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Vocal Problems - Part 2

I began a thread back in March of 2010, about problems I was having with my speaking and singing voice.  As a reminder, I followed everyone's advice and saw an otolaryngologist, who diagnosed muscle tension dysphonia.  I worked with a speech therapist who also noted some nerve damage.  I had some success with the exercises she gave me.  It has been two years, and though I know the correct way to speak, I find that it is getting more and more difficult to find the right placement.  My speaking voice continues to be somewhat raspy, and my singing vocal range hasn't improved at all.
At the beginning of the summer, I was intent on spending a lot of time working on getting my voice back in shape.  I planned to begin each day in silence, gradually warming up my voice and only speaking "correctly".  That intention was blown the first week of summer!  Each time I tried to begin the day silently, something (husband, children, mother, pet) got in the way, and by the time I remembered to talk correctly, my voice was so tired that I couldn't. 
Now, I'm about 4 weeks away from heading back to school, and my voice is in no better shape than it was 2 years ago - in fact, it may be worse.  I'm upset with myself that I can't commit to the "silent treatment" enough to restore my speaking and singing voice - that which is my livelihood and feeds my soul.  At this point though, I'm looking for ways that I can approach school and my students with a positive attitude.  Any teaching techniques that will spare my voice would be greatly appreciated.
Any other suggestions for my predicament would also be appreciated...
Replies (16): Threaded | Chronological
on July 20, 2012 9:36pm
Hi Sally - 
I can somewhat relate to your situation. I am finishing my Bachelors of Musical Arts (Choral Conducting) at Pacific Lutheran University, am 27 years old, and a Tenor. 
When I was attending community college from Sept 2003 to May 2006, I was taking private voice lessons when in January 2005 I was hit with both Tonsilitis and Mono. The Ear/Nose/ Throat specialist at first didnt know what to diagnose me with and I lost my speaking AND singing voice for 6 months. I LITERALLY could not make a sound without pain in my throat, for example, feeling like I had swallowed a razor blade or two. 
I was put on meds and although I couldnt make any prolonged speaking or singing at any audible volume level, I was hoping my voice wouldnt be too damanged once I healed. However, when I did heal my tenor voice could only sing from G3 (G directly below Middle C) to G4 (G directly above Middle C), and thus making my tenor range very limiting. It has since been 7 years since I first was able to sing and speak again and my range is still smaller than the average Tenor; Eb3 to B4. I do not have the low end that almost all other 1st tenors have at the college level.  In addition to my singing voice damage my speaking voice is raspy and evenmoreso after speaking for a couple hours. 
I work with a church choir and twice in the past year, during our regular wednesday night 7 to 8:30 rehearsals, my voice was raspy and fatigued to the point I couldnt demonstrate much with my own voice during the church choir rehearsal. Some techniques I used were;
1) speaking in a slightly higher voice (even if I had a slight accent) (may take some concious effort but its healthy)
2) having section leaders demonstrate singing a phrase
3) Playing parts on the piano (somewhat less musically affective when trying to show the shape of a sung phrase)
4) Have the singers use their hands and arms to shape the phrases (with my verbal instruction)
5) I even had hand gestures of my own (that the choir got use to) which they would recognize and instantly know what I was asking of them
6) I'd sing on ONE pitch and just demonstrate phrase shapes with dynamics (using a comfortable pitch in my middle-upper range)
Some therapeutic things I have done for my voice include;
1) Liptrilling (buzzing the tip of my lips) ON pitch every pitch within a phrase of music that I sing, then singing the phrase on words. (This helps clear up some raspy-ness).
2) Drink NON-CAFFEINATED tea. (this helps to NOT dry out the voice).
3) Sometimes I'd chew gum when the weather gets cold (to keep my throat warm). Prefferred MINT gum only. All other flavors have tons of sugar. 
4) Every morning I hum a couple of phrases or vocalises. 3-4 to loosen up my voice. This builds stamina. 
5) I also do a few breath exercises every monring. Ex: Breath in for 4 pulses and Hiss out for 8 pulses (then in for 6 out for 12 and so on). Another example, breath in for four, hiss out - pulsating each beat, 1 2 3+ 4 1 2 3+4. (in varying combinations).
Hope these help. I have many more suggestions but they may take up too much space here. 
All the best, 
Alan Davis
on July 21, 2012 8:41am
Though I'm probably saying the obvious, Sally, if you're not already using amplification for your teaching and rehearsing, please consider it.  If you're going to be starting the teaching year with your voice not at 100%, be sure that you're not trying to talk over your students with a "raspy voice."  As for other recommendations, I'm sure your otolaryngologist and your speech therapist know your situation, and the advice to give you, better than any of us could.  
Good luck, and I hope your voice is able to recover soon.
on July 21, 2012 11:07am
You MUST be silent!  Your husband and kids can go hang...and the dog...someone else can handle the dog.  Your mother will just have to deal with you being quiet....and don't answer the phone in the mornings if you know its her. Unless there's a fire or blood, nothing needs to be handled by you in the mornings by talking.
Gesture. Point.  Have a little notebook on a bracelet on your wrist to write notes.  Do whatever makes sense to BE QUIET.  Your family should be aware of what you need so you can EARN MONEY FOR THEM by not sabotaging your recovery.
Alan has some wonderful suggestions. And Charles is stating the obvious but it needs to be said!
Cut down on caffeine.  Drink clear water and teas--stay hydrated at all times--"pee pale" to quote several ENTs of my aquaintence.  Get enough rest--and just plain "take time to enjoy the roses"--without talking, of course.
We as wives and mothers and daughters think we need to handle all the crap that comes down the pike in our families, but being a little bit of a diva so your voice can have some rest and heal this summer ain't gonna hurt anyone. Might be good for their character, too!
Marie, the spouse of an ENT--and he  KNOWS not to expect me to talk in the mornings if I have to sing (it's just plain not good for HIS health!)
Applauded by an audience of 1
on July 23, 2012 9:24am
WOW! Talk about hitting the nail on the head and making no apologies! Kudos, and AMEN! We need more people to tell it like it is in these forums, not mensing word or trying to be PC or sounding so academic all the time. Good to read a down-to-earth response.
on July 21, 2012 12:32pm
Muscle tension dysphonia. You need vocal rest.  You have four weeks, in which you can make alot of headway toward vocal health.  Just tell your husband and kids that you have to be quiet. Do not give in. Write your words on a pad.  If the kids don't behave, elect to use corporal punishment for the next month.
You only have one set of vocal cords, and you may only have one chance to heal them.
Good luck.
on July 21, 2012 6:50pm
Hi Sally,
The methods described in "Your Voice At Its Best" by David Blair McClosky would certainly be helpful to you.  In simplest terms, it will teach you to create a reliable easy breath flow, and to relax the suprahyoid muscles.  Feel free to respond privately if you would like more info on this method and where to find teachers.  If this does not appeal, then you might look into Alexander Technique, because the way you hold your head and neck can make a big difference to the ease of vocal production.  And when you are back in the classroom, NEVER speak over noise.  Develop as many tricks as you can think of for quieting the room BEFORE you speak a word.  Also, on a workday, warm your voice up gently before leaving the house, and stay well hydrated EVERY DAY.  Good luck and best wishes!
on July 22, 2012 7:16pm
Thank you all for your wonderful thoughts and suggestions.  As of tomorrow, I'm QUIET!  I've informed my family and friends that my vocal health is important, and that my voice is just too tired to continue on this way.  I don't think they fully understand how hard this is for me to handle, as I've "handled" so many other physical and emotional upheavals quite well over the years (cancer, fibromyalgia diagnosis, mental health issues, bilateral knee replacement last August, father's illness and subsequent death this past January).  The problems with my voice have been going on so long, I believe they wonder why I'm getting so serious about it now.  My answer is that I'm tired of having to deal with the tension in my neck and shoulders, the extreme fatigue in my voice, and my inability to sing (well) and give vocal examples (well) to my choirs.  It makes me feel very unprofessional when I attempt to give an example of how I want something performed, only to have my voice give out, crack, or otherwise sound wretched.  I've stopped giving the examples, which means I have to talk more to explain what I want, and sometimes I lose the nuances I could convey with my voice.
Most of you have mentioned cutting down on caffienated beverages.  I don't drink coffee, but do drink Diet Mt. Dew.  I don't drink it for the caffiene (or so I tell myself), so I'll switch to the decaffienated, and continue to limit myself to one per day.  During the school year, I'm good at hydrating - carrying a water bottle with me at all times.
Alan - thank you for the suggestions.  I already utilize some of the rehearsal techniques you described, but will try others that I don't currently use.  I will also try some of the therapeutic vocal exercises you mentioned.
Marie - I needed your "tough love" approach!  I have really wimped out on this huge problem in my life.  It's been a rough year, and EVERYTHING has fallen to me as the daughter and sister.  Since my father's death in January, my mother and my handicapped sister have needed additional help and care.  In addition to my OWN family, I've been doing housekeeping, shopping and "etc." for 2 additional households.  Finally, things have settled down, and going back to school in fall, I'll be able to concentrate on MY work, home and voice.
Charles, Tom, Jay and those who responded privately - thank you for your input.  I'm going to be doing some reading and researching, and may be contacting you.  Thank you each!
If anyone else has suggestions for my voice, or for classroom management, I'm definitely open to them.  Please pray for me as I undergo this difficult time - first, not talking, and second, hoping to regain some of my vocal health.  I'll be reporting on my progress (hopefully positive) as the days unfold!
on July 23, 2012 6:19am
Do invest in a personal amplification device, or ask your school administration to purchase it for you, as using your voice is critical to your job.  They run about $200 and are worth their weight in gold.  I have used ChatterVox   but there are others.  That little reinforcement is a HUGE help, and will support your voice without you having to work so hard all day.  You will be astounded at the difference in the way you feel at the end of a day of teaching when you use it.  The kids will completely forget about the microphone in a few minutes, especially  if you explain to them why you are using it.  
It is interesting that we are starting to see and hear more about professionals with vocal injury - Steven Tyler, Adele, and there was another recently.  So it is finally getting in the news and people are becoming more aware.  Use this to your advantage when you talk to your administrators about needing support and vocal rest. Most non-vocalists are unaware of the physiology and not particularly sympathetic, because they do not understand that your voice is your livelihood!
Do less explaining and use students to model what you want vocally. Get with a voice professional to keep you in shape!!
Good luck!
on July 22, 2012 9:35pm
The Alexander Technique was a huge help for me.  I went through speech therapy after my first year of teaching about 34 years ago!  It helped, but didn't solve my problem.  I taught in silence using the board, motions etc. sometimes when my voice was tired rather than strain it.  I am a pianist, so didn't have really solid singing technique to begin with.  Voice teachers tried to help me during those first few years, but it was a struggle for both of us.  After 3 years of teaching I attended graduate school at the University of Illinois.  There I took Alexander Technique lessons at the suggestion of my voice teacher.  They have a training center there.  It was like magic for me!  I attended weekly private sessions along with my voice lessons and it helped a great deal.  After graduation, I taught at a new school, but still continued to have vocal problems.  When I was still having problems while on maternity leave, I knew I needed help, so I found another Alexander Teacher to work with me.  It can be expensive, but worth it!  I also took voice lessons, and started singing in a church choir to "practice" my healthy new habits.  My voice is always fragile, and when it is tired, I back off right away.  I bet with the internet, you can find an Alexander teacher near you.  I really thought I would have to give up teaching music early in my career, but with some help from others I am still teaching Middle School music.  Resting your voice is a big help too!
Good Luck!
on July 23, 2012 9:03am
1. get a microphone set-up for yourself for teaching, with the little pack  you wear on your back.  A good friend of mine who had vocal probs and is now a successful choral dilrector at a University uses one, and it is not only easy on her voice, but allows her to speak in an unemotional tone and the rehearsals (I observed at Honor Choir) are a wonderful tone.  DO THIS!!!!!
2. Any cough drops with menthol actually dry out your chords.  Stick to plain w/o menthol (from a NATS Journal article)
3. Build routines so that it doesn't take your speaking to shift activities in the classroom --all the repetitive "Get  your folders, put your folders away, next piece is, and so forth.  A routine, an agenda on the board, and a few hand signals can take care of all of this.
4. I often said something softly and asked a sutdent to be my echo:  you say it, and then a student faces the class and says it -- helps students remember, too!
5.At home, be silent.
6. Continue voice therapy until you realize what you are doing that is keeping your voice strained.
Good Luck,
Applauded by an audience of 1
on July 23, 2012 10:59am
I forgot to mention that I worked with the first Alexander teacher for a few months and the second teacher for about a year with weeks missed here and there because of scheduling.  The sessions were helpful in setting up good habits in using my body with the least amount of effort which is important when using your voice.  Mr. Alexander developed his technique because of his own vocal problems.  I just wanted you to know that it is not necessary to work with an instructor for years.  If you can maintain the muscle memory from the lessons, then you are set.
Also, I use a microphone when teaching my guitar classes, so I can speak while they play.  Using the mic puts a smile on my face!  I use it for everything when I am vocally tired.  Our art teacher uses a microphone in her classroom.  There are many interesting and affordable ways to do this.  
Best wishes!
on July 24, 2012 7:17am
So I have a couple of questions as my "silence" continues.  I probably know the answer, but what about "whispering"?  Is that better than speaking if you're trying to rest your voice, or should that be completely avoided as well? 
My other question has to do with phlegm.  I have consistently felt a huge "glob" of phlegm in the back of my throat, which causes me to clear my throat or swallow many time a day.  I also have difficulty swallowing liquids (the nerve damage the therapist says, causes this).  Is the phlegm a result of the muscle tension dysphonia?  With adequete rest, and attention to body tension and alignment, could this improve, as well as the voice?
One doesn't realize how much we rely on speaking until you are trying not to! 
on July 25, 2012 9:43pm
The vocal cords are used in whispering, but I suspect that for a diagnosis of MTD this would not be a problem. 
As for the throat-clearing--this is best minimized, because it is rough on the cords.  Of course, we all need to clear our throats, but the gentler, and the less often, the better off you are.  If your mucous is very thick, then you may be dehydrated.  You might try drinking those 8 glasses of water per day that everyone is always telling you about, and perhaps you might add an expectorant containing guaifenesin (such as Mucinex)--but avoid buying one that also contains other medications, because other things such as decongestants will dry you out, which is not what you need right now.  Hope this helps!
on August 15, 2012 3:47am
I was diagnosed with vocal paresis a few months ago and have been in speech therapy for it. My therapist taught me how to swallow in order to clean off the vocal cords. Turn your head to the left and down, swallow and reverse the process. I too, begin school in a week and wonder how to sustain in a rehearsal. I have seen these suggestions and will most likely use most of them, including the amplification system. I do vocal slides, effect closures ( glottal catches with no pitch) taught to me by my therapist to strength the vocal cord that is paralyzed. Seems this is a neurological condition that can occur with a virus, unknown, like Bell's palsy. Anyone else out there  that have had this condition, please write!
on August 16, 2012 8:39am
Sally - First of all, Kudos and congratulations!  Many folks, going through what you have, might have given up.  You are a dedicated "trouper".  Singing and conducting when in the "sandwich" stage [taking care of 2 or 3 generations of people] is particularly challenging!  Marie has good points; don't let them "get" you! :)  Or as pop-singer Pink says, "Don't let me get me! I'm a hazard to myself"  (Sometimes we are our own enemy as we try to be caring for others, forsaking ourselves.. ;)  I've certainly been there.
If you are experiencing phlegm...have you been tested for allergies?  Many of us believe we have none, but tests - clinical , or self-administered, often show otherwise.  (My singing career was affected in my 20's by allergies and connected ailments.) 
If there is allergic drainage, it can impede the movement of the vocal folds, like someone lightly touching a cello string, making the cellist push harder on the bow to get sound.  Though I have not been there in the beginning of your difficulties, nor at the doctor's office with your discussions, it seems to me that this could have affected the start of your difficulty.
Allergies that affect singing can be airborne, like dust, pollen, etc...or they can be food allergies.  Most of us know that milk can increase mucous.  But I learned from a good ENT here that "bloodstream" allergies can show up 6 - 8 hours [that number may vary even wider with different people] after ingesting the allergen.  So, if you have a sensitivity to corn, and eat it for dinner, it might not affect your voice till morning.  [Marie, I'm interested in your husband's response to this?]
Don't let this make you paranoid :).  Just try going lightly on some foods you eat a lot, (one at a time so you know which one's the "culprit") and see if there's a difference.
I imagine you have a very clean house.  I learned from a doctor about black mold.  It can be present even in very clean, new, houses, and can be quite harmful.  Sometimes it is on drywall, or insulation, or cinder blocks.  If you have a water-dispender in your fridge door, check up inside of it.  Even though the water comes out clear, sometimes mold can build up there.
How much air movement is in your house, classroom, office?  Keep some humidity - another ronowned ENT reminded me that several gallons of natural liquid [saliva] drains across our throat each day to keep it lubricated.  Drink the water you need, but don't overdo it and wash out that natrual lubrication. :)
Have specialists recommended that you exercise the muscles around your throat, neck, chin, etc. while icing them?  The ice wil reduce swelling, but if you keep moving/massaging the whole time, your muscles will not freeze up.  Chiropractic, massage, KMI (kinesis-myofacial-integration) and as Suzanne mentioned, Alexander technique, can all be quite helpful in understanding and acting on the best way to move and relax our muscles, including the vocal muscle.
Whispering is air going across the folds.  It can dry them - again causing you to force more.  My daughter, recovering frm vocal surgery,  had succes with a Magna-doodle. :)  Quick to write, then easy to erase.  No chalk or marker-fume issues.
I'll try to find the silent lesson plan that I used when I was recovering from larynxgitis - three weeks before solo work in the Beethoven Mass in C!  ;) - and send it to you.
Best Wishes!  I think:
"Your dedication will see you through. 
Just focus on healing your voice, and you!"
on August 16, 2012 8:29pm
Kathy & Lucy ~

Thank you for your responses!  I am trying very hard to be positive, and am seeing some good results from my work at healing/correcting, but still appreciate concern rather than criticism! 
I have thought about allergies - food included - as well as mold, etc.  Imagining my house is very clean is not quite accurate!  With all of the other responsibilities I have right now, my house is the last on the list, and often gets taken care of remedially.  We just finished remodeling our bathroom, so that's a step in the right direction.  I'm hoping to continue getting our "old" house in better shape in the coming months.
As far as food allergies, I've wondered about dairy products, but having cut them out, haven't really noticed an improvement.  I haven't tried cutting out other foods, as nothing else has seemed to trigger any worsening of the phlegm, however, I'll keep an eye on that and continue to watch for foods that I react negatively to.
My new doctor has recommended a follow-up endoscopy, as I've had Barrett's esophogus in the past, which had healed, but she wants to check and make sure that it is still okay.  I take medication for reflux - not one that keeps it from coming into my throat, but one that completely eliminates the acid before it gets anywhere.  It has worked very well for me.
I'm definitely drinking more water, but not too much, and I've given up soda.  I must say I miss it, but it's worth it to me to get my voice back.  I still get some caffeine as I currently take Excedrin every day for chronic headaches.  My doctor also wants me to decrease and eventually be able to discontinue taking that since I lost a kidney to cancer 14 years, I'm working on it.
As far as the tension goes, I'm working on the McClosky relaxation and phonation techniques (shout-out to Jay), and have found that in the past 10-15 years I have taken on so many bad habits to cover up the vocal problems that I've been experiencing, that I'm speaking and singing completely incorrectly.  (Ironic - I know all of the correct vocal techniques, and teach them to my students correctly, but don't do them myself.)  I've already identified my major problems and started to correct them, which I know will be a slow process, but one I'm more than willing to take on in order to be able to sing again.  Right now, the only phrase I can speak or sing correctly is "How are you today?", but I'm sure that with practice, others will follow!
I have done some "silent rehearsals" in the past,  (check out forum discussions) and plan on doing many more of them this year!  Just praying for strength as I start classes next week! 
Thank you again for your words of encouragement, and all of the suggestions and help (J).
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