and avoidance of irritants such as smoke and alcohol.

Best of luck to you!

Thursday, October 2, 2014

Throat Pain After Singing

I have a concert coming up and so was practicing some complex portions of my song. I think I overdid it a bit and now I am having pain in my throat area (and a little below as well). I do not have any symptoms of a cold, sore throat, etc. I do have slight acid reflux. I am planning to rest my voice for a day or two. What other home-made preparations/therapy could I use to soothe the pain? Could I take any pain killers as well?

Melissa Kim, M.S., CCC-SLP writes...

In general, voice rest and good vocal hygiene are the best guidelines, including increased hydration, avoidance of environmental irritants, and possibly, over-the-counter medications for inflammation. For a more detailed description of vocal hygiene recommendations, please see our webpage on Tips for Professional Voice Users.


Good luck to you.

Tuesday, September 30, 2014

Paradoxical Vocal Cord Motion

A friend of mine has been experiencing voice problems. She went to see a speech therapist and was told that she has "paradoxical vocal cord motion." What does this mean?

Melissa Kim, M.S., CCC-SLP writes...

Vocal cord dysfunction (VCD), also referred to as paradoxical vocal cord motion (PVCM), is a condition in which the vocal folds close (rather than open as they normally should) during inspiration, resulting in any number of symptoms including shortness of breath, wheezing, and/ or cough. The cause of this disorder is often unknown, although in many cases it is thought to be irritant induced, such as chronic laryngeal irritation from acid reflux. Treatment is primarily therapy with a speech pathologist, targeting respiratory techniques to help to manage episodes, in addition to medical treatment of any underlying or contributing disorder.

Thank you for your question.