Monday, October 29, 2012

Can I Sing High Again?

I'm 22yrs old and I sing in church. I've had over five endoscopy's in the past two and a half years due to my trachea closing up on me and now when I sing my voice is very low.  I cannot sing high and I have Wegeners Disease. Will I ever sing high again? 

Lee M. Akst, M.D. replies...
Truly impossible to say what is going on here. I'm guessing, and it's only a guess, based on your few sentences, that you have subglottic stenosis and have required dilation. It's conceivable that airway stenosis or TVC scar may present a structural limit on high pitch; it's also possible that dome of this is functional. You should address your concerns with the surgeon who has been performing your endoscopy.

Joanna Lott, M.A., CCC-SLP replies...
I'm sorry to hear that you are having trouble with your singing voice. Though I can't say for sure without seeing you, I would guess that you may have some scarring of your true vocal folds which is making it difficult for you to reach your high notes. If that is the case (and I can't know for sure) you may benefit from examination and treatment by a laryngologist. Voice therapy may also be helpful, though scarring can be difficult to treat. If you are not being followed closely for the tracheal stenosis, I recommend that you find a surgeon to treat you for this. Meanwhile, if you are concerned that there is something going on other than the tracheal stenosis, I hope you will follow up with a laryngologist.
 

Lost Voice

I was cheering at a sporting event and my voice was sore after but I hadn't lost my voice and the next day my voice was normal but the day after that I hardly had a voice. It's been 5 days since the sporting event and my voice is getting worse. What is the cause and how can I help? And is it anything serious?

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

It is certainly possible that you experienced some vocal fold damage after the cheering episode... we often see a vocal fold hemorrhage or even the development of a polyp following a single vocally abusive incident. Given that your symptoms are continuing to worsen, I would suggest that you see an Ear, Nose, and Throat physician for a thorough evaluation.

Best of luck to you!

My Voice

About a week or 2 a go my throat kind of hurt so I went to the doctors and when he checked me he said I had nothing going on with my throat, but he still gave me medication and when I didn't feel my throat hurt anymore my voice won't fully come back. I can talk in a low volume but when I have to speak up I can't. Why and what can I do to get my voice back?

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

If you are experiencing persistent voice change after recovering from an upper respiratory infection, there may be an element of a functional voice disorder contributing to your symptoms. Ask your Ear, Nose, and Throat physician if he/ she feels that voice therapy might be helpful in your situation.

Best of luck to you!

Sunday, October 28, 2012

Strained Singing

I have been diagnosed with a 70% blockage in my right carotid artery. I am in a drama club play and after rehearsal I felt light headed and a little strained in the right neck area (singing soprano). Is it advisable to continue to try and strain and sing?

Barbara Messing MA CCC-SLP BRS-S replies...

I advise you to discuss symptoms of feeling light headed with your primary care physician. Stay informed of potential restrictions you should follow.  

Strain in the neck when singing may be related to vocal technique and the use of excessive muscle tension. Muscle tension dysphonia or vocal hyperfunction can represent a long term learned behavior that needs appropriately directed therapy or vocal training. It is important to discover the underlying reason. Consider being seen by a Laryngologist / Otolaryngologist and a Speech Pathologist for a laryngeal assessment through stroboscopy for the purpose of determining vocal issues that may be contributing to neck muscle strain and to rule out muscle tension dysphonia or any other contributing factors.

Thank you for submitting your question online.


 

Thursday, October 25, 2012

Two Tones at Once

In the past several weeks my falsetto has been voicing two tones at once - the intended note, as well as the fifth below it. For several years I have been experiencing a tightness in my throat when singing, and my range has been shifting lower and lower well into the bass range. My falsetto & upper range is pretty much gone. Help! Two tones out of one throat might sound cool on YouTube, but to me it sounds like I need to see an ENT...

Joanna Lott, M.A., CCC-SLP replies...

I agree! It does sound like you need to see an ENT. Diplophonia -- two tones produced by the vocal folds at the same time -- can be symptomatic of vocal fold weakness or of a vocal fold lesion. I recommend that you find a qualified ENT who specializes in voice and is experienced in working with singers, and who can perform a video stroboscopy as part of his or her exam. If you are in the Baltimore area, we would be happy to see you here at the Johns Hopkins Voice Center at GBMC.

Wednesday, October 24, 2012

Sound Like a Girl

I am a 16 year old boy, but my voice is like a girl's voice.  It is very soft.  How can I make it a boy's voice?

Melissa Kim M.S., CCC-SLP replies... 

I would first suggest that you seek out an evaluation with a laryngologist (an Ear, Nose, and Throat physician with specialized training in voice disorders) in order to determine if there are any anatomic or physiologic factors contributing to your vocal difficulties. If your larynx is determined to be structurally normal, you may be experiencing what is referred to as "puberphonia." Puberphonia is the persistence of abnormally high pitched voice following the onset of puberty, and can often be successfully treated in voice therapy with a speech pathologist.

Good luck to you.

Deep Voice

My daughter has had a very deep voice, if you walked into a room and didn't know she was there, you'd think it is a boy talking. It is embarrassing. Can anything be done to correct this?

Melissa Kim M.S., CCC-SLP replies...
I would first suggest that she see an Ear, Nose, and Throat physician to rule out the possibility that there is a structural abnormality contributing to her abnormally low pitch. If the problem is determined to be only a functional one, that is, a difference in the way that she is using her voice, then voice therapy with a speech pathologist experienced in treating voice disorders should be able to correct the problem.

Good luck!

Speaking in Falsetto While Sick

Is it healthy to speak in your falsetto while you are sick? I have heard that speaking in this register can reduce stress on vocal chords, but a more researched opinion would be awesome!

Melissa Kim M.S., CCC-SLP replies... 

The answer is a definite no! Speaking in any register that deviates from your modal pitch for extended periods of time can place additional strain on the vocal system as a whole. If you are experiencing voice changes secondary to an upper respiratory tract infection, best to just conserve your voice as much as possible, speak quietly when speaking at all, avoid hard coughing and throat clearing if at all possible, drink plenty of fluids, and rest!

 Thank you for your question.

Monday, October 22, 2012

Singing

I got sick recently and I am better now, but I want to join Choir at school and I can't sing the high notes anymore because after I got better my voice got really low and I don't know what's wrong with me. My parents just said that my voice is fine and that I am being very dramatic, but even my teacher said that something is wrong with my voice.

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

I would first suggest that you talk with your parents about seeing an Ear, Nose, and Throat physician to rule out the possibility that there has been some vocal fold damage that is contributing to your symptoms. If your larynx is determined to be healthy, your next step should be to seek out an experienced singing teacher to address any contribution that technique is playing in your vocal difficulties.

Good luck!

 
 

Vocal Range

I am a 38 year old female that has sung most all of my life. I was recently sick and completely lost my voice. Because of work I had to strain my voice and teach for 5 days with little or no voice. I am now unable to hit certain notes in my higher range. It has been about 3 weeks. I am extremely concerned. Should I be?

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

A voice change that persists for more than two to three weeks certainly warrants an evaluation by an Ear, Nose, and Throat physician. Visit the American Academy of Otolaryngology website to search for an ENT at
http://entnet.org/.
Thank you for your question.

Voice Problems

I have had a problem with speaking for at least 4 years now and I have been seeking help but I haven't gotten any diagnosis. The ENT specialists said there was nothing wrong and that they didn't understand why my voice was the way it was. All I can get out of my voice are whispered tones and I have to really strain and push to get one sound out and it is hard to maintain that sound for a full sentence.  Occasionally, I can talk a few sentences but my voice will go from voice to no voice at any second and continues to fluctuates. There is pain when I try to speak. And when I do speak there is this "werbolly tone" as one doctor described it. There is just this unstable sound to my voice and it is very unpredictable. I don't have any problems with the "high" pitch to my voice it is just the quality/clarity of it. THANK YOU SO MUCH FOR YOUR HELP!
I have been doing some research and do you think my condition is muscle tension dysphonia?   

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

If you've seen an ENT who performed a visual examination of your larynx (using either a flexible or rigid endoscope) and did not diagnose any obvious reason for your symptoms, I would suspect at least some element of a muscle tension dysphonia, or a problem with the way in which you are using your voice. If this is the case, voice therapy with a speech pathologist would be helpful. There are, however, additional voice conditions that might present in the way that you describe. I would suggest that you see a laryngologist, an Ear, Nose, and Throat physician who specializes in voice disorders, for another opinion. Visit the American Academy of Otolaryngology website to search for an ENT by subspecialty at
http://entnet.org/.

Best of luck to you!

Voice Loss

Last week I lost my voice for yelling at a show.  Now I have it back, but when I yell it comes out silent. What is that?

Melissa Kim M.S., CCC-SLP replies...
 
There are any number of possible explanations... the only way to determine the cause of your voice difficulties and appropriate treatment strategies is to be evaluated by an Ear, Nose, and Throat physician.


Good luck to you.





Voice Strained?

Today I was playing around with my voice like making "funny" noises to sound like monsters or whatever..to make people laugh but..now my singing voice isn't reaching what it was before it happened today it kinda cracks or my voice dies out. I'm guessing I strained my voice? And shouldn't do it again, but am I going to lose my singing voice?

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

It is possible to essentially "strain" your voice when using vocal pitch or quality that is unnatural for you. I would not guess that you have caused any long-term problems with this one incident, although I would suggest that you avoid this type of vocal behavior in the future now that you know that it has a negative impact on your voice. Practice good vocal hygiene until you feel that your symptoms have resolved; if they have not resolved in two to three weeks, see an Ear, Nose, and Throat physician.

For information on vocal hygiene guidelines, please see
http://www.gbmc.org/home_voicecenter.cfm?id=1558.

 Good luck to you.

Wednesday, October 17, 2012

Weak Voice

For as long as I can remember, my voice has been weak, scratchy and cracks often. I find in the morning it can be okay, but more often than not it becomes weak and strained. I have to clear my throat but it is still raspy and strained.

I'm not a singer, I'm 27 years old. I never noticed this to be a problem as a young teenager. It must have started at about 16. I've seen an ENT doctor who had no suggestions.

I often try to avoid situations where I have to talk, as it is that debilitating.

The morning after a big night out my voice is actually even and deep. But otherwise it is relatively high and scratchy.  Any ideas?

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

If you've seen an ENT who performed a visual examination of your larynx (using either a flexible or rigid endoscope) and did not diagnose any obvious reason for your symptoms, I would suspect at least some element of a functional voice disorder, or a problem with the way in which you are using your voice. If this is the case, voice therapy with a speech pathologist would be helpful. If your ENT did not examine you with an endoscope, I would suggest that seek out an ENT who can perform this type of examination for a more thorough look at your vocal folds.

Good luck to you.

Tremors in Voice

Where are they correcting voice tremors due to age? What dr. is using the implants? I saw it on the Doctors Show.

 Melissa Kim M.S., CCC-SLP replies...

The most common treatment for laryngeal tremor is an injection of botulinum toxin, which may or may not be helpful. A laryngeal "implant" is a treatment most commonly used to correct conditions in which the vocal folds don't fully meet, such as in cases of atrophy due to aging or in cases of vocal fold paralysis. A trained laryngologist (an Ear, Nose, and Throat physician who specializes in the treatment of vocal disorders) would be able to perform either of these procedures. Visit the American Academy of Otolaryngology website to search for an ENT by subspecialty at http://entnet.org/.

Good luck!


Loss of Voice/Hoarseness

Hx status asthmaticus, 2 recent intubations and now on Advair 500 twice daily. Out of hospital 2 weeks, ENT visualized vocal chords and no problems. Why am I still hoarse/raspy? These were my first intubations, both emergent/RSI. How concerned should I be? How long for return of my voice as I sing and can no longer do so?

Melissa Kim M.S., CCC-SLP replies...
A history of intubation would certainly put you at risk for swelling and inflammation of the vocal folds or even the development of a traumatic lesion such as a granuloma, although I would also be looking for subtle motion impairment that can also result from an emergent intubation. In addition, you also are at risk for swelling/ irritation and even fungal injection from use of an inhalant such as Advair. Ask your ENT about all of these possibilities, as they can all contribute to chronic hoarse vocal quality.

Best of luck to you.

Thyroid Surgery

I had a partial thyroidechtomy due to a benign sub-sternal goiter about 6 weeks ago. My surgeon made me pay $1500 dollars out of pocket for an "experimental" procedure to monitor my laryngeal nerve during the surgery.

The only discomfort I experienced was from the anesthesia. My speaking voice seems OK or even better than before the surgery, but I absolutely cannot sing in falsetto anymore.

Is this likely to improve over time, or did I waste my $1500?

Thank you so much.

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

Nerve monitoring can be very helpful during a surgery and it sounds as though you avoided a vocal fold paralysis, which is the result of recurrent laryngeal nerve (a branch of the 10th cranial nerve, or vagus nerve) damage that can be a complication of thyroid surgery. However, a change in the ability to alter pitch may indicate that the superior laryngeal nerve, another branch of the vagus nerve, may have been affected during the surgery. I would suggest that you return to your surgeon for assessment and treatment recommendations.

Best of luck to you!

Sore after Singing

I sang just as normal, doing my regular practicing, until the next day my throat started to feel a bit sore and kind of like a tiny bit of sharp pain too. I'm a bit worried that I might have damaged my voice permanently since it's the second day I have been having this problem. Should I take a break from singing until this problem stops?

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

A few days of refraining from singing is certainly called for if you are having pain, along with other basic vocal hygiene... increasing fluids, avoiding irritants, etc. If you continue to experience this pain once you resume your normal activities, however, a visit to an Ear, Nose, and Throat physician is warranted.


Thank you for your question.

Cannot Sing for Long

So I love to sing, and I do a lot of it in the car now that I"m not in any formal choir anymore. It is really hard for me NOT to sing along when I hear any song. Lately my voice has been getting tired a lot more easily than it used to. I can only sing for about 2 songs and then I can't hit the notes anymore and my voice gets really weak. I am 19 and this has been going on for almost a month. What should I do. What caused this? I was never sick, but I've been a bit more "mucousy" in my throat and nose but no other cold symptoms.

Joanna Lott, M.A., CCC-SLP replies...

Increased mucous can simply be due to a cold, allergies, or even just changes in the weather. Increasing your water intake can help to thin the mucous and allow for greater ease of voicing. However, it is possible that so much singing has left your vocal folds swollen and irritated causing you to work harder to get the sound that usually comes easily. Or, you may have been singing too much, too loud, or for too long at one time, and this can lead to phonotrauma -- a.k.a, overuse injury to your voice -– such as nodules, polyps, or vocal fold hemorrhage. I’m not suggesting that you have such a lesion, but if you do it is best to find out as soon as possible to prevent further damage. If the problem persists, I would recommend seeking treatment with a laryngologist (ENT specializing in voice) and an SLP voice specialist. Best of luck!

Off Pitch

I have an issue that many have not been able to diagnosis. I have even been to an ENT doctor, but there doesn't seem to be anything wrong physically.

The problem is that sometimes, when I am performing in a public place, I cannot hear that I am on the wrong pitch. And at first I didn't even believe I was off when the band director told me.  It wasn't until I saw the video that I accepted it.  You see, in my mind, when I was singing off tune, I felt I was singing right. And since the first occurrence, it has continued to happen and I don't know why.

And it is not that I cannot hear myself, because I can hear myself perfectly in the monitors. I just think that I am on the right note. Do you have any suggestions?

Joanna Lott, M.A., CCC-SLP replies...

Interesting question. Other than a possible problem with your hearing (which you might want to investigate at a hearing clinic) I wonder if your voice teacher could help you with elevating your soft palate during singing. This can help prevent you from singing just “under the note” -- even when you think you’re not. If lifting the soft palate is an unfamiliar concept, seek out a voice teacher with an understanding of the anatomy and physiology of the voice. I hope this helps!

Voice Issues

I am a singer and have seemed to have gained some hoarseness and cracking in my low to middle vocal range, but this only occurs when I don't push my voice or use "chest voice". I have also noticed at times what feels and sounds like a buzzing sound when singing certain pitches. I am not currently sick (other than a little sneezing) and have not done anything differently as far as singing and talking are concerned (haven't been singing or talking more than usual). Can you give me any idea what may be going on with my voice?

Joanna Lott, M.A., CCC-SLP replies...

It sounds like you should be seen by a laryngologist and SLP specializing in voice if the problem continues. Sometimes when there is a cracking or hoarseness associated with certain pitches, it is due to a vocal fold lesion (i.e., lump or bump -- usually benign) impeding closure at those pitches and causing air to leak out around the lesion. It could simply be that your vocal folds are slightly swollen or inflamed due to allergies or a cold, but if the problem continues I recommend seeking treatment.

Singing

I've been singing for along time. I'm 16 right now and I've never had a vocal coach because we just cannot afford it and I really want one but we can't get one so I've learned that to sing healthily you have to breathe from your diaphragm so I've been really trying to do that.  At first it was a little uncomfortable but it started to feel better and  I read that is how it is. So I've done breathing exercises and my ribs and back expand and my shoulders don't lift sounds like everything is perfect right? But when I sing my throat starts to feel a little sore and my voice gets kinda husky so I stop drink some water and after about 10 minutes it goes away my vocal range is like from d3-g7 and I know all about mid, head and chest voice I've done vocal exercises but why does my throat feel sore after I sing? I've tried not to strain and stay relaxed. What am I doing wrong? I do belt but I made sure I was relaxed when doing it and what I really am confused about is after I sing my voice is shaky and throat is sore.  I really need some help and I wish I could get a coach but I can't right now.  Please help me understand.

Joanna Lott, M.A., CCC-SLP replies...

I applaud your efforts to use good singing technique without the luxury of a vocal coach. Without actually hearing and seeing you sing, it is hard to know what you might be doing that leads to your complaints. My advice is to find a singing teacher who works on a sliding scale (charges a fee based on your income) or who is willing to work in trade (voice lessons in exchange for lawn mowing or dog walking), or find a vocal performance major at a university who is required to teach for credit. Some of these options may be affordable. There are also many community choirs or church choirs with gifted singers who might be able to offer you some help. But if you want to sing professionally – and especially if you are already running into difficulties – it is important that you find a good voice teacher. Meanwhile, it sounds like you understand some of the basic concepts of healthy singing, such as proper breath support and placement. But these are complicated concepts that change with pitch, volume, and style. Belting, for example, requires very different airflow, air pressure, laryngeal positioning, and support or anchoring than classical singing. These are the things you learn from experience and from working with a good voice teacher. If your complaints continue, I recommend that you be seen by a laryngologist and SLP specializing in voice. Best of luck!

Tuesday, October 16, 2012

Sore Throat

Hello, two weeks ago I was singing & over did it, my throat felt numb every time I swallowed. I engaged in complete vocal rest for a week, & drank plenty of fluids. I felt better, & yesterday I had a recital in which I performed, & my throat started to mildly hurt again. Now today I have a mild sensation of irritation again. When I sing I have not experienced any vocal range loss, I sound like normal, so I don't know what's going on. & my throat feels warm after singing & aches. This whole time my sore throat has been very mild, just a bit achy. No coughing no anything. But I am worried. Because I know the pain no matter how mild isn't good. Any suggestions?

Melissa Kim M.S., CCC-SLP replies... 

You may just still be experiencing the effects of "overdoing it," namely swelling and inflammation. I agree with following good vocal hygiene practices such as you have done, but if your symptoms persist for more than two weeks, a visit to an Ear, Nose, and Throat physician is warranted.

Good luck!

Thursday, October 11, 2012

Feminine Sounding Voice

I'm 22. My voice sounds very feminine. I'm in a deep stress because of my voice. Can you recommend any exercise to change my voice?

Barbara P. Messing, M.A., CCC-SLP, BRS-S replies...

The voice disorder you describe may be what is known as 'Mutational Falsetto' a.k.a. puberphonia. This is due to the males voice not changing after puberty but rather persisting as an adolescent voice. There may be medical reasons for the inability to transition to a male voice. Therefore a full medical work up by a physician is warranted. There may be psychological reasons for the continuation of the adolescent high pitch - more feminine sounding voice. Therefore counseling may be warranted.  


Voice therapy is very often a successful approach to making the transition to an age appropriate male voice. Voice therapy focuses on exercises or vocal tasks that help the person to produce a lower more age appropriate pitch level. It would be best to work with a speech pathologist who is trained to treat this type of voice disorder.

Kind regards,

Barbara Messing MA CCC-SLP, BRS-S

Wednesday, October 10, 2012

I Too Lost My Singing Voice!

I copied the post below because I experienced a loss of my voice during pregnancy at 29 years of age. The only difference is I did not have acid reflux. I am now 57 and my voice never recovered. I can hit notes that are lower than most male bass singers but my high notes virtually disappeared and my middle notes are worthless, inaudible and I crack horribly when moving between my registers. I finally gave up singing and it still pains me greatly. I attended college on a vocal scholarship, had a beautiful voice and singing was effortless, something I didn't think about, I just opened my mouth and the sound came out but something went horribly wrong. Over the years I have tried many things to fix this problem, I have seen specialists, speech therapists, took endless voice lessons, nothing has helped. I recently sang in church for the first time in about 15 years and it was pitiful! At time it just infuriates me that I cannot sing so I keep trying and would gladly entertain any advice.

Melissa Kim M.S., CCC-SLP replies... 

It certainly sounds as though you have seen all the appropriate specialists in this case, so I'm not sure what I can offer via Internet in terms of guessing as to cause of or solution for your vocal changes. What did the specialists that you've seen feel was the problem? What treatments did they recommend?
~ ~ ~ ~ ~ ~ ~

Loss of Singing Voice After Pregnancy
8/25/2012

Hello,
Singing has been my lifelong hobby. I used to be able to sing easily in high pitch. Then I got pregnant. Severe acid reflux during pregnancy. My throat used to burn after every meal. I lost my singing voice during pregnancy. I was unable to sing completely. I can now talk in a low voice. People tell me that I sound like a man now - I used to have a sweet voice. I delivered my baby a few days ago. No more acid reflux. But still unable to sing or talk loudly. I really miss my singing voice and wish to correct this. What specialist do I see? Is there hope?




Voice

I had a cold a few weeks ago and my voice had gone bad too, but as soon as my cold went my voice became normal. Now whenever I sing a high pitched song my voice becomes bad that day.  Please help me.

Melissa Kim M.S., CCC-SLP replies... 

Your symptoms may simply be the result of lingering swelling and inflammation related to the cold you described. If it has been several weeks since the resolution of your cold, however, and your symptoms have persisted, then I would suggest that you see an Ear, Nose, and Throat physician for an evaluation.
Best of luck to you!

Voice is Gone

Hello

About 22 days ago I went on a roller coaster and screamed  loud and very high for about 2 minutes.  As a professional singer this is not something I ever do -scream. The next day my voice was hoarse and singing was out of the question.  About two weeks later with a raspy voice I went to the ENT and he said one of my cords were red and swollen as well as my nasal passages. He said no nodes were present, that the cords looked good, just surrounding tissue was a bit inflamed. He ruled out acid reflux but said to take prilosec just in case. He said he thinks it's viral/allergies. My lower voice range is back but my high range is still gone. Nothing comes out but air. It feels like there is mucus on the cords and it just won't budge. Will it come back?

Melissa Kim M.S., CCC-SLP replies... 

An isolated vocally abusive episode with a resulting "red and swollen" vocal cord sounds very likely to be a vocal cord hemorrhage. This condition is one of the few where very strict vocal rest is encouraged, specifically, no talking at all for up to a week after the incident to allow for healing and re absorption of the blood that has pooled in the vocal cord. If you are past this time period, I would suggest that you ask your ENT for a referral to a speech pathologist for voice therapy, which may help to reduce scarring in the area and faster return to normal voicing.

Good luck to you.

Teacher Losing Voice

I am a kindergarten teacher and I basically loose my voice weekly. I normally talk loudly and in class I talk all day and we sing a lot! I tend to use my voice to control their voices during these kinds of activities. Usually by Thursday my voice is hoarse and I can't talk without straining it. By Monday it's back to normal but it is an ongoing cycle. Could I be causing permanent damage?

Melissa Kim M.S., CCC-SLP replies... 

There are many reasons why you may be experiencing this chronic cycle of voice loss. Teachers are especially at risk for developing something called vocal cord nodules, benign callous-like lesions that are very often the result of voice overuse/ misuse. Vocal cord nodules, or any benign traumatic lesion, may lead to permanent vocal change if left untreated. I would suggest that you see an Ear, Nose, and Throat physician for an evaluation and treatment recommendations.
Best of luck to you!

Tonsils and Adenoid

Hi.  I am 18 y/o and I have some problem in left side of my mouth as I get lot of pain  in there.  My left adenoid is always swollen and gives me pinch nose and my left tonsil also causes some pain and tonsil stone do come out of it sometime but it looks normal in appearance whereas right portion is completely healthy.  So, please tell what is the case with me and please tell me non-surgical cure as I cannot go for surgery due to financial causes. 

Melissa Kim M.S., CCC-SLP replies... 

There may be a number of causes of your swollen and painful tonsils and adenoids, many of which may be treated non-surgically. Treatment would depend on the cause, whether infectious, allergic, etc. See an Ear, Nose, and Throat physician for an evaluation and treatment considerations; simple medications may be helpful.

Good luck to you.


Difficulty Speaking

I have a hard time speaking clearly, and simply cannot pronounce many words properly, it seems like my voice cuts off due to a lack of airflow in my nasal passage. I base this conclusion on the fact that my voice seems to cut off behind my nose, and it is very difficult to project my voice, or speak with a higher volume. I have had this problem since I was about 12 years old, I've been to an Ear, Nose & Throat Specialist, and he told me I have a deviated septum and post nasal drip. My question is, what effect does a deviated septum have on speech, and will it improve my speech if I got a septoplasty?

 Melissa Kim M.S., CCC-SLP replies...

In some cases, a deviated septum affects resonance for speech, which may explain some of the difficulty you are experiencing. To gain a more thorough understanding of your speech/ voice/ resonance disorder, I would suggest that you see a speech pathologist for a thorough evaluation. A speech pathologist will be able to offer you insight as to whether surgery is your only option for improvement.
Good luck to you.

Thursday, October 4, 2012

Vocal Cords

Hi I’m a female singer that has been struggling for over 7 years with pain in my throat; I’ve gone to more than 10 ENTs and tried every treatment possible, changed my diet. Had had several laryngoscopes and my vocal cords seem to be fine, with my throat just looking red and with erosion. I feel like I have wounds or cuts in my throat. My voice range has gotten smaller and smaller. It started getting so painful I can’t sing at all and even talking bothers me loosing my voice occasionally. I finally got an endoscopy done and found a hiatus hernia, I had surgery a month ago and are now recovering, but my throat is still in a lot of pain and I still can’t sing. I want to know if I’ll ever be able to sing and rehabilitate my vocal cords that are fibrous. What can I do to now recover my voice and be pain free? It’s been a long road and I can’t do what I love most. By not being able to sing my depression gets worse. Please my doctors have not told me what I can do to fix my voice.

Melissa Kim M.S., CCC-SLP replies... 

What exactly is your diagnosis? If you had surgery to repair a hiatal hernia, I would assume that your ENTs are suspecting acid reflux to be a contributing factor to your "fibrous" vocal cords and vocal difficulties. If that is the case, I might suspect some secondary muscle tension dysphonia. This is a condition in which the muscles of the larynx are being used inappropriately in a response to underlying swelling and inflammation, causing hoarseness, odynophonia (pain with voicing), etc. This is treated most successfully in voice therapy with a speech pathologist. If there are additional findings in relation to the fibrotic nature of the vocal cords, additional surgical options may exist. See a laryngologist (an ENT who specializes in voice disorders).  
Best of luck to you!

Hoarse Voice

I had surgery over a month ago. Had a breathing tube in for 2 and a half hours during this time. I woke up with a sore and hoarse throat. I was told this would lessen a couple of days. Voice is still hoarse. Went to s ENT doctor and was told I have scar tissue on my vocal cord due to acid reflux. My question is if I didn't t have this before survey how can it be acid reflux when it happened after the breathing tube was put in?

Melissa Kim M.S., CCC-SLP replies... 

It is difficult to say... it is certainly possible that you had some pre-existing vocal fold changes secondary to acid reflux that were aggravated by the temporary swelling caused by the endotracheal tube. If you are not confident in the diagnosis made by your physician, I would recommend that you seek out a second opinion with a laryngologist (an ENT who specializes in voice disorders).

 Good luck to you!

Tuesday, October 2, 2012

Loss of Vocal Range

Recently I was sick with a minor sinus infection and was unable to avoid using my voice due to work requirements. This included singing. It's been 2-3 weeks and I've lost my upper range (it cracks and is basically silence). Do you think this will return if I rest my voice and just wait?

Melissa Kim M.S., CCC-SLP replies... 

It certainly may recover with rest and good vocal hygiene, if the difficulty stems primarily from infection-related edema (swelling). We do suggest, however, that any vocal changes that persist for longer than two to three weeks be evaluated by an Ear, Nose, and Throat physician.

Good luck!

Loss of Voice - Regains When Lying Down

My 74 yr old father has advanced Alpha One Antitrypsin deficiency, suffering from both emphysema and liver cirrhosis. He is on chronic oxygen, has limited mobility and for years has been on inhalers. Recently he has been sleeping in until 11am. When he awakens his voice is strong, by 4pm it is nearly gone, but not just a voice loss he also has a change, sounding almost like a duck. When he lies down for a couple hours, his voice is restored. Why might this be? His only recent med change is he was started on nadolol for cirrhosis.

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

It is possible that it is simply a matter of fatigue that is contributing to your father's voice difficulties as the day progresses; however, the only way to pinpoint the true reason for this vocal decline is to be evaluated by an Ear, Nose, and Throat physician.

Good luck to you both!