Monday, December 14, 2015

Voice Screenings

Voice screeningsThe Johns Hopkins Voice Center would like to announce our voice screening program! The speech-language pathology team provides assessments to professional and semi-professional voice users, or any lay person experiencing vocal difficulties. This program may also be beneficial for healthy voice users as a tool to establish baseline vocal performance, which may be a source of comparison if one encounters problems in the future.
Voice screenings are offered on the last Tuesday of every month from 3:00 - 5:00 pm; the charge for the screening is $15.00 that may be paid at the time of the appointment. 
Your voice screening will include:
  1. A review of your voice history to identify any potential problems.
  2. Visualization of the larynx with a small endoscope (camera) that is passed (painlessly) through the nose. This is optional for the squeamish, but the most objective way to look at the vocal cords.
If there is any indication of a voice disorder, you will be referred for a full voice evaluation under the supervision of both a physician and speech-language pathologist to make a formal diagnosis. A full evaluation will require a referral from your primary care physician, and you will be required to ensure authorization and coverage by your insurance. If you have questions regarding your insurance coverage for a full voice evaluation, please call 443-849-2087.
Speech-language pathologists cannot provide a formal diagnosis but can isolate need for further evaluation with a physician. At that time, the two professionals will discuss your case and determine any need for therapy, surgery, medications, etc.
Participants may register by calling 443-849-2087, or e-mail questions or to mkim@gbmc.org. E-mail requests will be confirmed with a reply.  Looking forward to sharing this great opportunity with you!

Tuesday, November 24, 2015

Singing the Praises of the Johns Hopkins Voice Center at GBMC

Singing the Praises of the Johns Hopkins Voice Center at GBMC

The Johns Hopkins Voice Center located at GBMC's Milton J. Dance, Jr. Head & Neck Surgery Center is hitting the right notes as it mends damaged voices with a little help from Fender Musical Instruments Corporation. Read the full article featured on The Baltimore Sun

Tuesday, November 3, 2015

Voice Change After Surgery

I had cervical disk fusion surgery on 4/21/15.  After surgery my voice was very hoarse and now several months after I have this feeling in my throat as if there is something in there, but this was also happening right after surgery. My voice gets hoarse now and then especially when I bend forward it gets worse. Is this going to get better?

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

A temporary change in vocal quality is not uncommon after this type of surgery, though I wouldn't anticipate the change persisting this long after your procedure. I recommend that you see a laryngologist (an Ear, Nose, and Throat doctor who specializes in voice disorders) for a full evaluation and treatment recommendations. Ask your surgeon for a referral or visit the American Academy of Otolaryngology/ Head & Neck Surgery at http://www.entnet.org/ to search for a physician by subspecialty.

Good luck!

Tuesday, October 13, 2015

Voice is Still Hurting

My wife and I are in need of serious help. My wife has been having speech difficulties for up to three years now. It causes pain for her to talk and resting only helps but doesn't seem to cure it. Though we haven't done an extensive rest for it. We have been to multiple specialists and have gotten multiple answers. My wife was once told she had polyps on her vocal cords. Then we went back to a different doctor a few months later and after scoping her he told us there was nothing there and he saw no problem at all. Which makes no sense to us because her voice is always in a differing state of pain. From slight to great. She used to have serious problems with acid but we have gotten that under control. She has never drank or smoked. We we're thinking it could be either contact ulcer or possible Chronic Non-Specific Laryngitis but we really have no idea. Her last two scopes showed nothing, but her voice is still hurting. We are really desperate to figure this out! Why could there be nothing on the scope but still she is having this problems? I hope you might be able to help. Thank you for your time and support.

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

In some cases, odynophagia, or pain with voicing, is related to how the voice is being used, rather than the presence of pathology. Muscle tension dysphonia (MTD) is a general term to describe excessive and unnecessary tension of laryngeal muscles during voicing. MTD is often referred to by many different names, including hyperfunction, functional dysphonia, ventricular or false vocal fold compression, etc. The condition is treated in voice therapy with a speech pathologist experienced in the treatment of voice disorders.

Best of luck to you both!

Wednesday, September 9, 2015

Hanna Somatic Education and Treatment

Hanna Somatic Education
Hanna Somatics is an integral part of working not only with vocal performers but with anyone experiencing tensions, misalignments and pain that limits their vocal life and overall wellness. Many of the vocal problems people have are not isolated to the larynx. Things that are happening all throughout the body can have an impact on the vocal sound we create. Chronic muscular tensions that affect ease of movement, breathing, and speaking and singing are not merely muscular tensions, they are (neuro)muscular tensions. Hanna Somatic Education changes the communication patterns between the brain and the muscles and within the sensorimotor areas of the brain itself.  

To schedule an appointment, please call the Johns Hopkins Voice Center at 443-849-2087 or click here.   

Dan Sherwood, MS/CCC-SLP, HSE, Speech Pathology Clinical Specialist
Dan Sherwood, MS/CCC-SP, HSE, Speech Pathology Clinical Specialist
Focusing on rehabilitation and retraining of the professional voice. Special interests include breathing retraining and movement education, with training in alternative/complementary disciplines, including Hanna Somatics®, Associative Awareness Technique™, Optimal Breathing®

Wednesday, August 26, 2015

Singing Voice

I was recently diagnosed with Bowed Vocal Cords. The next day I started a series of tests including the Iodine 123 trace indicating an over-active thyroid gland. Could the Hyperthyroid condition have effected my vocal cords and perhaps have caused the bowing?

Melissa Kim, M.S., CCC-SLP writes... 

While there may be differing causes of vocal cord atrophy, there is no known relationship between hyperthyroidism and presbylarynx, or "bowed" vocal cords. 


Good luck to you!

Friday, July 10, 2015

Services

  • Voice Evaluation and Treatment 
  • Laryngeal Stroboscopy 
  • Medical and Surgical Management of Laryngeal Disorders 
  • Office-Based Procedures: 
    • KTP Laser 
    • Vocal Fold Injection Augmentation 
    • Botox Injection 

For Consumers

Monthly Voice Screenings

For Professionals

Annual Voice Conference
Annual Head and Neck Conference
Annual Post Larynectomy Voice Restoration Conference

Friday, May 29, 2015

Breathing Issue

I have seen a variety of specialists-diagnosed as having no LPR present (last ENT said there was) by two different specialists, and as having vocal cord dysfunction. Breathing exercises help a little and .5 mg. of Klonopin helps a lot, but doctor wants me off it. Are there other treatments that work for this? Symptoms are no heartburn at all, no problems with food, breathing difficulties, and lump in throat. Occasionally, cords bowed over. Happens every day.

Melissa Kim, M.S., CCC-SLP writes... 

It sounds as though your treatment plan is appropriate, as the typical treatment for Paradoxical Vocal Fold Motion, sometimes referred to as "vocal cord dysfunction," addresses any underlying cause (e.g., anxiety, reflux) in addition to respiratory re-training with a speech pathologist experienced in treating this disorder. 

If the current management strategies have not successfully addressed your symptoms, however, then I would suggest that you seek out another opinion.

Good luck to you!

Tuesday, May 5, 2015

Speech and Language Services



Our pediatric speech-language pathologists at the Milton J. Dance Jr. Head and Neck Center evaluate and treat children of all ages who have difficulty communicating.

Speech

Children who need help with their speech development may be hard to understand. They may have trouble saying sounds and words correctly or may not be speaking at all. At our Center pediatric speech pathologists specialize in helping children with a variety of speech problems including: articulation difficulty, apraxia of speech, phonological processing disorders, stuttering, voice disorders, and speech-resonance issues associated with cleft lip and palate.

Language

Children who need help with language development may struggle with understanding spoken or written information such as directions, questions, and stories (receptive language). They may have trouble using words or symbols to communicate, using correct grammar, or may not speak at all (expressive language). Children with language disorders or delays may also have trouble with social communication (pragmatics) and have trouble interacting with others, making proper eye contact, or staying on topic. Our pediatric speech-language pathologists specialize in helping children who have language difficulty due to these communication barriers.

LEARN MORE

Monday, April 27, 2015

Laryngospasm?

About 3 or 4 minutes AFTER performing highly aerobic dance (this never happens DURING the performance) I experience a severe tickle in my throat, followed by very frightening stridor. Drinking water irritates that tickle, and even air that I inhale irritates it. The worst part of this episode can last as long as 20 minutes. While I have been told that I am actually getting sufficient oxygen, it feels like I can't inhale. I will probably resign from the dance team because of this, even though I love it. Any hope for preventing these unpleasant episodes?

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

I would suggest evaluation by a laryngologist (an Ear, Nose, and Throat physician who specializes in the larynx) for evaluation of possible Paradoxical Vocal Fold Motion (PVFM). PVFM is a disorder in which the the vocal folds behave normally most of the time, but inappropriately close on inhalation during an episode. The cause of PVFM is not always well understood, but triggers may include allergies, acid reflux, anxiety/ panic disorder, or frequent upper respiratory infections - to name a few. In addition to treatment for any underlying cause, therapy with a speech pathologist is crucial to learn techniques to interrupt the inappropriate vocal fold movement and stop an episode.

Best of luck to you!

Wednesday, April 15, 2015

Polyps Removed - Unable to Speak

I had polyps removed one week ago and have not been able to speak since. The doctor told me that I CAN talk, but my vocal cords don't know it yet. (Muscle tension dysphonia). I cannot find a voice therapist who can see me in less than six weeks, and I'm only able to make deep, grunting sounds. Are there any vocal exercises I can do until I see the therapist? The only input I got from my ENT is to hum.

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

You can certainly try to produce any vocalization you would like - I wouldn't recommend any specific exercise. I'm sorry that you're not able to see a speech pathologist sooner; perhaps your physician could offer you another referral.

Good luck to you!

Swelling of Vocal Cords

My vocal cords start swelling after I talk for an hour or more unlike other people. Does post-nasal cause swelling of vocal cords? My doctor suggested that I have anti allergic. Does post nasal cause mild changes in voice? This is the only question I wanted to ask.
Thanks :)

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

Yes, it is possible that post-nasal drip may cause swelling of the vocal folds and associated vocal changes.

Best regards

Monday, March 23, 2015

Compassionate, Loving and Concerned Care


Even though I have wonderful and loving memories of the staff of GBMC, not every story, particularly in a hospital, has a happy ending. Mine definitely does not, as my husband died after spending several days and weeks at GBMC over a four-year period. The last was 32 days at GBMC and 7 days in Gilchrist. Read more...

Wednesday, March 4, 2015

Presbylarynx


I have been diagnosed with presbylarynx, the ENT told me that my cords were weak though they were in fine shape.  He told me to go for voice therapy and told me there is no other option of any other treatment.  I have been having this problem for 2 years.  Will voice therapy help me with the discomfort and vocal fatigue I feel while talking? I am hardly 20 years old and I don't want to have these problems at this stage.

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

Presbylarynx refers to age-related atrophy of the vocal folds in individuals more than approximately 60 years of age, so at 20 years old it would be unlikely that your symptoms are related to presbylarynx. Vocal difficulties secondary to "weak" vocal cords certainly can improve with voice therapy, but if in your situation there is actually poor closure of the vocal folds, injection of a filler such as Radiesse Voice gel can also help to improve the voice.

Best of luck to you!

Wednesday, February 18, 2015

11th Annual Voice Conference

Topics in the Diagnosis and Treatment of Laryngeal Disorders
Laryngeal Stroboscopy in Clinical Practice with Hands-On Instruction

Friday & Saturday June 26 & 27, 2015

VIEW BROCHURE



Monday, February 9, 2015

Voice Range Decreased

My voice range is decreased from last year and I feel discomfort while speaking and my voice gets tired after speaking for an hour or 2. I visited an ENT and he told me that my vocal folds were weak. Did he mean that it is vocal cord paralysis though he said both cords were moving?

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

Certainly, vocal fold "weakness" is described in cases of vocal fold paresis or presbylarynx, the condition of thinning or atrophy of the vocal folds due to aging; however, I cannot comment on what your Ear, Nose, and Throat physician meant by his/ her description. If you were unclear as to your diagnosis, I would suggest re-assessment or perhaps a second opinion.

Good luck to you!


Feminize My Voice - Laser Assisted Voice Adjustment

Hi,

I got your information from the Chase Brexton web site for Voice Therapy. The web site referenced Melissa Walker. I would be interested in a Laser Assisted Voice Adjustment to feminize my voice more.

Is this something that can be done; also, in general what would be the cost of such a thing?

Barbara Messing MA CCC-SLP, BCS-S replies....

Our laryngologists have not performed any laser-assisted surgeries to feminize the voice. Jennifer Anderson in Toronto has published a series of patients for whom she created anterior commissure web, functionally shortening the vocal folds and raising pitch.

However, we do not know whether she uses laser for that or not. Our laryngologists recommend that you contact Jennifer Anderson (http://www.otolaryngology.utoronto.ca/faculty/list/anderson1.htm?quot;%20title=) directly if you desire more information.

Kind regards
Barbara Messing MA CCC-SLP, BC
S-S

Thursday, January 22, 2015

Laryngeal Stroboscopy

Laryngeal stroboscopy is one of the most useful and state-of-the-art techniques currently available for the examination of the larynx.  At the Milton J. Dance, Jr. Head and Neck Center, the laryngeal stroboscopy examination is performed jointly by a physician and a speech pathologist.

Laryngeal stroboscopy examinationVIEW BROCHURE

Frequently Asked Questions about Laryngeal Stroboscopy

What happens during the evaluation?

Step 1:  You will first be asked to complete a questionnaire regarding the onset of your voice problem, your medical history and current medications, current voice demands, and any specific symptoms related to your voice problem.

Step 2:  A speech pathologist will guide you in performing simple vocal tasks using a microphone.  Computer analysis of your vocal quality will then be performed.

Step 3:  The physician may spray a topical anesthetic in your throat for your comfort during the procedure. (Note: Please inform the physician if you have had any reactions to anesthesia in the past.)

Step 4:  The physician will insert a small endoscope through your mouth towards the back of your tongue.  The endoscope provides a telescopic video recording of your larynx.  The speech pathologist will then ask you to perform various voice tasks in order to observe the movement of your vocal cords and the condition of your larynx.
Laryngeal stroboscopy examinationHow long will it take?

The entire evaluation may take approximately thirty minutes to one hour; however, the total time that the endoscope is in your mouth is only approximately two minutes.

When will I receive the results?

Immediately following the evaluation, the physician and speech pathologist will review your results and provide recommendations which may include one or all of the following:  referrals, medication, voice therapy, and/ or surgery.

How do I need to prepare?

There is no preparation required for the procedure.  You may eat and drink as you wish.  Please arrive 15 minutes prior to the appointment to complete the necessary paperwork.

For information or to schedule an appointment, please call (443) 849-2087.

Monday, January 12, 2015

Foamy Secretions

My brother has cancer of the esophagus - lost his voice and is now speaking again. He is still unable to swallow after radiation /chemo.  He keeps getting lots of foaming coming up even after trying to swallow one drop of water. Any suggestion to eliminate the foaming? Thanks

Barbara P. Messing, M.A., CCC-SLP, BCS-S replies...

Thank you for your online request. Certainly every situation is different and it is not possible for me to know what treatments were performed, but generally speaking - I would recommend that evaluation by a speech pathologist to determine why swallowing is not possible and that may indeed determine why foamy secretions are so persistent and copious.

Kind regards,

Barbara

Monday, January 5, 2015

Attorney Objects to Persistent Hoarseness

Richard Eventoff -- GBMC patient

For attorney Richard Eventoff, persistent vocal hoarseness presented a challenge in his everyday life. Treatment at the Johns Hopkins Voice Center located at GBMC changed his life. This is his story, in his own words.

Hospitals and doctors’ offices are all too familiar for me. I’ve had more than 15 surgeries during my life, from an appendectomy and tonsillectomy as a child to orthopedic surgeries on my knees and wrists as an adult. After a frightening open heart surgery in 2003, I hoped that my days of medical procedures would be behind me. Unfortunately, that was not the case.

In 2012, I started to develop a raspy voice that didn’t go away. It wasn’t a painful feeling; I was just always hoarse. The symptom continued for about a year and a half. Since I’m a lawyer who negotiates union contracts for a living, it’s important for me to be able to speak clearly and effectively. I finally went to see a doctor, looking for answers. The first doctor told me that I simply needed to rest my voice and the problem would resolve itself. So, for a while, I tried to do most of my work by email instead of speaking.

When the hoarseness didn’t go away, the doctor examined my throat more closely, diagnosed me with vocal cord disease and recommended surgical procedures to remove several lesions that had developed. But the symptoms persisted and the lesions kept coming back. My doctor sent me to see Lee Akst, MD, an otolaryngologist at the Johns Hopkins Voice Center located at GBMC, for more specialized treatment.

When I walked into the Voice Center, I was filled with uncertainty, wondering if I might have cancer or if I would need to have my vocal cords removed. When I met Dr. Akst, he had a calming effect on me. It was apparent that he had cared for patients like me before. He was very knowledgeable and took his time explaining everything to me.

Mr. Eventoff and Dr. Lee Akst, MD -- GBMC VoiceWith vocal cord disease, repeated surgeries can cause scarring in the throat, which affects the long-term quality of a person’s voice. I did not recover quickly from the first surgeries and had to whisper for weeks at a time afterward instead of speaking normally. I was concerned about what my voice might sound like in the future as a result of the procedures. Dr. Akst and the Voice Center team established a way to manage my vocal cord disease while keeping my voice quality intact using a technique called microlaryngoscopy. The treatment was much less invasive than what I had previously experienced. For example, when he looked at my throat, Dr. Akst used a device that went through my mouth instead of my nose. This method was easier and also put my anxiety to rest.

During my most recent appointment with Dr. Akst, he said my throat looks better than ever! I have never liked looking at the screen showing images of my vocal cords, but during this last appointment, Dr. Akst strongly encouraged me to look at the remarkable “before and after” photos. It was truly amazing to see the difference that I can already feel and hear. Today, everyday life is enjoyable. It’s much easier now to communicate with my clients! I’m married to a wonderful woman and a typical weekend finds us relaxing at the pool in our backyard with any of our nine grandchildren. In my free time, I help to rehabilitate birds of prey and tend to my freshwater stingray tank. There’s never a dull moment at our house! I’m so grateful to Dr. Akst and the Voice Center for allowing me to continue living the life I love.

An Inside Look at the Voice Center

Fender Voice & Music Studio—Voice therapy for performing artists is provided in the fully equipped music studio offering guitars, a digital baby grand piano, amplifiers, microphones and recording capabilities to meet the needs of performers.

Laryngeal Procedure Room—Laryngeal Stroboscopy, vocal fold augmentation/injections and vocal fold laser treatments are performed in the laryngeal procedure room. These procedures are performed for a variety of vocal fold impairments.

Stroboscopy Room—In the stroboscopy room, a physician or speech pathologist uses an endoscope, which provides telescopic video recordings of a patient’s larynx, to help diagnose underlying causes of a patient’s voice issues. During the procedure, the physician and the speech pathologist instruct the patient to perform various vocal tasks in order to observe vocal cord movement and to identify any vocal pathologies.

Body & Movement Room—The movement education studio is designed for body-centered therapy to enhance body awareness, release chronic muscular tensions and promote the physical freedom necessary for vocal flexibility

For additional information about the Johns Hopkins Voice Center located at GBMC, visit www.gbmc.org/voice or call 443-849-GBMC (4262).