Sunday, July 28, 2013

Polyp Surgery and Voice Problems

I had surgery 5 months ago to remove a polyp on my vocal cords. My singing voice has not come back the way it was before. There seems to be a spot in the center of my range that I can't seem to hit the way I could without my voice cracking. The funny thing is I can hit higher notes with no problems. I have only started singing a bit as I decided to take a year off from singing. I am worried that I have done some damage to my voice. Is this normal to expect when you start back singing? Once I experienced these issues I just stopped singing, but it's an important part of my job.  Thanks.

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

It is certainly possible, and in many cases expected, to experience some changes in how the voice sounds and performs after phonosurgery. I would suggest that you see your surgeon for evaluation as to why you continue to have singing voice difficulties five months after surgery. If the problem is a functional one, voice therapy with a speech pathologist may be helpful.

Good luck!

Vocal Cord Surgery

Can vocal nodule surgery cause vocal scarring and can vocal scarring lead to permanent hoarseness? I mean what are the chances of vocal scarring and permanent hoarseness?  Which way is good to minimize vocal scaring surgery - by CO2 laser or by normal instrument?

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

Yes, with any vocal fold surgery there is a slight risk of scarring and permanent hoarseness; you would have to ask your specific surgeon about his or her incidence of post-operative scar. There are phonosurgeons who excise vocal fold nodules using C02 laser, and there are those who use cold instruments. I'm sure physicians in both camps feel that they are able to perform surgery without risk of significant scarring. What is important is finding a surgeon with whom you feel comfortable.

Good luck to you!

Tuesday, July 23, 2013

Vocal Nodules

I'm having vocal nodules. I was diagnosed by an ENT and he told me that the nodules were small so he said you don't need surgery right now.  So, I have had15 days voice rest and my voice is normal when at normal pitch but when I go for high notes while singing I can't reach those notes.  I want the nodules out as soon as possible.  Can you tell me which surgery is safer? The one which is performed with an instrument or the co2 laser?  As one of my uncles, who is a general physician told me, the surgery could give permanent voice hoarseness if a scar develops.  Can you tell me the safe way to get those nodules out please?  The other thing is that no KTP laser is used in our area.  Please help.

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

In most cases, voice rest will not resolve vocal cord nodules; voice therapy with a speech pathologist is the treatment of choice for acute (newly formed) nodules. If vocal fold nodules have been long-standing, it is possible that voice therapy will not resolve the nodules and surgical removal may be an option. If you interested in having the nodules excised, surgeons may use either cold instruments or CO2 laser. Although surgeons usually fall into one camp or the other in terms of their approach, both methods can be used to effectively treat vocal cord nodules.

Best of luck to you!

LPR (GERD) Esophageal Dismotility

On July 10, 2013 I was diagnosed with GERD and esophogeal dismotility.    I have acid come into my throat all the time. My ENT told me I have LPR.  My doctor doesn't acknowledge this disorder (LPR).  My doctor told me to go home and "pray". He stated that there was nothing I could do for the problem. I am a kindergarten teacher and my voice is my career. I can't bend over without acid entering my throat. I CONSTANTLY cough, choke, my voice breaks all the time. I have had several episodes where my throat closes and I can't inhale any air. It only lasted 15-30 seconds but I was panicked. Do you have any suggestions?  My doctor said surgery (fundolpication couldn't be done due to the dismotility. He stated that I might not be able to get food into my stomach and I might have to "drink my food". That would be better than what I have to put up with now. Any ideas? I am desperate.

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

If your physician is unable to offer you any treatment option for your acid reflux disease other than prayer, I would suggest that you seek out a second opinion.  


As to the episodes of throat closing you describe, it sounds as though you are describing laryngospasm, an involuntary muscular spasm of the vocal cords, which temporarily impairs your ability to inhale and/ or exhale. Laryngospasm can be very frightening, but episodes typically resolve on their own fairly quickly. Laryngospasm is often the result of acid irritation to the throat, so treatment involves effective medical management of acid reflux. If reflux is appropriately managed and episodes of laryngospasm persist, respiratory retraining with a speech pathologist can often be helpful in reducing or eliminating such episodes.


Best of luck to you!

Friday, July 12, 2013

Vocal Ranges

Recently I have been improving on my vocal ranges. I was able to sing higher octaves while sounding good. However, a few weeks ago, one of my tonsils was red and a little bit swollen making it difficult to swallow, cough, or sing. I went to the doctor's and she said that it was a minor infection caused by some nasal activity (I don't quite remember). My tonsils isn't swollen anymore nor does it hurt. However, now when I sing it has become more difficult to reach those high notes when I sing. It comes out very breathy and less clear. 

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

There could be any number of reasons for your vocal difficulties. I would suggest that you seek out an Ear, Nose, and Throat physician for an evaluation and treatment recommendations.

Good luck!
 

Can't Hit High Notes - 2 1/2 Years After Tonsil Removal

About 2 1/2 years ago I had my tonsils removed and my uvula reduced and before my surgery I asked my doctor if the surgery would affect my singing voice. My doctor said it was unlikely and if there was an effect it would return to normal in due time. Since the removal of my tonsils I can't hit the semi high notes at all, which I could do easily. I can't even whistle ANYMORE! My voice has been noticeably lower and this has severely hindered my attempts at getting singing opportunities I have been told what happened to your voice or You used to be able to hit that note. Is there any damage that could have possibly occurred? Is there some way to get back the ability I used to have because when I attempt to sing a higher note or register it sounds like I am hissing and there is virtually no sound at all. I can literally try to sing high and scream notes but I will absolutely be blue in my face and no sound but just air and me straining is the result. No I have not returned to the ENT who did my surgery which I know be step one but I also would like to know any other alternatives or help you can suggest in addition to seeing my ENT again. Thank you in advance!

Melissa Kim M.S., CCC-SLP replies... 

Tonsillectomy and palatal surgery can result in altered resonance, although this wouldn't typically affect pitch range. Placement of an endotracheal tube during the surgery may, in some cases, affect the vibratory behavior of the vocal folds secondary to scar, lesion, etc., but I would assume that something like this would have already been seen on examination with your ENT given that your surgery was more than two years ago. I can only suggest that you seek out a second opinion as to the cause of your vocal difficulties; I would specifically suggest that you see a laryngologist (an Ear, Nose, and Throat physician with specialty training in the treatment of voice disorders). Ask your physician for a referral or see
www.entnet.org to search for an ENT by sub-specialty. 

 Best of luck to you!

Phlegm / Mucus Issues

I have issues constantly clearing my throat of mucus and my voice is thin and reedy. The only time my voice feels strong is when I have a cold and the mucus tends to be in the nose. My voice is obviously different when I have a cold but never the less stronger and more resonant. Can you help?

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

If mucous is especially thick, simply increasing hydration can be very effective in thinning your secretions and lessening the sensation of the need to clear your throat. That being said, there can be any number of reasons for chronic problems with excessive mucous and the vocal weakness you describe; see an Ear, Nose, and Throat physician for an evaluation.

Good luck!

Voice Loss

In early April I got a minor cold which, normally, I could recover from in two weeks. However, after the cold went away it started to hurt to talk and I lost much of my vocal range. It doesn't hurt to talk anymore but my range is still impaired. I used to be able to sing an F6 and now an F5 is almost difficult. My ability to project is also virtually gone. I am also cracking a lot which never used to happen. I'm 17, so is my voice just changing or should I see a doctor? Any advice? 

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

If your vocal symptoms have persisted since April, I would recommend an evaluation by an Ear, Nose, and Throat physician.

Good luck!

Tuesday, July 9, 2013

Voice Problem

I am having a voice problem leading to cracking and a lot of vibration when I speak.  I was suffering from cracking before and when I went to an ENT specialist he did my vocal endoscopy and found that I was suffering from edema. This means that I was having edema in my vocal cords my vocal cords have swollen.

I have undergone treatment of around 1 month and also after that I took rest of around 15 days but then I am also having problem in my voice. It cracks and vibrates a lot when I speak due to this vibration I think that my voice is becoming a bit heavier. Also when I try to call someone in a bit high tone (not very loud someone who is 10 meters away only) my voice gets heavier and cracks. I love to sing a lot. When my voice started cracking I stopped my singing and immediately went to an ENT doctor but of no help. Please help me get rid of this problem.  I'll be waiting for your valuable and helpful guidance.

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

In order to suggest treatment options or to remark on rehabilitation potential, it would be necessary to know the cause of your vocal fold edema (swelling). If the cause is infection, allergy, or acid reflux, medication would be helpful. If the cause is environmental irritants (e.g., tobacco smoke, alcohol, chemical inhalation), avoiding these irritants would be your first step. If the cause is simply voice overuse/ misuse, I would suggest that you ask your ENT for a referral to a speech pathologist for voice therapy.

Best of luck to you!

Voice

I'm a 17 year old male. I fell on my throat while skating on the April 20th 2013, it's been about 2 months since the incident, and I still haven't been able to access my higher singing notes. I'm a singer and musician, and I really would love to have my high vocal range back. What are some things I could do to help my vocal cords get back to the way they used to be? PLEASE HELP!

Melissa Kim M.S., CCC-SLP replies... 

Unfortunately, I cannot offer any advice as to rehabilitation potential without a diagnosis. See an Ear, Nose, and Throat physician for an evaluation and treatment recommendations.

Good luck!

Monday, July 8, 2013

Cracking Sound

I am a male of 21 years old. I can sing in high pitch, but there has been a problem since one month that I get a cracking sound whenever I sing.  It's not only when I pitch my voice up, it's also in medium pitch and also feel that I need to clear my throat always and a cough is always there...so, what should I do?  Is honey a solution?  If so, then what amount should it be? 

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

Persistent change in vocal quality or performance, throat clearing, and cough are symptoms that should be evaluated by an Ear, Nose, and Throat physician. Ask your primary care physician for a referral or see
www.entnet.org to search for a provider.

Good luck!

Wednesday, July 3, 2013

Deep/High Pitch Voice with Throaty Yell

I have a throaty talk/yell right now from cold, what is the best remedy for a sore throat and an altered voice?

Melissa Kim M.S., CCC-SLP replies...
Practice excellent vocal hygiene when you are experiencing hoarseness and sore throat as a result of an upper respiratory infection. Basics of vocal hygiene include adequate hydration, vocal conservation, and avoidance of environmental irritants such as smoke. For more helpful hints and suggestions, please see our webpage
http://www.gbmc.org/home_voicecenter.cfm?id=1558.

Best of luck to you!

Vocal Cords

I have a problem with my voice and it has been 10 days now.  I got this after singing too much and 3 days before I had a problem like clearing my throat.  My throat was dry all the time, even when I used to drink lots of water, but now it’s fine.  My throat isn't dry anymore, but my voice range has decreased.  When I talk normally it sounds fine, but when I talk loud or when I hit high notes it doesn't sound normal.  It sounds hoarse.  My vocal range is decreased.  One friend of mine told me that it is laryngitis, but I'm afraid of nodules.  Are these symptoms of vocal nodules?
Melissa Kim M.S., CCC-SLP replies...

A persistent change in vocal quality or performance warrants an evaluation with an Ear, Nose, and Throat physician. Ask your primary care physician for a referral or visit the American Academy of Otolaryngology athttp://www.entnet.org/ to search for a provider.

Good luck!

Voice

Hello, I am 13 years old (girl) and I have a medium range voice cannot go low CANNOT go high and it's very frustrating to the point I want to cry.  When I try to go at least two notes out of my range, I squeak, I don't really crack, but I get horse and I squeak.  I've heard that it's called pinching my vocal muscle but I don't know what else to do other then that I can sing very well in my medium range. I just wish to go higher even if it's just a little. Thank you so very much and have a nice day :)

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

Your issue may simply be one of technique. Seek out an experienced singing voice teacher for instruction and guidance in safe and effective ways to increase your pitch range. If you continue to experience difficulties despite working with a teacher, see an Ear, Nose, and Throat physician for an evaluation.

Good luck!