<p>I would also like to know what Coach C says about mucinex. it wasn't on the list, but it is now sold otc...maybe that's why. my S had similar problems a couple of years ago and was on several allergy meds. as per the ENT, we stopped all the harmful medications, but he does use mucinex to help thin and get rid of the congestion/drainage. it does not seem to dry him out. we also moved last year to a climate that is better for his allergies, but that's not an option most of the time!</p>
<p>Sorry for so long w/out answers to these great questions! :) I'm moving (staying in Pittsburgh but moving areas of that city), so things have been very hectic. I need to check the specifics of all the meds-related questions on Monday when I work: b/c I am not a physician, I always verify these questions with the wonderful ENT's with whom I work.</p>
<p>As for typecastme 22's question: NOLAMOM is right on the money.;) The way evaluations work at our facility is you are seen by an SLP first and then by the ENT, but the SLP's portion of the visit is called a Medical Speech-Language Evaluation and is designed to ADD to the info the ENT gathers by looking at your vocal folds and doing a head and neck exam (looking in your ears and nose, feeling the lymph nodes and other structures in your neck, etc.) Like NOLAMOM said, ONLY an ENT can diagnose the vocal problem: although an SLP can see what the general problem when you're scoped and may even do the scoping herself (depending on the practice and the laws of your state), only the ENT can definitely say what it is you are facing. In our practice, the SLP evaluates if you are "stimulable for voice change" - meaning, in your case, if we can help you produce voice that is less raspy by improving your speaking (or singing) technique. In many cases, the answer is yes, so the ENT uses that info from us in deciding to prescribe a course of voice therapy before deciding to do any surgical procedures. </p>
<p>I'd be seen ASAP by your ENT - you may be fighting allergies or even reflux (which you can have w/o feeling ANY heartburn and which really wreaks havoc on vocal folds), both of which are improved a great deal by meds - but the meds need time to kick in. I know that we have had a HUGE increase in calls about allergy-related voice issues this past week b/c the pollen count was so high.</p>
<p>One final note - make sure you see a LARYNGOLOGIST - a VOICE specialist ENT!!!! I don't know where you're located, but if you are ANYwhere near Pittsburgh, contact me and come to see us. There are also amazing laryngologists in Chicago, Philadelphia, NYC, and several other locations - but there really aren't hundred of true voice experts, and that is what a "professional voice user" needs!!! If you don't see a VOICE expert, you will likely end up with incomplete information or referral to see a voice expert: we see many, many patients who had procedures done elsewhere and come to us still facing problems.</p>
<p>Hope this all helps - meds info on Monday evening, I promise! ;)</p>
<p>Actually, Mucinex is the trade name for guaifenesin. It is on the list with a potential beneficial effect if taken with lots of water</p>
<p>Sometimes vocal nodules (nodes) have an organic cause (allergies, illness symptoms such as drainage), but for singers and actors all too often the cause is functional, i.e. incorrect vocal habits. It is always appropriate and necessary to consult with an ENT/Laryngologist. Voice therapy is the discipline which has the best success treating functional nodules. Even in the case of organic origins, the nodules likely develop because of compensatory usage and habits, hence the suggestions for vocal rest. Voice therapy has many practitioners who began as teachers of singing, and often they have the better ears to notice qualitative differences in the sound, send the voice user for medical evaluation, and monitor and encourage the healing process. Most if not all states now require accreditaion for treatment of vocal disorders within the realm of the speech pathologist, but voice teachers deal with functional issues every day, and it would be disingenuous to suggest otherwise.</p>
<p>Thank you very much CoachC for your EXTREMELY helpful information.
I got the person's name from the website you provided when this thread first started. I am very close to NYC so getting into NYC would not be a problem to see a good ENT.
I think that the issue might be allergies just becuase my eyes have started itching, congestion, etc. But I will get checked out for both regardless.
Thanks for your help!</p>
<p>I have vocal nodules and believe me, you DO NOT want your kid to develop them. They not only affect the sound of my voice (somewhat raspy), but they make me feel as if every sentence I utter is an effort, which my D (who studies the Lessac and Linklater ways of producing sound in her arts hs) tells me is the worst thing to feel. It's as if I have to force sound out <em>from</em> my throat. (I can just imagine Coach C squirming in her chair about now, itching to get her hands on me! :)) This cautionary tale is meant to tell you to make SURE your child has a competent voice teacher who is smart and astute and educated enough about how the human voice works to ensure your child is not using bad technique to make sound. A lot of harm can be done in a short amount of time ....</p>
<p>I dont know if this will help anyone, but here is my S's story regarging allergies, etc. When he went to college last year, he lived in an old dorm and began developing upper resperatory problems (thank goodnes there is a new dorm for next year) he had lots of sinus congestion and lots of sore throats. I gave him the usual over the counter stuff and it didn't seem to help, we got the personal steamer and the room humidifier, etc and he was as little better but not much. Over winter break I took him to an ENT he got scoped, the cords and folds were fine, but the best thing that came out of it was a Saline Nasal rinse. We got a kit called Neilmed. He started using it two or three times a day and it really made a difference. Apparently when you have lots of post nasal drip it pools up when you sleep and can cause a sore throat and the rinse thins out secreations and also washes away dust, pollan and other irritants. He uses over the counter Clairitan sometimes ( with lots of water), I haven't heard him complaining at ALL this spring, so fingers crossed, maybe we have found the right combo: Humidifier, personal steamer, Neilmed rinse and the occasional clairitan. ( Oh, regular clairitin, not clairitan D). I would be interested in what Coach C has to say about the rinse.</p>
<p>I just read your post re: the student overworking the voice and suddenly had no voice. He got into the Voice Center asap and found to have had a vocal fold hemorrhage. Other than voice rest was there any other treatment, such as steriods? This just recently happened to my D during a rehearsal which followed a sore throat and fever. She cultured neg. for strep but has been having blood when she blows her nose. The Dr. said it is a virus, but it has been one week and the sore throat is still there.</p>
<p>just read your post re: the student overworking the voice and suddenly had no voice. He got into the Voice Center asap and found to have had a vocal fold hemorrhage. Other than voice rest was there any other treatment, such as steriods? This just recently happened to my D during a rehearsal which followed a sore throat and fever. She cultured neg. for strep but has been having blood when she blows her nose. The Dr. said it is a virus, but it has been one week and the sore throat is still there</p>
<p>A vocal fold hemorrhage would not cause blood to come out of a nose (or mouth), b/c the bleeding is contained by the vocal fold mucosa - and it's not a lot of bleeding by nosebleed standards. Blood coming out of her nose likely relates to her sinuses - but she should get checked out again if you're worried. My student who had a hemorrhage did not get steroids, and I'm not sure if a doctor will do that for hemorrhagic swelling - but I work tomorrow and will add it to my list of questions. :) Is your D involved in a performance right now? And has she seen a laryngologist?</p>
<p>Just thought I give credit where it is due to Coach C - it was my son who had the vocal hemorrhage - in describing his symptoms to Coach C over the phone (she was his teacher, mentor, coach, and still is), she made a very accurate diagnosis, directed him immediately to the right place and saved his voice. As a teenager he had demands of 2 spring musicals, choir committmenhts, junior prom and did not respect the demands placed on his voice. Thankfully because of Coach C's expertise and pull at the vocal center. He was treated with complete vocal rest for 2 weeks, then attended vocal therapy sessions. Today he has a much better respect for his vocal health, is handling vocal demands much better and thankfully has not had another hemmorrhage. CC is lucky to have Coach C on board as a vocal resource!</p>
<p>this is a little off course but is there any vocal consequence to severe snoring It would seem that the drying would be hard on the singer but is there any known consequence and if so what is recommended to alleviate the problem.</p>
<p>jacksdad, I would think that the important thing to find out is WHY the person is snoring. I am a layperson (not an expert), but I would think that snoring could be a <em>symptom</em> of other things awry in the upper respiratory system that could eventually effect a singer. (Adenoids, apnea, obstructions, etc.) If the person snoring is a child, I would recommend calling your pediatrician first and then a child sleep specialist or ENT. Perhaps the snorer has allergies that have not been diagnosed and could be treated easily.</p>
<p>Thanks for the reply but we know there is nothing awry medically. I am a physician and a singer as well and we come from a long line of snorers!!! Just curious if there were any detrimental effects to the vocal apparatus.</p>
<p>Thanks for the "shout-out," shoremom!!! :) And important clarification - I didn't officially "diagnose" shoremom's son, b/c there's no way that can be done w/out his vocal folds being examined (and as an SLP and not a physician there are only a few diagnoses I can make officially, and hemorrhage is not one of them) - but I did say that based on his symptoms, which were extremely an hoarse voice that CHANGED SUDDENLY into this quality - that was the key factor - it SOUNDED like it was hemorrhage. That's an important distinction b/c I want our singers to know you MUST see a doctor for diagnosis when you are having vocal difficulty! </p>
<p>As promised, I picked the brains of my more seasoned medical voice colleagues at work and got the answers to the questions that have been posed over the last week or so:</p>
<ol>
<li><p>Mucinex (aka guaifenisen) = good stuff IF you drink a loooooooot of water along with it!! It is designed to thin secretions, so it uses some of the body's water stores to do this and therefore they need to be replenished.</p></li>
<li><p>Nasal irrigation = also good if you feel like it provides sinus relief. The salt water/saline solutions that are sold are the same composition as is found in the body, and it's perfectly ok to do this.</p></li>
<li><p>From an earlier query: aspirin should be AVOIDED for vocal fold difficulty b/c of its anticoagulant properties. (I have said this before but verified it with our ENT today.)</p></li>
<li><p>For those with severe asthma who need pretty "hardcore" asthma meds, our team recommends working closely with your pulmonologist and ENT to arrive at the smallest dose that's safe for you, and also to stay super-hydrated. </p></li>
<li><p>jacksdad - The damaging effects of snoring would be the mucosa drying every night, but that should be remedied with super-hydration. I assume, like NMR said, your son has had his adenoids examined - b/c bigger adneoids can cause qualitative sound differences in singing - even if they aren't "removable" by medical standards for laymen. But as a physician, I'm guessing you know this already! ;)</p></li>
</ol>
<p>Hope this helps! Keep the questions coming! ;)</p>
<p>Exciting news for all of you southern California singers - there is finally a medical voice center - aka laryngologists' office - opening in the LA area!!! I apologize if my understanding that there is not currently a voice center in the LA area is incorrect - that info was posted here last year by an LA-area parent who is also an SLP. Either way, this new voice center is going to be a tremendous place for LA-area singers and actors to be seen by a top young laryngologist. :)</p>
<p>The new voice center will be a part of Loma Linda Medical Center, a very well-know research and teaching hospital. (<a href="http://www.llu.edu/%5B/url%5D">http://www.llu.edu/</a>) Dr. Andrew Florea, our current clinical fellow in laryngology at the UPMC (Pitt) Voice Center, where I work, was recently hired to develop and open this voice center. He is a top-notch diagnostician and voice surgeon who is finishing up the very last phase of his specialty training with us (under my boss, Dr. Clark Rosen). Dr. Florea will be opening the Loma Linda Voice Center in January 2008. I believe they will be ready for patients in April 2008, but I will post more as the info becomes available. I know that seems distant, but finding true EXPERT voice doctors is very rare, as I have posted many times before, and I get to watch Dr.Florea in action all the time - so I know he's GREAT! :P In addition, he is caring and funny - he'll make even the most nervous singer feel at ease! </p>
<p>I hope it's ok to post this "referral" here - b/c we singers need to know who are the BEST people to go to to take care of our precious instruments! ;)</p>
<p>Thanks Coach C for the quick response. As of yet her Peds Dr. has not referred her to an ENT although I have the request on file. Today D was Rx a strong 3 day antibiotic since Dr. felt a sinusitus (like you suggested) and some bronchial effects are the source of her problems. Also, using an inhaler, but your advice on limited use has me concerned. We will re-evaluate in 3 days after the antibiotics are gone. </p>
<p>To answer your question re: shows,...yes she is in blocking and full runs of our communities Passion Play, rehearsing for a trio performance, and a choral performance. School has also been stressful. She just did stop her dance classes for a month and stopped teaching music lessons because of the pressures and health challenges. </p>
<p>Your advice about the Voice Centers led me to research them which had awesome advice on voice care. I emailed them to my D and she is taking this more seriously. When kids are young teenagers it is so hard for them to take responsibility for their voice, unless of course, there is a risk of losing the purity of the tone. Again, thanks for the help.</p>
<p>Thanks Coach C for the quick response. As of yet her Peds Dr. has not referred her to an ENT although I have the request on file. Today D was Rx a strong 3 day antibiotic since Dr. felt a sinusitus (like you suggested) and some bronchial effects are the source of her problems. Also, using an inhaler, but your advice on limited use has me concerned. We will re-evaluate in 3 days after the antibiotics are gone. </p>
<p>To answer your question re: shows,...yes she is in blocking and full runs of our communities Passion Play, rehearsing for a trio performance, and a choral performance. School has also been stressful. She just did stop her dance classes for a month and stopped teaching music lessons because of the pressures and health challenges. </p>
<p>Your advice about the Voice Centers led me to research them which had awesome advice on voice care. I emailed them to my D and she is taking this more seriously. When kids are young teenagers it is so hard for them to take responsibility for their voice, unless of course, there is a risk of losing the purity of the tone. Again, thanks for the help.</p>
<p>I don't know why but every time I post I get a double post. I apologize to all readers.</p>
<p>I read the post that was concerned about the effects of intubation during surgery. Does anyone know if endocscopy carry any risks to the singing voice? Or are there alternative procedures to diagnose GERD, stomach problems? Thanks!..</p>