Your Voice, Your Choice, Part 3

By Abby White

PREVENTION AND TREATMENT
Many singers have their own methods to preserve the quality of their voices. When we interviewed k.d. lang, she stressed the importance of warming up your body as well as your voice, and incorporating stretching into her pre-performance routine. She also drinks a lot of water and doesn’t eat too close to her performance time, favoring foods that serve as a “squeegee” for the throat such as lettuce and melon. And while she admits it’s more of a psychological thing, she has to brush her teeth “for a really long time” before she sings.

Roy Orbison reportedly had to have his Coca-Cola in the studio, and lang agrees that Coke is “magic"—she drinks it in the studio as well, especially when she has a difficult vocal to record. Dave Grohl of the Foo Fighters is rarely seen onstage without his trademark gum, although many doctors would undoubtedly advise against singing while chewing because of the obvious choking risk (Grohl found another hazard to his onstage gum chewing when he was chased by a bee who was attracted to the sugar in his gum). Celine Dion has been rumored to refrain from speaking during the day, communicating solely by writing on a pad of paper or tapping into the phone receiver. If this seems a little dramatic to you (then again, can you belt out that high note from the Titanic theme song?), there are some different, less drastic precautions you can take.

Vocal rest refers to relative—and in some cases, absolute—non-speaking. A few days of complete voice rest are usually only necessary for more serious injuries, such as vocal fold hemorrhage, and it’s rarely recommended for more than 10 days. So, along with repairing your vocal folds, you’ll probably become an excellent listener. If you are suffering from mild laryngitis, you may benefit from speaking only when necessary. Never whisper—whispering can be more damaging than soft y speaking—and adhere to the proper speaking techniques that we mentioned earlier.

If you don’t know whether you should resort to vocal rest, consult a doctor. The doctor can determine if you’re experiencing hoarseness or other vocal discomforts as a result of improper singing and speaking techniques or as a result of an upper respiratory or throat infection. According to Dr. Hooper, “A good rule of thumb is, if you cannot speak in a very soft , ‘confidential’ voice at 25 percent of your pitch range, then you probably are in some serious trouble (at least that day), and it would not be a good idea to sing. Singing over laryngitis is like running on infected, inflamed feet—much worse things can happen!” Those who choose to perform when they’re not in top form do it at their own risk—ask yourself if it’s worth risking permanent damage to your voice. Radiohead’s Thom Yorke struggled through their spring 2004 Australian dates with inflammation of his vocal cords. After seeing an ENT specialist, he was diagnosed with a severe upper airway infection and cancelled the remaining dates.

DIAGNOSIS AND VOCAL THERAPY
As the mechanisms of voice function are better understood, rehabilitation techniques through vocal therapy are increasingly successful. According to Dr. Hooper, “If a disorder, such as nodules, is caused by vocal abuse, and the client is willing to engage in reduction of the abuse and vocal function exercises, then therapy is quite successful.” Speaking and singing are athletic activities and, like any physical therapy, vocal therapy is comprised of exercises that teach the patient to refrain from behavior that results in vocal disorders and instead to use the voice in a more efficient, effective manner. Vocal therapy stresses the importance of breathing and abdominal support and lessening unnecessary muscle activity in the neck and larynx, along with teaching vocal hygiene, techniques to eliminate vocal strain, hydration maintenance and avoidance of outside irritants.

If you think you need vocal therapy, consult an otolaryngologist for a full evaluation, in which you will reveal your lifestyle habits to locate the triggers of the vocal disorder and undergo a medical examination to rule out a more serious cause of the vocal dysfunction. Your doctor should take a comprehensive history of your vocal disorder to determine how long it’s been going on and how oft en it occurs. The doctor will also attempt to determine what triggers the problem and what you normally do to overcome it (especially if you’ve received previous evaluations or treatment). Your doctor will conduct various tests, including a head and neck examination and a laryngeal examination. Th e doctor can get a closer look at the voice box through laryngoscopy, which is commonly done by passing a flexible viewing scope through the nose down the back of the throat. Laryngeal videostroboscopy enables your physician to view the vocal folds while you’re singing or speaking, which can reveal problems that cannot be seen from a static view of the folds. Additional tests that may be conducted include acoustic analysis, which oft en entails recording the voice and using a computer to analyze the recording to determine quantitative measurements of abnormalities.

While each case differs, vocal therapy usually requires two or three sessions a week for several weeks and, depending on the severity of the vocal abuse, oft en runs for a minimum of six to 12 weeks. Patients need to practice the principles outside of the doctor’s office and apply them to their everyday routines if they want to see substantial improvement in vocal quality and endurance. If you’re diligent in adopting these habits, you’ll see the results. According to Dr. Jayne Eyre McDonald, executive director at the Eugene Hearing and Speech Center in Oregon, “I feel fortunate to have 70-to 80-percent success with those who follow through with plans.” Ultimately, a patient who undergoes vocal therapy should be able to identify changes in the voice, and will be able to adapt the new habits into not only singing but also conversational speech. Ideally, the techniques learned in therapy will be integrated into everyday speech without conscious effort. Posttherapy, a comprehensive voice evaluation is recommended to measure the progress and define the extent of further treatment.

(Next: Surgery and Medications)