Thursday, January 31, 2013

Tonsil Surgery

As a kid my parents noticed I couldn't sleep at night..my tonsils would get swollen. After the surgery I wasn't able to talk as well anymore. I'm not sure what happened. Could you answer me this? What happened that affected my speech? I'm 14 and I have no idea what happened.

Melissa Kim M.S., CCC-SLP replies...
Is it your speech that has been affected? Or your voice? It is possible to experience some hypernasality following tonsillectomy that typically resolves spontaneously. Occasionally, an individual with altered resonance secondary to tonsillectomy will require voice therapy to address incomplete / insufficient closure of the soft palate. The only way to determine the cause of your symptoms and appropriate treatment strategies is to return to your surgeon for re-assessment.

Good luck to you!

Voice - Yelling

Hi. I'm a 24 year old female. I have a loud unlovely voice. I have always tried to speak lower but I can't and it makes me crazy. Is there any way or any drug or anything that could help me to have a normal voice? Please let me know and send me an email. I always cry after this shouting at my family but I don't know how to stop it. It doesn't matter if I'm angry, happy or sad. I just shout at others and they don't want to hear my voice again. Show me how to stop yelling!

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

I would first suggest that you see an Ear, Nose, and Throat physician to rule out any structural or functional issues that may be contributing to your vocal symptoms. If the larynx is determined to be healthy, ask your ENT for a referral to a speech pathologist. Voice therapy is often helpful in remediating any functional voice issues that may be contributing to your excessive volume.

Good luck!

 

Screamed for Entire Concert

So about a week ago I went to a concert, somehow ended up in the front row for my favorite band of all time (whom I've never had a chance to see live) and ended up screaming every word to an hour-long set. And I do mean, screaming, honestly, not singing. Loud.

Needless to say, not a good idea, as I know full well, but can't go back and change it now. Anyway, I didn't completely lose my voice, but my throat has felt... off for the past week? It doesn't hurt to talk, but my throat feels kinda dry and, for lack of a better way of putting it, tight? I can point to the specific point on one side of my neck where I feel this.

Oh, also I'm a singer in a rock'n'roll band (yes, I know; I really ought to know better than to have done something like this) and I definitely lost most of my singing range, though I didn't lose my speaking voice. After about 3 days I noticed my range was getting a bit better, but my throat is still dry-ish and feels weird and it's been a week since I stupidly blew my voice out.

I've been taking it easy, basically not talking unless I have to (which is rough because I'm a teacher - I've been using a microphone to address the class for the past week), I'm not singing at all, drinking LOTS of water and honey-tea, sleeping with a humidifier and taking non-menthol cough drops.

I've lost my voice a few times before (including once when I could barely talk at all for a day or two), but the fact that it's been a week and I haven't fully recovered is starting to scare me. Should I just keep on doing what I'm doing and hope it continues to improve?

At what point (how long out) should I see a doctor if I'm not back to normal? I've read a lot about this type of strain, and it seems most people say "just give it time," and that's fine, I just want some advice on how long it should take, given slow improvement, before my voice is back to somewhat-normal. (i.e. If it's not relatively recovered by WHEN might I need to go see somebody to see what's up?)

Just a little freaked out, dunno if going over a week without full recovery is normal or what.

(P.S. Rest assured I won't ever be making such a mistake again...)

Melissa Kim M.S., CCC-SLP replies...
As it has been at least a week of persistent voice change, I would suggest that you make an
appointment with an Ear, Nose, and Throat physician. With any luck, your symptoms will resolve before your appointment! In the interim, continue all the excellent vocal hygiene practices you outlined in your email - you're doing everything right!

Good luck to you!

Tuesday, January 29, 2013

Regurgitation

I've been having a hoarse voice for over a year now and I'm a singer. I'm unable to sing properly. I had put my voice to rest for two months but I can't sing. The ENT doctor said I have regurgitation. I'm really worried. I don't know what to do. Please help.

Melissa Kim M.S., CCC-SLP replies...
I assume that by your doctor's comment as to "regurgitation," he/ she suspects acid reflux to be contributing to your vocal symptoms. If acid reflux is affecting your voice, then appropriate medications and diet/ lifestyle modifications should be very helpful in improving your voice. In some cases, individuals with voice problems related to acid reflux will benefit from voice therapy with a speech pathologist once their reflux is under control. Ask your physician for a referral if this is the case.

Good luck!

Recurrent Crackling Voice and Burning Throat

Hi. I am a 26 year old woman who lives in the UK. I have been to see a doctor about my symptoms. They told me not to worry, but I am concerned and would like to improve them. Around 6 months ago, I went camping and suffered a large coughing fit when getting some food lodged in my throat. Since then, I have experienced my symptoms recurrently. Around once a week, I experience a crackly voice for around 3 days. If this is a particularly difficult session, I get a scratchy / burning feeling also. After 3 days, I am back to normal for a week, as though it never happened! This is not getting worse, and I do not feel a lump in my throat, I am not losing weight or do not get food stuck when trying to swallow. I do talk quite a bit in my job and enjoy singing in my car. I would really like two things - a little reassurance that my symptoms do not (on the balance of probabilities) point to something sinister, and secondly, some advice on what I might be able to try to reduce my symptoms. Thank you so much.

Melissa Kim M.S., CCC-SLP replies...
I certainly can't comment, without having evaluated you personally, whether or not your symptoms are pointing to something sinister, although it sounds as though you've had a physician's examination that was reassuring. It is also difficult for me to suggest strategies to reduce your symptoms because I don't know your diagnosis - what did your physician feel was the cause of your symptoms?


Monday, January 28, 2013

Can't Sing or Talk Well

A couple weeks ago, I had a cold. My throat was hurting and for these past two or three weeks, I haven't been able to sing. In my high school choir, I have to lip sync during practice because my voice is so bad. I could barely talk for a while, but I am able to talk more now. My throat doesn't hurt, but I still can't sing. I don't know if I'm still sick, or what. I was going to audition for my school's version of American Idol next week, but I don't know if I'll be able to since my voice has been so messed up. Is there anything I could do to get it back to normal or to at least help it before the 29th? If you have anything to give me, thank you!

Melissa Kim M.S., CCC-SLP replies...
Excellent vocal hygiene is key as your voice recovers. Visit our web page at http://www.gbmc.org/home_voicecenter.cfm?id=1558 for a list of recommendations, but basic vocal hygiene guidelines would include:

1. Drink half your body weight in ounces of non-caffeinated, non-alcoholic fluids daily.
2. Maintain a "moist" atmosphere by using a warm-mist humidifier in your home.
3. Conserve your voice as much as possible; avoid hard coughing and throat clearing, yelling/ screaming, and prolonged loud talking.    

If your vocal symptoms persist, see an Ear, Nose, and Throat physician for an evaluation. Good luck!

Wednesday, January 23, 2013

Voice Loss Due to Flu - Starting to Regain

After loosing my voice with the flu 18 days ago now it is coming back, but hoarse.  How do I help my voice heal the correct way? 

Melissa Kim M.S., CCC-SLP replies...
Excellent vocal hygiene is key as your voice recovers. Visit our web page at
http://www.gbmc.org/home_voicecenter.cfm?id=1558 for a list of recommendations, but basic vocal hygiene guidelines would include:

1. Drink half your body weight in ounces of non-caffeinated, non-alcoholic fluids daily.
2. Maintain a "moist" atmosphere by using a warm-mist humidifier in your home.
3. Conserve your voice as much as possible; avoid hard coughing and throat clearing, yelling/ screaming, and prolonged loud talking.   

Best of luck to you!

Monday, January 21, 2013

Botox Injection Question

Is there any evidence to suggest that there may be a loss of taste after Botox injection for treatment of adductor spasmodic dysphonia? Thank you.

Melissa Kim M.S., CCC-SLP replies...
If a Botox injection is done in the operating room (rather than in an office setting), then there is the possibility for taste change because of the pressure of the laryngoscope (a device used to access the larynx) against the lingual nerve. Most taste changes that result because of this type of procedure are temporary, and taste sensation returns to normal in weeks to months afterwards.

Thank you for your question!
 

Lost My Voice

I got a pain in my throat and I lost my voice. Can you help me to get back my voice again?

Melissa Kim M.S., CCC-SLP replies...
See an Ear, Nose, and Throat physician to determine the cause of your voice loss and appropriate treatment strategies.

Good luck to you!



Thursday, January 17, 2013

I'm Losing My Falsetto

Hi , I'm 13 years old going to 14 in a couple months.  Here's the thing, a couple months after I turned to 13 suddenly I lost my falsetto voice, well my voice is changing from couple months before but I can still use my falsetto and hit high notes with falsetto but suddenly my falsetto is gone. I know how to do falsetto but when I'm trying to do falsetto it sounded dry and then disappear or not sounded at all, but I still can do whistle with the same range that I used to even though whistle is lot higher than falsetto. I don't know if that is part of voice changing or not, but I really love to sing and falsetto is important. I've been to an ENT and they said that my throat is good. I asked my singing teacher and she don't know, so please help me if you know how to solve my problem? Thanks.

Joanna Lott, M.A., CCC-SLP replies... 
You must make sure you find a laryngologist specializing in voice to look at your vocal folds using video stroboscopy. If this is not the method of exam that your ENT used, see if you can find someone else for a second opinion. It is not unusual to experience changes in your voice during your teen years. It could be that you are going through a period of hormonal change and your voice will eventually balance out again. Meanwhile, make sure you are drinking enough water (64 ounces per day), don't overuse your voice, and keep working with your teacher. Hopefully things will improve. Best of luck!

Poor Bass Voice

I am a female singer from India. My problem is that I have a very poor bass voice-I can hardly reach middle A in the daytime. My diet consists of the typical Indian food (which is pretty oily and spicy) and I have Pani puri (spicy dish) every alternate day. I wanted to know how I can improve my bass voice. Will practice help? I have read that trying too hard may cause permanent damage to my vocal cords so I'm a little apprehensive. I'm pretty good at high pitches and can reach up to high E, and higher in falsetto.

One thing I've noticed is that in early morning (4AMto7AM) and late nights (11PM), I can reach until low D#, but as I said before reaching A in the normal hours is a problem. Please suggest voice exercises and tips to improve my bass voice.   This is important because I generally land up shifting the song some notes higher to fit my range, which causes inconvenience to the band members etc.
I will really appreciate your help. Thank you.

Joanna Lott, M.A., CCC-SLP replies... 
I wouldn't recommend trying to sing outside of your range unless you are being guided by an experienced voice teacher. And even then, it's generally best to stick to your true range. You can adjust the key or change the tune to accommodate your true vocal range. Otherwise, I would suggest that you just enjoy your healthy voice! Best of luck!

Voice Falling to the Ground

When one has been singing since a child and in their 50's completely loses their singing ability over approximately 2 years~ it is very difficult to live with and the unbelief of people who don't believe I can't sing any more is, almost unbearable. I've been seen by two specialists and had two laryngoscopics taken.(?)Both professionals stated that my throat and vocal organs appear picture-perfect and they assumed I had acid reflux.(Which I do not have). They put me on meds for same, but I became very sick so that ended quickly. It feels to me that when I try to sing that air is escaping for I cannot hold a note long and can't hang onto a tone for long, it will drop off and crack. My singing voice is more of a whisper. I can speak, but cannot shout out loud or project even my speaking voice any more. If I have to yell, my voice just falls off. Do you have any experience with such questions? Singing has been the one thing I was all about...until 2010 and it all came to a halt.

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

I'm sorry to hear that you are having such difficulties. It is not unusual for vocal folds to begin to atrophy at around your age. When vocal folds atrophy, they become thinner. As they thin, you will have to work harder to get good vocal fold closure, which will make singing feel effortful. This can cause you to use the muscles surrounding your vocal folds to "help" your voice. Unfortunately, this doesn't really help -- instead it only leads to increased tension and vocal fatigue. It sounds like you could benefit from some voice therapy. Do either of the laryngologists you saw have SLP voice therapists on staff? If so, it would be a good idea to work with one of them. They can help you unload the laryngeal strain and tension and even increase your vocal strength and stability. I hope this helps!

Voice Cracking During Performance

I have been singing regular at church for about 7 years. Recently my voice has started cracking during my performance. I am 58 years old and a non-smoker. I get plenty of rest and drink a lot of water each day. I can only sing about 5 songs before this starts. What do you think could be the cause? Is there a remedy?

Joanna Lott, M.A., CCC-SLP replies...  
It is hard to know for sure without meeting you and seeing a video stroboscopy of your vocal folds. But some questions for you to think about: Do you warm up? Are you singing songs that are comfortable in your range? Are you pushing your voice too hard? What about the rest of your day? Do you use your voice a lot? Have you noticed these "cracks" in your speaking voice if you talk for a long time? Or just in your singing voice? The best advice I can give you without seeing you myself is to recommend a video stroboscopy with a laryngologist and possibly some voice therapy with an SLP specializing in the singing voice. If you are in the Baltimore area, give us a call at 443-849-2087. If not, try this link to find a specialist in your area. Best of luck!
http://www.gbmc.org/home_voicecenter.cfm?id=1551

Tuesday, January 15, 2013

My Male Voice - Still Soft

I am a 25 year old male, but my voice is still very soft, like a girl's voice.  I cannot talk loudly and hard. Please help me. 

Melissa Kim M.S., CCC-SLP replies...
In the absence of anatomic or physiologic abnormality, persistence of abnormally high pitch in young men or women after the onset of puberty is referred to a "puberphonia," and can be treated in voice therapy with a speech pathologist who specializes in the treatment of voice disorders. I would first recommend an evaluation by an Ear, Nose, and Throat physician to rule out the possibility that something structural/ functional is contributing to your symptoms, and a referral to a speech pathologist if puberphonia is suspected.

Best of luck to you!

Pain in Neck

I have started taking singing classes.  My right side of the neck, outside part just inside the skin, muscular part is paining. What should I do?  Take some rest or get myself checked?

Melissa Kim M.S., CCC-SLP replies...
Although muscular pain in the neck or throat area after singing is often related to improper technique / excessive strain, it certainly wouldn't hurt to be evaluated by an Ear, Nose, and Throat physician to determine if there are any other contributing factors to your symptoms.

Good luck!

Lose Voice Easily

I am a worship leader and I sing regularly. During the summer I had kinda lost my voice but was on a trip with my team and had to sing even though my voice was extremely weak. Ever since then whenever I sing after 30 to 40 minutes my voice is shot. What can I do to recover my voice?

Melissa Kim M.S., CCC-SLP replies...
I would first suggest that you see an Ear, Nose, and Throat physician to rule out any structural or functional issues that may be contributing to your vocal symptoms. If the larynx is determined to be healthy, ask your ENT for a referral to a speech pathologist. Voice therapy is often helpful in remediating any hyperfunctional voice issues that may have resulted from singing while the voice was "weak."


Good luck!


Unable to Sing After ET Tube

On December 27, 2012 my 15 year old daughter had scoliosis surgery. She had an ET tube for about 28 hours. She loves to sing and wants to be a professional singer. She is now over two weeks out from her surgery and finds that she still can't sing. When she tries to sing in her upper range her voice cracks, sounds airy, and hurts. Will this heal? Is there anything she can do to promote healing and get her singing voice back? Please help.

Melissa Kim M.S., CCC-SLP replies... 
Although the reason for your daughter's vocal symptoms may simply be post-intubation edema (swelling) that may resolve with time, it is certainly possible that she has experienced an intubation-related injury. Intubation injuries to the larynx most commonly present as vocal fold motion impairment or development of granulation tissue in the posterior larynx. The only way to determine the cause of her persistent symptoms and appropriate treatment strategies is to be evaluated by an Ear, Nose, and Throat physician.

Best of luck to both of you!

Voice Deepened

I have been sick for the past couple of days.  My throat was very sore. Two days ago it started getting better, but then my voice got really deep and my friends described it as sounding like a man! How can I get my voice normal again for school tomorrow? 

Melissa Kim M.S., CCC-SLP replies... 
The vocal cord inflammation that is often the result of common upper respiratory infections can result in a temporarily low-pitched voice, so you may simply have to wait until the sore throat subsides. If your vocal symptoms persist after you are feeling better, I would recommend that you see an Ear, Nose, and Throat physician for a thorough evaluation.

Best of luck to you!


My Voice - After Flu Shot

I have been sick for over two weeks but after going to the hospital from an asthma attack I received the flu shot, upon leaving the hospital I felt sick again. Now 6 days later I feel fine but my voice is completely gone I've been drinking tea constantly and I'm not sure what the problem is. I am a college student. I need my voice back please help!

Melissa Kim M.S., CCC-SLP replies... 
Persistent loss of voice warrants evaluation by an Ear, Nose, and Throat physician... ask your family doctor for a referral or see the American Academy of Otolaryngology website (
http://www.entnet.org/) to search for a physician by area.
Good luck!

Voice Not 'Cracked'

My age is 22 and until now my voice has not cracked. For many years my voice is like this only. Please help me in this what should I do?  I haven't done any surgery. I am facing problems since many years. My friends voices at this age have cracked, but mine has not yet.  What is the reason?  Please tell me if this is a problem or if is this normal.

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, persistence of abnormally high pitch in young men or women after the onset of puberty is 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!

Vocal Support

I am a singer and have to take a day job in a call centre all day to make ends meet. How can I prevent damage to my voice or having my voice too worn out to do any singing at weekends?

Many thanks for your time and help. Best wishes.

Melissa Kim M.S., CCC-SLP replies... 
Kudos for seeking out advice as to preventative voice care... individuals who work in call centers are certainly at risk for developing voice problems! In general, practice excellent vocal hygiene; see some advice below, and visit our web page at
http://www.gbmc.org/home_voicecenter.cfm?id=1558.

1. Drink half your body weight in ounces of non-caffeinated, non-alcoholic fluids daily.
2. Maintain a "moist" atmosphere by using a warm-mist humidifier in your home.
3. Conserve your voice as much as possible during the work-day; try to practice vocal "napping" by avoiding prolonged talking while on breaks, at lunch, etc.
4. Warm up and cool-down the voice before and after your work day... see our web page at
http://www.gbmc.org/home_voicecenter.cfm?id=1559 for ideas.
5. Most importantly, watch your volume! Individuals who work in call centers very often unknowingly use excessive volume when speaking on the job for many reasons, most often because of excessive background noise. If you find yourself unable to monitor your volume because of background noise, try this trick - use a single earplug! Wearing a single earplug gives you immediate feedback about your volume, so most people will immediately lower their volume when wearing one.

Good luck!

Sunday, January 13, 2013

Raspy Voice

Since the beginning of the summer 2012 I have had a bad throat, my throat doesn't hurt, but I used to have a 2.5-3 octave range in my voice and over the last 6 months every time I sing I get a really hoarse, raspy voice. I do not really know what is wrong or how to fix it! Let me know if you have any idea what it might be!  Thank you!

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

There are any number of possible explanations for your vocal symptoms. 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!

Friday, January 11, 2013

Voice

I recently had my adenoids removed, and the ENT thought that my deep voice would sound clearer and that people would be able to understand me more. But the surgery didn't improve anything. I also went to see a voice therapist. She said it might be because when I speak air blows through my nose. Does this affect the pitch of the voice?

Melissa Kim M.S., CCC-SLP replies... 
No, altered resonance does not directly impact pitch. Although the perception of pitch may be altered with changes in resonance, pitch is a phenomenon of frequency of vibration of the vocal folds. You may want to seek out a second opinion from a speech pathologist who specializes in the treatment of voice disorders.

Best of luck to you.

Nasal Squeaks When Reading Voiceover

I'm a voice over talent and I'm hearing very audible "squeaks" from my nose when speaking into the microphone.

From time to time, I have had this problem and I don't know how to remedy this issue quickly. However, the problem has become very persistent and hard to work around. In fact, it's making me question my chosen career path if I cannot get rid of it.

I've tried everything - very literally. Re-positioning my microphone, a new mic, Breathe Right Strips, Nasal Spray, Neti Pot, etc. I even had someone recommend that I put cotton in my nose (and I'm embarrassed to say that I tried it).

What suggestions do you have?  Thank you for any suggestions.

Melissa Kim M.S., CCC-SLP replies...
What does your physician say? My first step would be to see an Ear, Nose, and Throat physician to determine if there is something structural in the sino-nasal area that is causing your "squeaking."

Good luck!

Throat

My throat constantly has mucus or what feels like mucus in my throat and it's causing me not to sing very well.  What should I do? I don't smoke or drink or do anything to it.

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

If the reason for your increased mucous is simply a response to environmental dryness, then increasing humidification should help... drinking half your body weight in ounces of non-caffeinated, non-alcoholic fluids each day, using a warm-mist humidifier in your bedroom at night, and using saline spray to the nose should all help in thinning mucous and allowing you to clear it more effectively. There are many other reasons, however, that might cause you to experience excessive or thick secretions, so if this symptom persists, see an Ear, Nose, and Throat physician for an evaluation. Good luck!

Thursday, January 10, 2013

Voice Cuts Out

Within the past few months I've noticed that if I try to yell or talk loudly my voice will cut out. I've been asked quite a few times if I was getting a cold, but I wasn't. I also had one episode of laryngitis a few months ago which came out of nowhere and went away in a few days. I don't have a sore throat or anything, but at times my throat feels "full" and my voice feels strained.  Any suggestions? Thanks!

Melissa Kim M.S., CCC-SLP replies... It is possible that your perception of  "strain" is the root of the problem... functional voice disorders arise from the way that you are using the voice. However, 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!

Cannot Sing High Notes

I am a 17 year old female and in the last 3 years, I have lost my higher range notes. My voice has been very unreliable, I can sing sometimes better than other times, but I can't sing the high notes anymore. My falsetto is very week, and my voice cracks when going from low to high, and I have pitch problems with medium and high notes. I have seen an ENT and don't have damage. He thought it was GERD and caffeine. Can this be my voice changing?

Joanna Lott, M.A., CCC-SLP replies...  
Did you see a general ENT? Or a laryngologist specializing in voice? An ENT won't always have the equipment or expertise necessary to recognize the subtle damage to the vocal folds that singers can experience. I recommend seeking out a laryngologist specializing in singers. Also, make sure you are studying with a voice teacher who understands the anatomy and physiology of voice. It could simply be a technique issue. Good luck!

Wednesday, January 2, 2013

Hoarse Voice

I am a 79 year old male taking Gleevec for 15 years for CML. I am constantly getting a hoarse voice. It doesn't hurt, but I can't project my voice high enough to be heard. I also have high blood pressure and take meds. I had my tonsils out when I was four years old.

Melissa Kim M.S., CCC-SLP replies...
There are any number of possible explanations for your vocal symptoms. 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!

Voice Problem

My 10 yr old brother has a problem with his voice. He is having a hard time talking to us because his voice hardly comes out.  He is fine but his voice is as if every time he talks it is like he is whispering. It has been a year or two and I'm very much worried. Don't know what to do.

Melissa Kim M.S., CCC-SLP replies...
I would first suggest that your brother be evaluated by an Ear, Nose, and Throat physician to determine if there are any anatomic or physiologic factors contributing to his vocal difficulties. If the larynx is determined to be structurally normal, his symptoms may be the result of how he is using his voice. If this is the case, voice therapy with a speech pathologist may be helpful.


Thank you for your question!

My Alto Voice

I'm a 13 y/o girl and my voice is very low.When I speak,sometimes people can't understand what I'm saying. I always hated my alto voice.  Is there any way to make it higher?

Melissa Kim M.S., CCC-SLP replies...
I would first suggest that you seek out an evaluation with An Ear, Nose, and Throat physician 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, your vocal quality may be the product of how you are using it. If this is the case, voice therapy with a speech pathologist may be helpful.

Good luck!