Vocal Hygiene

Vocal Hygiene Practices

·         REST! Most people require 7-9 hours of sleep. Lack of sleep creates fatigue and affects the voice. Do not attempt to override a cold or laryngitis. See your physician, rest your voice, drink liquids.

·         HYDRATION!  Drink 8-10 glasses of water per day to maintain hydration. Avoid dry interior climates, use a humidifier, avoid breathing polluted air, and avoid alcohol and smoke-filled rooms.

·         WARM UPS! Vocal warm-ups and cool-downs should always be used. Gentle humming and pitch glides are good. To get someone's attention, use non-vocal sounds: clapping, bells, or whistling.

·         RANGE! Avoid speaking/singing in a range near the extremes of your own vocal range. Limit speaking in noisy environments. Don’t shout, scream, say vocal sound effects or cradle the phone.

·         DO NOT WHISPER! In fact, it is more damaging to whisper than to talk when you are ill. This especially includes the "stage whisper." Reduce general voice use before a performance. Do not strain your voice. Move closer and face the person with whom you are speaking. Use amplification as needed. Be aware of noise in the environment. Rest your voice when fatigued or stop/reduce talking. A “confidential” voice is suitable for resting the voice, using soft, but supported tones.

·         GOOD HEALTH! Eat whole grains, fruits and veggies to keep mucous membranes healthy. Monitor dairy foods. Exercise daily. Yoga and the Feldenkrais Method provide a good stretch.

·         LIMIT alcohol and caffeine! These act as diuretics and cause the body to lose water which dries out the voice. Alcohol irritates the mucous membranes that line the throat. Caffeine dehydrates you and relaxes the upper and lower esophageal sphincters, leading to acid reflux.

·         REDUCE STRESS! Tension is the enemy of the voice. Take a warm bath. Get a massage. Go for a walk. Think happy thoughts. Live in the moment. Speak your truth….Find a mentor with whom you can confide your deepest thoughts, or just speak out loud when alone. Cultivate a peaceful life.

ROAR AND PACE! Notice when animals (lions and tigers and bears….oh my!) become startled or alarmed. The first thing they do is roar, to sound the alarm and release the fear or warning voice from their system. Then, they pace until the energy is burned up, after which they usually curl up and fall asleep. Adult humans generally repress this response, holding their emotions in. As a result, tension occurs in the throat and neck. Muscles can remain clenched for days, weeks, months, even years. Without releasing the energy, it stays bound inside, causing possible problems which start in the throat area, then potentially expand to other areas of the body as well, triggering stress-related health issues. Babies and children cry out, adults remain silent. We need to “cry out” as well, not necessarily by roaring, but by talking out loud, crying or vocalizing. It’s not enough to think it through, or write it down. We must voice our feelings out loud to release emotions, either to a professional counselor, friend, mentor or just to ourselves, allowing muscles to relax and return to normal function. Then, do something physical to release pent up energy. You’ll sleep better!

Anti-Reflux Protocol to Minimize LPR

Anti-Reflux Protocol to Minimize LPR

Stomach acid may leak out of the stomach and into the esophagus and throat, causing irritation and muscle spasms. Reflux at the stomach level (gastroesophageal reflux disease - GERD) causes heartburn and sour stomach. Reflux at the throat level (laryngeal-pharyngeal reflux - LPR), may cause coughing, hoarseness, sharp burning pain in the larynx, soreness, throat clearing, excess mucus, bad taste, weak voice, belching, a sensation of a lump in your throat and the voice taking more than 15 minutes to warm up in the morning. LPR is called “silent reflux,” and you may experience no obvious symptoms except hoarseness and excessive phlegm, usually with redness, irritation and swelling of the vocal folds. LPR may disrupt your ability to feel the vocal cords which can result in excess squeezing and pressure on the larynx creating further injury.

If you have been diagnosed with LPR, follow these suggestions to minimize the effects:

1.      Take PPI anti-reflux medication as prescribed by your health care professional.

a.      Take the PPI medicine 30 minutes prior to eating, then you MUST EAT a full meal, including protein, within 30-45 minutes, to activate the acid pumps in your stomach.

b.      If you don’t eat, the medicine won’t work. The pumps are activated by eating.

2.      Lose weight to reduce pressure on the diaphragm which moves the acid upward into the throat

3.      Eat regular meals, including a larger breakfast, medium lunch and a lighter evening meal.

4.      Eat a bland diet, (spicy foods may irritate the stomach), and chew thoroughly.

5.      Avoid the following foods, which irritate the esophagus, relax sphincters and stimulate acids:

a.       Alcohol, tobacco, coffee, sodas, citrus juices,

b.      Tomato products, 2% or whole milk, nuts, fatty fried foods

c.       Chocolate, and anything with MINT (candies, gum, lozenges and breath fresheners)

6.      Stop eating/drinking 4 hours before bedtime (except water).

7.      Elevate the head of the bed, or use a wedge pillow to keep acid in the stomach.

8.      Avoid tightly fitting clothing, and don’t bend or stoop after eating, which may bring acid up.

9.      Practice deep, diaphragmatic breathing (not chest breathing) when you have symptoms.

10.  RELAX! Stress is a killer. Take a walk, talk it out. Try meditation or yoga.

More on Nodules

More on Nodules

Nodules are similar to callouses that might form on the fingers of guitar-players. Deposits of tissue build up as a protection to the tender layers beneath. The primary cause is frequent, intense oppositional movement of the vocal folds against each other, such as yelling or using the voice too much and/or too vigorously. They can also be caused by smoking, alcohol or caffeine consumption, chronic cough or allergies. The vocal folds vibrate during the normal speaking range at approximately 200 beats per second for females and 100 beats per second for males. When the voice is being used gently, a healthy voice can usually withstand this frequency, and even much greater ones when singing. Flexible vocal folds will vibrate as lips do during a “lip buzz.”  However, when the voice is squeezed too tightly and the intensity is too strong, the cords become strained and injury is initiated. Sometimes it takes years for the full extent of damage to occur. The harm may be so gradual at first, that no change in the voice is noted. But as the callous builds up, the vocal cords become stiffer and cannot vibrate freely. This causes a tighter squeeze so that the voice can come through, becoming a vicious cycle of abuse. If you notice hoarseness that lasts longer than 2-3 weeks, be sure and visit a vocologist and an otolaryngologist who specializes in voice, to take a picture of your vocal cords and see what might be causing the problem. If you can catch nodules while they are still soft, there’s a chance of avoiding surgery and making changes to heal and prevent further growths from occurring. 

Oh No, Nodules!

3/8/16

Oh No, Nodules!

Vocal fold nodules are a singer’s worst nightmare. In the past, when nodules were discovered on the vocal folds, the primary solution was to remove them. However, it was soon discovered that once removed, they often recurred in very little time. Nodules are formed due to excess stress on a particular area of the vocal folds, commonly called a form of vocal abuse. Removing the nodule does not cure the problem. Most people continue in the same vocal habits, leading to more nodules. Even well-trained singers can develop nodules if they use their voices excessively, sing too loudly or at the outer limits of their comfortable range too frequently. Singers are not the only ones who develop nodules. They can form as a result of errant speech patterns as well. A singer is taught to sing, but one rarely receives “speaking” lessons. Speaking patterns and mannerisms are typically learned from our major caregiver as a child, and carried through life, for better or worse. Many people are surprised to learn the importance of adequate breath support, forward focus, ease of phonation, release of tension and easy onset in maintaining a healthy speaking voice. In today’s society, a low-pitched, gravelly voice is frequently the norm for many, including adolescents. Most are not even aware of the fact that they are harming their voices by the way they speak. Awareness is the first step. Fortunately, for someone diagnosed with nodules, surgery is rarely the only option, nor is it the first one considered. Vocal rest is usually recommended along with a course of voice therapy from a skilled speech-language pathologist who specializes in voice. The voice therapist will provide compensatory strategies, gentle exercises and instruction in ways to allow the breath to support the sound and produce “easy” speaking, to reduce the load on the voice. This course is usually a radical change in self-concept for the participant. Many argue that the new speaking method just “isn’t me,” expressing concerns that it will change their personality if they switch to a gentler mode of speaking. While it is true that the voice will hopefully change to something healthier, the personality need not necessarily follow suit. One can maintain personality traits without using vocally damaging speech patterns to get points across during conversation. You only have one chance at a healthy voice. Treat it gently. Avoid excessive or loud speaking, yelling, vocal fry, grunting, singing outside of your range and in general, anything that tires your voice excessively. It is much easier to prevent nodules than to treat them once they form. Take preventative action and develop healthy speaking patterns to reduce the possibility of nodules in your future. 

Short Bio

Rebecca A. McGarry is exceptionally qualified to provide skilled voice therapy for speaking and singing voices. She obtained a Master’s Degree in Music, with an emphasis in Vocal Performance from the University of Utah. Beyond her personal performances in opera and lead roles in musical theater, Rebecca taught voice lessons at USU, was an adjunct professor of music at Snow College (Utah) and has provided vocal instruction for beginners and professionals for many years.

Rebecca received her Master’s Degree in Speech-Language Pathology from Utah State University and post-graduate work in Vocology (the science and practice of voice habilitation) and is uniquely qualified to assist those with damaged voices to return to optimal health and vigor.  Voice is Rebecca’s passion! She has assisted thousands of patients to achieve their goals and improve their voices. Her mission is to share her unique qualifications and expertise to help those who have “lost” their voice to “find” it again.

Welcome

Welcome to my blog! My name is Rebecca McGarry, and I have a passion for the voice. The voice is a very delicate instrument, capable of producing incredible sounds and having amazing stamina, yet subject to trauma, illness fatigue and abuse. Voices are designed to last a lifetime, but often, this is cut short. People have no trouble seeking the help of a physician when they break a leg. After the leg is healed, a course of physical therapy is recommended to return the leg to normal function. However, when a voice “breaks,” most people simply ignore it, thinking there is no cure. The voice becomes hoarse, breathy and raspy, yet no help is sought. Most people are unaware of therapy designed specifically for voices. My purpose is to assist those whose voices have failed them, to “find” their voice again, and return to normal functionality. Of course, the best cure is to prevent injury from happening in the first place, so tips will be included to keep the voice healthy and strong for a lifetime. In spite of our best efforts, however, voices often “give out.” Like breathing, we don’t usually notice our voice unless something goes wrong and it doesn’t function normally. Suddenly, we pay attention and wonder what is wrong. The human voice is a unique instrument. It takes longer to train a voice than other instruments, because it is part of the anatomy and so many factors affect how the instrument responds from day to day. Unlike a piano, which sounds the same whenever you strike the keys, the voice responds to illness and fatigue and is not as predictable as a keyboard. Because of this, it’s important to take good care of your vocal health in order to have the best voice possible and to have it last a lifetime.

BREATHING

Breathing for singing and speaking should be easy. Children and animals automatically breathe correctly, but adults tend to breathe inefficiently. Stemming from bending over desks in school, computers, steering wheels or cell phones, many develop a habit of clavicular breathing, or breathing from the chest rather than from the abdomen. This creates problems when speaking or singing for extended periods of time. The body was designed for diaphragmatic breathing. The diaphragm is a large muscle which divides the lungs from the abdominal cavity. When inhalation occurs, the diaphragm contracts, dropping downward, creating a vacuum which pulls air into the lungs. As the diaphragm returns to its “resting,” dome-shaped position, air is expelled from the lungs. Maintaining an upright position, with chest high and wide facilitates diaphragmatic breathing. 

ACID REFLUX

Acid reflux can be a serious problem for singers and voice users. Minimally, it causes redness, swelling and erosion to the delicate tissues in the throat and larynx. At its worst, it can lead to esophageal cancer, so it is definitely something to be reckoned with. Typically, an Ear, Nose and Throat (ENT) physician will prescribe medications to minimize the acid being produced by the body. Additionally, behavioral lifestyle changes can be made that will help prevent acid reflux. For instance, going to bed with food in the stomach is a major contributor to reflux. It is best avoid eating 3-4 hours prior to lying down, so the food has time to digest. Gravity assists in keeping acid in the stomach when you are upright, so raising the head of your bed at night can be helpful. Maintaining an ideal weight is crucial to keeping acid under control, reducing pressure on the diaphragm. Eating regular meals, including a larger breakfast, medium-sized lunch and smaller dinner will help. Bland foods are better than spicy. Foods to avoid are alcohol, tobacco, coffee, carbonated beverages, caffeine, citrus juices, tomatoes, whole milk, nuts and fatty fried foods, such as burgers and fries. Caffeine, chocolate and mint relax the esophageal sphincters which allow the acid to flow upward into the larynx. This causes burning, mucous and swelling in the vocal folds which make your voice hoarse, weak and sore. You may not be aware that this is happening. It does not feel like gastroesophageal reflux disease (GERD), in which you have significant heartburn and sour stomach. Laryngopharyngeal reflux (LPR) is often called “silent reflux” because the only signs might be subtle hoarseness, excessive phlegm, and the presence of redness and swelling on the vocal folds. A drop of acid is to your larynx like a drop of Clorox is to your clothing.  Both can cause significant damage. 

DEHYDRATION

Do NOT drink anything with alcohol, caffeine or carbonation, which can undo the hydration you have just provided. Alcohol regarded as poison by the body, providing no nutritional value, but acting as a stimulant, a sedative and in large quantities killing you. The body responds to what it determines “poison” by flushing it out quickly, using precious liquids which are meant to hydrate your body. Alcohol causes dehydration, excess mucous, numbness limiting muscle coordination, and dilated blood vessels which interfere with blood flow to the vocal folds. It can also strip the body of necessary B vitamins which affects the nervous system. Caffeine acts as a diuretic, draining the body of needed moisture, increasing stomach acid and producing dehydration. Carbonation can increase air in the stomach, causing burping and changing the sound of your voice.  Another source of dryness is medications, particularly those prescribed for allergies. If you require medications for serious allergies, be aware that they have a drying effect, and you will need to consume more water to make up for the deficit. It might be a good idea to consume water containing electrolytes, such as Powerade or Gatorade to assist with the balance of minerals in the body.

HYDRATION

Hydration is very important. Drinking plenty of water and humidifying your environment can keep the voice moist and the vocal folds “floppy.” When the vocal folds become dehydrated, they shrink and cannot vibrate effectively. This forces vocal strain, as extrinsic muscles attempt to help the cords come together, creating additional problems. Using a humidifier in dry climates, especially during the winter months, is a good idea. Sipping water throughout the day is more effective than drinking large amounts all at once. When you drink large quantities, it usually passes right through without “plumping” the cells. Sipping frequently will allow the body to absorb the moisture and retain the hydration. Most adults require 10 glasses per day (that’s half a gallon plus two more cups!). If you are not drinking enough water, start today. You will notice results within just a few days.