Voice Issues / Sickness / Medical Advice

<p>so sorry to hear that. but, since you've had the shot which was what i had mentioned.......i wanted to encourage you and say that when my d had that it did really help. and it's really not just a "fix." it's medication and a healing process. it just speeds things up. the concern for young people is that they will feel better and then overdo, making matters worse. so, even though, she'll feel better, encourage her to be careful with her voice. and best of luck. you have a whole country full of parents who have "been there" rooting for you. and i'll say a prayer for you.</p>

<p>Razorback1,</p>

<p>Thank you so much for your kind words....not sure how d is today..still sleeping. Final dress last night was ok...d did more of a walk through. She is just real down more than anything. Most of her friends are coming tonight. My family came in from NJ to see the show. She just wants to be her best. She is also bummed because she plays guitar and was asked to sing and play with her guitar teacher's band Saturday night at the cast party and she doesn't think she will be able to. We'll see maybe she will wake up today and be much better......hoping for good things.....</p>

<p>A lot can happen in a day. I swear, I thought my d was never gonna make it; she was hoarse. But the night of opening, after not having talked all day, she was fine. Crossing fingers!</p>

<p>Lots of us are crossing fingers for you! We're holding positive thoughts....waiting with baited breath for good news!</p>

<p>Kathie, I'm so hopeful for you that opening night is a big success! I truly hope she feels better. She must be very talented to have this role.</p>

<p>Thanks to everyone for being so kind....D still not at her best but the raspy voice certainly worked for her acting. It added a little something to give Ariel a sexier sound. She made it through her singing which also sounded great. There were people who didn't know she was losing her voice who said they couldn't even tell and those who did know said they liked what that voice added to the role. She got some many compliments and the show as a whole was wonderful!<br>
For the screams in the train seen they had someone scream from behind the train trestle in place of my daughter. I thought it was rather funny since I knew it wasn't her but noone else knew it wasn't her...it looked great!</p>

<p>Ericsmom,
After watching the role of Willard more closely, it is such a great role! Our Willard definitely was a stand out with such great acting ability. I'm sure your son will be an absolute stand out as well! </p>

<p>Now til tomorrow's papers to wait for the reviews!</p>

<p>Hi, all, and sorry it's taken me so long to answer the question posed a few days ago about honey - work commitments have kept me very busy! But I have been reading and am glad that kaysmom's D is doing ok. I have to say that I, too, was not a fan of the cortisone idea, for the reasons mentioned here. I am glad it worked out for her, but I would like add an impassioned message to that whole issue which some of you will NOT like, but which you MUST heed. High school and community theatre productions are NOT worth sacrificing voices for - really, no productions are, but the issue becomes a bit different when a performer is being paid and going on is truly one's job. I am not AT ALL implying that kaysmom's D put herself at foolish risk - this is a general caveat to all young singers who become passionately involved in EACH project they do and often juggle many shows at once along with school, training, extracurriculars, etc. I can't tell you how many students I have seen who have just run themselves ragged doing their high school shows when in the end, NO ONE (college admissions people or professionals) cares how many high school leads you have on your resume!!! Of course, to audition well, young performers need experience, so of course do your shows, do EVERYTHING you can - UNTIL you become overtired, vocally taxed, etc. At THAT point, you have to begin making choices about what will benefit you in the LONG TERM - which is the absolute hardest thing to do when your school is "counting on you" because you are the best performer, when all your friends are doing your high school show or community theatre show, etc. But if it's going to jeopardize your voice (because you already injured or just too completely tired), sometimes you have to say no. And frankly, many high school theatre and even choral directors have no idea how to listen for overtired voices that need to be protected - you often have to look out for yourselves!!!</p>

<p>Before you all kill me :), keep in mind that I directed a huge, top-notch high school musical theatre program for five years and was also a teacher of academics at that same school (not just a comparatively univolved "visiting artist"), and I also TOTALLY support the idea of well-rounded PEOPLE going into MT (meaning do lots of activities, learn about other disciplines, etc.). But bottom line, I hate that young singers often don't treat their voices with the same care that young athletes treat their bodies - and ANY good largyngologist (meaning voice-specialist ENT, at a voice center or otherwise) will tell you that singers are VOCAL ATHLETES! Singing is a physiological process, a MUSCULAR process, so you have to give your body proper nourishment and REST in order to perform at peak condition.</p>

<p>So back to the cortisone - I worry that all who read this will consider that as an option if they are vocally hurting and in a show. It is ONLY used as a last resort, even professionally - and the singer usually then has to rest and be cycled off it while resting. An example of this: last summer, when ASSASSINS was on Broadway, Neil Patrick Harris (who played The Balladeer/Lee Harvey Oswald) was really sick and could barely talk, but this happened to coincide with the week that the Tony voters were seeing his show, so he was given cortisone, sang through the weekend just barely surviving, and then rested for several days while his cover went on. This was planned and CAREFULLY monitored by a doctor, but was really a NECESSITY because of the Tony voting process. If it had NOT been Tony voting time, however, he would NOT have gotten cortisone.</p>

<p>Ok, so in community and high school theatre, you rarely have understudies and of course you want to not let anyone down - but sometimes, you have to "disappoint" people in order to protect yourself! So when you are having vocal trouble, don't go to the doctor and ask for cortisone, ask if there is anything you can do that won't put you in jeopardy. If, as in the case of kaysmom's D, the doctor suggests that and you know he knows PROFESSIONAL voice issues (and that is SO important - as I keep saying here, you need a VOICE SPECIALIST ENT!!!), go with it, following the doctor's monitoring instructions EXACTLY! But if the doctor says you should NOT sing - DON'T argue!!!! If you do, you are jeopardizing your career!</p>

<p>Whew - ok, done with lecture! (I know, I sound like all of your moms and dads, right? :) ) In answer the honey question: honey, Throat Coat tea, sprays like Entertainer's Secret and Singer's Saving Grace, slippery elm throat drops, etc. all provide some relief from pharynx (throat) pain and sometimes inflammation, but they do NOTHING to help your actual voice. That is produced by the vocal folds which are protected (by the epiglottis) from having any liquids touch them. (Refer to the medical/voice issues thread for a great explanation of this from the UPMC voice center.) All of those remedies that I just mentioned provide psychological relief to a hurting singer, but that's it (and trust me, I know this and still use them when my voice feels shot). The best thing to do for a shot voice is SLEEP AS MUCH AS YOU CAN to restore your overall body (which of course is usually impossible when you are in tech for a show) and also, use STEAM! Steam actually DOES get down to the level of your vocal folds, because anything your breathe in goes right between your vocal folds into your respiratory system (which is why smoking is so bad for singers - the heat "fries" the folds). As you know, I am still an SLP grad student, not a true "expert," yet, so I want to assure you I got this info about remedies from my fave PhD voice therapist (at yes, that wondeful place, the UPMC Voice Center - all singers should live in Pittsburgh so as to have access to this place!) The best kind of steam for reducing vocal-fold edema is concentrated toward the face (although a hot shower can achieve some of the same results). You can get a good personal steamer at any drugstore for about $35 - Vicks makes a nice one. This is basically a tiny heating element that with a water reservoir and face mask of top of it. A cool bit of trivia: European opera houses at one time had steam kettles to loan to fatigued singers!</p>

<p>The other thing to do for an ailing voice is to make SURE your support is as optimal as possible - when we are tired, our support tends to go away, and therefore both our speaking and singing voices can "drop" and strain our folds.</p>

<p>Hope this helps! And if you pm-ed me or emailed me recently, I am working on answering all of those and should do so by the end of this weekend.</p>

<p>CoachC</p>

<p>Coach C...thank you for all of your information. I have to agree that I don't know that getting that shot did too much good. It certainly didn't get her back to perfect....and three days later she is still "froggy". We did go to an ENT and that is what he suggested though. </p>

<p>It has been a lot of stress on my d. You are right...I am sure the best option would have been to say, she can't do it to save her voice. But how many kids would actually do that. She feels responsible, people counting on her. It's certainly a hard thing to do. I truly hope she made the right decision and didn't do any permanent damage. Maybe I should be at fault for not taking her out of the show as well but it just couldn't do it. Her heart was set on it...she worked hard for it and she loves it. I do appreciate your advise...that is why I asked to begin with! I take it seriously. My d takes it seriously. Thank you again for all of your words of wisdom.</p>

<p>I have to say I love this discussion thread! Too often neglected area of discussion and education - maintenance of the voice. And I wish this kind of advice had been around for me when I was a young performer - worried about "coming through" for the show, not letting people down, and not feeling that I was an "inferior" instrument. I too often overdid it and lost my voice OFTEN; and now, I am one of the true female baritones on the west coast...</p>

<p>A few things that I wish I had heard when younger:</p>

<p>One: no one in the audience, except maybe your family and close friends who have heard you rehearsing, knows what you sound like "at your best" in this role. So don't feel you have to push to impress; "marking it" at a level appropriate to performance will save your voice more than blowing out full-effect. The audience will "get" the material, the given circumstances, the story, the character, the heart and the melody. That is all they really need to enjoy the show. And they won't KNOW that it isn't your best performance! So take the pressure off yourself in this respect.</p>

<p>Second: another word of caution (I know, blah, blah, blah...) - and this from my ENT when I was in vocal/speech therapy (yes, been there, done that). Performers with TRAINING are usually supporting and placing the tone correctly WHEN ON STAGE (even when feeling under the weather). However, EXTREME caution should be given when NOT onstage (speaking backstage, on the phone, at CAST PARTIES, etc.). This is when your guard is down (naturally, as you are not "on"), and one can really strain/stress the voice at these times. So if you are in the risky area of hoarseness due to illness or fatigue, no, and I mean NO!, talking when not onstage is best. DON'T go to cast parties, sing with friends or a CD or the radio, talk on the phone, etc. It is very hard on the ego, but much easier to enforce if you are not putting yourself in the position of being tempted to speak - meaning, after the show and turning in your costumes and props, GO HOME AND REST. This is ESPECIALLY true for the opening night party or cast get-togethers that inevitable follow theatrical openings/performances. It is too much to ask of yourself - silence in a very celebratory environment (and it is not much fun, I've found, when you do attempt this).</p>

<p>Okay, enough lecture... SOOOOOO glad your D is feeling better, made it through opening, and is on the way to healthy voice and spirit!</p>

<p>(man, I'm capitalizing a lot today - must be a great hidden passion in me)</p>

<p>Capitalizing is THE BEST. :) (lol - I am a little excessive on the caps sometime, but I do think it reveals passion for your subject - I DO!)</p>

<p>Great advice, Prof!</p>

<p>And kaysmom, please give your daughter my best wishes. I absolutely, positively was NOT criticizing her or her decision but rather putting out some more general advice and encouraging vocal health awareness. Obviously you are monitoring her every step of the way and are acutely aware of her vocal health. I'm sure your ENT will do a follow-up vocal strobe to compare to the first one he did and can then assess how her vocal folds are doing. And the shot is a short-term fix, just like cortisone for athletes with injured knees, etc. - so it probably did what it was supposed to, it's just that she would have needed a course of cortisone over several days to really mask the swelling, like Neil Patrick Harris got - which I am glad your doctor did NOT recommend!!! As I said, Neil had to be monitored extremely carefully and cycled off the steroids, as you do with any steroids.</p>

<p>Most importantly, singers are often made to feell like "failures" if they incur a vocal injury or have trouble as your D has - which is RIDICULOUS. We don't usually fault athelets for getting hurt - as long as singers are doing everything they can on their end to protect their voices, they are no different! It sounds like people have been really supportive of your D, so hopefully she doesn't have any inkling of bad feelings about vocal "inadequacy" because of losing her voice. And she has learned some great lessons about vocal health! Keep us posted - I'm sure all will be fine in the end!</p>

<p>Hey there - </p>

<p>I tried to respond to your email but it says I can't do so through CC, and I don't want to use my personal email...please enable your email!</p>

<p>CoachC</p>

<p>I was in a seminar at International Thespian Festival, and one thing the professor encouraged was to disallow any singing on the bus/van/cars on the way to a performance/competition. He believes that the kids will "over-sing" and in his experience, hurt their voices. I never thought about it before:)</p>

<p>i think when you're a singer (and this is going to sound so "duh"), that you have to be so careful all the time. my d has been performing since age 11....a lot. and she never yells, would never join in singing on a bus, etc., won't touch a drink after someone else has. if someone asks her for a sip of her drink, she just tells them she's finished and they can have the rest. she carries hand sanitizer all the time and takes echinacea. she was a cheerleader for 3 years and moved her mouth but never uttered a sound unless they were doing a major competition and that was rare. it's frustrating. if you get a cold, you can still do anything else in the world except sing a song. oh well, nothing earth-shattering, just sharing thoughts and memories of past years.</p>

<p>bumped for tenorsmom :)</p>

<p>bumped for tenorsmom :)</p>

<p>Hi all; I've relegated myself to mostly lurker in the past several months because my daughter is really struggling with decisions regarding her future, and when I get too obsessed with reading this board, I tend to indirectly pressure her to MT. I want this to be her decision and not mine. However, this topic really piqued my interest based on some experiences we've had this summer.</p>

<p>My daughter had been diagnosed with exercise-induced asthma several years ago while she was still playing soccer; she uses her albuterol inhaler as a preventative whenever she exercises/dances, etc. This seemed to work until this summer when she started noticing that just a few minutes into running, her breathing felt "tight", despite using the albuterol prior to running. So we went to our family physician who referred her to an pediatric pulmonologist (one of the most highly respected ones in the Chicago area). His comment on her first visit - because she tends to experience the "wheezing" or tightness on inhaling vs. exhaling, he wasn't quite so sure it was asthma, so he scheduled her for a treadmill test. He also told us that it's very common for girls her age (16) who sing a lot to have some vocal cord dysfunction that can mimic asthma. I asked her voice teacher about this theory and she said she thought my daughter had good technique and was not abusing her vocal cords, but she asked to be kept informed of the diagnosis. She also said many of her students have exercise-induced asthma.</p>

<p>My daughter had her treadmill test and she came back positive for exercise-induced asthma (based on her reaction to the "cool-down" period, and the fact that symptoms were only finally relieved after she used her inhaler). However, during the test, as the pulmonologist was watching her run on the treadmill, he made a comment to me to look at her posturing as she took breaths. Something along the lines of how she was extending her chin or something (it happened to fast for me to recognize) - that led him to believe she also has an element of vocal cord dysfunction. For the asthma, he is putting her on a preventative inhaler (Flovent) to see if she can get to the point where she doesn't need to take the Albuterol every time she goes to show choir class (4-5 days a week). He said once we got the asthma under control, it was up to us as to whether or not to pursue some therapy for the vocal cord dysfunction. The good thing is that insurance would cover the therapy (he refers to it as speech therapy). Now after reading this folder, I'm thinking some therapy might be worth pursuing, but what can we expect from this... some have replied to some kind of tests - are they invasive, because she will protest. She's had enough prodding/poking with an irregular heartbeat as a pre-teen, mild scoliosis and IBS. She also has allergies (which surprisingly don't really set off the asthma to the extent you'd think they could). </p>

<p>On a side note, she visited Emerson with her dad a couple of weeks ago, and fell in love with everything about it. Her struggle I mentioned earlier is between MT and film or TV broadcasting as a major. Emerson has reputable programs for both majors and so it's a comfortable choice for right now, especially if she decides not to pursue MT. If she decided to pursue MT, she will undoubtedly have to find other schools that appeal to her. In the meantime, after reading this folder, I'm second-guessing how I've somewhat minimized this possible vocal cord dysfunction, and would appreciate some feedback.</p>

<p>Thanks</p>

<p>Hi teriwtt - </p>

<p>I think before you make any definitive decisions, your daughter should see an ENT who is a laryngologist experienced with treating singers and dancers who have this particular vocal fold dysfunction. Did they tell you the name of the dysfunction? From what you describe, there are several things it might be. The necessary tests might not be invasive - they could involve watching her vocal folds function with a rigid scope, which simply goes into her mouth like a long metal tongue depressor - but they also might be slightly "invasive." I think they would be more likely to watch her vocal folds function with a flexible endoscope, which goes through her nose - they would numb her nasal passages first and it doesn't hurt, it just feels really "weird" - I have had this done myself. But if your family really wants to make an informed decision about whether your daughter should pursue MT professionally, some such test is probably necessary because the laryngologist will need to know exactly what her vocal folds are doing in order to determine what her prognosis is AFTER THERAPY - the therapy itself would probably consist of various exercises to manage muscular tension and respiration (depending on the exact nature of her problem) - it will be a lot like voice lessons, but with a different focus. (In other words, the therapy itself won't be painful or too stressful.) If the "vocal fold dysfunction" is something that comes from her speaking/singing/breathing technique, it is likely that therapy can help tremendously if she really commits herself to "practicing" her therapy exercises. (By the way, she could have very good singing technique and still need this therapy - as other have stated here, most singers who face problems like nodules have damaging SPEAKING technique, because we don't think about applying good breathing, relaxation, posture, etc. when we are doing everyday things!) But only a laryngologist watching her vocal folds function can determine what kind of vocal fold dysfunction may be going on - so see if your pulmonologist recommends one. If you need suggestions, let me know - I can check my Voice Center directory and I can also check with friends who are in the WICKED Chicago company to see who they use.</p>

<p>Good luck - and please keep me posted here or via email/PM. I wish your daughter the very best!!!</p>

<p>Just wanted to thank CoachC publicly for suggesting the voice center approach. My D had her evaluation appointment today, and with a great doctor who really understood her needs and her problems. The result is that he thinks she has a simple allergy problem. He checked for nodes with that endoscopic camera (if that's what it's called)...the pictures were COOL. He had her sing while the camera was inside her throat. </p>

<p>The procedure is not bad at all, I'd say, from her reaction. So she's undergoing allergy testing next week at the same office. He also said the following:
1) DON'T use decongestants
2) use warm steam
3) might want to try a filter for her bedroom that filters out allergens while she is asleep
4) use an over the counter OR prescription antihistamine
5) the allergy shots are not practical for a kid who will be moving around - it's a 3-4 year commitment - wait until you're living somewhere semi-permanently. They have to be taken regularly and the doctors find that students have a hard time keeping up the shots on a regular basis.
6) avoid the allergens (whatever they are!)</p>

<p>thanks, CoachC!</p>

<p>Chrism - </p>

<p>Glad it all went well! I actually peformed my very first vocal stroboscopy today - meaning I was the person wielding that camera! Quite cool...</p>

<p>Visit your Voice Centers, singers - there's a lot to learn even if you're "healthy!" :)</p>

<p>CoachC</p>

<p>I am bumping this thread because allergy season is upon us and colds are circulating.</p>

<p>CoachC-</p>

<p>I have a question for you...someone mentioned warm steam for a cold...I noticed in one of your posts you advised to avoid menthol cough drops...would you say then to avoid menthol additives to steam machines?</p>

<p>Can anyone recommend a good personal steamer? Sounds as though that might be a good thing for kids to have on hand for the "what if" times....and I am speaking in regards to congestion due to colds/allergies, not throat conditions that have been previously discussed on this thread.</p>

<p>Sorry if I am being redundant by asking a question that someone may have asked in the past...it's just that some of the posts get awfully long and they are bit hard to read when they go on and on.</p>

<p>Thanks for any advice....it's greatly appreciated.</p>

<p>SUE aka 5pants</p>