Voice Issues / Sickness / Medical Advice

<p>Yikes, all this posting about singers with allergies, etc. has made me aware that we should probably have our D evaluated by an ENT who works with singers. My D has various upper respiratory allergies (dust mites, etc.) and though her voice apparently is quite good at this point (I am her mom so do not consider myself in any way unbiased! <g>), having a professional eval makes sense, it seems. Just for the record, my daughter is under the care of an allergist, but from what I read here, it seems we ought to see someone who can do a full eval. Are those things covered by most insurance, does anyone know?
Thank goodness for this forum. It really is amazingly valuable.
Lisa</g></p>

<p>I work in a clinic, so I can speak to the the insurance issue a bit: in general, if there is any kind of "problem," the eval will be covered by most insurances. It usually depends upon the diagnostic code used by the evaluator. The insurance question is a GREAT question to ask, b/c I had a very good friend who makes a verifiable living as an Equity singer/actor, and he assumed his eval would be covered since the voice problem he was having directly affected his livelihood, but when it was submitted to his insurance, they rejected it, and he was told he had to pay over $1000! (The cost of a videostroboscopy alone can be $700+!!) If you D's eval is a "healthy voice" baseline, as it sounds like it is, you should check with your insurance first because they might NOT cover it. In that case, a good alternative is to see if there is a university with a Speech-Language Pathology grad program and associated clinic in your area, and if they have voice eval capacity (not all SLP clinics do). At my grad school, our clinic does complete healthy voice evals for $60!!! They are absolutely of the highest caliber (yep, this includes a videostrobe) and 100% supervised by a certified clinical instructor, but the cost is lower b/c we are a training facility and also b/c my university has as part of its mission statement that we will provide services to our community, so all therapy here is based on a sliding fee scale. At a good university clinic, you often get very intensive one-on-one attention as well, since the student clinicians with whom you are dealing usually only have a few clients on their caseloads.</p>

<p>Good luck - and PM me if you'd like! I'm not sure where you are located, but you might even be near me and we could see you at my university clinic!</p>

<p>NotMamaRose....if it is any consolation, my daughter has allergies like yours does. She is not under the care of anyone (not espousing that, just commenting). She has not had any problems performing that I know of in recent memory. I'm not counting coming down with a very bad cold the opening night of her run as Dorothy in the Wizard of Oz in tenth grade ;-( but it wasn't an allergy.</p>

<p>However, she had one problem with her allergies relating to theater in the past. She was always allergic to our local community theater...how convenient, lol. The whole space was a problem but particularly backstage. It got better in recent years, when they redid the backstage areas and green room. But when she was 11, she was Annie in Annie. It was a big problem every time she went to the theater to rehearse. She would get an allergic reaction and it was really tough and that role has to sing a lot as you must know if you have a daughter, lol. So, we did take her to a throat doctor. He prescribed a certain medicine that I can't recall what it was called. It did help some. She was on it throughout the months of rehearsals. The week of the final rehearsals, she was having some stomach problems with a lot of pain. During dress rehearsal, she was in such utter pain bent over that she could not stand up and had to leave the dress rehearsal in the middle, it was so bad. We were beside ourselves wondering how she was going to do the run of the show which was to start two days later and there was NO understudy. She was taken to the doctor's and if I recall, apparently the side affects of this particular medicine she was taking for her throat/allergies, was like eating away at something in her stomach and causing severe pain. We had to take her off the medication and she was fine. She had to do the run with allergies but I recall we did not let her in the green room (though all the other orphans, including her sister who was Pepper hung in there). When she was 15, she was in their production of The Crucible and I wondered if she'd be fine there but the renovations helped and we used over the counter allergy medications through that run. This past summer, she rented the theater space to run a youth musical theater program she created/directed and she seemed to be OK there though likely wasn't backstage herself. Being allergic to the local theater was not fun! </p>

<p>Other than that, you are hearing experts here. I don't have any advice, just commisserating to have a child who also has allergies and is in MT.</p>

<p>Susan</p>

<p>Since I had recently read that Norbert Leo Butz had developed vocal nodes/nodules, I had a question. Sould singers be checked regularly for this? He certainly has had great training, so how does one make sure to not develop nodes?</p>

<p>st8gemom-</p>

<p>May I ask, where did you read this news about Nobert developing vocal nodules? This is the first I have heard of it.</p>

<p>I think what he does musically for the most part is a lot of God-given natural talent. He was always quite musical growing up. At Webster he was a Regional Acting BFA Major....he may have taken voice on the side as most do.</p>

<p>I would like to know where you read this. Thanks!!</p>

<p>It's true. Norbert has been out of DRS since late last week (although he did perform yesterday's matinee because it was the one being filmed for the Broadway archives) and is on vocal rest for an indefinite period.</p>

<p>I've read that too, but that he is performing Sunday as it is John Lithgow's last performance, but otherwise is on indefinite period of vocal rest.</p>

<p>st8gemom -
I would be curious to see what CoachC's response would be - but my gut reaction is that you should at least have someone who you trust (vocal coach, etc.) listen to you on a regular basis, so if they hear something start to change, you could get checked early on. Also - if you know your own mechanism well, DON'T push yourself when you can tell that something doesn't feel quite right. And - sometimes problems can be caused by specific vocal things, but sometimes problems can occur because of getting generally run-down, so you compensate vocally for lack of energy, etc.</p>

<p>5Pants</p>

<p>The first place I had heard about it was on the BroadwayWorld discussion board.</p>

<p><a href="http://www.broadwayworld.com/board/readmessage.cfm?thread=881898&dt=011206042311%5B/url%5D"&gt;http://www.broadwayworld.com/board/readmessage.cfm?thread=881898&dt=011206042311&lt;/a&gt;&lt;/p>

<p>Thanks for the info st8gemom...I will pass the info along. Lots of fans at Webster of course.</p>

<p>I did read that there were plans for him to do a TV sit com...all is not lost for sure!</p>

<p>SUE</p>

<p>I'm not surprised at the news of Norbert developing nodes after seeing DRS a month ago in NY. The way he was manipulating his voice was extremely harsh and left me wondering how his vocal cords could stand that kind of treatment 8 times a week. It makes me sad that such a great performer could have a problem like this, but at the same time it's a bit of relief that even people like Norbert have to be careful of their voices. I am very aware of how my voice is doing at any given moment because of my work, and sometimes I feel like other singers have it so easy - their voices are always reliable, they never have "bad days" etc, but my rational mind knows that's not true. And when my suspicions about Norbert's harsh singing in DRS turn out to be well-founded, it makes me realize that all singers need to be careful, and I don't have weaker vocal cords than anyone else does.</p>

<p>That was a bit rambling, but hopefully I got my point across. :)</p>

<p>So having heard Samia sing, I can definitely say she does NOT have "weak" vocal folds... ;)</p>

<p>But her point is well-taken - ALL singers must protect their voices, no matter how "strong" they might be. Your vocal folds are very thin pieces of muscle and cartilage and, though remarkably resilient when you consider their size (tiny!), EVERYONE is susceptible to vocal injury or damage when they strain too much. MusThCC had a great answer to "how often to strobe" - when the singer hears or feels something "different" (this involves really PAYING attention to your instrument on a daily basis and knowing the difference between hoarseness b/c of a bad cold and "worrisome" hoarseness, for example) OR when an expert (usually, a voice teacher) advises you to get checked out. As I have posted before, a baseline is always a good idea - meaning get a strobe when you are healthy so the ENT has a basis for comparison if you ever are vocally injured. Once you have a baseline, you only need to be strobed when you are having difficulty that endures beyond a cold, etc. or when you feel an abrupt change in your voice. Looking back through this thread will provide anyone with concerns with a wealth of info about vocal health issues, so I won't repeat - except to remind everyone that nodules CAN resolve in many cases - the key is TRUE vocal rest!</p>

<p>Hi Coach,
Just wanted to post an update. My D mentioned yesterday that she feels physically so much better this winter than she did last winter (last year's audition season) - she's much less tired, less chronically congested (we didn't even know she was congested because she'd always been like that), and her voice feels "clear". </p>

<p>I so appreciate the advice you've posted here and urge everyone to get allergy tested if there's ANY question at all! </p>

<p>Chrism</p>

<p>As many of you know, my D is a freshman in the MT program at College of Santa Fe. She's loving it, and has been preparing for and looking forward to tomorrow's auditions for Urinetown, especially because her voice teacher has been very encouraging about her auditioning for Hope. However...she called just a little while ago sounding awful and with a fever of 101 (which at least was lower than it had apparently been earlier in the day!). She's been sleeping, drinking lots of water and tea, taking over-the-counter stuff for the fever. Of course, especially at 1900 miles away, I can't guess if this is a quick-hit thing or the start of something worse...but does anyone have any suggestions for how she can feel as good as possible for tomorrow's 4:30pm audition? She emailed the production team to let them know she's sick. Callbacks are Sunday, so maybe they'll cut her some slack and let her audition then. I just don't know. I'm really feeling the distance right now!! Thanks all.</p>

<p>I have to be my own grammar cop here: I meant to say I want her to feel as well as possible, not as good as possible. Once a copy editor, always a copy editor. :-)</p>

<p>artsymom,
I wish I had a magic potion that could provide your D the quick fix to make her good as new for her audition tomorrow...... I don't, although it sounds like she is already doing the best things she can under the circumstances. What I can offer is compassion and understanding for how frustrating it can be when unexpected illness can corrupt an exciting performance possibility. My own D is dealing with an extended viral infection while in the midst of a really grueling rehearsal process for the PSU spring musical as well as several important summer stock auditions on the horizon. There just isn't the option to slow down and really rest the body which is probably the main road to getting healthy.
I will send "healing" thoughts her way and hope that the audition results meet her expectations. If not, tack it up to another one of those life lessons necessary to learn in the world of performance!</p>

<p>I, too, can relate from a mom's perspective. My d, a freshman MT major at OCU, has battled illness and severe allergies...usually right at audition times and it has been both discouraging and eye-opening for her. I think the added stress along with lack of sleep and not eating right are partly at fault, and I, too, am half-way across the country from my d and feel helpless to comfort her. I am sending thoughts and prayers your d's way, though, that she makes a quick recovery and that her auditions go well.
Lexasmom</p>

<p>Okay, I'll put my nurse hat on now.</p>

<ol>
<li><p>Chicken soup works wonders (the steam in your face). Homemade is best of course, but those dry mixes now available are really good too.</p></li>
<li><p>Medicate only for the specific symptoms (ibuprofen for fever, decongestant if congested, etc) and don't take a multi-concoction that will give more substances that really needed. I personally like zinc lozenges and ecchinechea with goldenseal to boost the immune system (taken for 2-3 weeks). </p></li>
<li><p>With that fever, she should really be checked for strep throat if there is any sore throat involved. Antibiotics are in order for a few things and this is one of them. Most run-of-the-mill viruses, colds, flus don't respond to antibiotics.</p></li>
</ol>

<p>If she has any kind of sore throat, with her fever like it is, she really should NOT sing - many singers can "sing through" illness but are actually phonating by using their extrinsic laryngeal muscles to squeeze swollen vocal folds together - in layman's terms, she's squeezing to get sound out when she shouldn't be - and a lot of vocal damage results not DURING illness but after, when the singer retains the squeezing habit that got her through the illness.</p>

<p>That having been said, I know what it's like to "need to" sing through illness - one of my good friends is in a major Equity national tour right now and IM'ed me earlier today to say that he had lost his voice b/c of a throat infection but he has to perform all weekend b/c his understudy doesn't yet have costumes. :(</p>

<p>I hope your daughter heals well and quickly!</p>

<p>Thank you all so much for your help and empathy! (the CC equivalent of tea and sympathy?) I knew I was throwing my question out to the perfect population of understanding people with on-target experience. Monkey & Lexasmomkbj, thanks for the commiseration and healing vibes. ElliottsMom, your nurse expertise is vital. I'd urged my D not to hesitate to get herself checked, even if the school health office is closed and she has to go to the emergency room or a doc's office. (Fortunately, her boyfriend has a car, and I also have a dear friend in Santa Fe who will gladly help -- and who, because her adult daughter is a singer/dancer/actress in a major Vegas show, understands these situations.) And CoachC, I appreciate your caution about about my D not singing through her illness. We'll just have to see how the powers that be handle things if my she's still feeling sub-par. L'chaim!</p>