Thursday, November 29, 2012

Voice Maturity

I am 20+ but my voice has not yet matured.  I have two voices. When I speak normally have a kid like voice, but when I speak a bit louder, the voice comes from my throat and is like a 40 year old man. So I want to know which is my real voice and how can I speak to people?

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. 

Although I would guess that your "real voice" is the one that sounds like a grown man's voice, I hesitate to make that judgment without personally evaluating you.

Good luck to you!

Loss of Voice From Stretching

Sometimes I will stretch my arms above my head, like you do in the morning, or reach from a seated position to get something off the floor and if I push a tad more than the usual amount, I will lose my voice for about 10-20 seconds after. Air will pass through like I am talking but it is below a whisper and no actual voicing will happen. Sometimes it just switches back on and sometimes it takes a few seconds to progressively go from a foggy voice to my normal voice. I am female and 32 years old, have not smoked for a year, and have seasonal allergies for every season. Thoughts?

Melissa Kim M.S., CCC-SLP replies...
I suppose that it is possible that there is a muscular explanation for your symptom, but I would suggest seeing an Ear, Nose, and Throat physician, where you could attempt to replicate the problem while the physician is visualizing the larynx.

Thank you for your question!

Loss of Voice After Surgery

I had surgery on my C6 & C7 disc on October 12th of this year. The doctor went through my neck, and I knew I would lose my voice but I still haven't gotten it fully back.  How long will that take, and what can I do to help?

Melissa Kim M.S., CCC-SLP replies...
Individuals who have had anterior cervical disc surgery are at risk for voice disorders given the chance of injury to the recurrent laryngeal nerve. In some cases, a vocal cord paralysis will result, but persistent hoarseness can also be the result of simple edema and/ or excessive muscular tension with voicing. The only way to know the reason for your ongoing voice difficulty, prognosis for recovery, and potential treatment options, is to have your larynx examined by an Ear, Nose, and Throat physician.

Good luck to you!

Vocal Issues: 28 yr old Female

I rely on my voice to do my job as a music therapist. A few years ago I suffered though about 8 months of problems before I finally went to an ENT and they told me I had no nodules. It was just really bad sinuses and a nasal spray helped me. My voice was back to normal and whenever I had an issue, it was usually just a sinus infection or sinus pressure and a simple medicine would make it go away. Well I don't believe that is the case here. Back in March I got myself checked for nodules again because I started noticing changes in my voice- speaking primarily and was told again that I have no nodules. Now starting about 2 months ago, my singing voice is sounding very weird. I have no confidence because my range used to be pretty even and flexible through out and now I am just weak on certain shapes and I don't feel as flexible and at some points- I sound like I am going though puberty. My voice gets tired easily and when that happens it gets airy and cracks. I have a wide range. Please help. Thank you.

Melissa Kim M.S., CCC-SLP replies...
There are any number of conditions, other than vocal fold nodules, that might result in the symptoms you describe. Other than your ENT telling you that don't have vocal fold nodules, what diagnosis was suggested? If you feel that you have not been diagnosed accurately, I would suggest that you seek out a laryngologist, an ENT who specializes in voice disorders. See the American Academy of Otolaryngology to search for an ENT by sub-specialty at
http://www.entnet.org/.

Good luck to you!

Acute Onset of Voice Change

I am a professional singer, female, age 50. I had a very bizarre experience today where my voice suddenly cut out on me with no warning.One minute I was singing just fine, the next minute I was croaking. Not only was I extremely hoarse, I was suddenly unable to control the pitch. Just as suddenly about 3 hours later, it returned completely. No swelling, soreness, illness, congestion, dehydration, over-use, just a feeling of fatigue.   My voice has always been very reliable. Any ideas? Weird menopausal thing? Unusual virus? I am now afraid it will happen again in the middle of a concert.

Joanna Lott, M.A., CCC-SLP replies...
Any time there is an acute onset of voice change like that, we recommend being seen by a laryngologist who specializes in the singing voice just to be on the safe side. Even if it turns out that there is nothing wrong, at least you will have peace of mind. Check out our
national referral database for someone in your area. Good luck!

Monday, November 26, 2012

Hoarse Throat

I am 15 and I care a lot about my health and always try staying healthy. But 3 days ago I woke up with this weird feeling in my throat.  It felt very unusual but I decided to leave it alone and thought it would leave by the next day. The next day when I woke up and tried to speak my voice did not sound right and my throat felt a bit clogged. I had a hoarse throat and at the moment I still have it. I'm not sure what the cause was since I haven't been sick for months.  So my question is what does it seem like I have and what can I cure it with? I really need help because I'm worried.

Melissa Kim M.S., CCC-SLP replies...
The only way to determine the cause of your symptoms is to be evaluated by an Ear, Nose and Throat physician. Ask your primary care physician for a referral or visit the American Academy of Otolaryngology website at
http://www.entnet.org/ to search for a specialist.

Good luck!

Hoarse Voice

I went to an ENT today and he examined me and told me that my throat is normal and that he can't see anything wrong. But I know something is wrong. My voice used to be soft and high-pitched. I can reach high notes without difficulty. I have been singing since I was three. But now my voice is very raspy and hoarse. Last August, I was diagnosed with laryngitis and my doctor made me take some medicines but my voice never came back to normal. I already went to two doctors and they gave me medicines but my voice gets worse. Please help me. Not being able to sing is a torture.

Melissa Kim M.S., CCC-SLP replies...
Persistent vocal difficulties in the absence of an obvious structural issue may be related to a functional voice disorder (i.e., the way that you are using your voice). To determine if your symptoms are functional, or if there is an underlying medical reason for your symptoms that has not yet been determined, I would suggest seeking another opinion, this time with a laryngologist (an Ear, Nose, and Throat physician who specializes in voice disorders). See the American Academy of Otolaryngology website at
http://www.entnet.org/ to search for a specialist.

Good luck to you.

Potential Vocal Cord Damage?

I'm a male and I had a huge argument with my father which led to me screaming at the top of my lungs. Ever since then, I couldn't speak or sing properly. It didn't help that I got sick afterwards from the common cold and coughing a lot either. Now... I have a cough that won't go away and when I speak I feel pain. What should I do?

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

Voice over-use and a cold... the perfect storm! Persistent cough and pain with speaking warrants a trip to an Ear, Nose, and Throat physician. In the meantime, rest your voice as much as possible, drink plenty of non-caffeinated fluids, and avoid any environmental irritants, such as smoke.

Good luck to you!


Thursday, November 22, 2012

Repair of Cracked Voice

I am a singer and a nursery school teacher. We had a vigil in church 3weeks ago. After that vigil, my voice cracked. I have tried menthol, warm water etc. yet I still can't sing. What do I do? I am missing the choir.  

Joanna Lott, M.A., CCC-SLP replies...
If you have been overusing your voice, it will probably need a rest. I don't know how long your vigil lasted, but if you were singing for many hours, you should rest your voice for at least that long. Though menthol can feel soothing, it is actually an irritant for the voice and should be replaced with a glycerin-based lozenge such as Hall's Breezers or Grether's Pastilles. And when it comes to beverages, your best bet is always going to be room temperature water rather than anything very hot or very cold. If you can, take some time to rest your voice. And just to be safe, make an appointment for an exam with a laryngologist specializing in singers.

Steroid Treatment

Hi I'm a 23-year old classical singer who recently had bronchitis. My ENT found my vocal chords had swollen as a result of the severe cough and overuse, and so he prescribed steroids (cortisone) for 8 days, and told me to wait 72 hours afterwards to begin singing again.

Today was the first day I started singing again. However, after a few exercises, I feel weak and have a scratchy feeling in my throat. Is this normal? Does it mean the steroid treatment was effective? And how long should I expect to arrive at a full singing voice again after treatment of steroids? Thank you.

Joanna Lott, M.A., CCC-SLP replies... 
Steroid use does not generally prevent you from being able to sing. In fact, it is often used to get a singer through a performance while sick. The risk is that you can overdo it without knowing it. My guess in your case is that you need to ease back into singing after some time away from it. Don't try to do too much too soon. Try some lip trills and sirens to get warmed up and see how it feels. If it is uncomfortable or painful, you should see your ENT again. And make sure that your ENT is trained to work with singers.
 

Voice Improvement

I am a school teacher, but my voice strength is very low and I can't teach loudly, so is there any alternative to increase my voice strength?

Melissa Kim M.S., CCC-SLP replies...
I would recommend an evaluation by an Ear, Nose, and Throat physician to rule out the possibility that something structural/ functional is contributing to your low volume. In the absence of anatomic or physiologic abnormality, abnormally low volume can be the result of a functional voice disorder (i.e., how you are using your voice), and can be treated in voice therapy with a speech pathologist who specializes in the treatment of voice disorders.

Good luck to you!

Monday, November 19, 2012

Voice Destroyed

Is it possible that a specialist can see this video on YouTube of my laryngoscopy and give me a diagnosis?

http://www.youtube.com/watch?v=7yLkQsJnZD4

My voice is covered in extreme hoarseness and grogginess, I am a professional singer, and now I can only sing with strain and wrong posture so I get out a note. Only through yelling and straining can I produce a note that is not hoarse. When I try to sing in my mix voice with correct posture, everything sounds like it is extremely low pitched covered in groggy hoarseness. Same goes for normal speaking. Only through a bit of tension can I sound like I'm not hoarse and groggy.

Please help, endless gratitude.

Joanna Lott, M.A., CCC-SLP replies... 
It would be necessary to see you in person in order to give you a diagnosis. It sounds like you are having a lot of trouble with your voice -- you should make an appointment with one of our specialists or with someone in the national referral database at
http://www.gbmc.org/home_voicecenter.cfm?id=1551. Make sure that wherever you go they can offer you a video stroboscopic exam with a laryngologist specializing in voice, and voice therapy with a speech-language pathologist trained to work with singers. Good luck to you!

I Can't Sing

I've been singing since I was little and I haven't been doing it the right way. I used to have a decent range but now its withered away to nothing. I want to get a voice coach but haven't had time. Is there anything I can do to help get my voice back soon?

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

The best thing you can do is find a good voice teacher. Many offer 30 minute sessions, so it's not a huge time commitment. If it is really important to you, you will make it a priority. If you are concerned that there is something wrong, you should get checked out by a laryngologist and voice specialist. Best of luck!

Sunday, November 18, 2012

Paralyzed Vocal Cord

My sister has a paralyzed vocal cord on the left and a partially paralyzed vocal cord on the right. She has been told that she needs to have renervation surgery.  She lives in Reston, Virginia.  I trained at Kennedy Krieger Institute so wanted to contact your center to see where is the best place for her to be referred. Thanks.

Simon R. Best, MD, replies...
Vocal cord reinnervation surgery can be an effective form of treatment of vocal cord paralysis, but works best in younger patients (less than 50) or in those who have not had a paralysis for a long time (less than a year). Reinnervation takes a long time to have an effect, the end result is less consistent than medialization laryngoplasty, which is the surgery that I favor for paralysis. The results are immediate and more consistant than reinnervation, and the surgery can be performed in all age groups with any duration of paralysis.

I am happy to see your sister in consultation at the GBMC Dance Center if she would like to make the trip to Baltimore.  Please call 443 849 2087 for an appointment.

Friday, November 16, 2012

My Voice

I'm a singer and in the summer I noticed mucus build up and voice breaks when I would warm-up for about 20 minutes.  Then came show time and I was fine and my voice felt good. It was the same thing in the fall - some days more mucus build up which made it hard to sing and some days it was less and I was fine. I rested my voice for almost a week and it felt ten times better. I still rest my voice often now. There is still mucus but after 5 or 10 minutes I feel fine and there is no problem. My voice feels the best and loose after a show or a practice. What is this? Is my voice damaged?

Joanna Lott, M.A., CCC-SLP replies... 
My best guess is that you are dehydrated. If you don't drink enough water (64 ounces per day), your mucous will get thick and sticky and your voice will crack and break. Or it could be allergy related. If you have seasonal allergies and this seems only to happen during allergy season, a mucolytic such as Mucinex may help. Taken with a large glass of water, a mucolytic will thin out your mucous. Thin mucous is less likely to interfere with vocal fold vibration. Voice rest is always a good idea, especially if you have heavy professional vocal demands. It is a good sign that your voice feels at its best after a show or practice. If your voice were damaged, it's more likely that you would feel hoarse or vocally fatigued after a lot of singing. But if you are still worried, see a laryngologist who specializes in the singing voice. Best of luck!
 

Thursday, November 15, 2012

Can I Lose My Singing Voice?

I lost my voice on Saturday and I am regaining it now. Its still hoarse and I still cannot sing without me losing my voice. Is it possible for me to lose my singing ability all together? I am in choir and a good singer, please help.

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

It is unlikely that you would experience a permanent "loss" of your singing voice. I would suggest that you refrain from singing for the next several days, but if your hoarseness persists for more than a week or two, see an Ear, Nose, and Throat physician for a thorough evaluation.

Good luck!

Tuesday, November 13, 2012

My Friend's Voice

I have this friend and he's a tenor. He is currently 20 years old.  About two weeks ago, I went to his voice lesson with him, and it was amazing. However, a couple of days later... he wasn't able to sing. He used to sing up to a C and now he can barely go past an F... We thought it was laryngitis at first...and now we simply don't know. He isn't in pain, nor did he pull anything... Is it possible that his voice might be changing?? Is there a type of specialist he can see?

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

When a singer experiences a sudden change in voice, he should be seen by a laryngologist specializing in the singing voice. Changes like this can be the result of phonotrauma (trauma to the vocal folds caused by type or amount of voice use), in which case he will likely benefit from voice therapy with a speech-language pathologist specializing in voice. That said, singers sometimes experiences voice changes due to allergies, illness, environmental factors, etc., that may resolve on their own over time. But his best bet is to establish care with a laryngologist and voice therapist who specialize in treating singers. If he is in the Baltimore area, we would be happy to see him here. Otherwise, our national referral database should provide him with a list of professionals in his area (
http://www.gbmc.org/home_voicecenter.cfm?id=1551). Best of luck!

Hoarse Voice

I just got a hoarse voice. I don't feel sick or anything, I just have a hoarse voice and a little bit of a cough. Anyways, this is the third year in a row that I have had a hoarse voice around this time. I don't understand why it's happening. Why IS it happening? Is there anyway to prevent it from happening a forth year? And if so, how? Also, last year when I got my hoarse voice, I didn't get my regular voice back fully until THREE weeks after I got it! Is there any way I can make it so that I don't have it for that long this year? If so, how?

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

A viral laryngitis can cause hoarseness with or without other upper respiratory symptoms. If the reason for your hoarseness is simply a viral laryngitis, then no, there isn't much you can do to shorten the duration of your symptoms, you simply have to let it run its course. The only way to know the reason for your symptoms, however, and to know if there is anything you can do or medication you can take, is to be evaluated by an Ear, Nose, and Throat physician. 

Good luck to you!


Cannot Hit High Notes

I am a singer who could sing the soprano notes and really sing high and hold my breath for long. And the voice quality was really good. Lately I noticed when I was talking continuously to my mother, I felt a stress in my voice as if it gave way after which I am unable to hit high notes, it is becoming hoarse whenever I sing or talk a lot. I consulted an ENT consultant and he told me there was nothing wrong and it would improve by the day. I am worried because that is not the truth, the voice seems like it is improving but goes back to the same condition.

I remember I had swallowed a fish bone inadvertently, you know once you are affected you seem to relate all possible reasons. Is this something serious that I am going through?  Can it be helped?  How and in what way?  Please let me know.

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

 When you consulted the ENT, did you ask him if he specializes in voice? Many ENTs specialize in sinuses or ear problems. If the doctor you saw did not specialize in voice, you should find someone who does. Did his exam include a video stroboscopy? If not, he is limited in the information he can obtain from his exam. The best advice I can give you without seeing you myself, is to find an ENT specializing in voice and have him or her take another look. (It is doubtful that the fish bone affected your voice since, unless you choked on it, it would not have made contact with your vocal folds.) Best of luck!

Dry Throat When Singing On Stage

Whenever I'm singing with family members or with friends or even with the church choir my voice is fine and flawless, but when it comes to singing for large groups of people my voice gets pitchy. I figured its just because I'm nervous so I tell myself to calm down and be confident before I sing on stage. Well yesterday I had to sing at my friend's father's funeral. I was more annoyed than nervous because I was the last one to sing on the program, but when I got up on stage I was confident and not one nerve in my body was against me. When I started singing it was fine but as soon as I got to the chorus my voice became very dry. It sounded terrible and everyone noticed, I tried to fix the problem by just singing with more emphasis but it didn't work for most of the song. I don't know what happened, I drank a little water before I was called up and my throat was cleared. Point is, I would like to fix that problem because all my friends were there I don't think I ever want to sing again after that episode. Can you help me please?

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

This is not uncommon. Many singers struggle more when singing solo in front of an audience. Sometimes it is nerves, but other times it is the result of the environment. If you have been practicing at home or with your voice teacher, you can count on your voice behaving a certain way in those environments. But when you get to the performance space there are many factors that are not within your control -- such as dry air, dust, and fragrances (like flowers at a funeral home), not to mention the acoustics of the room. If the room had poor acoustics, you may have felt the need to push or strain to get the sound you wanted. This may have led to a feeling of dryness in the throat. Or it could be that the room was dry and dusty and you needed more water than usual to combat the dry air. Try to notice the environment as soon as you get to your performance space. Is it dry? Do you need to drink more water? How are the acoustics? And pay attention to how you feel while you are singing, more than to how you sound. In general, the best way to manage all of these unpredictable problems is to have as many tools in your "vocal tool box" as possible. That way, when you get into trouble you will know what to do. This means studying with a voice teacher trained in the anatomy and physiology of the vocal mechanism who can trouble shoot these issues with you. I hope you won't give up on singing. Best of luck!

My Voice

I am a 48 year old woman and have never been able to scream or sing as my voice is always in a low pitch noise.  I sound like a man.  It is very gruff sounding when I try to sing a high note.  My voice will only go in a low pitch.

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

I would recommend an evaluation by an Ear, Nose, and Throat physician to rule out the possibility that something structural/ functional is contributing to your symptoms. In the absence of anatomic or physiologic abnormality, abnormally low pitch can be the result of a functional voice disorder (i.e., how you are using your voice), and can be treated in voice therapy with a speech pathologist who specializes in the treatment of voice disorders.
Good luck to you!

Voice Problem

My father is a business man and he had construction in his shop in December 2011 and after the construction he got sick for 10-15 days and then he started to have a voice problem.  For a year he couldn't speak loud. Some ENT doctors say that he has fleshy mass on his vocal cord.  He gets some  pain in his throat a little bit and sometimes he gets muscle fatigue in his throat and larynx.  He drinks 3 glasses of pomegranate juice everyday for a week and ENT doctors say he should have an operation but he is scared of it. What should I do?

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

I don't know what operation was recommended for your father by the ENT physicians, but it may be to obtain a biopsy of the lesion which is a reasonable first step. To determine pathology of a lesion, the physician will most likely recommend direct laryngoscopy and biopsy in the operating room. The physicians may also recommend imaging studies, that is, either CT scan, MRI or PET/CT. Once the pathology is known and imaging results are obtained then treatment options should be recommended. If you and your father do not feel comfortable with the recommendation then a second opinion by another physician is advised.  

Thank you for posting your question.


Voice Loss - Strep Throat

I had strep throat about 3 weeks ago, during which I experienced almost total vocal loss, lasting almost a week. I am now recovering from a sinus infection as well and I have had 2 steroid shots during this month-long period. I am a singer (soprano) and I have not regained my lower/middle range to any of it's normal strength and control. What could be the cause of this issue?

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

Did you get the steroid shots in order to perform while you were sick? If so, it's possible that the false sense of vocal well being that steroids can cause led you to overdo it during your performances. You may have a phonotraumatic injury from singing while sick. Or you may just be going through a rough period of illness with a longer than expected recovery time. My advice, of course, is to see a qualified laryngologist specializing in singers who can do a video stroboscopic exam of your larynx. Come see us here if you are in the area, or check out our referral database for voice centers across the country. Best of luck.


Weight Loss and Voice Change

I am a soprano singer and can normally reach a high C.  However, I noticed in August this year my vocal range has reduced dramatically and my voice is slightly darker in colour - more of that of a mezzo singer. I have no idea what's happened.  The only changes are that I lost around 30lbs in weight in April-July and am wondering whether this could be the reason? My throat is a little tender at the moment but I've never experienced such dramatic change when having a sore throat before. Any ideas what may have happened? Thank you

Joanna Lott, M.A., CCC-SLP replies...
It is possible that the weight loss is a contributing factor to your voice changes. Sometimes when you lose a significant amount of weight, your vocal folds also loose mass, which can result in changes in pitch range and vocal quality among other things. The best advice I can give you is to get it checked out by a laryngologist. If you are in the Baltimore area, we would be happy to see you here. Otherwise, check out the national referral database for ENTs specializing in voice on our website. Good luck!

Cannot Use Falsetto Voice

I cannot use a falsetto voice for a few years now.  My breathing was difficult. Is this paralysis of the vocal cords?

Melissa Kim M.S., CCC-SLP replies... 

The only way to know the cause of your symptoms, vocal cord paralysis or otherwise, is to seek out an evaluation by an Ear, Nose, and Throat physician.

Good luck to you.


Monday, November 5, 2012

What Happened to My Voice?

Hello, I used to be able to sing really low songs such as Trololo, Chocolate Rain, and several other songs that no one else I knew could sing because of how low/deep they were. One day very recently, I just wasn't able to make my voice as deep, I wasn't able to hold the notes, and I can't sing those songs as a result. I'm an 18 year old male so I don't think it is a puberty thing. Should I let my voice rest or what should I do?

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

If the change was sudden and you aren't experiencing an upper respiratory infection or other obvious cause for voice changes, you should see a laryngologist and voice therapist for a video stroboscopy. Hopefully they will be able to get to the bottom of the cause. If no cause if evident, the voice therapist should be able to work with you on your vocal technique as appropriate. If you are in the Baltimore area, we would be happy to see you here. If you are elsewhere, please refer to the National Referral Database on our website for a provider in your area:
http://www.gbmc.org/home_voicecenter.cfm?id=1551. Good luck!

My Voice is Cracked

I used to be a great singer - singing high notes after age of 16.  My voice has cracked and now I suffer huge loss with my voice.  How could I regain my voice?  Thank you.

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

Based on this limited amount of information, my best guess is that possibly you are experiencing voice changes related to puberty. It is very common for the male voice to drop in pitch during this time. It is also possible that you have experienced a vocal injury. If you suspect this to be the case, you should be seen by a laryngologist specializing in voice. You may also benefit from working with a voice therapist and/or voice teacher to help you get through this adjustment. I hope this helps! Good luck!

Voice Skips

About four years ago I noticed my voice skipping when I raised my voice. As the years passed it has gotten worse so that it happens frequently during regular speech. A voice therapist told me I have Hypertension in my vocal cords. I have throat exercises but haven't noticed them benefiting me much. My throat feels so tight all the time. This problem causes me embarrassment and anxiety. Any helpful hints to get me through this?

Melissa Kim M.S., CCC-SLP replies... 

A hyperfunctional voice disorder (rather than "hypertension") is treated with voice therapy, but if you've not had success thus far, you may need to work with a different therapist or seek out as second opinion as to your diagnosis. Does your speech pathologist specialize in the treatment of voice? If not, I would ask your ENT for a referral to a specialist, or see a laryngologist (an Ear, Nose, and Throat physician who specializes in the treatment of voice disorders) for further assessment and treatment recommendations. 

Good luck!

Voice Problem for 2 Years

I am 21 years old I have had a voice problem since 2010. My voice sounds weak at times.  When I went to see my friend after a long time she said your voice has gone deep which it has, but my voice sounds deep and normal like once in a month. I went to see the ENT and they said you are suffering from acid reflux and the tablets they prescribed to me didn't work. Second time I went to see the ENT they said there is nothing wrong with your voice box. My voice problem is ruining my life and is blowing my confidence away and I avoid phone calls. My normal voice is deep but that only happens once in a month and back to the weak voice again. When I speak in the weak voice I can't feel the vocal chords vibrating. I always pray for my voice to be low the next day. Is thyroplasty surgery recommended for this problem? I just want to be confident and my proper low voice to come back again. I hope you can help me.

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

If an Ear, Nose, and Throat physician has determined that your larynx and vocal cords are healthy after a thorough evaluation, I would suspect that there is at least a component of a functional voice disorder (a problem with the way in which you are using the voice). To address a functional voice disorder, voice therapy with a speech pathologist who specializes in the treatment of voice disorders can be helpful. He/ she will be able to prescribe specific exercises to address specific concerns. 

Thyroplasty is a procedure done most often to correct a vocal cord paralysis. If you are still uncertain as to a diagnosis, which I suspect, I would suggest that you seek out a laryngologist (an Ear, Nose, and Throat physician who specializes in the treatment of voice disorders) for an evaluation and treatment recommendations. 

Good luck to you!

Very Hoarse Voice

I have a very hoarse voice.  I have had it for months.  I don't know what to do.

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

Persistent hoarseness warrants a visit to an Ear, Nose, and Throat physician for an evaluation and treatment recommendations.

Good luck to you.


Extreme Throat Problems

Hello, I am 50 yrs young. Started singing around 7. Was fine until about 21 yrs after I got out of the Army. My throat would get sore with extreme pain where I wouldn't swallow. It would happen at least 6-10 times a year. I was always just given an antibiotic with no success.Then one year my voice went away for at least a month with no pain, no swelling, you could barely hear me breathe, Docs didn't find anything wrong. After my voice returned I lost the high register and sometimes I get a painful cramp in my throat where I have to literary hold the base of my neck still while I twist my head to pop the knot in my throat. Now when my throat gets soar with mucus I get my high register back, when it gets well I lose it again. What do you recommend?

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

If an Ear, Nose, and Throat physician has determined that your larynx and vocal cords are healthy after a thorough evaluation, I would suspect that there is at least a component of a functional voice disorder (a problem with the way in which you are using the voice). To address a functional voice disorder, voice therapy with a speech pathologist who specializes in the treatment of voice disorders can be helpful. He/ she will be able to prescribe specific exercises to address specific concerns. 

If you have not seen an ENT, I would suggest that you seek out a laryngologist (an Ear, Nose, and Throat physician who specializes in the treatment of voice disorders) for an evaluation and treatment recommendations.

Thank you for your question.

Chronic Hoarseness/Fatigue

My voice is weak and tires easily. I'm told I have a "small" voice, in contrast to 5 years ago when I was told I'd make a good singer, and that my voice really "projects". I suspect problems arose from my being in denial of my natural range. I would really strain to hit those high notes. I visited an ENT who told me he couldn't see anything wrong. I was out of there in 5 minutes, and left wondering if he really looked. The vocal therapist he referred me to said she could notice my voice fatigues easily and suggested that maybe my trying to talk quiet to avoid strain, was actually I causing strain. I tried talking louder but my voice just tenses up and doesn't project like it should. I also choke and sputter on water if I'm not careful. Overnight my voice seems to gain some richness, but this quickly fades after a few minutes of speaking. It's been like this for a couple years now, and it might have gotten worse because I can't help but try and sing sometimes. I've heard vocal rest can help. Would this do me any good seeing as how my vocal problems seem to have already "set-in" after all this time? Many thanks. 

Melissa Kim M.S., CCC-SLP replies... 

If you're unsure as to whether or not an ENT actually looked at your larynx, I would suggest that you seek out an ENT who can perform laryngeal stroboscopy, which is the gold standard for visualizing the vocal cords. If it is determined that your larynx and vocal cords are healthy after a thorough evaluation, I would suspect that there is at least a component of a functional voice disorder (a problem with the way in which you are using the voice). To address a functional voice disorder, voice therapy with a speech pathologist who specializes in the treatment of voice disorders can be helpful. He/ she will be able to prescribe specific exercises (and not just make recommendations as to usage) to address specific concerns. This would be a better course of action than simple vocal rest. 

Good luck to you!

Thursday, November 1, 2012

Laryngitis

I'm a choral singer. Back in July I had bronchitis for a month and coughed my head off. First week of Oct had a URI and coughed a lot. On the 7th or 8th, lost my voice completely and while I can now speak, am still hoarse and can't really sing. Yesterday is the start of the 4th week of this. Have finished a whole bottle of Mary's Magic Mouthwash. Now gargling with warm water/salt/sugar/lemon. Have an ENT appointment at Indiana University on Nov 13. Trying not to talk and not singing. Question how likely is it I have developed nodes or granuloma...should I keep not talking and not singing? Is trying to sing worse than talking? Do I risk further damage if I try? I'm slightly panicked. Thank you very much.

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

Don't panic! Although I can't predict the likelihood of developing traumatic lesions such as vocal fold nodules, this diagnosis is easily made with an endoscopic examination performed by most ENTs. If it is at all possible, I would suggest that you continue to rest your voice as much as possible - particularly from prolonged singing - until you are seen by your ENT. What type of voice use is more damaging depends on the person... some individuals have technique issues with either or both speaking and singing.

Good luck!

I Want to Change my Voice

I'm 21 years old, but my voice sounds like a small child's voice.  I suffer a lot.  Everyone insults me.  I want to change my voice like a normal girl voice.  What can I do? 

Melissa Kim M.S., CCC-SLP replies... 

I would recommend an evaluation by an Ear, Nose, and Throat physician to rule out the possibility that something structural/ functional is contributing to your symptoms. In the absence of anatomic or physiologic abnormality, abnormally high pitch in young men or women is often referred to a "puberphonia," and can be treated in voice therapy with a speech pathologist who specializes in the treatment of voice disorders.

Best of luck to you.

Weak Voice

In 2010 and also in 2011 I had carotid body tumors removed. I have since had problems with my bottom lip function and problems singing. The lip function is much improved over time and unless you knew about it you would probably not notice it, but my voice is getting weaker and I can't hold a high note. Do you think anyone could help me?

Melissa Kim M.S., CCC-SLP replies... 

It is certainly possible that there was damage to the vagus nerve during surgery to remove a carotid body tumor, which would impact vocal fold function. The only way to know that type and extent of the injury would be to see an Ear, Nose, and Throat physician for an evaluation. If your vocal symptoms are due to a vocal fold motion impairment, which would be one potential outcome of this type of nerve damage, there are treatment options available.
Good luck!

Voice Nodules

Hi, I am 24-year-old female singer and teacher currently teaching English abroad in Japan. I visited an ENT here and was diagnosed with vocal nodules. I have already had vocal nodules once, when I was 17, at which time I went on vocal rest for several weeks but underwent no voice therapy or rehabilitation. This time, my doctor provided me with the poor advice of "reduce your talking." That's it. So I'm not sure what to do. Because of my job here, I can only afford to take one week of complete vocal rest, accompanied by several weeks of reduced talking and no singing. However, since I'm in a rural part of Japan and my Japanese level is low, speech/voice therapy here isn't a viable option. I'm wondering if you think one week of vocal rest would be enough time, if coupled with vocal rehabilitation. I'm also wondering if you know any opportunities for participating in online speech/voice therapy, or if you can recommend any general techniques for me to follow once I begin talking again. Thank you so much.

Melissa Kim M.S., CCC-SLP replies... 

It sounds as though you already know that prolonged vocal rest is not an effective treatment strategy for vocal fold nodules; however, short term vocal rest is often recommended to reduce any acute inflammatory changes associated with the nodules. Subsequent to that, voice therapy with a speech pathologist is the recommended treatment. Since you unfortunately do not have access to a voice therapist given your current situation, I would suggest general conservation of the voice when possible and that you practice excellent vocal hygiene for the duration of your assignment. I don't personally know of any voice center or program that offers web-based treatment, although that certainly doesn't mean if doesn't exist; please let us know if you discover such a program.

For detailed vocal hygiene tips, please see our web page at
http://www.gbmc.org/home_voicecenter.cfm?id=1558.

Good luck!

Loss of Singing Voice

I am a 55 year old female, been singing for many, many years. I have always had a deep voice but now its even deeper. I was hit in the throat, not very hard, about 10 years ago. I no longer able to sing and I miss it very much. I have had no sore throats or any throat irritations. I now sing monotone, no more high notes its almost like I am now a bass singer and I don't like it. Is there any exercises I can do to get my singing voice back?

Melissa Kim M.S., CCC-SLP replies... 

Your injury certainly may have impacted your ability to raise or alter your pitch. See a laryngologist (an Ear, Nose, and Throat physician with speciality training in the treatment of voice disorders) to determine if this is indeed the case. Only when the cause of your pitch change has been determined will you know whether therapeutic exercises prescribed by a speech pathologist will be helpful.

Good luck to you.