Voice Issues / Sickness / Medical Advice

College Majors Musical Theater Major
1

<p>Hi all,
I'm hoping someone can offer advice/knowledge on this one. </p>

<p>We live in the Northeast part of the country, which has experienced a heat/humidity wave (88 F, 90% humidity) for the last week+ or so. My D is preparing for her senior voice recital, to take place on Sunday. </p>

<p>She did a runthrough yesterday and noticed (and her voice teacher noticed) that her voice sounded better than it ever has. This is not to brag, but to point out that simultaneously with the voice quality improvement, this past week or so she has not been coughing, sneezing, or clearing her throat the way she normally does. </p>

<p>In fact, we 've gotten so used to her clearing her throat, etc and having morning coughing that I never really thought about it until this week, when I realized all the symptoms I got used to hearing were not there. </p>

<p>Can a change in humidity cause this? and what kind of doctor would know what is going on? anyone heard of anything similar? I feel like we're on to something but don't know how to pursue it. Ears nose and throat MD?
?????</p>

<p>thanks
Chris</p>

2

<p>I am a graduate student getting my MS in Speech-Language Pathology with a focus on Voice Therapy (which dovetails nicely with my MT performance and coaching background). As far as the kind of doctor you want to see: you want to seek an ENT who is a VOICE SPECIALIST if at all possible. It is much more common to find an ENT who is a sinus specialist, since sinus problems "bother" many more people than voice problems do - most people never think about treating their voices unless they are singers or other professional voice users (broadcasters, etc.) If your area has a Voice Center, go there, and they will do both an acoustic and medical examination/analysis of your daughter's voice - she will get a vocal strobe where they (and the both of you) can watch her vocal folds function and many other cool (in terms of knowledge for singers) tests where she will learn a lot about her voice. Most Voice Centers are GREAT about explaining things in a fair amount of depth to interested patients. </p>

<p>The fact that she usually wakes up and has to clear her throat big-time suggests that she might have acid reflux, which is VERY common (more than 50% of the population has it!!!) and often undiagnosed. Many, MANY singers are troubled by it and often don't know it, attributing their troubles instead to sinus or allergy problems. The type of reflux that makes you clear your throat is LPRD (laryngopharyngeal reflux disease), which you CANNOT feel as heartburn but which inflames the vocal folds (heartburn is GERD, or gastroesophageal reflux disease). Don't let the term "disease" scare you - a simple prescription clears reflux right up. It is diagnosed through the vocal strobe I mentioned above: the inflammation is clearly visible in a stroboscopy. </p>

<p>More info on what a vocal stroboscopy is, and other voice care info, can be found at the website for the University of Pittsburgh Voice Center (and other places I am sure, but I am a fan of this wonderful Voice Center!):
<a href="http://voicecenter.upmc.com/%5B/url%5D"&gt;http://voicecenter.upmc.com/&lt;/a&gt;&lt;/p>

3

<p>Last year my D. was sounding rough vocally and her choral teacher recommened she see an ENT as she was afraid she may have damaged her vocal chords...Anyway we went to a local ENT who did show me her chords and said they were not damaged (she was having allergy problems). He also said that there are ENT's who specialize in voice as
CoachC says and gave us a name in the DC area..sorry I cant recall who it was..but you should be able to call a local ENT and ask for a rec.</p>

<p>Her last voice teacher recommended drinking honey lemon cough drops in hot tea water to help clear the passages..which is a small help but not what you are looking for..</p>

4

<p>Just a word of caution - I studied voice for 20 years before I entered the field of medical voice care, and something I NEVER heard from a voice teacher (and I had many really great ones) but learned almost immediately in the voice therapy field is that while many cough drops may "clear the passages," this is referring to the NASAL passages. Anything with menthol in it (which most cough drops, including those designed for "soothing throats," have as an ingredient) can dry the vocal fold mucosa (a thin film of "good" mucos is necessary for the vocal folds to remain lubricated and therefore vibrate efficiently). I don't know if the honey-lemon cough drops mentioned have menthol in them (I mean honey-lemon cough drops in general, not a specific brand), but be careful! The purpose of throat drops for singers is really to keep the salivary glands working and therefore helping the mucosa of the pharynx (throat), which technically starts at the vocal folds, to stay lubricated. So look for throat drops which contain glycerin but NOT menthol: Halls Fruit Breezers are good, as are Grether's Pastilles (a gourmet blackcurrant candy that Sutton Foster swears by - they are expensive and hard to find, however) - and my very favorite voice therapist, who has her PhD in medical voice theraphy, swears by sucking on sugar-free gummi bears! </p>

<p>Some more info about this topic, from the website I mentioned in my earlier post:</p>

<p>(from <a href="http://voicecenter.upmc.com/Winter.htm%5B/url%5D"&gt;http://voicecenter.upmc.com/Winter.htm&lt;/a&gt;)
...it is important to remember that bathing vocal cords with fluids does not help a sore throat. Many people believe that fluids like warm tea, water, or the soothing liquid from mints or lozenges, directly bathe the vocal cords. While these liquids may coat and comfort the pharynx, or throat, they never touch the vocal cords and provide no direct relief from a sore throat. The vocal cords are the final valves that close to protect the trachea, bronchi, and lungs from foreign substances. When a liquid or solid does enter the area of the vocal cords, a strong reflex produces a cough in order to clear the area of the foreign substance, or, as we say, “it went down the wrong pipe.” </p>

<p>You also should avoid the use of throat-numbing lozenges. If you do use a mint or lozenge in an attempt to soothe a sore throat, do not use products containing menthol, phenol, or benzocaine that can numb the pharynx. While you may decrease the pain, the numbing effect may give you a false sense of security and and lead to further injury to your voice.</p>

<p>P.S. (added by me, CoachC) So what's the point of drinking liquids to "help" the voice? Drinking hot liquids may sooth a sore throat, as the above mentions, but the point of drinking lots of H20 (all those singers with their ever-present water bottles) is to provide systemic hydration, i.e., the internal hydration of the entire body that keeps the skin, eyes, and all other mucosal tissue (including, of course, vocal fold mucosa!) healthy and functioning optimally.</p>

5

<p>Hmmm maybe thats why she was her LAST voice teacher. Good info..and thanks for sharing.</p>

6

<p>wonderful information, CoachC, thanks so much. </p>

<p>I'll search for a voice center now. The listed symptoms of the acid condition you mentioned DO match.</p>

7

<p>For anyone else interested:</p>

<p>National Voice Center referral database:</p>

<p><a href="http://www.gbmc.org/voice/national.cfm%5B/url%5D"&gt;http://www.gbmc.org/voice/national.cfm&lt;/a&gt;&lt;/p>

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<p>Coach C - It's wonderful to have someone on the forum with such terrific knowledge. Thanks for passing some of it along!</p>

9

<p>Thanks to Lynn for the thanks...; )</p>

<p>I'm glad to be of any help I can here on this board - but I want to REALLY encourage everyone who has concerns or questions about how their voice is functioning to seek out a Voice Center! (I do not work for the UPMC Voice Center, btw - I am still a grad student, meaning only a "student clinician," and everyone who works there is a clinically certified professional (SLP-CCC) or MD, so please don't suspect that I am trying to drum up business for them or any specific Voice Center.) My reason for posting is that I see so many young singers who rely on home remedies, passed-on knowledge, etc., to combat voice problems - but if you are experiencing persistent voice trouble, you MUST rule out medical problems in order to protect your instruments!!! I am not talking about having a bad cold or strep throat and losing your voice - that's "normal" and WILL heal itself - I'm talking about persistent throat clearing (as chrism mentioned), regular and severe vocal fatigue (perpetually losing your voice after singing, or persistent "breaks" in your singing voice where there appear to be "no notes" (as opposed to REGISTER "breaks" where the SOUND of your voice might change - it is normal for young singers to struggle with singing through their passagios), for example. </p>

<p>As a word of caution: a chilling story, but with a happy ending. One of my students, who has a gorgeous voice, was a junior in high school last year and rehearsing two shows at once plus singing in choir, etc. After several days of too little rest and some hardcore singing, he lost his voice kind of suddenly - just felt something "change," and then couldn't really speak aside from a very rough, painful-sounding whisper. He called me, and I knew from his symptoms (sudden voice change leading to aphonia, or "no voice") that is was probably a fairly serious problem. I called my local Voice Center and described his situation, and they said "get him in here NOW." No, the situation wasn't life threatening, but they knew he was planning on making his life career as an MT and he also HAD A SHOW THAT NIGHT - he was playing the Baker in INTO THE WOODS. As soon as the ENT did a vocal strobe, they saw that my student had a vocal hemorrhage - not as gruesome as it sounds (no blood spewing out of the mouth, etc.), but still serious. He had basically burst some blood vessels in one vocal fold because of strain (at that point, he "oversang" quite a bit, producing sound more with his throat musculature than with breath support but switched vocal technique teachers soon after this injury fixed that problem!) The ENT said, "No show for you" - in fact, he was ordered to observe COMPLETE vocal rest for a short time (at least a week - I don't remember exactly) and then no singing for a month. Lucky for him, he healed beautifully - and as I said, this was a heads up to him to REALLY solidify his technique and not just rely on his natural vocal gift. But had he not gone to a Voice Center RIGHT AWAY, he likely would have done permanent damage to his voice!!!! (Think of a dancer walking on a broken foot for an extended time...) </p>

<p>The happy ending is that not only could he sing wonderfully again, but less than a year later, he got into 2 of the top MT schools and got large scholarships to both - in order to remain discrete, I won't name the schools directly but I willl say that they were among the following group: CCM, CMU, UM, and NYU-Tisch. This is less to brag (oh come on, gotta sing his praises a LITTLE - 2 scholarships to 2 top MT schools, both of whom paid special compliment to his voice, is pretty exciting! ; ) ) than to say that EVEN IF you have a SERIOUS vocal injury, it is POSSIBLE to heal, rehab (often through speech or singing therapy), and sing professionally. Yes, you can also recover from nodule surgery, etc. - not everyone does, depending on the amount of damage already incurred when the nodules are discovered, but it is definitely possible!! </p>

<p>Take care of those voices, friends! ; )</p>

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<p>If I could just dovetail on something that CoachC said.</p>

<p>It is very important to note that vocal nodules aren't always caused by singing but also speaking. I never developed vocal nodules from singing but did develop them when I was much younger from speaking incorrectly. I was once a tour guide at Universal Studios in California before they had adequate microphone equipment for tour guides when speaking to large groups of people (70 plus) outdoors prior to going into the sound stages. With no amplification for the voice provided, tour guides were virtually yelling outdoors to be heard. After a period of time I knew something was wrong with my voice and went to an ENT. Sure enough I had nodules. Thanks to a wonderful ENT and voice (speech) specialist I did not have to endure surgery and with much work on my part was completely cured within 6 months. I did have to learn how to speak properly, to raise my speaking "pitch", etc. This was wonderful training that augmented what I had learned to sing properly. I have never had problems with nodules since, (many, many years later).</p>

<p>Recently I had a very young voice student, (sixth grader) who sounded very hoarse to me when he spoke. I immediately told his mother to take him to an ENT. Sure enough he had nodules and is currently working with a speech therapist.</p>

<p>If surgery to remove nodules is being recommended by a doctor get a second opinion. Surgery isn't always the only answer. If you don't learn how to prevent nodules in the first place you are at risk for developing them again.</p>

11

<p>This seems like the appropriate place to raise this question.</p>

<p>I am currently looking for a voice teacher or vocal coach to help with auditions for colleges in the fall. I could just look someone up in the Yellow Pages (I already checked there are a good number of listings), but I recently met someone through networking at some of the proffesional theatres in town who is a musical director and a friend of a friend of mine. I asked him if he knew of any voice teachers who were good in the area or if he did that himself, and he siad that he will teach people who knows personally, but prefers to work on specific songs as per auditions than starting from scratch with basic vowel exercises etc. This seems great as I am focused on auditions and it seems all the BFA programs I am looking at have private voice instruction, but I was wondering if there were medical factors to view.</p>

<p>Anyone's comments would be great!
Thanks</p>

12

<p>Wow. I just got on CC after not posting or reading for a while to find this thread. (I've been quite busy with older D's college admission/acceptance process.) I am amazed at how exactly it describes my younger daughter! She is CONSTANTLY clearing her throat and has problems with intermittent "hoarseness". She recently did a show and played Marty in "Grease". She sang Freddy My Love which she claimed was "low for her", and was very hoarse on and off throughout the practices and performances. I attributed this to poor vocal technique and figured that voice lessons might solve the problem. My D's are both dancers who also have good singing voices, so the vocal training is the weak area for us right now. (Another story, but luckily D2 will be much stronger for her college auditions...I hope!)
After reading this thread, I was able to realize some other possible problems. In particular, the speaking tone of her voice. She speaks very low, but sings Soprano I in chorus class!
It seems that every problem mentioned on this thread affects her!!!Recently, this same D informed me that she has decided to pursue a career in MT, like her sister. After reading this, I am convinced that I need to try to find a ENT/voice specialist as CoachC recommends.<br>
Coach C, I realize your initial intent IS NOT to promote your own interests, and I appreciate you taking your time to share your knowledge on this forum. The Pittsburgh area just happens to be our closest major metropolitan area for medical care. I didn't even realize there was such a thing as a Voice Center! You may have saved one little fledgling MT major! Thanks again. Please feel free to send me a private message if you care to.</p>

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<p>CoachC's statement about the need for a voice center was confirmed again for me today - D had her senior voice recital and since it is not winter, is warm and humid, could hit all kinds of high notes that just weren't there (in the same songs) last winter. </p>

<p>I guess I have to wait until the symptoms crop up again in the late fall to make the appt! I"m eager to see what the voice specialists say. thanks again Coach C for opening my eyes to the obvious and pointing out the existence of Voice Centers!</p>

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<p>Congrats on your daughter's recital success! ; ) I want to let you (and other here) know, however, that if reflux is causing the problems your daughter encounters, it isn't "seasonal" - so it sounds like she may have something else (allergies?) going on. I'd still get her checked out ASAP and not wait til symptoms pop up again. If you tell the Voice Center you go to about her positive change in the humid weather, that info combined with what the ENT sees during the vocal strobe should yield enough info for her to get a diagnosis and begin preventitive measures so she DOESN'T have to struggle as much when the weather changes, etc.</p>

<p>Good luck!</p>

15

<p>KEEP UP THE GREAT ADVICE!!!!
I just read all of your advice and as an SLP with 20+ years experience I wish you the greatest success. My gripe about several voice "teachers" and choir directors that I have come across as a parent has been that they have been unfamiliar with basic anatomy. I am always appalled that people assume that because they can sing they can teach singing.......Which is why I see vocal nodules in little girls who are being taught to belt out "Tomorrow"</p>

<p>Just a note regarding locating a trained speech/language pathologist---being certified by the American Speech Language and Hearing Association is just a start. Make sure that the clinician specializes in the area of voice--specifically the PROFESSIONAL VOICE--- Don't just accept the referral from your insurance company or your HMO physician. Do some research in your area for someone who specializes in voice not someone who does it along with a busy caseload of say autistic children. LOOK FOR SOMEONE LIKE COACHC----often a student is more qualified than a clinician who sees 1-2 voice clients a year!</p>

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<p>wct--
Good call with the referral----too bad I don't take priviate clients or we could be a team outside of productions too!
C-</p>

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<p>Hi, musicman!</p>

<p>You posted last week asking about vocal coaching and possible medical concerns. Unless you are having specific vocal "issues" (problems), you probably don't have to worry about anything medically, although it's always cool for singers to get a "baseline" vocal strobe just to familiarize you with your vocal anatomy and, more importantly, to get a picture of your voice in its "normal, healthy" state as a basis for comparison if you ever DO have vocal trouble such as a vocal injury. However, most insurances probably won't cover this "healthy voice" care unless you are officially making your living with your voice (and sometimes you have trouble getting the coverage even then.)</p>

<p>Your main concern in looking for a vocal coach should be being aware of what YOU need this person to do. Basically, a "voice teacher" is someone responsible for instilling good vocal technique (breath support, relaxation of the throat and face musculature, creating "space" in your mouth, forming vowels properly, singing a truly musical "line," etc.) Many AMAZING voice teachers are NOT very good at selecting MT rep - although SOME are VERY good - because their education has not been about keeping up on MT trends - their rep education was most often centered around classical (opera, art song, & oratorio) rep. I say this NOT to "diss" voice teachers - a good voice teacher who is a real technique AND musicianship master is THE most important thing for a developing singer to find!!! However, you need to make sure your voice teacher really knows the MOST CURRENT needs for MT auditioners. That does NOT mean he or she is versed in WICKED, AVE Q, BROOKLYN, etc. - I am not talking about simply being versed in the most popular contemporary MT rep - in general, those thing are horrible choices for auditions anyway because they are so overdone! I am talking about someone who knows a WEALTH of both classic and contemporary MT songs and, if at all possible, what each school prefers. (Each school will certainly list your song REQUIREMENTS - a pre-1960 song, for example - but if you can get "insider info" on which schools REALLY love true Golden Age choices, which schools love more cabaret-style songs, etc., so much the better.) </p>

<p>In New York, many actors have BOTH a voice teacher and a vocal coach: the coach helps the actor pick really suitable rep for his or her type and also for the requirements of any partcular audition and also works on the overall acting and vocal style of the presentation - but usually doesn't address vocal technique AS MUCH as a voice teacher. But many voice teachers ALSO are excellent coaches of acting a song - and many ARE NOT.</p>

<p>I hope this seemingly conflicting info doesn't confuse you, but rather serves to point out that you can't necessarily take a teacher's word on his or her area of expertise. Without being disrespectful, you need to make sure each of your coaches and teachers can do ALL that you need to prepare to audition as an MT - meaning you will learn different styles of singing (girls, any teacher who tells you "you can't belt with me" doesn't understand SAFE belting or at least "mixy belting" and DEFINITELY doesn't "get" that girls MUST DO a belt song for nearly all conservatory auditions, as well as a legit song!!!) and have a wide variety of rep available to you - NOT just the songs in the Musical Theatre Anthology collections!!! (Yes, those are WONDERFUL resources - but if "everyone" uses them, you should try to avoid that material unless it REALLY fits you such that you "own" it!!!) </p>

<p>My #1 piece of advice, as a LONGTIME teacher who has coached alongside everyone from amazing teachers in small, isolated towns (like my hometown!) to current Broadway MT actors, is this:</p>

<p>Any REALLY GOOD teacher will NOT be afraid to admit what they CANNOT do for you. I tell ALL of my students that I am an excellent person to pick and coach rep but that I am NOT the best person to BUILD their voices (instill technique), although I certainly know more than most teachers - it just so happens that I have a colleague who is a MUCH better and MUCH more qualified (undergrad and Master's degrees from CMU in voice performance as well as Equity and AGMA performance experience) voice teacher than I am. So he and I work TOGETHER on preparing students for college auditions, to great success so far (admission and scholarships to UM, NYU, CMU, PPU, PSU, CCM, etc.).</p>

<p>And finally - if you live in a town with limited resources, or if your own financial resources are limited and you can't get a lot of coaching/teaching for those reasons, are you "doomed?" NO WAY! MT schools can recognize raw talent, for sure, even if you sing the "wrong" songs and are not very prepared. But the deal is that you have to be REALLY talented in order for that to be true. Like everything, college MT auditions are becoming more and more competitive, so any "edge" you can provide for yourself (solid, ineresting, and appropriate audition pieces, for example) helps you to be noticed. But colleges do NOT expect you to be a "perfect package" when you audition - otherwise, why would you NEED school? So do as much as YOU CAN to prepare for your auditions - but don't stress about what you genuinely CAN'T do!!!</p>

<p>Good luck to all - I hope this was helpful!</p>

18

<p>Important correction to my post - I didn't mean to say you can audition and NOT be prepared - I meant if you are "incorrectly" prepared because you didn't have a way to find out much beforehand (so you sing a song that is not age-appropriate, for example), you can still be noticed. But you MUST MUST MUST prepare as much as possible - or colleges see "slacker" or "disorganized person."</p>

<p>But you are reading this, of course, so obviously you have good prep habits already! :)</p>

19

<p>CoachC--You're adding a lot of valuable information to the MT forum!! Question: is there an excellent Voice Center in southern California? I like your idea of a baseline (other thread) look for a healthy voice. My D gets sick a bit too much, though, with sinus or allergy related infections that can affect her voice for 1-3 months at a time. She keeps asking me if she can get an "ecinacea shot" next year for auditions LOL.</p>

20

<p>I'm not very familiar with the West Coast as far as Voice Centers go - waitingmommy, any help?:) But chrism found this excellent resource which she posted a little ways up:</p>

<p><a href="http://www.gbmc.org/voice/national.cfm%5B/url%5D"&gt;http://www.gbmc.org/voice/national.cfm&lt;/a&gt;&lt;/p>

<p>From the looks of that, you have UC Davis and UCSF. I'm surprised UCLA doesn't have a Voice Center, too - but maybe one of the others is closer to you, anyway.</p>

<p>Good luck!</p>