Friday, June 28, 2013

Permanent Damage to Singing Voice

I sing, and I noticed a raspiness in my singing voice a couple months ago, and I was diagnosed with a minor edema and told to rest my voice and not sing, but not to go on total vocal rest and avoid speaking. I kept getting check ups, and the swelling slowly went down, but it took a couple of months. Finally, at my last evaluation the ENT told me that my cords looked ever so slightly swollen, but it could just be my vocal cords because she has seen that level of swelling in some people on a regular basis. But she told me I don't need to do anymore resting from singing or speaking.

After that I decided to sing again, but after I did I felt mild pain on the right side of my neck followed by a wet feeling, like maybe a bunch of mucus was dripping down, on the right side of my neck, and my speaking voice became hoarse afterwards for about 1 day. So I decided to do total vocal rest for about a week.
Now when I sing I don't feel pain, and my voice doesn't sound hoarse or raspy, but it sounds much more thin and nasal and less full than before, and doesn't have the ring or resonance it had before, also I don't really have much vibrato compared to before. So I have decided to try to rest it as much as possible and then try again later, and possibly go back for another appointment. The ENT said I never had any nodules or pre-nodules, just swelling/edema, and that it had improved dramatically. Since she said that I still had some very minor swelling at my last appointment, I was wondering if the change in my voice could be from minor residual swelling that will hopefully go away, or if you think that I may have done permanent damage to my singing voice. I only had an edema and never pre-nodules or nodules, and I know many people have gone on to recover their singing voice completely from nodules, but I am concerned at how long it took the swelling to go down and how slow the healing process was, and that there was still some minor swelling at my last appointment, and then problems when I sang. I was wondering what you thought about permanent damage and what you would recommend that I do?

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

Vocal fold edema, or swelling, does not cause permanent damage to your vocal folds. I am unclear, though, as to the cause of the swelling. Did your physician offer any explanations as to what potential contributing factors might be? Common causes of chronic vocal fold swelling include voice overuse/ misuse, smoking, acid reflux, and allergy/ infection. Treating the cause of the swelling would certainly make sense as a first step.

Best of luck to you!

Vocal Therapy

I am very interested in being a Musical Theatre performer, but I want to play female roles. Normally this would simply be classified as Drag, but I want to be able to change my voice to sound as feminine as possible during speaking and singing. I was wondering if there were any exercise or therapeutic techniques that would help me "feminize" my voice for performing, but preferably keep a "normal" voice during my everyday routine?

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

An experienced vocal coach or singing teacher would be helpful in finding your "feminine" voice for performance. I would caution you, however, that prolonged use of pitch or vocal quality that is dramatically different than your natural voice may contribute to the development of hyperfunction of the laryngeal musculature or even traumatic lesions (e.g., vocal fold nodules, polyp, etc.) Discuss this with your instructor and don't use your voice in any way that feels uncomfortable!

Good luck!

Wednesday, June 26, 2013

Vocal Cord Injection

About 7-8 weeks ago I had Radiesse Voice injected for unilateral vocal cord paralysis. Was under anaesthesia and breathing tube used. Voice today IS STILL hoarse after I talk for a while; doctor says a tube was used for breathing during surgery. WHEN CAN I EXPECT my voice to return to normal strength and sound? It's been 7 weeks. 

Melissa Kim M.S., CCC-SLP replies...
A temporary worsening of vocal quality following a vocal cord injection is expected; typically, voice will sound tight or strained for a few days following the procedure. Persistent hoarseness for weeks following the procedure is not expected... is the hoarseness you are experiencing similar to what you were experiencing before the injection? In some cases, an additional injection is necessary to achieve the glottic closure necessary for improved vocal quality in the setting of a vocal fold paralysis. It is also possible that some of the hoarseness you are experiencing is the result of hyperfunction, or excessive tension, of muscles around the vocal cords. If this is the case, voice therapy with a speech pathologist would be helpful. A third and final possibility is the injectable material has been reabsorbed... did you have a Radiesse Voice Gel injection (expected to last approximately six to eight weeks) or a Radiesse Voice calcium hydroxylapatite injection (expected to last a year or longer)? If you had the short-term injection, it's possible you simply need a repeat procedure.

Good luck to you!
 

Strange Vocal Problem

Hi, I'm a self-taught singer and I had a strange occurrence about two weeks ago, I started my usual warm-up routine that consists of lip-trills and then some scale stuff and before I even started I realized I had no voice it was just about completely gone. I had considered that maybe it was the Excedrin I had taken for my headache? I thought maybe it had dehydrated me or something. So, I just stopped and didn't talk for the rest of the night. The next day, my voice was back but, it was still a little strange. Also, I've been making sure I'm drinking a lot of water. For the past two weeks my voice has been kind of hoarse, not chronically at all, I've had no pain, and I thought it may have been the seasonal change or my allergies, I stopped taking my zyrtech because I'd learned it dehydrates as well. To me it seems I may have symptoms of LPR like, the tight throat, lump sensation (on and off), thick mucus, some post-nasal drip. When I talk my voice seems almost normal but, I can tell when I start to sing that it's not right, my voice feels dry and scratchy. Which makes me think maybe it's LPR causing some acute laryngitis? I've been trying to rest it but, it hasn't seemed to help too much. I can't figure out for sure what's going on and I'm in the middle of recording a record with my band so, any kind of advice would be helpful.

Melissa Kim M.S., CCC-SLP replies...
Unfortunately, it is impossible to offer advice as to remediation of your symptoms without a diagnosis. There are any number of explanations for your vocal symptoms, and treatment options would vary greatly depending on that explanation. I would suggest that you be evaluated by an Ear, Nose, and Throat physician. In the interim, continue to practice excellent vocal hygiene (visit
http://www.gbmc.org/home_voicecenter.cfm?id=1558 for vocal hygiene tips).

Good luck!

Vocal Cord Polyp

I have a hiatal hernia and barretts mucosa. After my recent gastroscopy I was told I have a vocal cord polyp to be removed. My question is, I am a bartender and wondering is it just going to be a day or two that I will have to be off work? Just curious because I don't want to lose to much work. 

Melissa Kim M.S., CCC-SLP replies...
Physicians vary in their recommendations as to post-operative voice rest, and these recommendations are often impacted by the specifics of a particular vocal cord lesion (e.g., size, location, excision method, etc.) A typical recommendation for total voice rest after phonosurgery is anywhere from 3 - 7 days. Ask your surgeon what would be appropriate in your particular case.

Best of luck to you!

Hoarse Voice / Prior History of Vocal Cord Nodule

My son is having issues with his voice quality being hoarse. His speech therapist at school has asked about it twice. My son had an endoscopy and reflux study approximately 5 years ago--results from the endoscopy (no issues) and reflux study (slightly loose valve that opens). At any rate his hoarseness has continued over time. He now does martial arts which involves a lot of yelling several nights weekly. I mentioned to pediatrician but he was not concerned. Should I have him re-evaluated for this by the ENT or the GI specialist, or is this normal?

Melissa Kim M.S., CCC-SLP replies...
Your son's persistent hoarseness may very well be just a matter of voice overuse, but chronic hoarseness can also be the result of several underlying conditions. I would suggest an evaluation by an Ear, Nose, and Throat physician.

Good luck!

Wednesday, June 19, 2013

Vocal Pain / Loss of Stamina

I've been singing professionally for five years, mostly Robert Plant, Steven Tyler type of stuff. My problem is strange because I can hit all my notes, however it's hard to get a crackle on any of them. There is an itchy constant but mild pain on the right side of my throat, I believe within the larynx. This itch refers forward to underneath my chin. Also my vocal stamina with singing and speaking has dropped quite a bit, and I get phlegmy and hoarse frequently. Any ideas?

Melissa Kim M.S., CCC-SLP replies...
There could be any number of explanations for your symptoms. See an Ear, Nose, and Throat physician for an evaluation of your larynx and appropriate treatment recommendations.
Best of luck to you!

Tuesday, June 11, 2013

Mystery Voice Pain / Tightness

I am a 22-year-old female who has never had any voice problems till 8 months ago, when I did an hour of singing a day for a week. I had to stop singing because of pain and tightness in my throat/voicebox. Since then, the pain/tightness hasn't totally gone away. Now even talking hurts. It feels like my throat is raw. The ENT says my throat looks healthy and the speech therapist says my voice sounds normal and I don't have any major bad habits. I have tried total voice rest for 5 days twice, cut out singing, yelling, throat clearing, etc., and reduced my amount of talking. But still the problem lingers on, becoming, if anything, worse. What else can I do? What could be wrong? Will I ever be able to talk and sing again without pain?

Melissa Kim M.S., CCC-SLP replies... 
It is unclear from your email whether or not your speech pathologist prescribed an exercise regimen to address the muscular tension and pain you feel, rather than just addressing the sound of the voice. If not, a second opinion might be helpful. Adjuvant therapies might also be helpful, namely, physical therapy to address upper torso and neck tension, and/ or myofascial release, a technique that involves applying gentle sustained pressure into the connective tissue to eliminate pain and restore motion.

Good luck!

Strengthening My Voice

Why does my deep voice thin out at times? When I get up in the morning my voice is extremely rich and deep. But as the day goes by it will not be as rich sometimes. When I have a performance or recording session many times I do not have that rich low tone as I did in the morning. Even after I warm up. It's not as consistent as I'd like it to be.

How do I strengthen my voice so I can have consistency with my voice during the day?

Melissa Kim M.S., CCC-SLP replies...
I would first suggest that you see an Ear, Nose, and Throat physician to rule out the possibility that something structural/ functional is contributing to your vocal symptoms. If your larynx is determined to be healthy, simple technique may be the culprit; consultation with a voice coach or singing teacher may be helpful.

Good luck!

Weakening Voice

For two weeks or so I have been having issues with my voice.  After talking in my usual baritone for a minute or so I start feeling my voice weakening. What is happening? I am 54 years old.

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

There could be any number of explanations for your symptoms. See an Ear, Nose, and Throat physician for an evaluation and treatment recommendations.

Best of luck to you.

Thursday, June 6, 2013

Voice Loudness

I had an auto accident that required a short term trach. I also paralyzed the left vocal cord and had the trach while in the hospital for 63 days. At first, my voice was low and I couldn't be heard.  Now, I have snoring issues, my son says in two octaves and loud. Also, my voice seems to be normal to me but I have been told too many times that I am loud, even when I try to be quiet.  Is this normal for my situation and how can I turn my volume down?  The ENT people put an endoscope down my throat and saw the paralysis and I have had times when the cord spasms, and I can barely squeak a breath in or out. This happened several times, twice called an ambulance. I can take a muscle relaxer and it helps but getting that down is hard. I get very embarrassed and consciously try to tone my voice down but I always seem to be heard.  Can I tell people why? Even my adult children remind me, and seem irritated because I am so loud. Please help.

Melissa Kim M.S., CCC-SLP replies...
Typically, individuals with a vocal cord paralysis cannot achieve normal loudness, because the vocal cords no longer meet at midline. That you have been told that you are speaking too loudly is unusual in your situation. My suggestion would be to ask your ENT for a referral to a speech pathologist who specializes in the treatment of voice disorders; in some cases, persistently inappropriate volume can be successfully addressed behaviorally in a therapy setting.

Good luck!