Tuesday, February 26, 2013

Vocal Cords Weak From Acid Reflex

Have weak voice and tremors.  Been to ENT and neurologist and have acid reflex and tightening in throat.  On Prevacid for 1 year and had every test 24 ph and gi tests first diagnosis with dystonia now they say corrosion from acid on my vocal cords.  Who should I believe?  Any suggestions?

Melissa Kim M.S., CCC-SLP replies...
Unfortunately, I cannot comment as to which diagnosis is accurate, or even whether both are accurate, without having evaluated you personally. If you don't feel as though you've been appropriately diagnosed, I would recommend that you seek out another opinion, specifically with a laryngologist (an Ear, Nose, and Throat physician who specializes in the treatment of voice disorders).

Good luck!

Singing and Speaking Voice

I have been singing for a long time then experience a problem after being told to sing very loud with a teacher, I experienced hoarseness, I have a scope and my vocal cords were good though had some reflux which is mostly okay now, and had speech therapy. I have had SLS singing lessons and my singing voice is okay mostly, but when I go back to speaking my voice feels and sounds really uncomfortable. My singing teacher is unsure of the next step. What is the best things I can do please? Thank you. 

Melissa Kim M.S., CCC-SLP replies...
If your larynx was determined to be healthy by an Ear, Nose, and Throat physician, it is very possible that your speaking voice difficulties are secondary to muscle tension dysphonia, a general term to describe excessive and unnecessary tension of laryngeal muscles during voicing. Muscle tension dysphonia is often seen in the setting of acid reflux that impacts the larynx, in that the negative vocal results of acid reflux often result in a compensatory change in vocal technique. Treatment for this condition is voice therapy with a speech pathologist who specializes in the treatment of voice disorders; ask your physician for a referral.

Good luck!

Wednesday, February 20, 2013

Deeper Voice


I realize I am unlikely to get the answer I want, but I have to ask: I'm 28 and still sound more like a boy going through puberty, or even a woman. Will I ever sound like a man? Will my voice ever truly deepen, or has that ship sailed?

Is there ANYthing I can do to make it deeper? I don't need to sound like James Earl Jones; I'm mostly just tired of people calling me Ms. on the telephone.


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!

Lost Voice December 8th, Now February 16th

I'm just curious as to why I am still without a voice after more than two months? I am usually on the healthier side and just one day in December I woke up and I had basically lost my voice! I literally whispered for a whole month straight. Now I am able to push out what voice I do have, but it is horrible sounding and it hurts! Why is this?

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!

Speech & Voice

Last year I got sick,went to the doctor who treated me for severe tonsillitis.  The medication did not help.  My throat got worse and I started vomiting and loosing weight.  My left shoulder muscle looked like it collapsed.  I could not eat, swallow and my voice was completely gone.  I had severe head aches which occurred mostly on the left side of my head and neck.  I was living on pain pills.  I was referred to a specialist who did all sorts of test like a berium swallow, MRI, Lumber punch.  They took blood and everything was normal they just said my right vocal cord was not moving.  I was referred to another doctor who did further tests and they said my lower cranial nerve was damaged.  They sent me home with steroid tablets and no further help was given to me. Today my shoulder muscle is healed, but I have a speech impairment.  I could sing beautiful, but I no longer can sing and my self-esteem is gone.  Please help me! I'm afraid!  My head-aches are starting again and my neck is also very sore. I'm afraid something else is going to happen.  What if my speech gets worse.  I already am struggling to be heard clearly! 

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

If the symptoms you describe in relation to difficulties with singing and being heard clearly are the result of your vocal cord "not moving" (vocal cord paralysis), there are number of options available to you. See a laryngologist (an Ear, Nose, and Throat physician who specializes in the treatment of voice disorders) to discuss available treatments, such as vocal cord injection or thyroplasty to medialize the paralyzed cord. Voice therapy with a speech pathologist may also be helpful.
Good luck to you!

Friday, February 15, 2013


I have strong lungs and I have been told I am a good singer. Only problem is I have a hard time singing quietly, and I get yelled at by my family for singing to loudly. What should I do with my voice?

Joanna Lott, M.A., CCC-SLP replies...
I recommend that you find a voice teacher who can help you learn to sing using healthy vocal technique at different volumes. Look for someone with specialized training in the style(s) you are most interested in singing. If you want to sing musical theater, for example, look for a teacher with experience in that genre. Ideally, you want to find a teacher who has knowledge and understanding of the anatomy and physiology of the voice and understands how the vocal mechanism works. Good luck!

Tuesday, February 12, 2013

Hoarseness After Laser Surgery

I had an operation three years ago, and had some scarring on the left vocal cord due to laser surgery. Is it still possible to regain some of my voice if given some kind of injection to my vocal cord? Has there been any operation that can make a voice better?

Dr. Lee Akst replies...
Vocal cord scar is a difficult condition to treat. There are some techniques which have shown some moderate promise, with limited data to support them - possibilities include pulsed KTP laser scar remodeling, repeated saline infusion, and even temporalis fascia or fat grafts into the vocal cord. If there are other issues alongside the scar, such as as glottic insufficiency, then these are more easily addressed with augmentation techniques to help improve voice. Certainly, with whatever degree of scar is present, working with a speech pathologist can help to optimize voice. I recommend that you make an appointment with a voice center with specialty laryngology and speech pathology care to learn more.

Difficulty Swallowing After Singing

Yesterday, I was singing along with the radio in my car, and while hitting some high notes, all of a sudden my throat and roof of mouth went completely numb, and I felt like I couldn't swallow. This triggered a panic attack which worsened the swallowing sensation.

Today, in the aftermath, I still feel like there is a rope around my neck, my throat feels tight and I have some lingering numbness and swallowing difficulty. I also find it difficult to speak loudly, and have been avoiding speaking altogether.

What could cause this to occur so suddenly? Is it possible to "blow out" a vocal cord? For reference, I have acid reflux, central sleep apnea, and mild neck arthritis. Thank You.

Melissa Kim M.S., CCC-SLP replies...  
A single episode of voice "abuse" or overuse certainly may result in damage to the vocal cords with resulting voice change, such as a vocal cord hemorrhage (bleeding into a vocal cord) or even development of a vocal cord polyp. Difficulty swallowing would most likely be unrelated but should also be investigated. See an Ear, Nose, and Throat physician for an evaluation of the larynx; while there, ask about a referral for a modified barium swallow study with a speech pathologist for thorough evaluation of swallowing function.

Best of luck to you!

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!

Voice Hoarseness and Taste Blood in Back of Throat

I am a smoker have been smoking cigarettes for a long while. I am a female only 26 years old and here lately over the years it seems like my voice has gotten dramatically deeper to the point when I talk people think I am a man, it is quite embarrassing. I also can taste blood in the back of my throat almost all the time and I cough and phlegm comes up discolored and with small amounts of blood or sometimes it is really lumpy and has a awful taste and smell but it is like stuck to the back of my throat, I really want to know what could be wrong or what I may need to do, could this be cancer, or what?

Melissa Kim M.S., CCC-SLP replies...
A common reason for significantly lowered pitch in female smokers is "polypoid corditis" or "polypoid degeneration, which refers to severe swelling of the membranous portion of the vocal cords. This condition will improve with cessation of smoking, though may not resolve entirely without surgical intervention. The only way to know if this condition is contributing to your symptoms, or something more serious, is to be evaluated by an Ear, Nose, and Throat physician.

Best of luck to you

Sunday, February 10, 2013

Lost Singing Voice 2 Years Ago

After having dental work done my singing voice has fallen away. Is it really dentally-related or could it be something else? I've been to 2 specialists who looked in the throat with cameras and said everything is great. They thought perhaps acid reflux for some pinkness, but I don't have a.r. It feels like 'air' escapes when I'm trying to sing and also I can no longer hold a note~ the voice just does what it wants, which feels like muscle laziness and I have no control over it. Very sad ex-singer/musician. Thank you for your time and expertise.

Melissa Kim M.S., CCC-SLP replies... 

It would be unlikely to be related to your dental work, but it certainly sounds as though you've not been properly diagnosed yet. I would suggest that see a laryngologist, an Ear, Nose, and Throat physician who specializes in the treatment of voice disorders. See the American Academy of Otolaryngology website at
http://www.entnet.org/ to search for a specialist.
Good luck!

Friday, February 8, 2013

Singing Voice

Hello, I'm from Philippines and I accidentally seen your website here just perfectly when I wanted to have because I really need an expert opinion about my condition. Well I had my tonsillitis gone about a week ago but there is this scabs that still on my tongue that somehow (I think) prevents me to not sing my high notes. Not to bragged but I had a high voice when I'm singing I always get to hit a note (whatever note that is I don't wanna know). But later this day I cannot do it anymore I try to drink lots of water and it still does not work. When I try to sing or to belt the only thing comes out is this husky/hoarse sound that I cannot understand. Please help me to regain my voice. I really love to sing. Thanks a lot.

Melissa Kim M.S., CCC-SLP replies... 

A persistent change in vocal quality and / or performance after an upper respiratory infection warrants an evaluation by an Ear, Nose, and Throat physician. Only after the cause of your symptoms has been determined can appropriate treatment be recommended.

Good luck!

Hoarse Voice for 4 Weeks

I came down with a bad cold, thereafter a bad cough and lost my voice. This happened 4 wks ago, since had seen a GP was put on a 5 days course of antibiotics. Last Wed, revisit the GP though the voice has come back, but very hoarse. He prescibed a 5 days course of Prednisolone... Today still very hoarse. Pls advise.

Melissa Kim M.S., CCC-SLP replies...
Persistent hoarseness after resolution of an upper respiratory infection warrants an evaluation by an Ear, Nose, and Throat physician.

Good luck!

Post Nasal Drip

As a 25yr voice over veteran, I've been plagued with drainage onto my vocal folds that require throat clearing. Over the past 2yrs it's been unbearable. I've tried Ipratropium, Dymista and Astepro - none provide what I need for my sessions to go unhindered...none! Have you had any tough cases such as this and been able to treat effectively?

Melissa Kim M.S., CCC-SLP replies... 
Effective treatment would depend on the cause of the drainage, such as infection, allergy, obstruction, acid reflux, etc. Only your physician could counsel you as to the likelihood of one of these diagnoses and appropriate treatment strategies. If the problem is simply thick secretions, then simple behavioral changes to thin mucous will likely be very effective, e.g., adequate hydration, humidification, and/ or medications to thin mucous, such as guaifenesin.  

Keep in mind that throat clearing can and often does become a habitual behavior, despite what you might feel is excessive drainage. A speech pathologist who specializes in the area of voice disorders should be able to provide therapy for what is often coined as "irritable larynx." 

Best of luck to you!

Speaking for Long Periods

Does talking beyond 2 hours or less have an effect leading to poor performance in voice? I am the type of person that loves hearing himself while speaking because of this more confidence is derived from it keeping me in whatever I'm doing. Your response will mean so much.

Barbara P. Messing, M.A., CCC-SLP, BRS-S replies... 
There are many factors that would contribute to the voice becoming tired after speaking for long periods of time. I cannot say how that would affect the voice during a vocal performance because it would depend on what the vocal performance entailed. I would recommend, however, that you should rest your voice prior to a vocal performance, stay hydrated and be sure to do vocal warm ups and cool downs.

Best wishes

Frequent Changes in My Voice

Whenever I lay down to either have a rest or sleep when I wake up the tone and sound of my voice would have being altered. I assume the common cause of this is that I am going through puberty meanwhile I am 20 year old and I believe this stage of puberty shouldn't be at hand but this continues. However I do sing and rap and I am aspiring to become a motivational speaker as well as a teacher.  As a result of frequent change in my voice I'm beginning to shy away and the level confidence I was used to when talking to girls demised and now I'm left with worries. Secondly, I do experience this when after eating that the food bit of it do flush up to my lungs. Please I am so concern about this. I need more information to go about caring this problem.

Barbara P. Messing, M.A., CCC-SLP, BRS-S replies...
You mention several different issues. First of all, on average young men typically go through puberty from the ages of 12-16. By the age of 20 the vocal changes related to puberty are typically resolved. If not, then I recommend voice therapy which can be very helpful. Regarding your comments about eating, I would suggest that if you feel food going into your lungs when eating that you should have a swallowing evaluation. You should be seen by an Otolaryngologist and speech pathologist for your vocal complaints. Also, the speech pathologist can evaluate your swallowing to determine if you are indeed having food go into your lungs when you swallow. This should be evaluated since it is not healthy for your lungs. 

Thank you for posting your question to our website.

Loss of Falsetto Due to Whooping Cough

Hi, I have had Whooping cough for the past two months, and am just finishing a weeks course of antibiotics to deal with it. About a month after the coughing started I was coughing up blood, and completely lost my voice. Now that I am finishing my antibiotics, my voice and normal singing voice have almost (still quite breathy and hoarse) returned back to normal. However, my falsetto has literally disappeared. It's just not there at all anymore. It has been over a month since I had my falsetto voice now and I am seriously distraught at the idea of this being permanent. I am a 21 year old male student currently studying acting at a London Drama School, for which voice work and singing is a huge part. Not to mention, I love singing. I understand that the falsetto voice is created by the edges of the vocal folds vibrating whilst the main body of the folds stay relatively relaxed. Is it possible that that I have permanently damaged the edges of my vocal chords and that my falsetto will never come back? Or will it just need time?

Melissa Kim M.S., CCC-SLP replies... 
I can understand your concern! It would be impossible to remark on whether or not your apparent loss of falsetto is permanent without a physical examination; see an Ear, Nose, and Throat physician for evaluation and treatment considerations.

Best of luck to you!

Loss of High Notes

I used to be able to hit really high notes while singing, and I fear that from yelling at my husband in the past really loud and trying to sing while sick, has taken it's toll. If I scream as loud as I can at the end their is nothing...like I can scream loud but when I try to get a high note my voice fades or falls out, there is nothing. Is there some sort of exercise I can do to bring those high notes back to life?

Melissa Kim M.S., CCC-SLP replies... 
It is certainly possible that some sort of vocal exercise or voice therapy may be helpful in alleviating your symptoms; however, the only way to determine if this is an appropriate treatment strategy is to be evaluated by an Ear, Nose, and Throat physician.

Good luck!

Tuesday, February 5, 2013


I am 40 years old and I have been singing since since I was 9. I have been in rock bands for the past 6/7 years. I have lost my range. I get hoarse easily, tight vocals, sore throat, use to feel like I had a lump in my throat (not any more), cracking in range, hard to sing calm notes (not steady), and takes forever for me to warm up. I sing for a living. I went to the ENT 3 years ago and no problems. I guess acid reflux could of been a factor but I no longer eat late and I have went back to eating clean for the past 7 months. Will it be possible for me to clear this up? I still sing but some shows its a struggle. I was thinking about taking vocal lessons. Is there a certain technique I should look for in training? Please help!!! Thank you in advance.

Joanna Lott, M.A., CCC-SLP replies...
You should find a laryngologist at a voice center -- not a general ENT -- and make sure you are examined using video stroboscopy so that they are able to observe the vibration of the vocal folds. A general ENT may not have that equipment. It sounds like you would benefit from voice therapy with a speech-language pathologist trained to work with singers, and a laryngologist at a voice center should be able to set that up for you. Then, the voice therapist should be able to refer you to a good voice teacher when you are ready. If you are near Baltimore, we would be happy to see you here (
https://www.gbmc.org/home_voicecenter.cfm?id=26&eformid=121). Otherwise, our national referral database (http://www.gbmc.org/home_voicecenter.cfm?id=1551) should provide the resources you need. Best of luck.


I sang in a choir for about 4 years. I could always reach the high notes, but today I tried again. Nothing came out. At all. But this was only when I went into head voice. It just sounds like a lot of air. What should I do?

Joanna Lott, M.A., CCC-SLP replies...
When you have a change in your voice like this you should see a laryngologist at a voice center. You may benefit from voice therapy with an SLP specializing in treating the singing voice.

Friday, February 1, 2013

Hoarse Voice & Can't Sing

I lost my singing voice about 15 months ago. Not that I'm a professional, but I've always sang! My talking voice is very hoarse sounding and it gets worse by the end of the day. I'm a 3rd grade teacher, so not talking is not an option. I saw an ENT doctor in April 2012. She saw nodes on my vocal chords and guessed that it was due to acid reflux. She had me change my diet. I've had some other issues occur. Was diagnosed with Polymyalgia Rheumatica, so that took a top priority. I'm on Prednisone (10 mg/day) for that. I had a scope done last week - hoping for some answers to get my voice back. I do not have nodes on my vocal chords now. They did find a 3cm sliding hiatus hernia in my esphogus, but don't think that's causing the problem. Not sure what to do! I'm not a smoker, but do have a chronic dry cough. Is there an alternative method that might work? Tea, vitamins, exercise? Really want to sing again!

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

When you say that you were scoped last week - do you mean by a GI doctor or a laryngologist? If it was a GI doctor, you should also follow up with your laryngologist. One suggestion is to use amplification in your classroom and find activities for the students to do that give you an opportunity to rest your voice. Also, try to think of alternative methods of quieting them down other than raising your voice. And if you haven't had voice therapy yet, you may benefit from that as well. There really isn't a tea or pill that can help with hoarseness. Some teas can be soothing to the throat, but they don't actually reduce swelling or inflammation. An SLP trained in voice therapy can teach you vocal exercises that may help. Speak to your laryngologist about that. If there isn't one in his office, he may know of someone in the area. I hope this is helpful! Best of luck.

Lost Falsetto

I lost my falsetto during Marine Corps Boot Camp from screaming so much. I can't seem to get it back. It's been almost 7 months and it still has not improved much. It's really frustrating. My range used to be huge with my falsetto and now it's just completely non-existent. Can I ever get it back? If so how? Will I need surgery?

Joanna Lott, M.A., CCC-SLP replies...
I can't say whether you will need surgery, but I would recommend that you see a laryngologist to find out what has changed. Screaming can cause traumatic changes to the vocal folds such as a polyp or nodules. In either case, voice therapy would be the first line of defense. With benign vocal fold lesions such as these, we try to avoid surgery unless absolutely necessary. Find a team specializing in voice (laryngologist and SLP-voice therapist) and hopefully you will have your questions answered. If they immediately recommend surgery - get a second opinion. Good luck!

Voice Tension

I am a 49 year old male, singing professionally for 25 years. I have a natural tenor voice and have never had vocal issues until about 3 years ago. Was diagnosed with silent acid reflux. Since then I have cleared up the reflux and also saw a speech therapist to help with the tension that had set in. My middle to midhigh range was my main issue. The exercises given to me were mainly tension releasers, breathing voiceless exercises, blowing through a straw into water. I was then encouraged to see a vocal coach which I did and she led me to sing everything in falsetto. So I have been there done that with my treatment it seems like to me & I still struggle with singing on pitch and placement with freedom in that range. My low & high range have been unaffected. Do I have severe muscle tension dysphonia that was never really cured? I have seen multiple ENT's just scoped again and was told I was vocally healthy. My speech therapist specializes with singers, so I would assume they have pointed me in the right direction. I just have been so frustrated, because it takes me hours to warm up my voice and then it doesn't keep the focus it once had. Can you give me any additional wisdom for my situation?

Joanna Lott, M.A., CCC-SLP replies...
It sounds like you might benefit from a therapy technique called resonant voice therapy. I think you should also seek out a voice teacher who will work on your entire range, not just your falsetto. Falsetto requires a very different set-up for the vocal mechanism involving a higher airflow through stiffer vocal folds. I'd like to see you working with a teacher and/or SLP-voice therapist who will focus on helping you achieve a barely adducted (closed) vocal fold posture with low-impact but large-amplitude vibrations of the vocal folds. Check with your voice teacher and therapist to see if this is something they can work on with you. If not, it never hurts to look around. Best of luck!

Lost Singing Voice After Being Sick

I've been sick for about two weeks which consisted of non stop coughing and just got better but when I tried singing I couldn't reach high notes or low ones and my range seems to have decreased by A LOT. I can't hold a note without staggering or my voice cracking. I was able to sing just fine before I got sick. Will my singing voice return to normal? If so, how long will I have to wait?

Joanna Lott, M.A., CCC-SLP replies...
It can take a while for the vocal folds to feel "back to normal" after a bad cold, especially one with a lot of coughing. Coughing can be very traumatic to the vocal folds causing them to remain swollen and inflamed after the cold has otherwise resolved. You should be seen by a laryngologist if you are concerned for any damage to the vocal folds. Otherwise, be patient and hopefully you will see a return of voice soon. Good luck!

Vocal Range Issue

Hello, I am a 15 year old male and I play the guitar and really have a passion for music. Recently I have taken up singing and I've realized I can't hit high notes at all. I understand the technique to hit the notes but my voice just won't let me. I remember I used to be able to make a high pitched voice but now I just can't. I try and it just sounds like air is coming out. Also when I was younger I had calluses on my vocal chords. I understand that puberty changes your voice but I would like to know if I will ever be able to hit high notes? Thanks in advance!

Joanna Lott, M.A., CCC-SLP replies...
Hello. Do you know if the calluses on your vocal folds resolved? If not, they could be the reason that you are having difficulty hitting high notes. You should be seen by a laryngologist to see what your vocal folds look like now. You would also likely benefit from voice therapy from and SLP specializing in singing voice treatment. Good luck!