Tuesday, February 12, 2013

Complicated Voice Problems

I am a professional voice user and speak up to 6 hours a day with intermittent breaks. I started getting breathy and wheezy and a sore throat. I started taking Claritin and Zantac with little improvement. I then started coughing, and the coughing increased and was very productive. This was followed by difficulty swallowing. I had an EGD and there was a lesion on my esophagus and was started on 20 mg Prilosec for GERD and advair for the cough. A month later I was not improving and I went to an ENT who scoped me and put me on an aggressive dose of medications for LPR. The dysphagia resolved but the coughing and dysphonia remains. I was started on Albuterol and Atrovent and the wheezy portion has improved. I continue to cough, have voice fatigue and my voice breaks after one hour of speaking. Voice rest does improve the symptoms. Any thoughts I can take back to my doctors? I actually found this site while I was researching tips for voice users to help educate my peers who are also heavy voice users. This is a very impressive site. Thank you,

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

Thank you, I'm so glad you found our site to be informative!

In the setting of severe, persistent cough, it is not surprising that you continue to experience voice change. At the very least, excessive coughing for any period of time will lead to vocal cord swelling, which in itself can cause vocal "breaks" and fatigue. Persistent, excessive cough can also contribute to the development of other vocal cord pathologies, so I would suggest that you see an Ear, Nose, and Throat physician who will perform a laryngeal stroboscopic examination, the gold standard in the evaluation of the larynx and vocal cords.

Good luck!

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